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- 05/25/17--11:25: _WATCH: Trump chasti...
- 05/25/17--11:32: _Block against Trump...
- 05/25/17--11:41: _Insurers continue t...
- 05/25/17--11:42: _House GOP sticks wi...
- 05/25/17--11:59: _WATCH LIVE: NATO Se...
- 05/25/17--12:28: _Column: How teacher...
- 05/26/17--05:21: _Trump travel ban sh...
- 05/26/17--06:18: _Trump meeting with ...
- 05/26/17--06:53: _WATCH: Pence speaks...
- 05/26/17--07:26: _WATCH: Hillary Clin...
- 05/26/17--07:45: _Dozens dead after a...
- 05/26/17--08:12: _AP Report: Lawyer s...
- 05/26/17--08:49: _Boehner: Trump’s te...
- 05/26/17--09:48: _As Trump announces ...
- 05/26/17--10:14: _U.S. plans first te...
- 05/26/17--10:51: _Europeans making sa...
- 05/26/17--11:57: _As elderly populati...
- 05/26/17--12:49: _Column: Close the p...
- 05/26/17--12:54: _During Watergate, i...
- 05/26/17--15:25: _W. Kamau Bell wants...
- 05/25/17--11:32: Block against Trump’s travel ban upheld by appeals court
- 05/25/17--11:41: Insurers continue to hike prices, abandon ACA markets
- 05/25/17--11:42: House GOP sticks with Montana candidate Gianforte despite assault
- 05/25/17--12:28: Column: How teachers can support students during Ramadan
- 05/26/17--05:21: Trump travel ban showdown headed for Supreme Court
- 05/26/17--06:18: Trump meeting with G-7 leaders after going on offensive
- 05/26/17--06:53: WATCH: Pence speaks at U.S. Naval Academy graduation
- 05/26/17--07:26: WATCH: Hillary Clinton addresses Wellesley College graduates
- 05/26/17--07:45: Dozens dead after attack on Coptic Christian buses in Egypt
- 05/26/17--08:49: Boehner: Trump’s term ‘disaster,’ aside from foreign affairs
- 05/26/17--09:48: As Trump announces famine aid, relief funds face big cuts
- 05/26/17--10:14: U.S. plans first test of ICBM intercept, with North Korea on mind
- 05/26/17--10:51: Europeans making sales pitch to Trump on climate accord
- 05/26/17--12:54: During Watergate, it was country first, party second. Not anymore.
- 05/26/17--15:25: W. Kamau Bell wants America to get awkward
BRUSSELS — President Donald Trump opened meetings with European Union leaders Thursday against the backdrop of striking anger from Britain over intelligence leaks and a decision by Manchester police to withhold information from the United States about the investigation into this week’s bombing.
A British official said Thursday that Manchester police have decided not to share further information on the investigation due to leaks blamed on U.S. officials. The sharp rebuke comes as Trump is in Brussels, a city he once called a hellhole, to address leaders at both the European Union and NATO, a pair of alliances whose necessity he has questioned.
The EU council president said a discussion with Trump produced sharply different views on Russia. NATO leaders nervously waited to send Trump would pledge to adhere to a mutual defense pact. And the new French president pushed Trump on a sweeping climate agreement and even engaged in an apparent handshake stand-off.
Later in the day, Trump was expected to attend his first meeting of NATO, the decades-long partnership that has become intrinsic to safeguarding the West but has been rattled by the new president’s wavering on honoring its bonds.
British Prime Minister Theresa May said she plans to discuss the leaks with her American counterpart at the NATO gathering to “make clear to President Trump that intelligence that is shared between our law enforcement agencies must remain secure.”
British officials are particularly angry that photos detailing evidence about the bomb used in the Manchester attack were published in The New York Times, although it’s not clear that the paper obtained the photos from U.S. officials.
Trump, who unlike other leaders at the summit is not planning to address reporters, did not respond to shouted questions as to whether the UK can trust the US with sensitive material.
The rebuke comes amid a backdrop of uncertainty in Brussels toward Trump over his past comments publicly cheering the United Kingdom’s vote to leave the EU last summer and slamming the alliance during his transition as “a vehicle for Germany.” Trump has taken a less combative tone since taking office, praising the alliance as “wonderful” and saying a strong Europe is very important to him and the United States.
After meeting with Trump on Thursday at the EU, European Council president Donald Tusk said he and the U.S. president agreed on the need to combat terrorism but some differences loomed large.
“Some issues remain open, like climate and trade. And I am not 100 percent sure that we can say today — we means Mr. President and myself — that we have a common position, common opinions about Russia,” said Tusk, who said unity needed to be found around values like freedom and human rights and dignity.
Trump also had lunch with France’s new president, Emmanuel Macron, who has been critical of the Republican president. As the press watched, the two men exchanged a very firm handshake during their meeting, both men gripping tight, their faces showing the strain.
NATO leaders have been anxiously awaiting the upcoming meeting. Trump has mused about pulling out of the pact because he believed other countries were not paying their fair share and he has so far refused to commit to abiding by Article 5, in which member nations vow to come to each other’s defense.
But the European capitals that have been shaken by Trump’s doubts may soon find a degree of reassurance. Just like his position on the EU, the president has recently shifted gears, praising NATO’s necessity. Secretary of State Rex Tillerson said Wednesday that “of course” the United States supports Article 5, though Trump still wants other nations to meet their obligation to spend 2 percent of their gross domestic product on defense.
“I think you can expect the president to be very tough on them, saying, ‘Look the U.S. is spending 4 percent. We’re doing a lot,'” Tillerson told reporters on Air Force One. He also said he thought it would be “a very important step” for NATO to join the 68-nation international coalition fighting the Islamic State. The move, which is expected during Thursday’s meeting, is symbolically important, especially since the terror group claimed responsibility Tuesday for a deadly explosion at an Ariana Grande concert in Manchester, England.
An anti-terror coordinator may also be named. But most changes will be cosmetic, as NATO allies have no intention of going to war against IS.
While in Belgium, Trump will unveil a memorial to the terrorist attacks of Sept. 11, 2001, the only time in the alliance’s history that the Article 5 mutual defense pledge has been invoked. He will also speak at NATO’s gleaming new $1.2 billion new headquarters.
But while the Europeans greeted Trump warily, tens of thousands gathered in Berlin to hear his predecessor and German Chancellor Angela Merkel discuss democracy and global responsibility at a Protestant conference as the country marks the 500th anniversary of the Reformation. Barack Obama made a case for American involvement internationally, saying “we can’t isolate ourselves, we can’t hide behind a wall” in the hours before Merkel was set to meet Trump in Brussels.
Brussels is the fourth stop on Trump’s nine-day international trip, the first such trip of his presidency. Protests were slated to take place outside the heavily guarded security perimeter near the city’s airport and downtown.
Trump is slated to leave Brussels late Thursday for the final piece of his trip, a two-day stay in Sicily for G-7 meetings.
The post WATCH: Trump chastises NATO allies ‘not paying what they should be paying’ appeared first on PBS NewsHour.
WASHINGTON — A federal appeals court dealt another blow to President Donald Trump’s revised travel ban targeting six-Muslim majority countries on Thursday, siding with groups that say the policy illegally targets Muslims.
The 4th U.S. Circuit Court of Appeals upheld a lower court ruling that blocks the Republican’s administration from temporarily suspending new visas for people from Iran, Libya, Somalia, Sudan, Syria and Yemen.
The Richmond, Virginia-based 4th Circuit is the first appeals court to rule on the revised travel ban, which Trump’s administration had hoped would avoid the legal problems that the first version encountered.
“Congress granted the president broad power to deny entry to aliens, but that power is not absolute. It cannot go unchecked when, as here, the president wields it through an executive edict that stands to cause irreparable harm to individuals across this nation,” the chief judge of the circuit, Roger L. Gregory wrote.
Trump will likely appeal to the U.S. Supreme Court.
A central question in the case is whether courts should consider Trump’s past statements about wanting to bar Muslims from entering the country.
The federal judge in Maryland who blocked the travel ban cited comments made by Trump and his aides during the campaign and after the election as evidence that the policy was primarily motivated by the religion.
Trump’s administration argued that the court should not look beyond the text of the executive order, which doesn’t mention religion. The countries were not chosen because they are predominantly Muslim but because they present terrorism risks, the administration says.
The first travel ban in January triggered chaos and protests across the country as travelers were stopped from boarding international flights and detained at airports for hours. Trump tweaked the order after the 9th U.S. Circuit Court of Appeals refused to reinstate the ban.
The new version made it clear the 90-day ban covering those six countries doesn’t apply to those who already have valid visas. It got rid of language that would give priority to religious minorities and removed Iraq from the list of banned countries.
Critics said the changes don’t erase the legal problems with the ban.
The Maryland case was brought by the American Civil Liberties Union and the National Immigration Law Center on behalf of organizations as well as people who live in the U.S. and fear the executive order will prevent them from being reunited with family members from the banned countries.
This is a developing story. PBS NewsHour will update the post as more details become available.
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People shopping for insurance through the Affordable Care Act in yet more regions could face higher prices and fewer choices next year as insurance companies lay out their early plans for 2018.
Blue Cross and Blue Shield of North Carolina is asking regulators for a 23 percent price hike next year because it doesn’t expect crucial payments from the federal government to continue. That announcement comes a day after Blue Cross and Blue Shield of Kansas City said it will leave the individual insurance market next year, a decision that affects about 67,000 people in a 32-county area in Kansas and Missouri.
