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The Daily Frame

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A ballerina performs during a dress rehearsal on the eve of the opening of the new stage at the Mariinsky Theatre in St. Petersburg. Photo by Olga Maltseva/AFP/Getty Images.


Preventing Drug Shortages with Cell Phones in Malawi

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Eighty percent of the 13 million Malawians live in rural areas, making delivering health services challenging, especially in remote parts with no roads. Photo courtesy of JSI/cStock.

BALAKA, Malawi -- Ishmael Katanga's clinic is a small, two-room mud hut in southern Malawi that serves approximately 3,000 local residents. He sees roughly 15-20 patients per day, usually children under 5 years old suffering from malnutrition, malaria, dehydration and diarrhea. In treating these preventable diseases, one of Katanga's biggest setbacks is access to medication and supplies.

Often, he has to turn patients away or encourage them to come back at a later time to receive their necessary medication. This scenario is common in rural clinics, where supplies and medications are scarce, causing what is known as a "stock out."

Health Surveillance Assistants (HSAs) receive training on the cStock system.

That's why the Malawi Ministry of Health (MOH), in partnership with public health research organizations such as John Snow, Inc. (JSI), has developed a mobile health program called cStock. It's part of a larger project with the goal of finding affordable, simple and sustainable supply chain solutions that address the unique challenges of community health workers.

cStock is a mobile text message-based reporting and web-based resupply system currently being used by more than 1,000 community health workers -- commonly known as health surveillance assistants (HSAs) -- for monitoring and managing community-level essential medicines and commodities for child health, family planning and HIV testing. In a 2010 Ministry of Health assessment, only 27 percent of HSAs had all the medicines they needed to treat pneumonia, diarrhea and malaria in stock on the day officials visited. HSAs live in the villages and are available day and night for patients to bring sick children to be treated quickly.

The mobile system allows HSAs to transmit information regarding their supply of 19 essential medicines to their local health center. The system is called cStock because it literally allows district and central level staff to "see" what medications and supplies are in stock at the community level. This transparency streamlines the needs of HSAs to their local health center, hopefully preventing future "stock outs" and improving relevant supply chains.

By using mobile technology, health care workers such as Katanga are able to text their medication and supply needs to health centers on a bi-weekly schedule. "I used to turn patients away because I didn't have the proper medication to treat even the simplest case of diarrhea," Katanga said while visiting his small clinic. "Now that I've been trained to use cStock, I am hopeful that I won't have to turn away the children and I can better serve my community."

cStock is part of The Supply Chains for Community Case Management Project (SC4CCM), which is a five-year project aimed at identifying, testing and implementing interventions in supply chain management in three countries: Malawi, Rwanda and Ethiopia. SC4CCM has also trained more than 45 data collectors to use Java-enabled mobile phones equipped with data collection software to conduct assessments of community case management supply chains.

While cStock is improving access to medication and supplies on the rural and health center level, there are still challenges. Clinics are understaffed and overcrowded and electricity is not reliable, making it difficult for community health workers to have a steady and consistent charge on their phones.

But officials say these challenges are being addressed at the Ministry of Health level as qualified health workers are being trained and electrical infrastructure is a priority nationwide.

Katanga, for one, is grateful for his training, particularly given that one of his recent patients was his own son. "I ran out of rehydration salts last week but was able to get a new batch of medication yesterday," he said.

This story is part of a series of reports on the impact of mobile technology and health in 10 African countries. For more, visit The Cheers Report.

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For Sarah Brightman, 'Dreamchaser' Is a Prelude to Upcoming Space Journey

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Sarah Brightman's voice has been often described as heavenly, which more than ever seems especially appropriate, as the soprano has recently turned her sights to the skies. Her latest album, "Dreamchaser," is inspired by her life-long fascination with space, and in two years Brightman's childhood dream is set to become reality when she boards a rocket and travels to the International Space Station.

Brightman, who first gained international fame for the role of Christine in the London and Broadway productions of "The Phantom of the Opera," has made a career of blending musical genres. In "Dreamchaser," she features a range of songs, from Paul McCartney to Polish composer Henryk Gorecki.

When she's not on stage, she continues to train extensively for her upcoming journey to space, first passing all the medical and psychological tests required to join the Russian space agency crew. She also recently set up scholarships for young women and girls to focus on STEM (Science, Technology, Engineering and Medicine) courses.

We caught up with her to talk about her album and space travel plans:

ART BEAT: The new album, "Dreamchaser," seems borne from your love of space and exploration. Can you talk about the process of crafting this new work?

SARAH BRIGHTMAN: I've always been interested in space and the idea of exploration in that area since I was a child growing up through the '60s. Of course, then the idea of space exploration was incredibly relevant because of the first man landing on the moon we all saw on television. That's really followed through in my life, although I've worked in the area of music. Finally my dream came true in that there was a possibility that I could travel to the International Space Station. I've gone through the medicals and the training and now I'm officially, by the Russian Space Federation, a cosmonaut in training. This journey it's taken me many, many years to get to this point.

I was totally inspired to put together an album of songs that are very expansive in their feel, all the wonderful emotions that we all have in the idea of what the universe is, what it may hold in the future, all the things we're discovering through the Hubble, through all the forms that we're getting back now. It's very inspiring to somebody who's creative, because the universe is created. Through the last few years, I put together this collection of pieces. The response from it has been absolutely amazing. In effect it is what one would call a concept album.

Sarah BrightmanART BEAT: It's a beautiful album. As a classical, crossover artist you've always blended a lot of work with your voice, and this album is no different. Songs range from Paul McCartney to the Polish composer Henryk Gorecki.

SARAH BRIGHTMAN: Yes, as I said a little earlier, I wanted pieces of music that had a very expansive feel. For example, there's a beautiful piece on there by a group called Sigur Ros. They come from Iceland and they've written this beautiful piece called "Glosoli," which is very expansive in its feel. It starts off in a very ethereal way and ends up with this huge, huge energy in it. Subliminally it may be what the audience who listens to it may feel, which is what I wanted. And of course the beautiful Gorecki piece from "Symphony of Sorrowful Songs," which really is reflecting on humankind and all the wrongs that we have done. But throughout those wrongs there's always a ray of hope, there's always hope that we can get better in the kindness that we do for each other and for own planet. It actually explains many things, these little bits of messages in all of these pieces that I've chosen. Also with the Paul McCartney piece, which is called "Venus and Mars," there is a very huge fun aspect to the idea of space and the universe. I felt that was a lighter piece in the album that reflected our fun aspect of the universe.

ART BEAT: Speaking of fun, what are you looking forward to most as a cosmonaut in training? When you eventually get to space, what are you dreaming of? What's a moment that you really are just eagerly anticipating?

SARAH BRIGHTMAN: Well, the fun aspect of this is that I'm going into this like a child. I've obviously done a fair amount of research just getting to this point. I've learned a huge amount by it being around me and from listening and gaining information, but I do feel like a child. I'm experiencing something really, really new every day. I don't really have any expectation, because apparently what you go through and what you feel you can't understand while standing here on Earth. I think the feelings are going to be completely different to what one is used to feeling here. The fun aspect is that I'm like a child again, learning. And I love it.

ART BEAT: And on the darker side, are there things you're scared of as you prepare to take this huge journey?

SARAH BRIGHTMAN: When I started to think about going for the first medicals, I thought about this incredibly seriously because it is a very serious thing to take on. It's an important journey and you have to be, I think, psychologically very ready for it. I'm not worried or fearful in any way whatsoever. Because the window to go isn't until 2015, my main focus is really to stay as healthy as possible and hope that nothing happens to me in that way.

ART BEAT: Throughout your career you've brought classical music to large audiences that might not have experienced it otherwise. Outside of the recording studio and the stage you've also worked to bring science and promote the study of STEM to young women and girls. Why is that so important to you? How do you see that work in your life?

SARAH BRIGHTMAN: Well, what I've realized in the few years that I've been involved in this is that there seemed to be very few women working in the STEM area. I've started up a couple of scholarships for young women who could be brilliant in this area but obviously need some funds once they are in university or college to help them on their way. I'm hoping more women will work in this area because I was incredibly inspired by it as a young person and by watching what happened back then in the '60s. When young people talk to me about the journey I may be taking, they're incredibly excited. You see their eyes light up and it opens up a whole area in their mind. I think there are lots and lots of women that can get involved more in all of these areas and may be be the next cosmonauts or astronauts to go.

ART BEAT: We will be following your journey and we will be listening. The new album is "Dreamchaser" by Sarah Brightman, who joined us by phone from New York City. Sarah, thank you so much for taking the time to talk with us.

SARAH BRIGHTMAN: Thank you so much. It was a lovely interview. I wish you a wonderful day.

Guatemala: Why We Cannot Turn Away

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GUATEMALA CITY -- When the trial of Guatemalan General and former de facto head of state José Efraín Ríos Montt and his then chief of intelligence José Mauricio Rodriguez Sanchez began on March 19, 2013, I was in Washington D.C., working with NewsHour correspondent Miles O’Brien on some new science reporting projects in a shared office. The first time I went to Guatemala was around 1989, during the country’s 36-year civil war -- I was a teenager, and the experience was one of the most important and formative of my life. My interest in the peace and justice process following the end of the armed conflict and the lives of the Guatemalan people, has only grown since. So I was happy to learn that Guatemalan independent online media groups were in the courtroom with laptops and modems, live-streaming video and audio of tribunal proceedings.

I tuned in as soon as court opened at 8:30 every morning, Guatemala time. And in our shared D.C. office, over a course of weeks, every day Miles and I worked while listening to audio streaming over the internet from that courtroom far away in Guatemala City. The background audio of our workdays included witness testimonies; defense lawyers yelling at the judges; and elderly Ixil Maya women weeping as they re-told the horrors of being raped, and watching their children, brothers, mothers, and grandfathers be killed.

Both of us were trying to do other work at the time, unrelated to this story. But neither of us could turn away, or turn off the audio, even as the stories grew more graphic, more upsetting, more awful with each witness. Imagine the worst possible thing one human being can do to another. Each testimony was like that, but each in a new and seemingly more horrific way than the last.

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Miles O'Brien and Xeni Jardin report on the role of science and forensics in the Ríos Montt genocide trial in Guatemala. 

During one of my trips to Guatemala in the 2000’s, I produced a documentary series for National Public Radio about the role science and technology played in some interesting stories related to peace and justice, and related to social and economic development for the country’s majority population who are poor and indigenous. Some of the episodes focused on entities such as the Guatemalan Forensic Anthropology Foundation (FAFG) and the Project for the Recuperation of the Historic Archives of Guatemala’s National Police (AHPN) -- groups that have produced forensic and documentational evidence that became central to the 2013 Rios Montt genocide tribunal.

Miles and I listened to those 2007 NPR reports together during a long car ride after the genocide trial began. And after we’d listened to the last one together, we agreed that revisiting those projects, those people, and the question of what role science plays in this process -- that all of this would make a really great NewsHour story. And luckily for us, NewsHour agreed.

Within a few days, we were off to New York and Connecticut to interview anthropologist Victoria Sanford, mapping expert Russell Schimmer, and filmmaker Pamela Yates, who famously interviewed Ríos Montt in 1982. That interview was introduced as evidence in the trial, and the General himself watched silently as the video played in the courtroom.  

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Boing Boing's Xeni Jardin, who co-produced the NewsHour's broadcast report, updates Miles on the status of the genocide trial from a security checkpoint in Casillas, Guatemala.

Then, we flew to Guatemala City, to observe the trial, and interview people on both sides of the genocide debate. Miles spoke with Ríos Montt’s daughter Zury Ríos Montt; and with his longtime advisor Harris Whitbeck -- who ran the regime’s “Frijoles y Fusiles” (Beans and Bullets) aid program in the Guatemalan Highlands, and coordinated support with American Evangelical aid groups, including those led by popular television evangelists Jerry Falwell and Pat Robertson. 

Ríos Montt was trained at the U.S. Army’s School of The Americas; the Guatemalan government and Army received funding, military training, weapons, and essential equipment such as helicopters directly from the U.S. (and through our allies: Israel and Taiwan, among others). President Ronald Reagan was a staunch ally of Ríos Montt, even as other lawmakers in Congress and the Senate raised concerns about reports of human rights abuses against indigenous populations. In arguing for more military aid for Guatemala, Reagan once famously said at a 1982 press conference in Honduras that the General had received “a bum rap” on human rights.