The Kansas City company’s decision also will leave shoppers in 25 counties with no options for coverage sold on public insurance exchanges, unless another insurer steps in, according to data compiled by The Associated Press and the consulting firm Avalere. The law’s insurance exchanges are the only place where people can buy coverage with help from an income-based tax credit.
Other insurers around the country, such as Aetna and Humana, have already said they will not offer coverage on exchanges next year, though several, including Centene, say they will.
Options are growing thin in many markets. The Kansas City insurer’s decision means that only 10 of Missouri’s 115 counties will have more than one insurer selling coverage on the exchange next year.
Blue Cross and Blue Shield of North Carolina sells coverage in all 100 North Carolina counties, and it is the lone option in 95. It said Thursday that its participation for next year is not guaranteed.
Insurers still have a couple months to consider their options before finally committing to selling coverage in 2018.
The North Carolina insurer said it expects no help from federal cost-sharing reduction payments next year, and that’s reflected in its initial rate request that calls for a 23 percent price increase, on average. If it could be assured of the subsidies that are part of the law and have been paid in the past, it said prices would rise about 9 percent. The insurer covers more than 460,000 people who bought coverage on the exchange.
It said about two thirds of those customers get cost-sharing help, but the price increase for providing insurance without this help will be spread over all of its customers in that market.
“Many ACA customers will pay more for coverage that is already a large portion of their household income,” said Brian Tajlili, director of actuarial and pricing services for the insurer.
The government has been giving insurers money to help customers with modest incomes cover out-of-pocket expenses like co-payments and deductibles. But the future of those payments, which are separate from the income-based tax credits that help people buy coverage, is in political limbo.
Republicans had sued the Obama Administration to stop the subsidies, and that case is now tied up in court. President Donald Trump’s administration has sent mixed signals over how it will pursue the case or whether the payments will continue. Insurers want some assurance that the payments, which total about $7 billion, will continue through 2018.
Tajlili said his company wants to see some sort of a legal guarantee, like Congress appropriating the money, in order to feel comfortable that the payments will actually be made through 2018.
Some of the biggest companies on the exchanges have yet to announce their coverage plans for next year. Those include Anthem Inc., which covers more than 1 million people through Affordable Care Act exchanges, offering Blue Cross-Blue Shield insurance in large states like New York, California and Ohio.
Many insurance companies have faced large financial losses selling this type of insurance and have responded by either raising prices or abandoning that kind of coverage altogether. Blue Cross and Blue Shield of North Carolina said earlier this year that it lost $38 million on ACA plans last year and more than $400 million between 2014 and 2015.
AP data journalist Meghan Hoyer contributed to this report from Washington, D.C.
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WASHINGTON — House Republicans stuck with their candidate in Montana’s special House race Thursday even though he was charged with misdemeanor assault after allegedly slamming a reporter to the ground.
Speaker Paul Ryan said Greg Gianforte should apologize, but the GOP leader did not disavow Gianforte’s candidacy or call on him to drop out. And Ryan indicated that Gianforte, a wealthy tech company founder, would be welcome in the House Republican conference if he wins what appeared to be a tight race against Democrat Rob Quist.
“If he wins, he has been chosen by the Montana, the people of Montana,” said Ryan, R-Wis. “I’m going to let the people of Montana decide who they want as their representative. That’s not our choice. That’s the people of Montana who choose that.”
“I do not think this is acceptable behavior, but the choice will be made by the people of Montana,” Ryan added.
Rep. Steve Stivers of Ohio, who chairs the House GOP campaign committee, said: “From what I know of Greg Gianforte, this was totally out of character, but we all make mistakes.”
“Today’s special election is bigger than any one person; it’s about the views of all Montanans,” Stivers added. “They deserve to have their voices heard in Washington.”
It was unclear what impact the late-breaking news would have on the election, especially since a significant portion of voters already had cast early ballots. Montana is a Republican-friendly state where Donald Trump beat Hillary Clinton by a wide margin.
Gianforte and Quist, a cowboy-hat-wearing musician, are competing for the state’s sole House seat, left vacant when Trump appointed GOP Rep. Ryan Zinke to serve as Interior secretary. Gianforte has strongly embraced Trump throughout the campaign, and the race has been watched closely for signs of whether Democrats can make inroads in GOP areas ahead of the 2018 midterm elections.
Wednesday’s incident occurred at a Gianforte campaign event in Bozeman, Mont., when Ben Jacobs, a reporter for The Guardian, approached Gianforte to ask him about a new Congressional Budget Office analysis of House-passed health care legislation. It was a moment when Gianforte was not taking media questions, and the candidate quickly became enraged and threw Jacobs to the ground, punching him and breaking his glasses, according to audio of the event and witness accounts.
Gianforte was charged with misdemeanor assault and would face a maximum $500 fine or six months in jail if convicted. The Gianforte campaign defended its candidate in a statement describing Jacobs as a “liberal journalist” who was asking “badgering questions” and displaying “aggressive behavior.”
The charges themselves or even a conviction would not prevent Gianforte from serving in the House. The chamber’s rules say winning candidates can be seated as long as they meet the constitutional requirements of age, residence and citizenship.
Democrats condemned Gianforte and called on Republicans to denounce him. House Minority Leader Nancy Pelosi of California criticized Gianforte as “a wannabe Trump.”
“And we’ve really got to say, ‘come on, behave, behave,'” Pelosi added. “That was outrageous.”
Reactions were mixed from rank-and-file House Republicans who exited a closed-door conference meeting Thursday morning on unrelated issues. Similar to when they’re asked about the latest controversial pronouncement or action by Trump, most lawmakers were reluctant to discuss the issue at all, with many saying they didn’t know enough about it to comment.
A few others offered a variety of views.
Asked if assaulting a reporter is appropriate behavior, Rep. Duncan Hunter, R-Calif., replied: “Of course not. It’s not appropriate behavior. Unless the reporter deserved it.”
Rep. Bob Latta, R-Ohio, said that “You don’t want to have any violence out there. Period. You want civility and you want to make sure everyone’s safe.”
Rep. Luke Messer, R-Indiana, offered perhaps the most forthright take on the political ramifications of the incident when he said of Gianforte: “I’m not sure whether it will hurt him or help him.”
Associated Press writers Mary Clare Jalonick and Stephen Ohlemacher contributed to this report.
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NATO Secretary General Jens Stoltenberg is expected to speak at 3 p.m. ET today from the group’s headquarters in Brussels.
The NATO chief’s news conference follows the promise he gave earlier in the day that the international alliance “will send a strong political message of NATO’s commitement to the fight against terrorism and also improve our coordination within the coalition.”
Stoltenberg did, however, add that the group will not engage in combat operations against Islamic State militants.
Stoltenberg’s remarks, in part, react to President Donald Trump’s repeated demands that NATO allies do more in the fight against extremism. Earlier today, the U.S. president, in front of NATO leaders, said the other countries were not doing enough to counter terrorism.
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Ramadan is a month in the Islamic calendar when Muslims observe fasting from sunrise to sunset. And it can be a difficult month for many to get through, especially students who have to go through a normal school day without eating or drinking. This year, Ramadan will begin on Saturday, May 27, when many schools have yet to finish for the summer. For schools, it’s important to provide an environment for students where they feel safe to practice their religion, but maybe more importantly, one that ensures their well-being during the school day.
Who fasts and why
Not everyone is expected to fast. Fasting is not obligatory for children, until they reach “of age.” There is scholarly debate on what that age might be, though most scholars do recommend that fasting start when one reaches adolescence, anywhere from 13 and up. There are some Muslims who start earlier, or later. For example, I started when I was 9, but I did “half-days,” meaning I fast from either morning until about lunchtime, or from lunchtime until evenings.
Often Muslims are also exempt from fasting if they’re ill or have certain medical conditions, or traveling. Pregnant and breastfeeding moms are also exempt, as well as elderly folks.
Ramadan is considered one of the holy months in the Islamic calendar. Kindness, forgiveness and charity are recommended and often pursued as good practice in faith. It is also a time to be more compassionate and show empathy to those who are in need.
While fasting, Muslims abstain from eating, drinking, smoking and sexual activities. Ramadan is a time for Muslims to make an extra effort to abstain from lying, gossiping and other sinful acts. Many Muslims use Ramadan as a time to reset and start anew, creating new goals and improving old ones to improve oneself and rejuvenate the spirit and the soul. (Here is a quick video I made about some of the reasons I fast.)
Fasting often provides a spiritual perspective for Muslims that allows them to understand the suffering of those who are less fortunate, in poverty, and those in need. It also reminds us to not be wasteful of God’s blessings.
How schools can be supportive
During this holy month, one of the hardest things that I often hear my Muslim students complain about is the lack of space and lack of understanding. Here are several ways to support your students during the month of Ramadan:
• Understanding: One of the vital pillars in creating a safe environment for Muslim students in Ramadan is to educate oneself about the month. Many teachers and classmates do not understand why Muslims fast. It’s important to try to form your own understanding about the month, and to not rely on Muslim students to educate the class.
• Space: Lunchtime is probably one of the most difficult periods to endure while fasting. Many students will tell you that they don’t care if you eat in front of them, and chances are that might be true. However, hunger often worsens when you’re in a room full of people eating. It might help to have a comfortable space for Muslim students to go to instead of the designated lunchroom during lunchtime. The room can have some iPads, books, magazines and other things to keep students busy. Of course, it’s then up to the student whether they choose to go there or not, but having that as an option, even for students who are not fasting, is usually beneficial.
• Physical Education: I have heard that some teachers are not very tolerant of Muslim students practicing Ramadan, and therefore are not very understanding when students cannot participate in phys ed classes. Some students have grades deducted due to their lack of participation during Ramadan. This is not okay. It is within students’ right to practice their religion, while having the necessary conditions for them to succeed and achieve their best potential. Teachers can make accommodations for practicing students, such as assigning a different task/project for students to complete that does not require them to do any strenuous work while they’re fasting.
• Empathy: This sounds a bit easy, but having empathy requires one to truly understand the other person’s situation and feelings. When planning school activities and events, think about how it’ll impact practicing Muslim students. Will they feel left out? Will they need to break their fast during that time if it’s during Iftar (i.e. sunset)?
If students have the right accommodations and support from teachers and their peers, it can turn a challenging month into the most rewarding. If you’re still unsure about how to help practicing Muslim students in your school, don’t hesitate to ask them privately what they need, and how you can support them.
The post Column: How teachers can support students during Ramadan appeared first on PBS NewsHour.
WASHINGTON — Donald Trump’s administration is pledging a Supreme Court showdown over his travel ban after a federal appeals ruled that the ban “drips with religious intolerance, animus and discrimination.”
Citing the president’s duty to protect the country from terrorism, Attorney General Jeff Sessions said Thursday that the Justice Department will ask the high court to review the case, although he offered no timetable.
The Supreme Court is almost certain to step into the case over the presidential executive order issued by Trump that seeks to temporarily cut off visas for people from Iran, Libya, Somalia, Sudan, Syria and Yemen. The justices almost always have the final say when a lower court strikes down a federal law or presidential action.
The case pits the president’s significant authority over immigration against what the U.S. Court of Appeals for the 4th Circuit said was a policy that purported to be about national security but was intended to target Muslims.
Parties generally have 90 days to appeal to the Supreme Court, but if the administration waits until late August to ask the court to step in, the justices probably would not vote on whether to hear the case until October and arguments probably wouldn’t take place until February 2018 at the earliest. That would be more than a year after Trump rolled out the first travel ban.
Administration lawyers could instead seek the justices’ approval to put the travel policy in place on an emergency basis, even as the court weighs what to do with the larger dispute.
If that happens, the justices’ vote on an emergency motion would signal whether the government is likely to win in the end. It takes a majority of the court, five votes, to put a hold on a lower court ruling. If at least five justices vote to let the travel ban take effect, there’s a good chance they also would uphold the policy later on.
Thursday’s ruling by the U.S. Court of Appeals for the 4th Circuit was a loss for the administration. The court ruled 10-3 that the ban likely violates the Constitution and upheld a lower court ruling blocking the Republican administration from enforcing the travel ban unveiled in March, a revised version of the policy first issued in January.
The Richmond, Virginia-based 4th Circuit is the first appeals court to rule on the revised ban. Trump’s administration had hoped it would avoid the legal problems that the first version encountered. A second appeals court, the 9th U.S. Circuit based in San Francisco, is also weighing the revised travel ban after a federal judge in Hawaii blocked it.
A central question in the case is whether courts should consider Trump’s public statements about wanting to bar Muslims from entering the country as evidence that the policy was primarily motivated by the religion.
Trump’s administration argued the 4th Circuit should not look beyond the text of the executive order, which doesn’t mention religion. The countries were not chosen because they are predominantly Muslim but because they present terrorism risks, the administration said.
But Chief Judge Roger L. Gregory wrote that the government’s “asserted national security interest … appears to be a post hoc, secondary justification for an executive action rooted in religious animus and intended to bar Muslims from this country.”
The three dissenting judges, all appointed by Republican presidents, said the majority was wrong to look beyond the text of the order. Judge Paul V. Niemeyer wrote that Supreme Court precedent required the court to consider the order “on its face.” Looked at that way, the executive order “is entirely without constitutional fault,” he wrote.
Sessions said the court’s ruling blocks Trump’s “efforts to strengthen this country’s national security.”
Trump’s first travel ban issued Jan. 27 was aimed at seven countries and triggered chaos and protests across the U.S. as travelers were stopped from boarding international flights and detained at airports for hours. Trump tweaked the order after the U.S. Court of Appeals for the 9th Circuit refused to reinstate the ban.
The new version made it clear the 90-day ban covering those six countries doesn’t apply to those who already have valid visas. It also got rid of language that would give priority to religious minorities and removed Iraq from the list of banned countries. Critics said the changes don’t erase the legal problems with the ban.
Ilya Somin, a law professor at George Mason University, said it’s difficult to make a confident prediction on what the Supreme Court will do with the case. If the Supreme Court follows a partisan divide, the Trump administration may fare better since five of the nine are Republican nominees. Still, he said, “Supreme Court justices don’t always vote in ideological lockstep.”
Associated Press writers Alanna Durkin Richer in Richmond, Virginia; Darlene Superville in Washington; and Matt Barakat in McLean, Virginia, contributed to this report.
The post Trump travel ban showdown headed for Supreme Court appeared first on PBS NewsHour.
TAORMINA, Italy — In the Middle East, President Donald Trump was feted with pageantry, the leaders of Saudi Arabia and Israel seemingly in competition to outdo the other with the warmth of their welcomes and the depth of their pledges of cooperation.
But in Europe, Trump has faced a far cooler reception and has been eager to go on the offensive.
Cajoled on issues like climate change and NATO’s defense pact, he’s responded by scolding some of the United States’ most loyal allies for not paying their fair share. He’s also refused to explicitly back the mutual defense agreement that has been activated only once, during the darkest hours of September 2001.
Still, Trump hailed the trip a success as he arrived to the G-7 summit in Sicily Friday, the final stop of his maiden international trip, a grueling nine-day, five-stop marathon.
“Getting ready to engage G7 leaders on many issues including economic growth, terrorism, and security,” Trump wrote on Twitter. “Trip has been very successful. We made and saved the USA many billions of dollars and millions of jobs.”
Once more, he will likely be received warily, a president who ran on a campaign of “America First” with suggestions of disentangling the United States from international pacts, now engaged in two days of pomp and policy with the leaders of the United Kingdom, France, Germany, Italy, Japan and Canada.
Donald Tusk, president of the European Council, said the group’s leaders “sometimes have very different views” on topics such as climate change and trade, “but our role as the EU is to do everything to maintain the unity of the G-7 on all fronts.”
The White House believes that Trump has made personal breakthroughs with his peers, having now met one-on-one with all the leaders of G-7.
“It’s time for him to have an intimate discussion and understand their issues but, more importantly, for them to understand our issues,” national economic adviser Gary Cohn told reporters on Air Force One late Thursday.
One of those relationships was on display as Trump began the day with a meeting with Japanese Prime Minister Shinzo Abe. The president hosted Abe at the White House and his Mar-a-Lago resort back in February, where they appeared to hit it off.
Abe was the latest world leader to publicly flatter Trump, saluting his visit to the Middle East and address to NATO on Thursday.
“Unfortunately,” Abe told reporters, “this time around we won’t be able to play golf together.”
The president said he and Abe would cover many topics, including North Korea, which he said “is very much on our minds.”
“It’s a big problem, it’s a world problem, but it will be solved at some point. It will be solved, you can bet on that,” Trump said. North Korea has conducted a series of recent missile tests, rattling its Pacific neighbors.
Foreign policy will be the focus on Friday, with meetings on Syria, Libya, North Korea, Afghanistan and Pakistan. Other meetings over the two days will include discussions of global economy and climate, a meeting with small African nations — Trump will be seated between the leaders of Niger and Tunisia — and migration issues.
Trade will also be a big topic, with Cohn saying the United States’ guiding principle will be “we will treat you the way you treat us,” suggesting that retaliatory tariffs could be imposed.
The day will feature a welcoming ceremony and concert at the remains of an ancient Greek temple, as well as a relentless number of meetings, many of which White House aides are hoping to keep short in order to keep Trump’s attention. What the Sicily stay will likely not offer: a news conference, as Trump appears set to defy presidential tradition and not hold one during the entire trip.
The Republican president arrived in Italy fresh off delivering an unprecedented, personal rebuke to NATO, traveling to its gleaming new Brussels headquarters to lecture its leaders to their faces on the need for them to spend more on defense.
“This is not fair to the people and taxpayers of the United States,” Trump said. “If NATO countries made their full and complete contributions, then NATO would be even stronger than it is today, especially from the threat of terrorism.”
The 28 member nations, plus soon-to-join Montenegro, will renew an old vow to move toward spending 2 percent of their gross domestic product on defense by 2024. Only five members meet the target: Britain, Estonia, debt-laden Greece, Poland and the United States, which spends more on defense than all the other allies combined.
Trump refused to say he would adhere to the mutual defense pact, known as Article V, though the White House later claimed that his very presence alongside twisted World Trade Center steel — a memorial outside NATO headquarters — was evidence enough of his commitment.
As Trump spoke, the NATO leaders, including German Chancellor Angela Merkel and French President Emmanuel Marcon, stood in awkward silence. Later, as they took the traditional “family photo” group shot, the heads of state quietly kept their distance from Trump, who minutes earlier was caught on video appearing to push the prime minister of Montenegro out of the way to get to his spot.