The question of who is responsible for atrocities that occurred during the Guatemalan civil war is not just a question for Guatemalans.

In Guatemala, we also interviewed people from organizations that produced criminal evidence for the trial, including AHPN and FAFG, and Patrick Ball from the Human Rights Data Analysis Group. Our interviews took place in an increasingly polarized climate in Guatemala; rumors were spreading that some trial witnesses and people involved in the prosecution were receiving threats. Some, we were told, were forced to leave the country out of concerns for safety. Paid 20-page inserts by a pro-Ríos Montt, anti-genocide-tribunal group appeared in each week’s Sunday paper: “The so-called ‘genocide’ trial is a lie perpetrated by neo-Marxist guerrillas enabled by the Catholic Church,” the headlines read.

But the most challenging part of our reporting trip came when we traveled to the Ixil area, to interview Mayan survivors, including a woman who appeared in the tribunal as one of the appoximately 100  “querrelantes,” or criminal witnesses. We spoke with José Ceto Cabo, an Ixil civil war survivor who runs a small NGO that works to aid fellow Ixil survivors, and we listened as seven Ixil men and women from Chajul, Cotzal, Nebaj, and other communties at the center of the genocide trial told us the stories of the atrocities they survived. In the courtroom back in Guatemala City, women covered their faces with traditional woven shawls as a gesture of grief and to hide the overwhelming pain and fear they felt as they re-lived their trauma. In the room in Nebaj where our cameras and lights were set up, this group of men and women chose to show their faces, even as some of them wept and trembled, retelling horrors.

We followed one of these war survivors to her home in San Juan Cotzal. Doña Juana Sanchez Toma offered us coffee grown in a nearby field, cooked over a fire in her dirt-floor hut. Her cat curled up nearby, and a war widow named Doña Inez crushed coffee cherries on a stone metate just outside.

Miles asked Doña Juana if she had any photographs of her family that we might be able to film, to help tell the story. She stepped away, and returned with a weathered, faded print: a smiling teenage girl, and an older woman with a sad, empty expression. The girl was a war orphan their family took in; the older woman was Doña Juana’s mother, who was captured and raped not long after her daughter suffered the same.

“They tied her arms and legs and carried her like a dog, when they kidnapped her from our home,” Doña Juana told us, weeping again. “They held her in the church, and the soldiers, all of them, they raped her for two weeks.”

The photograph was taken after. She soon died, Doña Juana told us, after suffering incalculable physical and psychological trauma.

As we write this blog post, the trial is in its 25th day, after being suspended and restarting and re-suspending a number of times. One of Ríos Montt’s attorneys, Garcia Gudiel, has just screamed at Judge Yassmin Barrios, “I will not rest until you are in prison.” I have been in Guatemala reporting on this story now for more than a month, and each day, it takes some new, unexpected, dramatic turn.

One week ago, President Otto Perez Molina (a former General under Ríos Montt, who was implicated by one of the witnesses in the genocide trial) declared an “Estado de Sitio” (State of Siege) in four communities surrounding a U.S./Canadian-owned Escobal silver mine in San Rafael, just east of the capital. By various accounts, more than 8,000 Army and police troops have been sent in to the Siege zone.

I visited the area last Friday, and observed joint military/police checkpoints and interrogations, spoke to guards at the mine, observed sites where violence had taken place, and spoke to members of indigenous and community groups who say that the military occupation is a re-play of the repressive policies of the miltary during the 1980s.

Being in the “estado de sitio” area reminded me of passing through Army checkpoint zones  during the war. Camionetas, those brightly colored school-buses, were pulled over by soldiers; all passengers ordered off, all identification checked, some questions asked. Back in the ‘80s, I was one of the bus passengers myself. And I remember observing that some people pulled off by soldiers were not allowed to get back on the bus.

Dozens of indigenous leaders held a dramatic demonstration inside the Guatemalan congress yesterday, as lawmakers met to consider ratifying (or not) the State of Siege. “Justice! Justice!,” they shouted in unison, forcing their way into the congressional chamber, “No to militarization! We have suffered enough under the Army! Get out of our pueblos now!”

Miles has been called back to the U.S., and I must leave Guatemala soon, myself. But I don’t want to. The story of these people continues to unfold, and I cannot turn away from it. When I return home, I will be tuned in, just like we were in the early days of the trial.

And I hope, we hope, and they -- many of the Guatemalan people -- hope that you will, too. 

 

Esteban Castaño of Skylight Pictures, contributed to this report. 

New Report Shows Staggering Differences in the Cost of Medical Treatments

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A new report released by the federal government raises questions about how exactly hospitals determine the cost of treatment, after it revealed that facilities across the country are charging wildly different amounts for the same medical procedures.

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The Center for Medicare and Medicaid Services (CMS) compiled a report that examines the costs of 100 of the most common inpatient procedures from 3,300 hospitals nationwide. What it revealed was that in many cases, hospitals -- sometimes in the same city -- price treatments up to twice as much as they would in another location.

For instance, in one Miami hospital, the average cost to insert a permanent pacemaker ran a little more than $60,000 in 2011. Meanwhile, in another facility, which is less than a third of a mile away, the same procedure costs more than $127,000. The Washington Post has compiled an interactive graphic looking at these discrepancies.

Yet despite the often staggering differences in costs, experts today questioned what impact these prices really have on the average consumer -- roughly 84 percent of whom had either public or private health insurance in 2011.

In theory, hospitals determine the costs of their procedures using what they call a chargemaster, which is essentially a database containing the costs of every item and procedure required at the facility. These prices vary depending on the location of the hospital and are adjusted for specific factors, including whether the hospital services low-income patients, is located in densely populated areas or is designed to be a teaching center.

Medicare payments, however, are not based on this data, but rather on a set of rates determined by the Center for Medicare and Medicaid Services, which are considerably lower. Additionally, private insurers will directly negotiate with hospitals to lower these costs for their clients. Ultimately, this means that insured patients will pay significantly less than what is being asked by these hospitals.

Based on the data from CMS, on average Medicare paid roughly 27 percent of the charges hospitals were requesting in these specific cases.

"The chargemaster can be confusing because it's highly variable and generally not what a consumer would pay," Carol Steinberg, vice president at the American Hospital Association, told the Washington Post.

Still, there is some disagreement as to whether this actually occurs in practice or not. Steven Brill, who wrote extensively about ballooning medical costs for Time Magazine, explained on the PBS NewsHour how hospitals often pad the costs in their chargemasters.

"They're typically five to 10 times what it costs the hospital to buy those items or provide those items," he said. "And insurance companies get big discounts off of the chargemaster, but the discounts that they get are still not enough to keep these hospitals from making very high profit margins and from all the non-doctor administrators at these hospitals from making exorbitant salaries."

Meanwhile, Jonathan Blum, the deputy administrator and director for the Center of Medicare, stressed that it is not the insured but rather the uninsured and underinsured who are most at risk, as they are the ones most likely to be faced with these charges.

"While the vast majority of patients in our country have public or private insurance there is a significant number of patients who are subject to these charges," Blum said. "We do not see any business reason why there is so much variation in the data. We want to have that conversation, but today we have not heard a logical business reason. While we can appreciate that there are variations due to the teaching status or the health status of patients, that cannot explain 5-to-1, 10-to-1, 30-to-1, 40-to-1 variations."

Ultimately, Blum added, the goal of the release is to better educate consumers of their options regardless of their insurance status. In addition, he said consumers can expect further releases in the future which may include more procedures.

"This is a two-goal effort," he said. "First to help those consumers who are navigating a very complicated pricing market and second to continue and elevate conversation as to why there's so much variation."

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House Hearing Is Latest Chapter in Political Dispute Over Benghazi Attack

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JEFFREY BROWN: The battle over the Benghazi Consulate attack was renewed today in Congress. At a lengthy hearing, a House committee heard new testimony about what happened during the deadly assault and after.

NewsHour correspondent Kwame Holman has our report.

KWAME HOLMAN: From the opening gavel, the political battle lines were clear. Republicans still accuse the Obama administration of deception about the attack on the U.S. mission in Benghazi eight months ago that killed U.S. Ambassador Christopher Stevens and three other Americans.

California Republican Darrell Issa chaired today's hearing.

REP. DARRELL ISSA, R-Calif.: I want those watching this proceeding to know that we have made extensive efforts to engage the administration and to see and hear their facts. The administration, however, has not been cooperative, and, unfortunately, our minority has mostly sat silent as we have made these requests.

KWAME HOLMAN: But Maryland's Elijah Cummings, the top Democrat on the Government Oversight Committee, led his party's response that Republicans merely are pursuing political gain.

REP. ELIJAH CUMMINGS, D-Md.: What we have seen over the past two weeks is a full-scale media campaign that is not designed to investigate what happened in a responsible and bipartisan way, but rather a launch unfounded -- of unfounded accusations and to smear public officials.

Let me be clear. I am not questioning the motives of our witnesses. I am questioning the motives of those who want to use their statements for political purposes.

KWAME HOLMAN: Committee Republicans invited three State Department officials whose statements about the U.S. response to the attack have resurrected the issue.

Veteran Foreign Service Officer Gregory Hicks was deputy chief of mission in Libya at the time of the attack.

GREGORY HICKS, Former Deputy Chief of Mission, Libya: That none of us should ever again experience what we went through in Tripoli and Benghazi on 9/11/2012.

KWAME HOLMAN: Hicks was based in Tripoli, more than 600 miles from Benghazi. He spoke with then-Secretary of State Clinton in the early hours of the assault.

GREGORY HICKS: She asked me what was going on, and I briefed her on developments. Most of the conversation was about the search for Ambassador Stevens.

It was also about what we were going to do with our personnel in Benghazi. And I told her we would need to evacuate, that was the right -- she said that was the right thing to do.

KWAME HOLMAN: But Hicks said his staff also was wary of walking into a trap. And he described futile attempts to call in help from the U.S. African Command and a U.S. air base in Italy.

GREGORY HICKS: I asked the Defense Attaché who had been talking with Africom and with the joint staff, is anything coming? Will they be sending us any help? Is there something out there? And he answered that the nearest help was in Aviano, the nearest where there were fighter planes. And he said that it would take two to three hours for them to get on site, but that there also were no tankers available for them to refuel.

KWAME HOLMAN: In an e-mail on Monday, Pentagon spokesman George Little defended the U.S. military's response. He said: "Department officials started taking action immediately after learning that an attack was under way. But our forces were unable to reach it in time to intervene to stop the attacks."

Today's hearing is the latest chapter in a political dispute arising from the attack on the Benghazi facility last fall. A total of five House committees, led by Republicans, have conducted investigations. Last month, they issued a report together charging that the Obama administration had -- quote -- "willfully perpetuated a deliberately misleading and incomplete narrative."

In the days just after the attack, U.N. Ambassador Susan Rice and others in the administration suggested it could have been triggered by Muslim protests, like an earlier incident at the U.S. Embassy in Egypt.

U.N. AMBASSADOR SUSAN RICE, United States: What this began as was a spontaneous, not a premeditated, response to what had transpired in Cairo.

KWAME HOLMAN: The administration has said Rice was simply following unclassified talking points based on the best information available at the time.

Republicans insist officials knew almost immediately that it was a terrorist attack, but didn't want to say so in the midst of President Obama's reelection campaign. Secretary Clinton, a potential presidential candidate in 2016, confronted the claims at a January hearing just before stepping down.

HILLARY RODHAM CLINTON, Former U.S. Secretary of State: The fact is, we had four dead Americans. Was it because of a protest or was it because some guys out for a walk one night who decided they would go kill some Americans? What difference at this point does it make?

KWAME HOLMAN: But at the hearing today, Eric Nordstrom, the former regional security officer in Libya, said it does make a difference.

ERIC NORDSTROM, Former Regional Security Officer, Libya: It matters to me personally, and it matters to my colleagues -- to my colleagues at Department of State. It matters to the American public for whom we serve. And, most importantly, excuse me, it matters to the friends and family of Ambassador Stevens, Sean Smith, Glen Doherty, and Tyrone Woods, who were murdered on Sept. 11th, 2012.