But while Trump lectured some of the United States’ strongest allies, he cozied up to the repressive regime in Saudi Arabia while pushing for the Arab world to root out extremism at home. It was a similar story in Israel, where Prime Minister Benjamin Netanyahu warmly greeted Trump and the president reciprocated with emotional appearances at the Western Wall and Holocaust museum and suggested that there was an opening for peace with the Palestinians.
The post Trump meeting with G-7 leaders after going on offensive appeared first on PBS NewsHour.
Vice President Mike Pence is scheduled to speak today at the graduation and commissioning ceremony for the U.S. Naval Academy’s Class of 2017, beginning around 10:20 a.m. EST. You can watch the speech live on this page.
ANNAPOLIS, Md. — Vice President Mike Pence is scheduled to address the graduating class at the U.S. Naval Academy.
The commissioning ceremony is set for Friday morning in Annapolis. Graduation for the Class of 2017 is taking place at Navy-Marine Corps Stadium.
About 1,000 students will graduate. Most will be commissioned as officers, either as Navy ensigns or 2nd lieutenants in the Marine Corps.
The vice president’s son, Michael, is serving as an officer in the U.S. Marines.
This report was written by the Associated Press.
The post WATCH: Pence speaks at U.S. Naval Academy graduation appeared first on PBS NewsHour.
Hillary Clinton will deliver the commencement address at Wellesley College beginning around 10:30 a.m. You can watch live above.
WELLESLEY, Mass. — Hillary Clinton didn’t mention Donald Trump by name, but she peppered her Wellesley College commencement address Friday with barbs aimed at her rival in last year’s presidential election.
The former Democratic presidential nominee took aim at Trump’s proposed budget, calling it “an attack of unimaginable cruelty on the most vulnerable among us” and saying it fails to address critical issues such as opioid addiction and climate change.
“It is shrouded in a trillion-dollar mathematical lie,” she said during the Friday speech at her alma mater. “Let’s call it what it is. It’s a con. They don’t even try to hide it.”
Clinton also painted a portrait of a political environment where some are hostile to the fundamentals of an enlightened society and are engaged in “full-fledged assault on truth and reason.”
She said people on social media can deny science and concoct “elaborate, hurtful conspiracy theories about child abuse rings operating out of pizza parlors.”
“Some are even denying things we can see with our own eyes, like the size of crowds,” she said, a reference to the Republican president’s false claims about the size of his inauguration crowd.
“When people in authority invent their own facts and attack those who question them, it can mark the beginning of the end of a free society,” she said.
Clinton urged graduates to listen to those they may disagree with and get out of their internet bubbles, despite the push-back they may receive.
“In the years to come there will be trolls galore online and in person eager to tell you that you don’t have anything worthwhile to say or anything meaningful to contribute,” she said.
“They may even call you a nasty woman,” she said, referring to a comment Trump made to her during a debate.
Clinton said she understands the anger that some of the graduating members of the class might be feeling in the wake of the election. She said she felt similar outrage as she was graduating 48 years ago.
She said in her classmates distrusted authority and were angry at the growing casualties in Vietnam — and the occupant of the White House.
“We were furious about the past presidential election of a man whose presidency would eventually end in disgrace with his impeachment … after firing the person running the investigation into him,” she said, drawing a parallel between Richard Nixon and Trump.
She said graduates shouldn’t be afraid of their ambition, dreams or even their anger, calling them powerful forces that can be harnessed to make a difference in the world.
Republican National Committee Chairwoman Ronna McDaniel said Clinton’s speech was a “stark reminder” of why she lost the election.
“Instead of lashing out with the same partisan talking points, Hillary Clinton would be wise to look inward, talk about why she lost, and expand the dwindling base of Democrat Party supporters,” she said.
Clinton’s speech marked a return engagement of sorts for Clinton. She delivered the first student commencement address 48 years ago in 1969, the year she graduated from the all-women’s school. She also delivered the 1992 commencement speech.
Clinton appeared relaxed and joked at times during the speech.
She said after her defeat she was able to rely on her family, her grandchildren and long walks in the woods.
“I won’t lie, chardonnay may have helped,” she added.
This report was written by the Associated Press.
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More than two dozen people are dead, including children, after gunmen fired on buses filled with Coptic Christians south of Cairo, Egypt.
A pickup truck and two buses were traveling to the monastery of Saint Samuel the Confessor in Maghagha in Minya governorate when the attackers began firing, killing at least 26 people and wounding 23 others, The New York Times reported.
“The gunmen got on the bus and they shot people point-blank,” said Bishop Makarios of the Coptic Orthodox Church in Minya Province.
The attack, which has not been claimed by any group, follows several recent attacks on Egypt’s Christian community by the Islamic State.
In December, 28 people died after a suicide bomber attacked a church in Cairo, and last month, suicide bombings at St. George’s Church in Tanta and St. Mark’s Cathedral in Alexandria killed dozens on Palm Sunday, prompting Egyptian President Abdel-Fattah el-Sissi to call for a three-month state of emergency.
Egypt’s Copts form the largest Christian community in the region and 10 percent of Egypt’s population of 93 million people, according to the Associated Press.
Copts have long faced discrimination in the Muslim-majority country, but tensions between the two groups have been especially high in the last several years, especially after the Copt-backed Sissi led a military coup that ousted the Muslim Brotherhood’s Mohamed Morsi.
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WASHINGTON — President Donald Trump’s son-in-law, Jared Kushner, is willing to cooperate with federal investigators looking into ties between Russia and the Trump campaign, his attorney said.
The statement from attorney Jamie Gorelick was issued Thursday amid reports that the FBI was investigating meetings Kushner had in December with Russian officials.
“Mr. Kushner previously volunteered to share with Congress what he knows about these meetings. He will do the same if he is contacted in connection with any other inquiry,” the statement said.[Watch Video]
Meanwhile, the chairman of the House oversight committee asked the FBI to turn over more documents about former Director James Comey’s interactions with the White House and Justice Department, including materials dating back nearly four years to the Obama administration.
The FBI and the oversight committee — as well as several other congressional panels — are looking into Russian meddling in the 2016 presidential election and possible connections between Russia and the Trump campaign. Trump fired Comey May 9 amid questions about the FBI’s investigation, which is now being overseen by special counsel Robert Mueller, a former FBI director.
NBC News and The Washington Post first reported that the FBI’s ongoing investigation includes a look at Kushner, which would place the probe inside the White House.
Kushner, a key White House adviser, had meetings late last year with Russia’s ambassador to the U.S., Sergey Kislyak, and Russian banker Sergey Gorkov.
The Post story cited anonymous “people familiar with the investigation,” who said the FBI investigation does not mean that Kushner is suspected of a crime.
Earlier Thursday, House oversight committee chairman Jason Chaffetz told acting FBI Director Andrew McCabe that he wants records of Comey’s contacts with the White House and Justice Department dating to September 2013, when Comey was sworn in as FBI director under President Barack Obama.
In a letter to McCabe, Chaffetz said he is seeking to review Comey’s memos and other written materials so he can “better understand” Comey’s communications with the White House and attorney general’s office.
Chaffetz, R-Utah, previously requested Comey’s recent memos about his private contacts with Trump. But the bureau told him Thursday it could not yet turn them over because of Mueller’s probe.
Chaffetz, who said last week he has his “subpoena pen” ready to force Comey or the FBI to turn over the documents, told McCabe that “Congress and the American public have a right and a duty to examine this issue independently of the special counsel’s investigation.”
He added, in a thinly veiled threat, “I trust and hope you understand this and make the right decision — to produce these documents to the committee immediately and on a voluntary basis.”
Chaffetz’s letter comes a month before he is scheduled to leave office after abruptly announcing his resignation earlier this year. He canceled a hearing scheduled Wednesday after Comey declined to testify.
Assistant FBI Director Gregory Brower told Chaffetz on Thursday the agency is evaluating his request and will update him as soon as possible.
Some Republican members of Congress have pressured Chaffetz to step down from the Comey probe, saying it should be led by someone who will remain in Congress.
Rep. Trey Gowdy, R-S.C., is considered the front-runner to replace Chaffetz as oversight chair. Gowdy led a special House panel that spent more than two years investigating the deadly 2012 attacks at a U.S. diplomatic compound in Benghazi, Libya.
Associated Press writer Eric Tucker contributed to this report.
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WASHINGTON — Former House Speaker John Boehner says that aside from international affairs and foreign policy, President Donald Trump’s time in office has so far been a “complete disaster.”
Speaking at an energy conference Thursday in Houston, Boehner praised Trump for his approach abroad and his aggressiveness in fighting Islamic State militants, according to the energy publication Rigzone.
“Everything else he’s done (in office) has been a complete disaster,” the Ohio Republican said, according to the publication. “He’s still learning how to be president.”
Boehner said he’s been friends with Trump for 15 years, but still has a hard time envisioning him as president. He also said Trump shouldn’t be allowed to Tweet overnight.
David Schnittger, a spokesman for Boehner, confirmed the comments on Friday.
According to Rigzone, Boehner said that the Republican tax reform effort “is just a bunch of happy talk” and that the border adjustment tax — a major priority for Boehner’s successor, Speaker Paul Ryan — is “deader than a doornail.” He said he was more optimistic about tax reform earlier in the year, but “now my odds are 60/40.”[Watch Video]
Earlier this year, Boehner said he was pessimistic about another congressional Republican priority — repealing and replacing former President Barack Obama’s Affordable Care Act.