KWAME HOLMAN: A review board led by former Ambassador Thomas Pickering and Former Navy Admiral Mike Mullen found that serious management and leadership failures at the State Department led to grossly inadequate security in Benghazi.

Republicans argued today the review did not get at all the facts and that a cover-up continues. In turn, White House spokesman Jay Carney insisted the administration has cooperated fully, and he lashed out at the critics.

JAY CARNEY, White House Spokesman: Attempts to politicize this, which have guided Republicans unfortunately since the hours after the attack, and the Republican nominee for president issued a highly misguided press release about it in an attempt to turn it into a political issue, have been unfortunate and haven't been focused on the problem itself.

KWAME HOLMAN: Today's hearing may have resolved little, but there's more to come. Republicans say the investigations will go on, and they say former Secretary Clinton may be subpoenaed to testify again. 

News Wrap: White House May Revamp Wiretap Laws

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HARI SREENIVASAN: The Obama administration may be close to approving a revamp of surveillance laws, making it easier to wiretap online conversations. The New York Times reported today the FBI plan aims to catch up with technologies that go beyond telephone communication. The plan would have to be submitted to Congress, and technology companies already oppose it. They argue it would quash innovation and open systems to hackers.

The president of South Korea told the U.S. Congress today that North Korea must be rid of nuclear weapons. President Park Geun-hye was greeted with a long ovation as she entered the House of Representatives. She paid tribute to U.S. veterans of the Korean War, and singled out four congressmen who served there. But her main message to the lawmakers was that a nuclear-armed North Korea is unacceptable.

PRESIDENT PARK GEUN-HYE, South Korea: The leadership in Pyongyang must make no mistake. Security doesn't come from nuclear weapons. Security comes when the lives of its people are improved. It comes when people are free to pursue their happiness.

HARI SREENIVASAN: This was Park's first overseas trip since taking power in February.

Former South Carolina Gov. Mark Sanford is headed back to Congress, four years after he plunged into political disgrace. The Republican beat Democrat Elizabeth Colbert Busch in a special election Tuesday, winning a seat he held for three terms in the 1990s. Last night, after winning 54 percent of the vote, Sanford joked that he had returned from the political dead.

CONGRESSMAN-ELECT MARK SANFORD, R-S.C.: Some guy came up to me the other day, and he said, you look a lot like Lazarus.

And I say that because, if it was just about market-based ideas and limited government, this campaign would have been easily won a long time ago.

HARI SREENIVASAN: Sanford was governor in 2009 when he disappeared for five days, and then admitted he had gone to Argentina to visit his mistress. He is now engaged to her.

A leading contender in Pakistan's weekend elections is expected to make a full recovery from a serious accident. One-time cricket star Imran Khan was at a political rally Tuesday when he fell 15 feet off a forklift. He fractured three vertebrae and a rib, but doctors now say they expect him to heal completely. Khan's party is considered one of the three main challengers in Saturday's voting for a new parliament.

European police have nabbed 31 people across three countries in a $50 million dollar diamond heist in Belgium. The robbery happened at the Brussels Airport on Feb. 18th. Men dressed as police officers and armed with machine guns drove onto the tarmac and off-loaded diamonds from a plane bound for Switzerland. It took barely five minutes, and succeeded without a single shot fired. Today, the Brussels prosecutor's office announced police in Belgium, France and Switzerland swept up the suspects and more.

JEAN-MARC MEILLEUR, Spokesman, Brussels Prosecutor's Office: Several objects were seized during the search. In Switzerland, some diamonds were found. We can already tell that they come from the heist. In Belgium, large sums of money have also been found. The investigation is now continuing.

HARI SREENIVASAN: It was unclear just how many of the stolen diamonds are still missing.

The former CEO of Enron could get up to 10 years shaved off his sentence after striking a deal today with prosecutors. Jeffrey Skilling has served more than six years of a 24-year prison term for his role in the collapse of the giant energy company. If a federal judge approves, the sentence could be cut to 14 years.

A new genetic test went on sale today that could help curb overtreatment of prostate cancer. The test is designed to gauge just how aggressive a patient's cancer is. Most prostate tumors grow too slowly to be life-threatening, but some can prove fatal. Until now, there's been no way to tell which is which. About 240,000 men in the U.S. are diagnosed with prostate cancer every year.

On Wall Street, the Dow Jones industrial average kept going after breaking the 15,000 barrier yesterday. The Dow gained nearly 49 points today to close at 15,105. The Nasdaq rose 16 points to close at 3,413.

Those are some of the day's major stories -- now back to Ray.

Missing Ohio Women Reunite With Their Families as Suspected Captor Is Charged

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RAY SUAREZ: Now we turn to the dramatic events unfolding in Northeastern Ohio.

Authorities today revealed more about how three women were held for a decade and outlined kidnapping and rape charges against one man. Neighbors and news cameras swarmed the scene this morning, as Amanda Berry and her 6-year-old daughter conceived in captivity arrived at her sister's home in Cleveland.

The sister, Beth Serrano, asked for time and understanding.

BETH SERRANO, Sister of Amanda Berry: We appreciate all you have done for us through the past 10 years. Please respect our privacy until we are ready to make our statements.

And thank you.

RAY SUAREZ: Berry is now 27. She was rescued Monday from a rundown Cleveland home 10 years after she was kidnapped.

Police also found 23-year-old Gina DeJesus, who disappeared in 2004. She, too, returned home today.

FELIX DEJESUS, Father of Gina DeJesus: I knew she needed me, and I never gave up, never gave up searching for her.

RAY SUAREZ: The oldest of the three women, Michelle Knight, remained hospitalized. Her grandmother said the family thought Knight left home on her own when she vanished in 2002 at age 20.

New details of the victims' ordeal also emerged today. A city councilman briefed on the case said the women suffered repeated sexual abuse and miscarriages. On NBC this morning, Police Chief Michael McGrath said investigators found restraints in the house where the women were held.

POLICE CHIEF MICHAEL MCGRATH, Cleveland: We have confirmation that they were bound and there was chains and ropes in the home.

RAY SUAREZ: Meanwhile, FBI agents searched the home of Ariel Castro for evidence. They removed the door that Berry had kicked out and escaped through before she called 911 on a neighbor's phone.

Castro, along with his brothers Pedro and Onil, have been arrested, and remained in jail. Authorities announced late today Ariel Castro has given a detailed statement, and is being charged with kidnapping and rape.

As for his two brothers:

VICTOR PEREZ, Cleveland City Prosecutor: No charges will be filed against these two individuals at this time. There is no evidence that these two individuals had any involvement in the commission of the crimes committed against Michelle, Gina, Amanda, and the minor child.

RAY SUAREZ: Officials said they have many questions that still need answers, and there could be more charges to come. 


Cleveland Kidnapping Victims Lived in 'Dungeon-Like' Environment

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RAY SUAREZ: For the latest, we turn to Peter Krouse. He's a reporter with The Cleveland Plain Dealer newspaper, which has been closely tracking the story.

Peter, welcome.

What do we know about this case that we didn't know this morning? I know the prosecutor and the chief investigator gave a news conference just before we went on the air this evening. Did they reveal some new facts?

PETER KROUSE, The Cleveland Plain Dealer: Well, they did reveal some new facts.

Obviously, the -- one of the more interesting facts is the fact that two of the brothers are not being charged, and that they're saying that they -- there's no evidence that they had anything to do with this crime. I think most of the reporting up to this point has been that all three were going to be charged in connection with this.

Instead, it's just Ariel Castro, the owner of the house, charged with kidnapping and rape. I think some of the more interesting details that have come out is that these women were in this home, it looks like, for the entire time, almost the entire time.

We are told -- and I think this came out at the press conference -- that they left the house twice in disguise and they went into the garage. They never apparently left the property in 10 years. Other information that came out today, not necessarily at the press conference, had to do with some of the conditions in there.

We had known about the ropes and the chains that were found. We also understand that there were slots in some of the doors where items could be passed in and out, such as food, which conjures up an image of a dungeon-like environment. We also learned that -- at the press conference that the -- that Amanda Berry gave birth to her child in an inflatable pool.

The information about the -- one of the other victims, Michelle Knight, being forced to deliver that baby was also, I think, some new information.

RAY SUAREZ: Three charges of rape were filed and four of kidnapping. Who was the fourth person?

PETER KROUSE: I believe that would be the child, the six-year-old daughter of Amanda Berry.

I believe that would be the fourth person. Interestingly, I understand there was no information apparently that relates the suspects here to the disappearance of a woman named Ashley Summers, who disappeared in 2007 when she was 14. I think the FBI and police were hopeful that this investigation would turn up some leads into that disappearance. My understanding is that it hasn't so far.

RAY SUAREZ: The two other brothers, Pedro and Onil, they weren't taken into custody at the house?

PETER KROUSE: No, they were taken into custody as they arrived at the house where they lived on another street. They didn't live there with their brother Ariel.

RAY SUAREZ: There was a steady drumbeat of stories coming out of that West Cleveland neighborhood talking about attempts to tell the police over the years, attempts to report Ariel Castro for various infractions.

Did the police handle that today in the press conference?

PETER KROUSE: I did not hear the entire press conference, but I believe they did say that they did everything they could.

In fact, yes, I know they did. They said that they investigated every lead that they knew of. And I know we have reported in The Plain Dealer a lot of the efforts that they went to, to try and find these girls. One of the officials said that, in hindsight, you know, they may discover that there was something that they missed, but that it would be hindsight. It was not -- it wasn't anything that they could pinpoint.

These cases -- at least in the case of Amanda Berry and Gina DeJesus, the two who were abducted as teenagers, those cases were pretty well publicized. And the efforts by the police to find some answers were pretty well publicized, too.

RAY SUAREZ: We caught fleeting glimpses of two of the women, Ms. Berry and Ms. DeJesus. The third, Michelle Knight, hasn't been seen at all. She remains in the hospital.

Do we know anything about her physical condition and why she's needed to be hospitalized all this time since she was freed?

PETER KROUSE: Well, I believe, when they entered the house, Michelle Knight complained of some heart problems. I'm guessing that that's why she was placed back in the hospital, that perhaps there's an issue. She was having heart pains or something of that nature.

I don't know exactly why she went back into the hospital. I did hear, though, that -- I think I heard that she was in good condition. I don't think there's -- I'm not aware of anything that is life-threatening or anything of that nature.

While they were reported initially in pretty good condition, you know, I'm sure, you know, they had some physical problems that are going to have to be addressed.

RAY SUAREZ: The two brothers who remain uncharged are in police custody because they have other pending items before the police. But Ariel Castro, what's the next shoe to drop in his legal process?

PETER KROUSE: Well, I believe he will be arraigned tomorrow morning.

And an arraignment is when you plead to the charges. I am sure Ariel Castro will plead not guilty to these charges. He will -- depending on what his financial wherewithal, he will either -- he will either hire a lawyer or be assigned a lawyer by the court. I'm sure he will plead not guilty. And then the process of pretrials and discovery of information will begin.

This could take a long, long time. And, also, there could be other charges as a result of this. I'm not aware of any other potential victims that could arise from this investigation, but this is just the very beginning of the legal process. And that, I believe, will begin tomorrow with the arraignment.

RAY SUAREZ: Peter Krouse of The Cleveland Plain Dealer, thanks for joining us.

PETER KROUSE: You're welcome.

The Stockholm Syndrome and Printing Money

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By Terry Burnham

A note from Paul Solman: Former Goldman Sachs trader, biotech entrepreneur, money manager and economics professor at Harvard's Business School and Kennedy School of Government (where he taught me microeconomics), Terry Burnham, now teaching at Chapman College, is best known for his books "Mean Genes" and "Mean Markets and Lizard Brains." But he may be better known to NewsHour viewers from his appearances in stories on the dot.com crash, evolution and economics and the neuroscience of economics.

Burnham says we are headed for another stock market crash and Great Depression, due to the wanton printing of money by central banks like the Federal Reserve.

"How can we believe," he asks, "that printing money will make us rich?" Here's his answer. My skeptical response follows.