Boehner said that while Republicans would fix some problems of Obama’s law, repeal and replacement is “not going to happen.”
He added, “Republicans never ever agree on health care.”
The GOP-led House narrowly passed a bill earlier this month. The Senate has struggled to produce legislation that all in the GOP can back.
On investigations into Russia, Boehner told the Texas forum that “they need to get to the bottom of this” but said Democratic talk of impeachment is the best way to rile up Trump supporters.
Boehner made it clear he’s happier now that he’s left Capitol Hill.
“I wake up every day, drink my morning coffee and say, ‘Hallelujah, hallelujah, hallelujah,'” he said, according to Rigzone.
And unsurprisingly, Boehner said he doesn’t want to be president.
“I drink red wine. I smoke cigarettes. I golf. I cut my own grass. I iron my own clothes. And I’m not willing to give all that up to be president,” he said.
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WASHINGTON — When President Donald Trump met Pope Francis this week, the U.S. leader renewed a commitment to fighting global famine and proudly announced a new multimillion-dollar American aid contribution to four African nations in crisis. Left unsaid by the president or the White House: His proposal to slash such funds by more than 40 percent in the next fiscal year.
While the Trump administration’s 2018 spending plan does not eliminate money for emergency food aid, it ends a critical program by consolidating it into a broader account that covers all international disaster assistance. Doing so reduces the amount of money the U.S. dedicates to fighting famine to $1.5 billion next year, from $2.6 billion in 2016. The reduction is likely even steeper compared to 2017, but the administration hasn’t calculated figures for this fiscal year because it doesn’t end until Sept. 30 and more money may be allocated for famine relief before then.
Trump officials say the proposed changes will streamline U.S. aid programs, eliminate redundancies and increase efficiency. Relief organizations fear less U.S. money will mean an increase in famine and hunger-related deaths, particularly in Africa, if Congress approves the budget. Trump’s overall proposal, however, is already prompting significant opposition from Republican and Democratic lawmakers.
Trump’s aid announcement at the Vatican on Wednesday went largely unnoticed, tucked into the last paragraph of a brief White House readout of the meeting. And coverage of the president’s papal audience was dominated by atmospherics between two men with widely divergent views on many issues.
Officials familiar with planning for the new assistance said the White House was seeking “a deliverable” to announce after Trump’s discussions with the pope and settled on the additional famine relief for millions in South Sudan, Nigeria, Somalia and Yemen. The officials spoke on condition of anonymity because they were not authorized to speak about the issue publicly.
In the meeting, Trump “renewed the commitment of the United States to fighting global famine,” the White House said. “As he relayed at the Vatican, the United States is proud to announce more than $300 million in anti-famine spending, focused on the crises in Yemen, (South) Sudan, Somalia and Nigeria.”
The U.S. Agency for International Development, which along with the State Department could face a 31 percent budget cut, said the additional money brought total U.S. humanitarian assistance for those four countries to almost $1.2 billion since last October. “The United States is one of the largest donors of humanitarian assistance in all four crises,” it said, extolling the value of U.S. aid.
In what may have been a subtle reminder to the rest of Trump’s administration, the agency’s statement said: “The assistance we provide represents the best of America’s generosity and goodwill, while improving our national security by strengthening relationships with nations and people around the world. We will continue to work with our international and local partners to provide the life-saving aid needed to avert famine and to support surrounding countries that have been impacted by these crises.”
Yet, that support and broader disaster relief assistance would face drastic cuts if the administration gets its way.
The proposed 2018 budget seeks $2.5 billion for international disaster assistance. Of that total, $1.5 billion would be for food aid.
In 2016, the United States provided $2.6 billion in food aid through a combination of money from the disaster assistance fund and Title II of the “Food for Peace” program, which requires most of its money be spent on American food that is then shipped to areas in need. Trump’s budget would eliminate that program, which accounted for $1.7 billion worth of emergency food aid last year, calling it inefficient.
In its statement supporting the change, USAID said moving all famine aid to the disaster assistance account “allows USAID to both support the purchase of commodities in the U.S. and in markets overseas.” The U.S. would end up providing food assistance “more efficiently and in a manner that uses the most appropriate tool for crises.”
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WASHINGTON — Preparing for North Korea’s growing threat, the Pentagon will try to shoot down an intercontinental-range missile for the first time in a test next week. The goal is to more closely simulate a North Korean ICBM aimed at the U.S. homeland, officials said Friday
The American interceptor has a spotty track record, succeeding in nine of 17 attempts since 1999. The most recent test, in June 2014, was a success, but that followed three straight failures. The system has evolved from the multibillion-dollar effort triggered by President Ronald Reagan’s 1983 push for a “Star Wars” solution to ballistic missile threats during the Cold War — when the Soviet Union was the only major worry.
North Korea is now the focus of U.S. efforts because its leader, Kim Jong Un, has vowed to field a nuclear-armed missile capable of reaching American territory. He has yet to test an intercontinental ballistic missile, or ICBM, but Pentagon officials believe he is speeding in that direction.
Marine Lt. Gen. Vincent Stewart, director of the Defense Intelligence Agency, said this week that “left unchecked,” Kim will eventually succeed.
The Pentagon has a variety of missile defense systems, but the one designed with a potential North Korean ICBM in mind is perhaps the most technologically challenging. Critics say it also is the least reliable.
The basic defensive idea is to fire a rocket into space upon warning of a hostile missile launch. The rocket releases a 5-foot-long device called a “kill vehicle” that uses internal guidance systems to steer into the path of the oncoming missile’s warhead, destroying it by force of impact. Officially known as the Ground-based Midcourse Defense system, the Pentagon likens it to hitting a bullet with a bullet.
The Pentagon’s Missile Defense Agency, which is responsible for developing and testing the system, has scheduled the intercept test for Tuesday.
An interceptor is to be launched from an underground silo at Vandenberg Air Force Base in California and soar toward the target, which will be fired from a test range on Kwajalein Atoll in the Pacific. If all goes as planned, the “kill vehicle” will slam into the ICBM-like target’s mock warhead high over the Pacific Ocean.
The target will be a custom-made missile meant to simulate an ICBM, meaning it will fly faster than missiles used in previous intercept tests, according to Christopher Johnson, spokesman for the Missile Defense Agency. The target is not a mock-up of an actual North Korean ICBM.
“We conduct increasingly complex test scenarios as the program matures and advances,” Johnson said Friday. “Testing against an ICBM-type threat is the next step in that process.”
Officials say this is not a make-or-break test.
While it wasn’t scheduled with the expectation of an imminent North Korean missile threat, the military will closely watch whether it shows progress toward the stated goal of being able to reliably shoot down a small number of ICBMs targeting the United States. The Pentagon is thirsting for a success story amid growing fears about North Korea’s escalating capability.
“I can’t imagine what they’re going to say if it fails,” said Philip Coyle, senior science fellow at the Center for Arms Control and Non-Proliferation. He headed the Pentagon’s office of operational test and evaluation from 1994 to 2001 and has closely studied the missile defense system.
“These tests are scripted for success, and what’s been astonishing to me is that so many of them have failed,” Coyle said.
The interceptor system has been in place since 2004, but it has never been used in combat or fully tested. There currently are 32 interceptors in silos at Fort Greely in Alaska and four at Vandenberg, north of Los Angeles. The Pentagon says it will have eight more, for a total of 44, by the end of this year.
In its 2018 budget presented to Congress this week, the Pentagon proposed spending $7.9 billion on missile defense. Other elements of that effort include the Patriot designed to shoot down short-range ballistic missiles and the Terminal High-Altitude Area Defense, or THAAD, which the U.S. has installed in South Korea as defense against medium-range North Korean missiles.
The Trump administration has yet to announce its intentions on missile defense.
President Donald Trump recently ordered the Pentagon to undertake a ballistic missile defense review. Some experts argue the current strategy for shooting down ICBM-range missiles, focused on the silo-based interceptors, is overly expensive and inadequate. They say a more fruitful approach would be to destroy or disable such missiles before they can be launched, possibly by cyberattack.
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TAORMINA, Italy — European leaders have mounted a last-ditch effort to stop President Donald Trump from abandoning the Paris climate accord, using multiple meetings this week to sell the American leader on the global agreement to reduce carbon emissions.
French President Emmanuel Macron spoke with Trump at length about the climate deal during a meeting Thursday in Brussels. At the Vatican earlier in the week, Cardinal Secretary of State Pietro Parolin made his own pro-Paris pitch to Trump and his advisers. The matter was also expected to be a central focus of Trump’s two days of talks at the Group of 7 summit, which kicked off Friday on the picturesque Sicilian coast.
Nikolai Fichtner, spokesman for the German environment ministry, said the Europeans were “lobbying at all levels right now for the U.S. to remain in the Paris agreement.”
The White House’s slow decision-making on the future of the landmark 2015 climate change agreement created the opening for the European leaders’ persuasion campaign. Multiple White House meetings on the matter were delayed in recent weeks, and Trump advisers ultimately said he would not make a decision until after he returns to Washington from a nine-day, five-stop international trip.
As a candidate, Trump vowed to withdraw the U.S. from the accord, which was negotiated during the Obama administration. But as the opening months of his presidency have shown, Trump can be moved to change his positions and can be heavily influenced by other world leaders. He backed away from his tough campaign talk about trade with China after a summit with President Xi Jinping and abandoned his criticism of Saudi Arabia’s human rights record following his warm welcome in the desert kingdom earlier this week.
Gary Cohn, Trump’s top White House economic adviser, said the president is now “learning to understand the European position” on the Paris climate accord.
In Washington, discussions over the climate deal have sown divisions within the White House, splitting the nationalists and the globalists competing for influence within Trump’s administration. One potential compromise that’s emerged in the White House discussions involves staying in the climate accord, but adjusting the U.S. emissions targets.
Cohn hinted at that prospect as he briefed reporters Thursday night as Air Force One flew from Brussels to Sicily, the final stop on Trump’s trip.
“The last levels we put out in the Paris agreement were levels that would be constraining to our economic growth,” Cohn said. “But then you get into the whole discussion on Paris, is it non-binding, is it not non-binding, can you change your levels, how easy is it to change your levels.”
In a striking comment given Trump’s support during the campaign for American coal miners, Cohn also said “coal doesn’t even really make that much sense anymore as a feedstock.” He singled out natural gas as “such a cleaner fuel” and also noted that the U.S. could become a “manufacturing powerhouse” by investing in wind and solar energy.[Watch Video]
Nearly 200 countries are part of the Paris accord and each set their own emissions targets, which are not legally binding. The U.S. pledged to reduce its annual greenhouse gas emissions in 2025 by 26 to 28 percent below 2005 levels, which would be a reduction of about 1.6 billion tons of annual emissions.
A senior French official said Macron and Trump spoke at length about the Paris agreement — at Macron’s behest — when they met for lunch Thursday. There was no “disagreement” over the accord itself, the official said, but there were “differences” about how to apply it.
Macron, the newly elected French president, was critical of Trump’s threats to pull out of the Paris deal during his own campaign. In a dig at Trump, he invited American climate scientists who felt alienated by the Republican administration to come to France to work.
Even Pope Francis, who has framed climate change as an urgent moral crisis and blamed global warming on an unfair, fossil fuel-based industrial model that harms the poor the most, appeared to be sending a message to Trump. Among the three documents the pope presented Trump as a gift was his 2015 encyclical on the need to protect the environment.
It’s unclear if the pope pressed Trump specifically on the Paris accord in their private meeting. But Parolin, the Vatican’s secretary of state, did make a direct appeal in a broader meeting with the president and his top aides.
“They were encouraging continued participation in the Paris accord,” U.S. Secretary of State Rex Tillerson said. “We had a good exchange on the difficulty of balancing climate change, responses to climate change and ensuring that you still have a thriving economy, you still offer people jobs so they can feed their families and have a prosperous economy. That’s a difficult balancing act.”
Climate change was on the agenda for Friday’s opening discussions at the G-7 summit. But with Trump pushing off a decision on the Paris accord until after he returns to Washington, it was unclear how strong the group of wealthy nations — the U.S., Britain, Canada, France, Germany, Italy, and Japan — would be on climate issues in the summit’s final communique.
Associated Press writers Sylvie Corbet in Taormina, Italy; Angela Charlton in Brussels; and Geir Moulson in Berlin contributed to this report.
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A man sobbed in a New York emergency room. His elderly wife, who suffered from advanced dementia, had just had a breathing tube stuck down her throat. He knew she never would have wanted that. Now he had to decide whether to reverse the life-sustaining treatment that medics had begun.
Dr. Kei Ouchi, then a resident at Long Island Jewish Medical Center, had no idea what to say. The husband, who had cared for his wife for the past 10 years, knew her condition had declined so much that she wouldn’t want a heroic rescue. But when Ouchi offered to take out the tube, the man cried more: “She’s breathing. How can we stop that?”
Ouchi had pursued emergency medicine to rescue victims of gunshot wounds and car crashes. He was unprepared, he said, for what he encountered: a stream of older patients with serious illnesses like dementia, cancer and heart disease — patients for whom the lifesaving techniques he was trained to perform often only prolonged the suffering.
As the nation’s elderly population swells, more older Americans are visiting the emergency room, which can be an overcrowded, disorienting and even traumatic place. Adults 65 and older made 20.8 million emergency room visits in 2013, up from 16.2 million in 2000, according to the most recent hospital survey by the Centers for Disease Control and Prevention. The survey found 1 in 6 visits to the ER were made by an older patient, a proportion that’s expected to rise as baby boomers age.
Half of adults in this age group visit the ER in their last month of life, according to a study in the journal Health Affairs. Of those, half die in the hospital, the study found, even though most people say they’d prefer to die at home.
The influx is prompting more clinicians to rethink what happens in the fast-paced emergency room, where the default is to do everything possible to extend life. Hospitals across the country, including in Ohio, Texas, Virginia and New Jersey, are bringing palliative care, which focuses on improving quality of life for patients with advanced illness, into the emergency department.
Interest is growing among doctors: One hundred forty-nine emergency physicians have become certified in palliative care since that option became available just over a decade ago, and others are working closely with palliative care teams. But efforts to transform the ER face significant challenges, including a lack of time, staffing and expertise, not to mention a culture clash.
Researchers who interviewed emergency room staff at two Boston hospitals, for instance, found resistance to palliative care.
ER doctors questioned how they could handle delicate end-of-life conversations for patients they barely knew. Others argued the ER, with its “cold simple rooms” and drunken patients screaming, is not an appropriate place to provide palliative care, which tends to physical, psychological and spiritual needs.
Ouchi saw some of these challenges up close during his residency in New York, when he visited the homes of older patients who were frequent visitors to the emergency room.
He saw how difficult it is for these patients to make it to the doctor. Often, “they can barely see. They can barely get out of the house,” he said. To make it to a doctor’s appointment, he said, they’d often have to call for a ride service, which could take several hours to arrive.
“So what do they do?” Ouchi said. “They call 911.”
When these patients arrive at the emergency room, doctors treat their acute symptoms but not their underlying needs, Ouchi said. In more severe cases, when the patient can’t talk and doesn’t have an advanced directive or a medical decision-maker available, doctors default to the most aggressive care possible to keep them alive — CPR, intravenous fluids, breathing tubes.
“Our default in the ER is pedal to the metal,” said Dr. Corita Grudzen, an emergency physician at NYU Langone Medical Center who studies palliative care in the ER. But when doctors learn after the fact that the patient would not have wanted that, the emergency rescue puts the family in the difficult position of deciding whether to remove life support.
When older adults are very ill — if they need an IV drip to maintain blood pressure, a ventilator to breathe or medication to restart the heart — they are most likely to end up in an intensive care unit, Grudzen said. Rates of transfer from the ER to the ICU have been rising, she noted.
“It’s a terrible place to be if you’re older,” Grudzen said, as older patients are more likely to develop hospital-acquired infections and delirium. Meanwhile, it’s not clear whether these aggressive interventions really extend their lives, she said.
Some have sought to address these problems by creating separate, quieter emergency rooms for older patients. Others say bringing palliative care consultations into regular emergency rooms could reduce hospitalization, drive down costs and even extend life by reducing suffering.
There’s no hard evidence that approach will live up to its promise. The only major randomized controlled trial, which Grudzen led at Mount Sinai Hospital in New York City, found that palliative care consultations in the emergency room improved quality of life for cancer patients. It did not find statistically significant evidence that the consultations improved rates of survival, depression, ICU admission or discharge to hospice.
But frontline doctors say they’re seeing how palliative care in the ER can avert suffering. For instance, Ouchi recalled one patient, a man in his late 60s, who showed up at the emergency room — for the fifth time in six months — seeking relief from fever and back pain. In previous visits, doctors had quelled his symptoms, but they hadn’t addressed the underlying problem: The man was dying of cancer, which was causing persistent pain in his bones.
This time, a nurse and social worker called in a palliative care team, who talked to the patient about his goals.
“All he wanted was to be comfortable at home,” Ouchi said. The man enrolled in hospice, a form of palliative care for terminally ill patients. The hospice sent staff to his home to manage his symptoms and spiritual needs. He died about six months later, at home. His daughter returned to the hospital to thank the staff.
Now Ouchi and others are trying to come up with systematic ways to identify which patients could benefit from palliative care.
One such screening tool, dubbed P-CaRES, developed at Brown University, is a simple list of questions clinicians can answer about each patient in the ER. It asks if the patient has life-limiting conditions such as advanced dementia or sepsis. It asks the patient’s frequency of ER visits, the level of caregiver stress, and whether the doctor would be surprised if the patient died within 12 months.
Doctors are using the tool to screen patients at the University of California-San Francisco Medical Center at Parnassus and to connect them to palliative care doctors, said Dr. Kalie Dove-Maguire, a clinical instructor there. The questions pop up automatically on the hospital electronic medical record for every ER patient who is about to be admitted to the hospital.
Dove-Maguire said UCSF hasn’t published results, but the tool has helped individual patients, including a middle-aged man with widespread cancer who showed up at the ER with low blood pressure. The man “would have been admitted to the ICU with lines and tubes and invasive procedures,” she said, but staff talked to his family, learned his wishes and sent him home on hospice instead.
“Having that conversation in the ER, which is the entry point to the hospital, is vital,” Dove-Maguire said.