Terry Burnham: We are hostages to the destructive actions of central banks. Printing money destroys value. The puzzle is not economic, but rather psychological. Why do we allow Central Bankers to make us poorer and endanger us physically?

Patty Hearst holds an M1 carbine during the April 1974 Hibernia bank robbery. Photo by Federal Bureau of Investigation.

The answer lies in our non-rational brains. One aspect of our psychology, labeled the Stockholm Syndrome, is the human propensity to develop positive feelings towards captors in a form of traumatic bonding.

Nils Bejerot coined the phrase after a 1973 Stockholm bank robbery where four hostages were held for close to a week. Even after being released, the hostages showed sympathy for the robber, and blamed the police. The most famous U.S. incident is that of Patty Hearst, who joined the organization that kidnapped her and took part in a bank robbery with her abductors.

The phrase "economy supported by central banks" generates more than half a billion Google hits. Can it really be true that printing money is going to make us rich? No.

Printing money can destroy an economy, or its effects can be close to neutral. Destruction occurs when the money printing severely distorts economic decision-making. My catastrophic view is that printing money by central banks in recent years has had three main impacts: Printing money destroys wealth. We cannot see the full impact yet of recent printing, but we can look at the last round of printing. After the NASDAQ crash in 2000, the Fed funds rate of very short-term (overnight) interest rates was cut from 6.5 percent to 1 percent. The unemployment rate at the time was a little over 5 percent. The subsequent problems created by the Fed were much larger than any short- term benefits during the low-rate periods. Printing money shifts wealth from the prudent to the profligate.The Federal Reserve is specifically trying to drive down interest rates. Borrowers are happy to pay fewer dollars in interest. For every dollar not paid in interest, there is a saver that is made poorer. To the extent that the Fed is able to reduce interest rates, it transfers money from savers to borrowers. Distorting prices leads to bad decisions.Interest rates are prices and incorrect prices lead to bad choices. The most obvious of these are investments in risky assets because lower risk assets have rates close to zero. We will only see the impact of the bad decisions in the future, but we can be sure they are being made now. DAVID STOCKMAN AGREES WITH BURNHAM: What Are the Risks of Low Interest Rates?

Even the supporters of the Fed's creation of money argue that at best, it would be only slightly positive. So we return to the central question. How can we believe that printing money will make us rich?

To repeat, the answer lies in an economic version of the Stockholm Syndrome. Wikipedia states that the syndrome does not require physical kidnapping, but, citing scholars Dutton and Painter, states, "strong emotional ties that develop between two persons where one person intermittently harasses, beats, threatens, abuses, or intimidates the other."

Imagine that you are a retiree with financial assets of $120,000, which is the median wealth of American retirees. If you invest this money as safely as possible - in 3-month Treasury bills -- you will earn a total of $60 a year in interest before taxes and inflation. So you have barely $1 a week to live on. This is the financial version of intimidation and abuse.

Many of us suffer the Stockholm Syndrome and support the central printers (I mean bankers). The outcome will not be pretty and the guilt lies with the bankers, not with the hostages.

If I'm right, the current "boom" will end with a bang, not a whimper. Or more accurately, perhaps, a deafening thud. The stock market is booming because of the Fed printing money and using it to buy U.S. Treasury bonds.

As a result, the Treasury doesn't need to offer much in the way of an interest rate to attract buyers of its debt. Low interest rates on Treasury bonds punish investors, who become desperate for higher returns. They flood the stock market.

In addition, low interest rates allow speculators to gamble, borrowing cheap to chase higher returns. Again, the cheap money fuels the stock market - and all other speculative markets as well. Why not invest in almost anything if you can do so with money you can borrow, short term, at close to zero percent?

Moreover, as long as the Fed continues to create new dollars and use them to buy U.S. bonds, the bond market will be propped up as well.

I don't know when this will end. Neither does anyone else. But end it will. After that, there are no certainties, only probabilities. But I believe there is a substantial probability that the outcome will be worse than the Great Depression. In retrospect, people will feel contrite about having believed in printing our way to prosperity. But, like Patty Hearst, they will probably tell themselves they had no choice. In any case, it will be too late.

Paul Solman responds: Too much money? Too late? Maybe. Then again, maybe not. Maybe the Fed (and other central bankers) are doing what it takes to reinvigorate economies that have been artificially depressed in the wake of the Crash of '08. Maybe they're being careful about how they do it, by paying interest to banks -- the so-called "Interest on Excess Reserves" (IOER) -- so that the money being created doesn't rush out into circulation. IOER is something we've tried to explain here for years. Maybe they're trying to put the tens of millions of unemployed people in the developed world back to work.

How should one assess Terry's doomsday scenario? It's good to remember that even those who cry wolf are sometimes right. So, is there evidence of wild, unsustainable speculation? A stock market bubble, for example? Well, yes, the market is scaling new heights. But compare it to December of 1999, when the Dow Jones hovered near 11,500. With the Dow at 15,000 today, that's a compound rate of return of less than 3 percent a year, just barely keeping pace with the rate of inflation. In other words, by 1999 standards, the Dow hasn't returned a dime in real, inflation-adjusted returns. So is it really at some kind of new speculative high?

Sure, sure, December of 1999 was the height of the dot.com "bubble." And yes, today's price-earnings ratio of American stocks is higher than average. But at a ratio of something like 20:1, today's P/E is less than half what it was 1999.

Mightn't an alternative explanation to Burnham's and David Stockman's bubble hypothesis be that the stock market is expensive because shares of American companies are actually worth more these days than they used to be? Profits, as opposed to wages, account for a historically unprecedented share of corporate income, but is that a one-off bubble-like event or a function of labor's deteriorating bargaining power, a trend likely to continue?

And what about housing? A speculative bubble? Yes, prices are rallying, but they're still 30 percent or more below their levels of 2006-2007.

Meanwhile, the budget deficit is down, unemployment is down (if still stubbornly high), millions of Chinese and others are still leaving the farm for the city, where they keep world inflation in check by working cheap.

And for all the hand-wringing about a productivity slowdown, technology is working wonders. Hey, with the natural gas revolution, America even has excess fuel to burn!

But perhaps most persuasive, as I suggested to David Stockman when he made this same doomsday argument in an interview the other day, is that world interest rates are at historically unprecedented lows. That simply makes no sense if the world's central bankers, like the Fed, are out of control.

If the Fed and friends are "printing" too much money (they're actually creating it electronically), then interest rates would have to reflect the fact.

What is an interest rate composed of?

Three things:

The value of having the use of the money as opposed to someone else having the use of it. In other words, the rental cost of the money; how much you will get paid to wait for its return.

The risk of default: how much you will get paid for taking the chance that you might not get paid back.

The risk of inflation: that you might get paid back, but in dollars (or yen or euro) that are worth a lot less, in buying power, than when you loaned them out.

So, what are world interest rates right now? Give me a moment while I check the Bloomberg app on my iPhone. Let's see. The United States: 1.76 percent to borrow money for 10 years. No, that must be a mistake. The historical price or rental cost of money or risk-free rate of interest is something like 2 percent, at least. The world's collective investors can't be lending Uncle Sam money for a decade as a gesture of good will, can they?

Oh, and wait a second. I forgot about the default risk. That must be worth a few hundredths of a percent, no? And OMG! We all forgot about inflation. (Let me look that up.) Hmm, inflation is running at an annual rate of 1.8 percent at the moment.

In short, the impossible is happening: investors are lending the US money for less -- much less -- than it figures to be worth when they get paid back 10 years from now.

Oh, but that must be because, as economist Douglas Holtz-Eakin famously pointed out, America "is the best horse in the glue factory." That is to say, people are lending us money (by buying our bonds) for safe-keeping; everywhere else in the world is even riskier. So all we have to do is look at interest rates elsewhere to get a true picture of the money printing madness that's taken hold globally.

Okay, how about England? 10-year bond rate: 1.77 percent. France, one of those countries where they take to the streets if you threaten to cut their pensions? 1.81 percent. Italy, totally dysfunctional, where that Silvio Berlusconi character is still a power broker? 3.83 percent. That's not much more than a bank would charge me and my wife for a mortgage and it's got our house as collateral -- a house in which our equity stake is probably 70 percent.

And in case you (and Terry and David Stockman) remain skeptical, I offer you Japan. Ten-year interest rate? 0.6 percent. Japan. The country where they're desperate to create inflation. The country with a ratio of government debt-to-GDP well above 200 percent while people go nuts in America because, by the most generous reckoning, our ratio has reached 100 percent.

Admittedly, things could change quickly. It was suddenly spiraling interest rates that triggered the demise of AIG, of Lehman, the formal government takeover of Fannie Mae and Freddie Mac.

Admittedly, it is a probabilistic universe and disaster could strike at any time. All one can do is place one's bets. I may wind up feeling as bad about what I'm about to write as Patty Hearst must feel about her stick-up attempt but at the moment, I won't be putting my nest egg on double zero.

This entry is cross-posted on the Rundown -- NewsHour's blog of news and insight. Follow Paul on Twitter.Follow @PaulSolman

Treasury Secretary Lew on Long-Term Unemployment, Party Divide on Spending Cuts

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JEFFREY BROWN: And now the point man for the Obama administration on what for so many Americans remain the most pressing matters of the day: jobs and economic growth.

Treasury Secretary Jack Lew has been in the post since February.

NewsHour economics correspondent Paul Solman caught up with him on the road yesterday, part of Paul's ongoing reporting on Making Sen$e of financial news.

PAUL SOLMAN: Just outside Cleveland, Ohio, the new factory of one of America's fastest growing manufacturing firms, Vitamix, maker of hot products in haute and not-so-haute cuisine, high-end blenders.

We were here to interview Treasury Secretary Jack Lew, who ran the Office of Management and Budget for both Presidents Clinton and Obama, served for a year as the current president's chief of staff, and took over from Tim Geithner at Treasury in February. You will be seeing the new secretary's name on a bill near you soon, though, after the president joked about Lew's loopy signature, he decided to straighten it out.

As Treasury secretary, Lew is tasked with tackling, among other issues, the sequester, dealing with deficit hawks, mainly in the GOP, who think the sequester doesn't cut government enough, the slow pace of financial reform, the euro slump, and, of course, lackluster job and economic growth, which is what brought him to Vitamix, to trumpet a success story.

But, we asked him, what about nearly 11.5 million Americans officially unemployed, four million of them long-term unemployed? And that rate hasn't budged since 2011.

TREASURY SECRETARY JACK LEW, United States: We see a long-term unemployment rate that's too high, and it's not OK. It's something that we have to be just vigilant about addressing.

We have got to have economic growth creating enough jobs so that we cannot just deal with the new entries into the labor force and people who are in jobs, changing jobs, but creating enough jobs so that people who've been out of the labor force can get back in.

PAUL SOLMAN: But why don't these people, long-term unemployed, older workers -- I have been covering them lately -- why don't they seem to be your top priority?

JACK LEW: Our top priority is growing the economy and creating more jobs. We can't target where those jobs are created. The decisions are made in businesses like this, where, you know, there's economic activity and people are being put to work.

If you look around, all the packages here that are wrapped in red are for export. People are buying U.S. products because they're quality products. And if we make the things the world wants, we will sell things overseas and we will create more jobs.

I think that older workers are facing different challenges than younger workers. For older workers, the skills that they have, they may need some retraining. And we have some proposals that would help deal with retraining.

There are also challenges when people are out of the work force that they expect to lose some of their relationships and connections. You know, we have to use both official and some of the bully pulpit approaches we have to encourage employers to take another look at older workers who've been out of the work force.

PAUL SOLMAN: Is there something you can do?

JACK LEW: For younger workers, for younger workers, you know, we have to make sure that they get the skills training in elementary, secondary school and in post-secondary school, so they can get into the work force.

We have too many young people who are -- there's a hiatus between their graduating and their entering the work force and getting their first job. And we have to create opportunities that cut across these groups.

PAUL SOLMAN: You were in Europe recently. You're going back to the U.K. for the G7.

You have been telling them to ease up on austerity. Should we ease up on austerity here at home by ending the sequester, say?

JACK LEW: I have been going to our partners in Europe and making the case that they need to get the right balance between growth and austerity. They focus too quickly on deficit reduction and not enough on getting their economy moving.

They're looking at our growth rate, and they're, I think, aware of the fact that we have done something more effective than they did to get out of the recession. Here in the United States, we're probably doing more deficit reduction now than anyone really thought we should be. The sequester took effect not because it was designed to take effect. It took effect because Congress failed to enact a balanced long-term deficit reduction package.

We think that's wrong. We think that the sequester is irresponsible and it should be replaced with a more balanced longer-term approach, and we should remove that drag on the economy and also the specific effects, which are very damaging to the economy.

PAUL SOLMAN: But, from what I'm reading, you're credited with having helped concoct the sequester.

JACK LEW: If you go back to the summer of 2011, we were in a very difficult situation, where congressional Republicans were saying, we will not extend the debt limit, we will force a default of the United States unless something is enacted.

We tried every other option. There was no meeting of the minds on short-term policy. So then the question was, what could be put in place that would be so awful that Congress would never let it happen, so that they would then go to work and enact a balanced plan? And sequester was the result.

The thing that I find truly amazing is that there are members of Congress who are calling the sequester a success, a victory, their policy. They can have the policy. Nobody at the time thought it should take effect. It was meant to be something that would spur action on a more balanced basis.

PAUL SOLMAN: But isn't it an administration's job to figure out how to deal with the Congress that it faces?

JACK LEW: I can tell you it takes two parties for it to work. No one party can make it work.

And I think that the notion -- you know, if you look at what the president has done over the last several years, he has shown in -- time and again that he is willing to go more than halfway to make a reasonable agreement. In his budget this year, he put forward proposals that many on our side say, why did the president put that in his budget? And he put it in to establish clearly that there is a reasonable middle ground where we can have a balanced approach, with some more revenues and some serious savings on entitlement programs.

The question now is, will Republicans come forward?

PAUL SOLMAN: We're in Cleveland, where the foreclosure problem really began. Are you proud of the administration's record on foreclosures, given how many Americans lost their homes?

JACK LEW: I think we have made a lot of progress. There's still more progress to be made.

If you look overall, there's like 6.5 million Americans who've been -- managed to refinance their homes either directly because of what the government has done or because of programs where the private sector moved in and kind of followed in kind.

There's millions more who should be able to refinance their homes. There's no excuse for somebody who is in a home where they can pay their mortgage and they're stuck in a mortgage that's at well above current market rates not to be able to refinance.

Now, we think that's something that we ought to be able to get bipartisan agreement on. I actually am still optimistic we can. I wouldn't want to have to explain to a homeowner, whether it's here in Ohio or in Florida or in Nevada, that when interest rates start going up, they were the only -- they were the ones who couldn't get the benefit of lower market rates.

We're working on what whatever we can do administratively. And I think, in the end, it would require legislation to really help a lot of those families.

PAUL SOLMAN: It's three years since the president signed the Dodd-Frank Wall Street Reform Act. Most of it hasn't been implemented. And a lot of people say it’s Wall Street that's been slowing it down, chipping away at it.

Have you stood up to Wall Street?

JACK LEW: First of all, Dodd-Frank was an extremely important piece of legislation. It created powerful new tools, the first time in two generations that we have new tools to deal with a financial system that clearly had gotten out of control, and in 2008 caused a huge economic crisis.

At the beginning, it was difficult to implement Dodd-Frank. We had this enormous effort as soon as it was signed into law to repeal it. That slowed the process down. We're now in a place where I think there is a shared sense of urgency, certainly an urgency I feel as treasury secretary to get Dodd-Frank fully implemented.

PAUL SOLMAN: Last question, should we be ending the era of too big to fail banks?

JACK LEW: Dodd-Frank was enacted to end too big to fail.

It established as a policy that the federal government cannot go in and bail out banks again. So the question is now asked, do those tools work? And I think it's a little premature to answer, because we're still not across the finish line of implementing all of Dodd-Frank. I think you're seeing the regulators are looking at many of the dials that could be turned to make it more costly to be a big bank by raising capital standards, to make it more difficult to get overextended through the leverage requirements.

So I can't sit here today and see into the future and say with 100 percent certainty that we have succeeded, but I can say with 100 percent certainty we are determined to succeed.

PAUL SOLMAN: Mr. Secretary, thank you very much.

JACK LEW: Thank you. 

From Guatemalan Soil, Scientists Unearth Signs of Genocide

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RAY SUAREZ: Next: a story that combines murder, politics and science in the Central American nation of Guatemala.

It centers on the trial of the country's former leader, Efrain Rios Montt, charged with genocide that occurred during his rule in the 1980s. Rios Montt was a fervent anti-communist who was backed by the Reagan administration. At the time, the U.S. was criticized -- criticized for supporting Rios Montt's forces and claiming violence was decreasing there.

But, in 1999, President Bill Clinton traveled to Guatemala and expressed his regret for the U.S. government's role and for not doing more to stop the killings.

Now the trial of the former president comes at a pivotal moment for the country.

NewsHour science correspondent Miles O'Brien reports.

MILES O'BRIEN: In the lush volcanic highlands of Guatemala, a hike down a mountain trail often leads to the very heart of darkness.

And that is where Jose Ceto took me on this day near the village of Xexucap. They have exhumed 26 bodies here so far, girls, boys, elderly men and women, he told me. This place is one of at least 2,000 mass graves that dot the rugged landscape like festering wounds, the scars of a civil war that spanned 36 years in which some 200,000 were killed, more than 80 percent of them indigenous Mayans.

"There were total massacres," he says. "People were tortured, burned, shot, stabbed by soldiers. They were exterminating entire communities. You can't say that's not genocide."

This is at the heart of a turbulent trial in the capital. The man who ruled Guatemala during the bloodiest years of the long war, Gen. Jose Efrain Rios Montt, now 86, faces charges of genocide and crimes against humanity. The charges stem from 15 massacres targeting Ixil Mayans that left over 1,700 dead, and displaced 29,000.

Never before in world history has a former head of state faced charges like these in a domestic court in his home country. In 1999, a U.N.-sponsored commission reported that it had found evidence of genocide and acts of brutality committed by the army against Mayans. But unequivocal as the report is, it is not a not a legal verdict.

For years, efforts to bring Rios Montt to trial were thwarted because he held congressional office, giving him immunity. When his term ran out in early 2012, a judge ruled he should stand trial. Rios Montt has remained mostly silent since the trial began. His daughter Zury, a Guatemalan legislator and the wife of former U.S. Congressman Jerry Weller, has been at her father's side in court and in the court of public opinion.

Was there genocide during your father’s regime as president here in Guatemala?

ZURY RIOS MONTT, Daughter of Efrain Rios Montt: In Guatemala, there was no genocide during any regime.

MILES O'BRIEN: So what happened here?

ZURY RIOS MONTT: In Guatemala, there was confrontation. In Guatemala, there was war.

MILES O'BRIEN: But scientists have built a compelling forensics case that offers layers of evidence of a campaign to wipe out innocent indigenous Guatemalans.

It begins with the exhumations. Over the past 20 years, the Guatemalan Forensic Anthropology Foundation has unearthed 6,500 bodies from clandestine graves. The bones are cleaned, laid out and then carefully analyzed.

This skeleton shows evidence of four close-range gunshot wounds to the head. The man's hands were tied behind his back, an execution. Forensic anthropologist Fredy Peccerelli, a Guatemalan raised in the Bronx, is executive director here.

Would there be a case, would there be a trial without the evidence that you put together here?

FREDY PECCERELLI, Guatemalan Forensic Anthropology Foundation: There could be a trial without this evidence, but these are the bones and skeletons talking from the grave and telling them, telling the judges what happened to them. So if you take the physical evidence that we are presenting and you compile it with and compare it to the testimonial evidence, then you can make your own decisions.

MILES O'BRIEN: In a sophisticated DNA lab, they are grinding up bones or teeth and extracting DNA. Using software developed to identify 9/11 attack victims, they analyze about 300 samples a month, comparing genes found in the remains to relatives who lost their loved ones in the slaughters or who simply went missing.

So far, they have identified less than half of the remains they have exhumed. Their storage rooms overflow with a backlog of cardboard boxes filled with bones. But Rios Montt's supporters insist scientists are either imprecise or flat wrong, and there is no way to link the deaths to his nearly 17-month reign in 1982 and '83.

Guatemalan Harris Whitbeck was one of Rios Montt's top advisers in the Ixil region. He testified for the defense at the trial.

HARRIS WHITBECK, Former Rios Montt Adviser: Do they know who shot the bullet? Do they know exactly on the date these people were killed? I'm not a scientist. I don't know.

MILES O'BRIEN: In fact, the forensic anthropologists are not that precise. But the bones aren't all that are doing the talking. Thirty years ago, an eye in the sky was watching, a U.S. science satellite called Landsat passing overhead.

Russ Schimmer is an expert in geomatics, the science of gathering, analyzing and interpreting geographic information. He has pored over Landsat images of the Ixil highlands of Guatemala captured before and after Rios Montt's rule. He has documented huge swathes of land that were highly vegetated in 1979 and then barren in 1986. Schimmer ruled out natural events, leaving only massive deliberately set fires as the possible cause.

RUSSELL SCHIMMER, Yale University: There's no way you're going to go out there and light a match and you're going to see -- I mean, some of the areas that were burnt are five football fields large, and it covers areas which are just huge, hundreds of square kilometers of destroyed vegetation.

MILES O'BRIEN: But could the carnage during Rios Montt's regime be random casualties of war, not the mass murder of an ethnic group?

Also testifying at the trial, statistician Patrick Ball. He culled and compared homicide rates from four separate sources.

PATRICK BALL, Human Rights Data Analysis Group: We calculate that about 5.5 percent of the indigenous people alive in April of 1982 were killed by July of 1983; 5.5 percent were killed in those 16 months.

At the same time, among their non-indigenous neighbors, about 0.7 percent of the people who were alive in April of 1982 had been killed by July of 1983.

MILES O'BRIEN: There is also a massive incriminating paper trail that the Rios Montt regime left behind.

These are some of the 80 million documents found in a derelict warehouse in the capital in 2005. It was the headquarters of the national police, implicated in the torture, murder, and disappearance of tens of thousands of citizens, some of them children. An independently funded group is using the latest archival science techniques to clean, organize and scan everything into a searchable online database.

Kate Doyle is an adviser to the Guatemalan national police historical archive.

KATE DOYLE, The National Security Archive: The opening of public access to the material has just democratized this information, and it, in some ways, democratized people's understanding of the conflict itself, of the war itself.

MILES O'BRIEN: Filmmaker Pamela Yates also unwittingly gathered a key piece of evidence against Rios Montt in 1982, as she shot her film "When the Mountains Tremble."

She captured gut-wrenching proof of the brutality of the Guatemalan government forces. But it was an outtake of her interview with Gen. Rios Montt that proved most damning.

He told Yates: "Our strength is in our capacity to make command decisions. That's the most important thing. The army is ready and able to act, because, if I can't control the army, then what am I doing here?"

The clip became the centerpiece of Yates' 2011 film "Granito." And prosecutors played the full interview at the trial. Rios Montt could only watch as his own words confirmed he had firm control over the army and its actions during the slaughters.

PAMELA YATES, Co-Founder, Skylight Pictures: On one hand, we're using great technology, innovative technology to discover things that we didn't know before.

And on the other hand, we're using traditional technology, like the documents in the police archive, like the .16-millimeter film from 1982, that come together and form a meeting.

MILES O'BRIEN: But all the forensic science and technology would mean nothing without the courageous testimony of the Ixil, who are in court every day.

More than 30 women have testified. They recounted horrible stories of government soldiers killing their babies, husbands, and relatives, and then raping them repeatedly.

Juana Sanchez Toma was one of them. She told the court she was captured by Guatemalan army soldiers and taken to the main church in Nebaj, where they severely beat her.

"They raped us in groups repeatedly," she said, "a mountain of women, so many women. They raped us all, but none of the women said anything because we were terrified. But the pain never ended. I began to hemorrhage from all the rapes. They said, 'Go to your house.' They threw me out. But I was hemorrhaging."

The same thing happened to her mother, who died not long after she was released.

It's gripping testimony. Do you doubt the credibility of those women?