But time is scarce in ERs, where revenue depends on how many patients come through. Doctors’ performance is measured in minutes, Grudzen noted, and the longer they stop to make calls to refer one patient to hospice, the more patients line up waiting for a bed.
Finding someone to have conversations about a patient’s goals of care can be difficult, too. Ouchi enlisted ER doctors to use the screening tool for 207 older ER patients at Brigham and Women’s Hospital in Boston, where he now works as an emergency physician. They found a third of the patients would have benefited from a palliative care consultation. But there aren’t nearly enough palliative care doctors to provide that level of care, Ouchi said.
“The workforce for specialty palliative care is tiny, and the need is growing,” said Grudzen. Palliative care is a relatively new specialty, and there’s a national shortfall of as many as 18,000 palliative care doctors, according to one estimate.
“You can screen up the wazoo,” Grudzen said, but if there aren’t any palliative care doctors available to talk to a patient, “what are you going to do?”
“We’ve got to teach cardiologists, intensivists, emergency physicians how to do palliative care,” she said. “We really have to teach ourselves the skills.”
KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente. You can view the original report on its website.
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A hearing Thursday by the U.S. Senate’s Permanent Subcommittee on Investigations is tackling an issue that is essential to helping stem the opioid epidemic wracking our country: the shipment of synthetic opioids like fentanyl and carfentanil into the United States via the global postal system.
From 2014 to 2015, deaths from synthetic opioids rose by 72 percent, fueling the more than 33,000 opioid overdose deaths. Almost every week we hear of communities being ravaged by new, increasingly potent and exotic synthetic drugs. Reports indicate that China is the number one supplier of synthetic opioids, so addressing the shipment of these drugs into the U.S. is crucial. Yet a loophole in the global postal system allows bad actors overseas to avoid scrutiny and mail their drugs directly to Americans’ doorsteps with minimal detection from law enforcement.
As the opioid epidemic ravages communities across America, our lawmakers have a responsibility to do all they can to keep Americans safe. As officials gather for the Senate hearing Thursday to discuss how to shut down this pipeline of drugs into our country, here are three things to watch for.
How has the supply of synthetic opioids impacted the opioid epidemic?
Reports indicate that the opioid epidemic is shifting from prescription drugs like oxycodone to deadlier synthetic opioids. In the past month, Wisconsin, Maine, New Hampshire, and Maryland all reported their first overdose deaths linked to carfentanil, a deadly elephant tranquilizer that’s 10,000 times more potent than morphine. And states across the country — from New York to Alabama — are reporting deaths from a potent mixture of synthetic opioids called “gray death.” In some states, synthetic drugs are now a factor in the majority of overdose deaths.
How are synthetic opioids being sent into the U.S. through the global postal system?
According to the Drug Enforcement Administration, China is the number one supplier of fentanyl and its precursors to the United States, Mexico, and Canada. These drugs are sometimes shipped to Canada or Mexico and then trafficked into the U.S. In many cases, though, they are sent directly to recipients in the U.S. by individuals exploiting a loophole in the global postal system to avoid scrutiny.
More than a decade ago, legislation passed to improve the security of the mail system required private couriers to provide advance digital information on packages from overseas. For each package mailed to the U.S., private couriers such as FedEx and UPS must attach electronic information that includes the shipper’s name and address, the recipient’s name and address, and the weight of the package. This may be basic information, but it is vital: Given the large volume of mail shipped to the United States, officials can’t manually scan every package.
These data allow law enforcement to effectively target high-risk packages using analytical algorithms. While the private sector has implemented these security protocols, the global postal system has yet to adapt. Nearly 1 million packages continue to arrive in our country every day without critical security data that would help law enforcement identify and stop dangerous packages — including those containing deadly synthetic opioids.
Would closing the postal loophole help officials target illicit packages?
Homeland Security Secretary John Kelly recognized that closing this loophole would help officials shut down this pipeline of illicit drugs. In a Senate hearing last month, he agreed that the Synthetics Trafficking and Overdose Prevention Act, which would close the loophole by requiring electronic data on all packages shipped into the country, could help law enforcement identify and stop packages containing deadly synthetic opioids from entering the United States.
Today, more Americans are dying from drug overdoses than from guns and car crashes combined. There is no single solution to combating the opioid epidemic, but any serious approach must include disrupting the supply chain of these drugs.
In these politically polarizing times, it’s increasingly rare for people across all parties to unite on an issue. But with every state reeling from the opioid epidemic, there is no time for partisan bickering. Fortunately, there is bipartisan support for closing the global postal loophole, which is a commonsense step to disrupt the flow of these drugs into the U.S.
Our politicians just need to make it happen.
Juliette Kayyem is a lecturer in international security and faculty director of the Homeland Security Project at the Harvard Kennedy School; former assistant secretary of Homeland Security in the Obama administration; and a senior adviser for Americans for Securing All Packages, a bipartisan coalition of families, health care advocates, security experts, businesses and nonprofits who believe it is time to close a dangerous security gap in our postal system. Kayyem is compensated for her work as a senior adviser to the organization. This article is reproduced with permission from STAT. It was first published on May 25, 2017. Find the original story here.
The post Column: Close the postal system loophole that allows opioid shipments into the U.S. appeared first on PBS NewsHour.
For most politicians, comparisons to Watergate are a sure sign of trouble. But President Donald Trump, as he has often reminded the American public, is not your average politician.
Mr. Trump put that claim to the test this month by firing the director of the FBI. The move drew immediate comparisons to Richard Nixon’s dismissal of Archibald Cox, the special prosecutor investigating his presidency, after an extraordinary turn of events known in Washington shorthand as the “Saturday Night Massacre.”
James Comey’s firing and the whiplash pace of developments since then, including the appointment of a special counsel last week, bears some resemblance to Watergate. But it’s still too soon to tell how much the scandals have in common.
At this early stage, the differences between the Nixon and Trump eras stand out more than the similarities. The Comey firing and Russia investigations form a case study of the massive shifts in U.S. politics and media since the early 1970s.
The biggest change has to do with political polarization. The country is much more divided than it was four decades ago, and this fact will play a key role in determining how Trump’s current crisis plays out. In the end, the political division that Trump fomented as a candidate could help save his presidency.
Partisanship will shape the debate in two separate arenas: on Capitol Hill, and in the court of public opinion.
When the Watergate break-in took place, Republicans held the White House, and Democrats were in control of Congress. As a result, Nixon’s party was powerless to stop Democrats from initiating impeachment proceedings. Republicans also had less incentive to protect the president at all costs.
At the time, Republicans had a smaller “stake in keeping Nixon at the helm in order to pursue their policy agenda,” said Robert Shapiro, a political science professor at Columbia University.
“Now, Republican leaders in Congress have a huge incentive to stick by Trump because they have a legislative agenda to push through,” Shapiro said. “And they’re willing to ignore all else to see that happen.”
Republicans could potentially survive this crisis with their majority in Congress intact. They would retain their hold on the White House as well, if Trump resigned or was impeached for obstruction of justice or another charge in connection to the congressional and special counsel investigations into potential collusion between Russia and his 2016 campaign.
But a real fight over Trump’s hold on power would bring legislative activity in Congress to a halt. And while some Republicans would welcome the chance to install Vice President Mike Pence in the Oval Office, the process of replacing Trump would exact a heavy toll on the party. Republicans are already struggling to make progress on issues like health care and tax reform, and the partisan atmosphere in Washington today pales in comparison to a full-blown impeachment drama.
Then there is the issue of public opinion.
In Nixon’s case, “it took a lot of information, a lot of revelations and a lot of time until he lost” the backing of Republican lawmakers and his core supporters, said Thomas Patterson, an expert on government and the media at the Harvard Kennedy School.
But once solid evidence of a White House coverup emerged, and Nixon’s efforts to block Cox’s independent investigation became clear, public opinion of the president turned, and Republicans had no choice but to follow suit. By the October night in 1973 when Elliot Richardson, the attorney general, and his deputy, William Ruckelshaus, resigned after refusing Nixon’s order to fire Cox, and then Nixon fired the special prosecutor anyway — the infamous “Saturday Night Massacre” — Republicans in Congress were ready to see Nixon go.
“Republicans weren’t super aggressive in pursuing Nixon” at first, said Michael Greenberger, an aide to Richardson at the time who went on to serve in the Department of Justice under President Bill Clinton. “When the evidence was clear, the Republicans fell in line.”
The political dynamic is different this time around. In the 1970s, incumbent lawmakers from both parties faced far fewer primary challenges than they do now. Today, a Republican who abandons Trump runs the risk of angering the president’s supporters, and drawing a primary opponent from the far right.
“The understanding in Washington is that all of these problems are beneficial for Democrats,” Patterson said. “If you join the parade as a Republican, it’s not going to help with Trump voters. You’re going to anger Trump’s base.”
The only way that would change, Patterson argued, is if Trump’s job approval rating plummeted in conservative parts of the country, and he became a liability for the Republican Party in the 2018 midterm election. Trump’s approval rating among all voters has hovered around 40 percent since he took office, and he remains extremely popular with conservatives.
Among Republican voters, 84 percent approve of the president’s job performance, according to a recent Quinnipiac University poll, compared to six percent of Democrats. Poll numbers will likely influence Republican lawmakers’ response to the investigations going forward, Patterson said, a reflection of the fact that many politicians today are more “electorally minded than institutionally minded.”