"I doubt the credibility of several witnesses," Zury Rios Montt told me. "Some of them have invented stories which have been taught to them. Why? Because they were members of the subversive groups. They have been told that, if you say this or that, you are going to receive financial compensation."

Juana Sanchez Toma is desperately poor, and yet generous. She has taken in this devastated widow and is offended by the accusation she is simply seeking money.

"What I want is justice," she told me. "They gave the orders that all of the savages be exterminated, that they take out the garbage, because they said we were savages and that we were garbage."

Nearby, in the town of Nebaj, Ixil Mayans have not forgotten any of this. The rule of law and the rules of forensic science may be changing this country, but the change is slow. And, in the church where the women were raped, there is a shrine to those who died in the massacres, memories that no amount of justice will erase.

RAY SUAREZ: Producer Xeni Jardin is still in Guatemala covering the trial, where closing arguments began this evening. Miles gets more details from her in an online conversation. Plus, you can watch an extended version of the report you just saw. 

The Latest on Cleveland Kidnapping Case from Ideastream

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A police officer stands watch outside the family home of Amanda Berry, one of three women held captive in a Cleveland home for almost a decade. Photo by Brian Bull/90.3 WCPN ideastream

Authorities charged 52-year-old Ariel Castro with four counts of kidnapping and three count of rape Wednesday in the missing persons case of three women who were imprisoned in his home for almost a decade.

As authorities sort out the details of the triple kidnapping, Castro's brothers Pedro and Onil remain in custody, but face no charges.

The charges came in a day when two of the three women -- 27-year-old Amanda Berry and 23-year-old Gina DeJesus -- returned home to their families. The third woman, 30-year-old Michelle Knight -- who was abducted in 2002 -- remains hospitalized, according to the AP. All three women were rescued Monday night when Berry escaped from Castro's house. A 6-year-old girl, reported to be Berry's daughter who was born after her mother disappeared in 2003, was also found.

Ohio public media's ideastream reported that more than 100 neighbors, journalists and well-wishers gathered outside the family homes of Berry and DeJesus, as authorities escorted the women home. Their houses were decorated with balloons and homecoming signs.

Both families asked for privacy and time for Berry and DeJesus to recover. Neither Berry nor DeJesus spoke at the press conferences staged outside their houses.

Ideastream has been covering the story as developments in the case come to light. View their Storify timeline below for the latest news reports.

[View the story "Cleveland Kidnappings" on Storify]

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Seeking Method Behind the Madness of Hospital Billing Disparities

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Watch Video | Listen to the Audio

JEFFREY BROWN: Finally tonight: How much for that surgery or this ventilator?

The government today released data showing some of these costs for the first time, targeting what hospitals bill Medicare for the 100 most common procedures. And it turns out they can vary wildly from one hospital to another.

In Florida, for example, the University of Miami Hospital charges the government more than $78,000 dollars for a major joint replacement. But the Mercy Hospital and Medical Center in Chicago charges about $36,000 dollars for a similar procedure.

Even within the same city, differences can be great. At the Advocate Illinois Masonic Medical Center, that procedure costs $73,000 dollars. The numbers are striking, but the picture is more confusing still, since Medicare, insurers and patients don't typically pay these sticker prices.

Barry Meier of The New York Times covered the story and joins us now.

Well, Barry, welcome to you.

We gave a couple of examples. Tell us more about these disparities. What jumped out at you?

BARRY MEIER, The New York Times: Well, first of all, thanks very much for having me on.

It's kind of like giving a group of high school kids calculators and say, OK, kids, add up these numbers as quickly as possible and make up whatever numbers you want. On the surface, it looks like madness, just a kind of chaos of numbers that don't make sense when you look at them either directly or in comparison to each other.

So the question is, what is the method to this madness? Are these numbers driving up hospital costs? Are they costing us more as private payers, as government payers? And one has to think that higher sticker prices invariably do lead to higher costs. So the question now becomes, what is the connection between these charges and the prices we actually do pay?

JEFFREY BROWN: And before you get to that, though, what explains the great disparities between and among hospitals even within the same city?

BARRY MEIER: As far as that goes, your guess is as good as mine. I mean, these hospitals come up with charges.

They're built on some base that they develop years and years ago. They play some cat-and-mouse game between insurers and payers like Medicare, where they keep lopping on higher and higher charges. Then they deduct something. Then they charge more. So they all have their own cost basis that they use, and that's what you see in the wide disparity.

None of these numbers have any relationship to reality.

JEFFREY BROWN: In your reporting, I saw they responded in various ways. Some are teaching hospitals. Some are working with, I guess, poorer populations, so there was that response at least to the numbers today.

BARRY MEIER: Right.

There is some justification for variation, for the exact -- for the exact reasons that you said. And so you could see variations of, say, one to two times what the average payment might be. But, on average, what we were seeing nationally when we crunched the data was a four- to five-fold increase above the average.

And when we asked experts, like the official at Medicare that we interviewed, they have no clue as to why there's such a wide variation.

JEFFREY BROWN: Now, as we said, the government, Medicare, and insurers, they negotiate their own prices. So they're not actually paying the kinds of numbers that come out in this, right? I mean, to what degree is it a fiction? To what degree does it have real meaning for how much is actually paid?

BARRY MEIER: Well, I -- that's the real question.

I mean, Medicare supposedly pays about 91 cents of what it cost a hospital to deliver a service. Insurers pay about 30 percent more than Medicare. So they're paying dramatically lower than what the hospitals are sending in as bills. But the question then becomes, is the amount that they're paying being effectively inflated because the hospitals are saying, well, it really costs us this or we charge some people this?

And are those -- are those inflated bills showing up in the charges that are negotiated between Medicare or insurers and the hospitals?

JEFFREY BROWN: I see.

And what about for individuals, particularly uninsured individuals? How much would trickle down to them or would they have to pay?

BARRY MEIER: Well, they're -- you know, they're seeing the full freight. They're seeing what -- essentially the rack rate, you know, the highest price that the hospital will charge.

In some cases, they are being struck with those bills in court proceedings. These are sort of the extraordinarily high charges that may force people into bankruptcy. Other people simply don't pay the bill. And then the hospitals may write them down, write off those costs against their bottom line. So they're showing up perhaps as tax write-downs, and they're coming out of the public coffers in that way.

JEFFREY BROWN: Well, so, as you said at the outset here, this question that this plays into, of course, is the much larger issue of holding down costs. It's a very political issue.

Why are these numbers coming out now? How do they play into the current political debate? How will they be used or seen?

BARRY MEIER: Well, I think they play very strongly into the current political debate.

And that is, they open up the door to the fundamental question, which is what is the basis for the actual charge that -- or the actual bill that Medicare is paying or an insurer is paying? You know, how are hospitals and health care providers, be it drug companies, medical device companies, justifying the prices that they charge?

Don't forget, whatever the hospital is paying is basically an accumulation of what they're paying, say, for an artificial hip or a drug. And when you start digging down into those payments, you see that everywhere along the line, these prices are inflated. They don't make sense.

JEFFREY BROWN: All right, Barry Meier of The New York Times, thank you so much.

BARRY MEIER: My pleasure. Thank you.

JEFFREY BROWN: And there were some technical difficulties on that audio for the interview. We apologize for those.

And an online note: There's a $600,000 dollar discrepancy on what hospitals charge Medicare for the most expensive procedure. You can find out what that is and more on our Health page. 

After Emotional Benghazi Hearing, GOP Promises 'Investigation Is Not Over'

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Describing Benghazi Attack

Gregory Hicks, the former deputy chief of mission in Libya, testifies Wednesday before the House Oversight and Government Reform Committee. Photo by Jeffrey Malet.

The Morning Line

Last year's attacks on U.S. diplomatic facilities in Benghazi, Libya, have been the subject of presidential debates, a report from an independent review board and on Wednesday, compelling testimony at a hearing of the House Oversight and Government Reform Committee.

The hearing was fraught with emotion and political theater as Republicans leading the investigation sought to pin blame on President Barack Obama's administration and former Secretary of State Hillary Clinton.

Lawmakers grilled witnesses over what happened in the hours after the attacks that killed four Americans, including Ambassador J. Christopher Stevens. Former Deputy Chief of Mission Gregory Hicks choked back tears as he detailed his surprise at initial suggestions the events of Sept. 11, 2012, had any link to backlash against an anti-Islamic film.

House Republicans who have had five different committees examining the attacks charged in their own report that the Obama's administration "willfully perpetrated a deliberately misleading and incomplete narrative."

The panel's ranking Democrat, Rep. Elijiah Cummings of Maryland, complained about the nature of the queries. He called the hearing part of "a full-scale media campaign that is not designed to investigate what happened in a responsible and bipartisan way" but is instead intended "to smear public officials." Others suggested the new focus on Clinton was more about her possible 2016 presidential ambitions than on seeking answers.

Wednesday's hearing was just the latest in a lengthy battle on the issue between Republicans in Congress and Mr. Obama. The administration's response to the attacks cost Ambassador to the United Nations Susan Rice a potential promotion to replace Clinton after some Senate GOP lawmakers expressed concerns about her statements following the events.

Hicks has been dubbed a "whistle-blower." The New York Times summarizes his emotional testimony:

During a chaotic night at the American Embassy in Tripoli, hundreds of miles away, the diplomat, Gregory Hicks, got what he called "the saddest phone call I've ever had in my life" informing him that Ambassador J. Christopher Stevens was dead and that he was now the highest-ranking American in Libya. For his leadership that night when four Americans were killed, Mr. Hicks said in nearly six hours of testimony, he subsequently received calls from both Secretary of State Hillary Rodham Clinton and President Obama.

But within days, Mr. Hicks said, after raising questions about the account of what had happened in Benghazi offered in television interviews by Susan E. Rice, the United Nations ambassador, he felt a distinct chill from State Department superiors. "The sense I got was that I needed to stop the line of questioning," said Mr. Hicks, who has been a Foreign Service officer for 22 years.

He was soon given a scathing review of his management style, he said, and was later "effectively demoted" to desk officer at headquarters, in what he believes was retaliation for speaking up.

White House press secretary Jay Carney dismissed the hearing as "part of an effort to chase after what isn't the substance here."

Washington Post fact checker Glenn Kessler looked at the details emerging from the hearing and ticks off the facts coming from each side.

On Wednesday's NewsHour, Kwame Holman reported on the hearings. Watch here or below:

Watch Video

After six hours of testimony, committee chairman Darrell Issa, R-Calif., declared the hearing was closed. He added a note signaling more is to come: "But this investigation is not over."

LINE ITEMS

Bloomberg's Margaret Talev previews Mr. Obama's Thursday visit to Austin, which gives him a platform to promote initiatives talked about in his State of the Union address.

The Republican-led House on Wednesday passed a workplace fairness measure that allows for more time off, sending it to the Senate where it's unlikely to pass because of concerns from women's and labor groups. The White House also has threatened a veto.

Rep.-elect Mark Sanford admitted on Wednesday to trespassing on his ex-wife's property and agreed to pay $5,000 in Jenny Sanford's attorneys fees, Reuters reports. The former South Carolina GOP governor avoided punishment for contempt as part of a court agreement reached a day after winning Tuesday's special election. They had been scheduled to appear in court Thursday.

African-Americans voted at a higher rate than non-Hispanics in the 2012 election, according to a Census Bureau report released Wednesday. It marks the first time since the bureau began publishing statistics on voting by eligible citizens in 1996 that blacks cast ballots at a higher rate than whites. Nearly two-thirds of blacks, 66.2 percent, voted in 2012, up from 64.7 percent in 2008. Meanwhile, the rates for whites fell from 66.1 percent to 64.1 percent.

A new survey from the Pew Research Center shows the public's views of congressional leaders and illustrates that the nation remains deeply politically divided. On any issue, Republicans are very loyal to the GOP over the Democrats and have much more negative views of the other party over their own. Perceptions of Mr. Obama's effectiveness dropped from 57 percent in January to 49 percent in the survey.

Organizing for Action, the spinoff of Mr. Obama's re-election campaign, will have several citizens deliver to Congress on Thursday a petition signed by 1.4 million people supporting expanded background checks for gun purchases.