Peter Wallison, who served as White House counsel to President Ronald Reagan in the late 1980s, said Republican leaders in Congress deserved credit for launching several investigations into Russia’s interference in last year’s election. But he said it was clear that a fundamental shift has taken place.
“Unfortunately, we’re in a time now in which partisan politics are much more important than the institutional loyalties people have to the Senate and House,” Wallison said. In the past, he said, lawmakers were willing to stand up to a president from their own party. “That’s not true anymore.”
Wallison and others pointed to another important change from the Nixon era: the public’s growing distrust of the news media. It’s far less likely that a majority of Americans will come to a consensus about a president’s actions today, as happened during Watergate, in an era of “fake news” where Democrats and Republicans often disagree about the basic facts.
“We’re a lot more polarized than we were in the early seventies,” Patterson said, “and that creates barriers to movement” in public opinion.
The investigations into Trump’s associates and Russia have only begun, cautioned Greenberger, the former Justice Department official. Right now, “there’s still people who call it fake news and don’t want to believe it. But every day it gets worse and worse. I just don’t think it’s going to get better.”
“With Watergate, in the end, the facts and the evidence were just overwhelming,” said Shapiro, the polling expert at Columbia University. “At this juncture with Trump, a lot more remains to come out.”
“The question is,” Shapiro added, “even when we know all the facts, how much will polarization come into play? And how much will Trump supporters care?”
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HARI SREENIVASAN: Now a comic with a sharp edge and an astute take on modern life and politics.
Jeffrey Brown has this latest addition to the NewsHour Bookshelf.
W. KAMAU BELL, Author, “The Awkward Thoughts of W. Kamau Bell”: Have you heard of the phrase Black Lives Matter.
W. KAMAU BELL: And what do you think about that?
JEFFREY BROWN: Sociopolitical comedy, it’s a way of describing the work of W. Kamau Bell, host of CNN’s “United Shades of America,” in which he does something rather unusual these days, seeking out the America and Americans we don’t know or regularly interact with.
W. KAMAU BELL: Come here. Come here.
WOMAN: Can you say it, because — can you tell me a little bit?
W. KAMAU BELL: No, what you said is true. All lives should matter.
WOMAN: I know that.
W. KAMAU BELL: But right now, but not — right now, lives …
WOMAN: … offensive. Right? It does.
W. KAMAU BELL: Yes. No. Well, to many people it does, because all lives don’t really matter in the same way, and then all lives matter is like an aspirational goal.
White people, learn from her.
JEFFREY BROWN: Now Bell expands on his own view of the world in a new book, “The Awkward Thoughts of W. Kamau Bell,” with the subtitle “Tales of a 6′ 4″, African American, Heterosexual, Cisgender, Left-Leaning, Asthmatic, Black and Proud Blerd, Mama’s Boy, Dad, and Stand-Up Comedian.”
So, welcome. That says it all pretty much
W. KAMAU BELL: Yes. That’s the whole book.
JEFFREY BROWN: That’s the book.
W. KAMAU BELL: That’s the book.
JEFFREY BROWN: We don’t have to read the book anymore.
W. KAMAU BELL: Yes.
JEFFREY BROWN: “Awkward Thoughts,” though, the title, what does that mean exactly?
W. KAMAU BELL: It comes from the fact that I realize that the best things that have happened to me in life have been friends of mine sitting me down and having awkward talks with me, family members, or reading things that challenge me, that that’s when I feel really like I’m growing as a person, when I’m in an awkward situation.
And a lot of times, in society, we’re trained to run from awkward situations. If things get awkward, you either run from them or yell over them to try to control them. But, for me, when things get awkward, I get quieter and start to listen more.
JEFFREY BROWN: I used that sociopolitical comedy, which I took from the jacket cover of the book, so I assume you approve of that.
W. KAMAU BELL: Oh, yes.
No, I’m the one who started describing myself as that.
JEFFREY BROWN: You started that, but what does that mean?
W. KAMAU BELL: I think I found it somewhere, this idea of sociopolitical.
A lot of times, a comedian like me is a called a political comedian. But I think political comedy in America conjures up a pretty specific image. And I love political comedians, but I think there is a pretty big difference between what I’m doing and what you would think a stand-up political comedian is doing.
I’m talking about — I’m not talking much about politicians. I’m talking about social movements or people who are struggling or oppressed people. It’s not so much about what’s going on in D.C.
JEFFREY BROWN: In the television show and to some extent certainly in the book, this search for the other, right?
W. KAMAU BELL: Mm-hmm.
JEFFREY BROWN: One of the premises clearly is we’re all in our own boxes, and we need to get out of them.
W. KAMAU BELL: Yes.
The first part, when I was a kid, I just moved around a lot because my mom moved around a lot. So, I think I sort of was already being — I was always being broken out of boxes. My dad lives in Alabama. So we would be somewhere and go to Alabama.
And if you’re in the north or in the west and you go to Alabama, that’s a different box. So, for me, the whole thing has been about like searching for where I belong.
And then, as an adult, as a stand-up comedian, you travel around the country doing stand-up shows. And you go anywhere where they will hire you, so you’re in different places you never would think to go, like Garden City, Kansas, or Appalachian State University.
So, for me, it’s just been a natural thing. And then the TV show sort of takes all that experience and really pushes it forward another step.
JEFFREY BROWN: Well, it does.
Everything you just said is sort of your personal experience of why you get out of boxes. But then you are extrapolating, I think, to a larger — like, this is what we all need. This is what America needs.
W. KAMAU BELL: Yes.
JEFFREY BROWN: Yes?
W. KAMAU BELL: Yes, because I travel around, and I talk to people.
And everybody sort of loves their part of America, which is great, but then a lot of times, we think, this is the most America part of America, the part I live in. Like, the people in New York think, this is the most America. People in Alabama think …
JEFFREY BROWN: To the detriment, though, of the culture?
W. KAMAU BELL: Yes, because then you watch the news, and if you’re in New York and they say — they talk about Alabama, you think, ah, that’s not my country, that’s not my people.
And so somehow you condescend to what their experience is, or you think you can actually judge their experience, even though you have never been there. So, you think those people want — like, you look at people in coal country, people who don’t live in coal country go, why do they want to destroy the environment with coal?
But if you go talk to people in coal country, it’s about jobs. We sort of demonize them because we think they love destroying the environment.
JEFFREY BROWN: You talked to the alt-right leader, right, Richard Spencer.
W. KAMAU BELL: Yes.
JEFFREY BROWN: But you do it in a gentle, sort of humorous way. It’s not like you’re …
W. KAMAU BELL: Yes, I do it the same way I’m talking to you, yes.
JEFFREY BROWN: Yes. Yes.
But to what end? You’re not trying to convince them — and you have — and you’re clear about your own left-leaning, where you’re coming from.
W. KAMAU BELL: Yes. It’s not — I’m not pulling a trick on anybody. I sit down as the person I am.
I’m very Googleable, so people can find out everything about me.
JEFFREY BROWN: Yes.
W. KAMAU BELL: And they’re not going to be tricked about me.
JEFFREY BROWN: Not only are you Googleable. You say it all right on the cover of the book.
W. KAMAU BELL: Yes. I have written it down on paper. It’s forever.
But the idea is like, can we have a conversation? Can we actually get to a different place? And the thing that I’m doing on TV is, like, I know it’s for TV. So, if I talk to you and get you relaxed and make you laugh and I laugh, you’re going to say something that you weren’t expecting to say, because you’re more comfortable.
Richard Spencer normally sits across from people like me, and they’re pushing him and they’re challenging him. And it makes him defensive. And it sort of gets to the same place.
By me sitting down with me, we got to different places than he normally gets with other people, which exposed him in a different way to people who thought they knew everything about him.
JEFFREY BROWN: The election happened, surprised a lot of people.
And there was suddenly a lot of talk about an America that felt left behind, right, or left out. So to the extent you’re clear about where you’re coming from and your politics, what do you think people of your political persuasion should be doing now?
W. KAMAU BELL: I just wrote an op-ed for The New York Times saying people in Berkeley need to go vacation in Alabama.
I think that that is really — if you can, get out of your comfort zone and get out of your immediate area and go someplace you wouldn’t expect to go. You are going to learn more about people.
And I think people in Alabama should go to Berkeley. I travel the country a lot. And you talk to people and they’re like, I have never been to New York City. You have never been to New York City?
Now, I get a lot of that is economic. But some of that is just people think, that’s not for me. And I feel like the best thing you can do in this country is mix it up with other people. Now, if you can’t physically do it, you need to get online. You need to connect with people. You need to try to talk to people, not yelling at people on Facebook and Twitter, but actually really connect with people.
JEFFREY BROWN: Just one last thing in thinking about the comedy and the sociopolitical.
Serious issues, you’re dealing with. Is there a line? Is there someplace where you think comedy just can’t go?
W. KAMAU BELL: No, comedy is pretty nonpartisan.
Comedy goes wherever comedy wants to go. Whether or not something is a joke depends on the ability of the person who writes the joke to communicate the punchline. Comedy is not something that — it’s like math. It’s way more like math than people realize.
There’s comedians who are Republicans. There’s comedians who are Democrats. Comedy doesn’t care. Comedy is just there to make people laugh.
JEFFREY BROWN: All right, “The Awkward Thoughts of W. Kamau Bell.”
Thank you very much.
W. KAMAU BELL: Thank you.