Senate Democrats made a video to highlight Republicans who once called for a budget conference but are now against one forming.

Reuters' Caren Bohan reports on a new analysis suggesting the Senate Gang of Eight immigration bill "would help ease financial strains on the Social Security retirement program." The overall effect would be "positive," Social Security Administration officials wrote in a letter to Sen. Marco Rubio, R-Fla.

Sunlight Foundation rounds up all the influencers with stakes in immigration reform legislation.

Wonder why the GOP is concerned about a diversity problem? One of the authors of the Heritage Foundation's study on the costs of immigration legislation argued in his 2009 PhD dissertation that "the average IQ of immigrants in the United States is substantially lower than that of the white native population." He proposes administering IQ tests to select immigrants, writing, "No one knows whether Hispanics will ever reach IQ parity with whites."

The NRA released a television ad Wednesday defending Sen. Kelly Ayotte, R-N.H., against attacks from Mayors Against Illegal Guns. They are spending $25,000.

It seems Virginians aren't all that aware of the FBI's investigation into GOP Gov. Bob McDonnell's ties to mega-donor Jonnie Williams. With an approval rate of 61 percent in a new NBC/Marist poll, the term-limited McDonnell also leads Democrat Terry McAuliffe in a hypothetical matchup, 51 to 36 percent.

Newly promoted political reporter Emily Cahn scoops for Roll Call that ex-Rep. Bob Dold, R-Ill. will try to win back his seat in 2014.

National Journal's Reid Wilson examines what went wrong inside conservative super PACs during the 2012 elections.

Yahoo maps how your economic views are shaped by how your region voted last fall.

New Jersey GOP Gov. Chris Christie released a seven-minute YouTube video taking aim at himself as he searches for the fleece he wore routinely during the aftermath of Superstorm Sandy.

The Associated Press reports that first lady Michelle Obama said on NBC's "Today" show that her campaign to improve young people's health "is about the government providing information, not 'telling people what to do.'"

Gawker finds the best (or worst) presidential photoshopping ever via South Korean media.

Time for Christina to invest in Levi's.

NEWSHOUR ROUNDUP

Paul Solman catches up with Treasury Secretary Jack Lew at a Vitamix manufacturing plant just outside Cleveland to ask him about longterm unemployment and why Wall Street reform has been so slow to take effect.

Science correspondent Miles O'Brien examines how forensic science is being used to solidify genocide charges against former Guatemalan President Efrain Rios Montt.

Joshua Barajas and Allie Morris are collecting local sequestration reports from our public media partners.

Here is our report on the drama unfolding in Cleveland, and don't miss the reports from our partners at IdeaStream.

How did Watergate affect you? Let us know ahead of our May 17 special looking back at the scandal that changed American politics and made the NewsHour what it is today.

Imani Cheers reports from Malawi, where a mobile health program using text messaging allows local health centers to keep tabs on the stock of medicine and supplies rural community health workers need.

PBS is now streaming on Roku.

TOP TWEETS

How many times has Michelle Nunn considered a #GASEN bid? Her friend bought key domains in 04, 08 and 12 cycles bit.ly/12XeOxy

— James Richardson (@JamesRichardson) May 9, 2013

I'm calling on the Supreme Leader of North Korea or as I call him "Kim", to do me a solid and cut Kenneth Bae loose.

— Dennis Rodman (@dennisrodman) May 7, 2013

Attended morning prayers and mass w Dominican Sisters of St Cecilia in Nashville. Gloria Dei. twitter.com/RickSantorum/s...

— Rick Santorum (@RickSantorum) May 9, 2013

Another amazing @chriswilsondc tool that should appeal to @amyewalter @thefix @glennthrush @jaketapper @jeffzelenyyhoo.it/ZPDIlM

— Olivier Knox (@OKnox) May 8, 2013

DCCC spent nearly $500K on Colbert Busch, NRCC spent nothing on Sanford. He won by nearly 10 points.

— Andrew Kaczynski (@BuzzFeedAndrew) May 8, 2013

DSCC poll assumes @jackkingston will come out on top of crowded GOP #GASEN field bit.ly/141AD1x

— James Richardson (@JamesRichardson) May 8, 2013

"Don't let this happen to you." @theonion details exactly how it got hacked: theonion.github.io/blog/2013/05/0...

— Liz Heron (@lheron) May 9, 2013

"Asimple case of pneumonia, with no complications, cost $124,051 in Philadelphia and $5,093 in Water Valley, Miss." washingtonpost.com/blogs/wonkblog...

— Ezra Klein (@ezraklein) May 8, 2013

Desk assistants Simone Pathe and Mallory Sofastaii contributed to this report.

For more political coverage, visit our politics page.

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Questions or comments? Email Christina Bellantoni at cbellantoni-at-newshour-dot-org.

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The Daily Frame

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Click to enlarge.

Two women dance at the AfrikaBurn Festival in Tankwa Karoo, South Africa. The week-long art festival takes place annually in a temporary desert dwelling called Tankwa Town. Photo by Liza van Deventer/Foto24/Gallo Images/Getty Images.

Seven Tips for the Reluctant Senior Entrepreneur

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By Judi Henderson-Townsend and Cynthia Mackey

Two "senior" entrepreneurs (women in their 50s) explain how to overcome the reluctance to start your own business when you're older. These days, entrepreneurship is simply self-reliance, they explain.

Watch Video

NewsHour economics correspondent Paul Solman reports on late bloomers who decided to take the plunge into self-employment. Read the full transcript.

A note from Paul Solman: Judi Henderson-Townsend is the 55-year-old mannequin entrepreneur who, with her social media consultant Cynthia Mackey, fascinated NewsHour viewers a few weeks ago by extolling the virtues of "senior entrepreneurship." Graciously responding to my request, she and Mackey then offered readers of this page "Ten Tips for Senior Entrepreneurs". A further excerpt from my original interview with Townsend soon followed and high tech entrepreneur Vivek Wadhwa joined the discussion by explaining "Why Older Entrepreneurs Are Crucial, Even in Silicon Valley".

In Thursday's Making Sense post, Judi Henderson-Townsend and Cynthia Mackey address a familiar figure in America's latest "jobless recovery": the reluctant senior entrepreneur. They were plenty reluctant themselves, they write.

Judi Henderson-Townsend and Cynthia Mackey: Senior entrepreneurship is a trending topic. Yet for every senior who sees entrepreneurship as an exciting opportunity, there is another senior who sees entrepreneurship as an intimidating option of last resort.

Age discrimination, job layoffs, dwindling 401(k) accounts and the potential erosion of Social Security benefits are a few of the reasons why seniors are turning to entrepreneurship in large numbers. In our previous blog post we listed 10 tips for senior entrepreneurs looking to start a business. But owning a business can be an anxiety-ridden experience, and the anxiety is magnified if you are an entrepreneur because you "have to" vs. "want to."

As two senior entrepreneurs who were once reluctant to take the plunge, we want to share some advice that made a difference to us. But first a little background on our entrepreneurial journeys.

Cynthia's story: I enjoyed my corporate experiences but always felt constrained by the bureaucracy. As a consequence, I was always pushing the envelope, often a little too far. My first entrepreneurship experience was working for a small military sub-contractor. I had no desire to start my own company, but wanted to be part of a team. I loved this new opportunity and being part of the decision-making process! Despite the growing number of contracts the company brought in, we were blind to financial decisions of the chief executive that ultimately caused its demise. Similar situations occurred at other small companies I later worked for. I realized that working for others wasn't working out for me. So I figured there was one other thing I hadn't tried -- going out on my own.

Judi's story: An early experience in entrepreneurship when I was in my mid-30s was a disaster for me. I was so emotionally crippled by the experience that I swore I would never do that again. I became an accidental entrepreneur while purchasing a mannequin from someone on craigslist.com. The buyer ran the only mannequin rental service in town and was closing shop. I impulsively bought his entire inventory thinking this would be a fun hobby to do while still working full-time. Granted I had never touched a mannequin before or worked in retail. What began as a sideline business has become my full-time venture for the last 11 years. At 55, I am not thinking about retirement, but how I can further expand my business.

1. Entrepreneurship -- Another Name for Self-Reliance In the days of an agriculturally based economy, if crops didn't grow, one had to find another way to feed the family. Perhaps services were bartered or a product was created and sold. You had to use your talents and resources to solve a need -- which is what an entrepreneur does. However, today's meaning of the word can conjure up images of having to meet payroll, lease a building and deal with human resource issues -- which may seem daunting. It can be less intimidating if you see yourself as fulfilling a need and if you perhaps call yourself a freelancer, consultant, solo-preneur or independent contractor.

2. Lean Into it If possible, don't leap into entrepreneurship, but start gradually. When Judi first started her mannequin business, she still had a full-time job. She eventually negotiated to work there part-time so that she could still have benefits and a steady source of income while investing in and building up her business. When 9/11 put an end to her day job, she already had the foundation laid for her entrepreneurial venture, making the transition much easier. Cynthia put a little money aside for several years, and eventually reduced her personal expenses over time. She also took on extra contractual work to fuel the business and shore up financial resources. There is no specific or right way to do it, but "leaning in" gives you a great way to build as you are able.

3. Create an Ad-hoc Advisory Team Before you launch your venture, conduct informational interviews with senior entrepreneurs to get advice and bolster your confidence. If you don't know anyone in your field, Job Shadow is a website that allows you to conduct online interviews with entrepreneurs from a variety of industries. Walking the path of an entrepreneur can be isolating at times. As much as they love you, family and friends don't fully know what it's like unless they have done it before. So identify a trusted colleague or two, perhaps even an advisory board that supports your vision but is objective enough to be candid with you.

4. It Takes More Than Passion While passion is important, identifying a business that is suited to your personality and skill sets is equally as important. For example, if you have a passion for cooking, that doesn't mean restaurant ownership is for you. Perhaps there are other related ventures that may be a better fit for your skills, personality and finances such as catering or becoming a personal chef, restaurant critic, or instructor. Taking seminars for entrepreneurs can assist you in determining what your strengths are. Organizations such as the Service Corps of Retired Executives (SCORE), Small Business Development Centers and nonprofit organizations focused on developing small businesses can provide consultants, courses and resources at little to no cost. Search the Internet for online courses and free white papers to help you become better informed in your field and the latest technologies that affect it.

RELATED CONTENT:Ten Tips for Senior Entrepreneurs

5. Monetize Your Expertise If you've developed expertise over the years in a certain discipline, entrepreneurship can be a chance to capitalize on your experience. Judi's 58-year-old bookkeeper worked for a number of years in the finance departments of large corporations. She now works as an independent contractor for several small businesses. The flexible schedule and variety of skills she gets to use fulfill her in a way that working as an employee did not.

6. Turn Your Hobby or Interest Into Your Livelihood Have you ever imagined your hobby providing your entire income? Entrepreneurship can be a chance to explore interests that you could only dabble in when you worked full-time. A friend of Cynthia's worked for many years in retail before starting a bed and breakfast. Stories of seniors who have turned a personal interest into a business, like the therapist who became a perfume maker, can be found on the Senior Entrepreneurship Works website.

7. Avoid Analysis Paralysis Sometimes we can't get started because we are still trying to figure everything out. I mean, everything! Perhaps it's the perfect manufacturing process for your product or the logo that's exactly right for your brand. Often the best way to learn is by doing something, and if a mistake is made, then readjust. A business plan is an organic process not cast in stone.

In Cynthia's case she has pivoted her business based on the needs of clients. She initially provided web design services for a wide variety of clients. But since her clients were uncomfortable using social media, she started offering education and training for baby boomers so they could use social media to grow their business.

Judi initially started out just renting mannequins. But as a result of requests from clients, she expanded her business to include mannequin sales, mannequin recycling, mannequin repairing and even renting her mannequin warehouse out for events.

In other words, sometimes you have to take the first steps and feedback from clients will direct you to the next step.

Judi Henderson-Townsend is the owner of Mannequin Madness, an award-winning small business that rents, sells and recycles mannequins.

Cynthia Mackey is a tech-savvy online marketer and founder of BabyBoomerBusinessOwner.com, a website offering courses on how small business owners can use social media to grow their business.

This entry is cross-posted on the Rundown- NewsHour's blog of news and insight. Follow @PaulSolman

Around the Nation

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Here are four arts and culture videos from public broadcasting partners around the nation.

The latest installment from "Blank on Blank," a PBS Digital Studios series: "Beastie Boys on Being Stupid":

KCET's "Artbound" profiles the "poetically political art" of Nery Gabriel Lemus:

"The works of Nery Gabriel Lemus illuminate the fractures incurred from cultural collisions. Informed by his childhood shuttling between a predominantly Latino urban neighborhood to suburban Granada Hills, in a bus full of Latinos and African Americans, Lemus's work gracefully exposes the subtle racial tensions between two cultures."

video platformvideo managementvideo solutionsvideo player

MN Original profiles photographer Xavier Tavera, whose "striking portraits tell the stories of Minnesota's Latino and minority communities."

"Chicago Tonight" visits an exhibit at The Art Institute of Chicago "that celebrates the special relationship between Pablo Picasso and the Windy City:

Changing Minds in Senegal to Protect Girls From Genital Cutting

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NewsHour special correspondent Fred de Sam Lazaro asks Molly Melching about her efforts to educate Senegalese women about the harms of genital cutting.

Molly Melching didn't think she had much more than curiosity -- and a love of the French language -- when she ventured off soon after college for Senegal.

It turns out that this product of a conservative Midwestern Lutheran upbringing may have brought exactly the qualities and experiences needed to help engineer one of the most sweeping shifts in social norms and behavior in history. Her organization, Tostan, has helped 6,400 (and counting) communities in Senegal and seven other African nations abandon the practice of female genital mutilation, one that about 3 million girls endure each year and one that governments, aid agencies and missionaries have tried to end for centuries.

Melching's story from Danville to Dakar is chronicled in a book to be released April 30: "However Long the Night: Molly Melching's Journey to Help Millions of African Women and Girls Triumph."

Arriving in 1974, Melching quickly shed the mini-skirt wardrobe she'd packed from her years at the University of Illinois, in favor of the long flowing boubous worn locally.

"Senegalese are very accepting," she says of people in that predominantly Islamic West African nation. "But they would never have opened up to me if I did not show respect."

Molly Melching shows a video to villagers of Netti Daga, Senegal. Photo by Fred de Sam Lazaro for the PBS NewsHour.

That respect came naturally in an almost-instant embrace of her adoptive country, where she has now lived for nearly four decades. Melching quickly learned Wolof, a language in far wider use in the region than the colonial French of the urban elite and one that opened the door to a far wider circle of friends. Living in a thatched hut in rural villages afforded a peek into the myriad problems women endured with their health and that of their children -- most of which they attributed to evil spirits and curses.

When you lack information, superstition fills the vacuum, Melching says. "It was no different than when witches were burned at the stake."

When she began what would become Tostan, which means "breakthrough" in Wolof, her goal was simply to provide basic health information, things like germ transmission and infection. She had no intention of broaching the sensitive and extremely taboo subject of genital cutting. That cause was championed by her Senegalese colleagues and friends, newly armed with health information and driven in at least one compelling case -- a "cutter" named Oureye -- by her own guilt. Oureye is one of several strong characters in the book, written by New York-based journalist and author Aimee Molloy and published in a partnership between the Skoll Foundation (an underwriter of the NewsHour) and the HarperOne division of HarperCollins.

Also publicly revealed for the first time in the book is Melching's own encounter with sexual violence while in college, an experience that fed strong empathy for the women she would get to know in Senegal. That empathy is a hallmark of Tostan's approach to female genital cutting, a non-judgmental term she prefers to "mutilation" used by the World Health Organization.

The message is "we know you love your daughters and would never want to harm them," she says.

People cannot be shamed into behavior modification, Melching insists. They need good scientific information to make their own decisions. It's a simple powerful lesson that applies to just about any development endeavor, one she hopes the book will help spread widely.

Watch for Fred de Sam Lazaro's report on efforts to end the practice of female genital cutting on Thursday's PBS NewsHour. And read about more Social Entrepreneurs.

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Eight Types of Nurses You Never Knew Existed

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There are 3.2 million registered nurses in the U.S., and that will not be nearly enough in coming years as the Affordable Care Act kicks in and baby boomers begin to need more care. According to the Bureau of Labor Statistics, the registered nursing workforce is expected to grow by 26 percent in the years ahead, with a full 1.2 million new nurses needed by 2020.

A new book called "The American Nurse" looks at the faces and stories behind those numbers, through portraits and essays of more than 75 men and women in several different caregiving capacities.

Photographer and filmmaker Carolyn Jones spent the last two years profiling changes in the health care system and the compassion of those on the front lines. She interviewed nurses who care for prisoners at Angola Prison in Louisiana to coal miners in Kentucky, wounded soldiers in California and hospice patients in Florida, among many others.

The diversity of the job surprised her. "I really thought a nurse was a nurse was a nurse. They take your blood pressure and your temperature," she said. "I didn't know there were so many different kinds of nurses and what all they do and how many different ways they touch our lives."

In the interview above, Hari Sreenivasan sits down with Jones and Rhonda Collins -- the registered nurse who created the project in her current role as vice president of health care company Fresenius Kabi USA -- to discuss the role of nurses in American society and how the profession is evolving along with the rest of U.S. health care.

Below, "The American Nurse Project" team has assembled a list of eight nurses in the book with career paths that may surprise you.

Eight Nurses You Never Knew Existed, From 'The American Nurse Project'

1. Roller Derby Nurse

If you've ever seen a roller derby it's pretty obvious that those fierce warriors on wheels would need some medical attention from time to time. For the Windy City Rollers of Chicago that care comes from "Mama Doc," aka Judy Ramsay, RN, PEDS-SPEC.

A quiet pediatric nurse by day, Mama Doc spends her evenings voluntarily treating the sprains, bumps and bruises that these fiery women receive both in and out of the rink. She consults them on their needs as athletes, but is also happy to discuss with them sensitive personal issues. Her own daughter is a competitor.

"I do get nervous watching [them] out there; my pulse starts racing. My daughter has broken her nose, her leg and her collarbone, but I don't ever want to inhibit her from feeling that she could do everything she wants in her life."

2. NASCAR Nurse

Ranking right up there with the MLB, NFL and NBA, NASCAR is currently one of the four most popular professional sports in America. But even sports fans need medical care, and the attendees of the Daytona 500 in Florida have someone looking out for them while they watch their favorite drivers compete.

Kathy Vance, RN, spends her time at the race doing an initial assessment of the racers and pit members after an accident, but more often than not, she's helping to stabilize and treat injured or sick fans. She lovingly refers to some of her patients as Daytona's "over-beveraged guests," but she treats patients with more serious health issues, as well.

"One woman came in and she was actively having a myocardial infarction. I told her that she was having a heart attack and had to check into the hospital. She refused, saying, 'I'm sorry. I'm not going to miss the 500 for this. I'll go and see my doctor when we're done.'"

3. Flight Nurse

Here's a nursing career path for adrenaline junkies. Nurses at LifeNet in the Heartland out of Omaha, Neb., spend their days soaring over the plain states, rescuing patients from emergencies in remote places that are impossible to reach via ground transport.

Matt Tederman, BSN, CFRN, says, "Kids are always the toughest flights. A few years back, we had this kid who was on a snowmobile in a rural field. He didn't see a barbed wire fence and ran right into it. He had a very severe laceration on his neck and was in pretty rough shape. We were able to secure his airway and the outcome was positive. It's flights like that that make you feel you can provide a life-changing service for the patient and their family."

4. Prison Hospice Nurse

The overwhelming majority of inmates at the maximum-security Louisiana State Penitentiary in Angola, La., are behind bars for life, which also means that's where they will die. What's unique about this place is that many of these prisoners will die in the company of compassionate hospice volunteers -- inmates themselves -- who are trained in hospice care by a corrections nurse.

Tonia Faust, CCNM, RN, is the hospice program coordinator there, and she and her inmate volunteers help to bring palliative care and emotional comfort to inmates in their last days of life.

"When I am working with a patient, my thoughts are in the present. I don't look at their rap sheets, and I don't know what the majority of my patients have done to be here. I don't want to know. I know they've done something bad, but my job is to take care of a human being as if he were a family member. I don't treat these patients any differently than I would a patient out on the street."

5. Drug-Endangered Children's Nurse

Anyone acquainted with television shows like "Breaking Bad" or "The Wire" might feel they have a working knowledge of the culture behind drug production, distribution and abuse. But no one is more keenly aware of the harsh realities of that world than nurse Peggy Arvin, BSN, RN.

Working as a consultant with the state of Kentucky's foster care system, Arvin has been on the forefront of helping identify the physical and psychological effects of drug abuse on the most unwitting victims of the trade: children. As meth production in Appalachia began to spike, there was a sudden influx of children coming into foster care with a whole litany of never-before-seen issues. Arvin took action: educating herself about the drug in order to create a protocol for EMS and child-welfare workers to use when they encountered children in a meth home.

"We have one child whose parents owed either meth or money to a relative who kidnapped the child and said, 'Every day you don't pay me, I am going to burn the child with a cigarette.' The two year old was brought into foster care, and we found twenty-two burn marks on the child." The hope is that with the right care, these neglected kids can be treated for their physical and emotional needs and placed in foster homes where they can have a chance at a new, more stable life.

6. Transgender Outreach and Education Nurse

Members of the LGBT community often face intimidating barriers when seeking adequate, compassionate health care. Health care professionals might not understand their specific needs or might be discriminatory against their lifestyle. Sometimes, in spite of their best intentions, something as simple as a question about gender can immediately alienate a patient.

That's where Nathan Levitt, RN, MA, BSN, comes in. From his office at the Callen Lorde Community Health Center in New York, Levitt works double duty: he counsels and performs outreach to members of the local community, but he also functions as an educator to health care professionals, instructing them on how to provide LGBT patients with affirmative and sensitive health care.

"I did not know I wanted to be a nurse early on. I did a lot of LGBT-advocacy work and started working with doctors and nurses in San Francisco. That pushed me further to be a nurse because I wanted to help remove the barriers to care that I had faced myself. It's best to ask, 'How do you identify your sexual orientation?' or 'How do you identify your gender?' or 'What pronoun would you like me to use for you?' What I love about nursing is developing trusting relationships with patients to help them feel more comfortable in an environment that may feel alienating and discriminatory. I just need more hours in the day and night to do the work I love."

7. Wound Nurse

"My nickname here is 'Pus Princess'. I don't talk about my work at cocktail parties because people think a wound nurse deals in gunshot wounds. I say, 'Not so much, more like chronic, non-healing things.' That usually ends the small talk."

Amanda Owen, BSN, RN, CWCN, is a wound specialist in the Johns Hopkins Hospital's inpatient ward, treating people with problems the rest of us would probably rather not know about. "I tell people I went to school to become this glamorous looker of disgusting things," Owens said. Some of her patients will never fully heal and must be continually managed, but some do have miraculous outcomes.

"I didn't choose wound nursing; it chose me. I was a nurse on a medical nursing floor where I saw all kind of patients. My first successful wound patient was in the hospital for six months. I was able to try every wound product and technique on her to see what worked and what didn't. Then we had another lady who had this horrible disease and who shouldn't have healed, but she did because she had specialized care. At the time, the department did not have anyone who specialized in wound care, so that became my specialty."

8. Global Health Policy Nurse

Some nurses aren't only RNs, they're also MDs and PhDs, as well, and their work can take place far outside of the realm of day-to-day patient care. Nurse Marilyn DeLuca, PhD, RN, MA, MPA works as both an educator and consultant on issues of public policy, both locally and globally.

Her career began on an ICU ward, but she soon felt she needed to have a better understanding of the policy issues driving health care reform on a larger scale, so she returned to school for a PhD in health policy.

"If we could start from scratch, we would build a very different health care system than the one we currently have. Many of our current problems -- high costs and fragmented care -- are the result of the unexpected consequences of policy decisions. In the coming years, nurses will likely play more dominant roles in health care delivery. They have the capacity and clinical skills to improve the continuity and quality of care. I would like to see a large-scale project to improve the continuity of care."

All photos and footage courtesy of The American Nurse Project. Video edited by Justin Scuiletti.

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