The NewsHour With Jim Lehrer : WETA : September 2, 2009 7:00pm-8:00pm EDT; The NewsHour With Jim Lehrer

Captioning sponsored by MacNEIL/LEHRER ODUCTIONS

>> Lehr: GOOD EVENING. I'M JIM LEHRER. ON THE NEWSHOUR THIS WEDNESD: THE LEADTORY IS THE CALIFORNIA WILDFIRES, WHE FIREFIGHTERS ARE MAKING GAINS ANDOME SIDENTS ARE RETURNING HOME; THEN CE THE OTHER NEWS OF THE DAY; AN UPDATE OTHE VIOLENCE D THE ELECTION FALLOUT IN AFGHANISTAN; THE LATEST ON THE RECORD FINES OF UG MAKER PFIZER FOR IMPROPERLY RKETING SOME MEDINES; A SECOND TAKE ON THE SUMM'S WILDFIRES ABOUT THE IMPACT OWARMER WEATHER IN WASHINGTONTATE; ANOTHER HEALTH NVERSATION-- TONIGHT AN OPPONENT OF E PUBLIC PLAN; AND A RETURN VIT TO AN EYE CLINIC BRINGING SIGHT TO MILLIONS O PEOPLE IN INDIA. MAJOR FUNDG FOR THE NEWSHOUR WITH JIM LEHRER IS PRODED BY:

>> WHATHE WORLD NEEDS NOW IS ENERGY. THENERGY TO GET THE ECONOMY HUMMG AGAIN. THE ENERGY TO TACKLE CLLENGES KE CLIMATE CHANGE. WHAT ITHAT ENERGCAME FROM AN ENERGY COMPANY? EVERYDAY, CHEVN INVESTS $62 MILLN IN PEOPLE, IN EAS-- SEEKING, TCHING, BUILDING. FUELING GROWTH AROUND THE WORL TO MOVE US A AHEAD. TH IS THE POWER OFUMAN ENERGY. CHEVRON. INTE E WILLIAM AND FLORA HEWLETT FOUNDATION, RKING TO SOLVE SOCIAL AND ENVIRONMEAL PROBLEMS AT ME AND AROUND THE WORLD. AND WITH THE ONGNG SUPPORT OF ESE INSTITUTIONS AND FOUNTIONS. AND... THIS PROAM WAS MADE POSSIBLE BY THE CORPORATION F PUBLIC BROADCASTG. AND BY CONTRIBUTNS TO YOUR PBS STATION OM VIEWERS LIKE YOU. THANK YOU.

>> Lehrer: THERE WAS GOONEWS DAY ABOUT THE SOUTHERN CAFORNIA FIRES. OFFIALS SAID SUBSTANTIAL PROGRESS W MADE AGAINST A GIANBLAZE OUTSIDE LOS ANGELES, AND INSTIGATORS ISSUED THEIR RST STATEMENT ON WHAT CAUSED THE FI. NEWSHOUR SPECIAL CORRESPONDE JEFFREY KAYE HAS O LEAD STORY PORT.

>> Reporter: COOLER TEMPERATES AND HUMIDITY RED THE DAY, LPING FIRE CREWS GAIN GROUND IN A BATTLE TH BEGAN EIGHT DAYS AGO. OFFICIALS RERTED MAKING HEADWAY AGAINST THE GIT STATION RE IN THE ANGELES NATIONAL FOREST, FROM ACTOIN THE NOH, DOWN TO ALTADENA IN THE SOUTHWEST. THE G BLAZE HAD SCORCHED MORE TH 140,000 ACRES, AN AREA ROHLY THE SIZE OF CHICAGO. BUT BY TS MORNING, MORE THAN 20% OFT WAS CONTAINED WITHIN FIRE LINES. STILL, OFFIALS WARNED THE FIGHT IS FAR FROM OVER.

>> THIS IS GOING TO BE NO ALL FEAT OVER THNEXT SEVERAL DAYS. THAT'S NOT GOING THAPPEN. I'M STILL CHARACRIZING THE FIRE. IF IT HAS A HUMAN ARACTERISTIC TODAY, IT WILL BE CRAN ONE MORE DAY. ANIN TERMS OF IF WE'RE OUT OF THE WOODS ON THIS T, THE ANSWER IS . THERE'S A LOOF OPEN FIRE OUT THERE AND THERE IS A L OF WORK TO BE DO. >>eporter: TIME LAPSE VIDEO OF THERE MIGHT BE A WARNG SIGN TRE'S A CORNER UP EAD.

>> Reporter: TIME LAPSE DEO OF BILLOWG SMOKE SHOWED JUST HOW CLOSE THE FLAMES WERE RNING AR DOWNTOWN LOS ANGELES, JUS 15 MILES AWA AT ONE POINT, AUTHORITS HAD WARNEDHOUSANDS OF HOMES WERE. ENDANGERED. BUT TODAY, LOS ANGELES MAYOR ANTONIO VILLARAIGO SAID THE CITY'SUCK HAD HELD. >>E'RE VERY, VERY FORTUNATE. HAD THIS BEEN THE FALLITH THE SANTA ANA WIS, THIS FIRE COULD HAVEEEN MUCH LARGER AND MUCH MORE SERIOUS IN TES OF LOSS OF LIFE AND PROPERTY. SO FIRSTND FOREMOST, WE HAVE

>> Reporter: NORTHEAST OF S ANGELES FIREFITERS SET BACKFIRES DEFEND COMMUNICATIONSOWERS AND ANTENNASTOP MOUNT WILSON. THAT PEAK IS ALSO HO TO A FAMED, CENTURY-OLDBSERVATORY. AND RTHER TO THE EAST, FLAMES BURNED IO THE SAN GABRIEL WILDERNESS AA TODAY. BUT EVACUAON ORDERS WERE LIFTED FOR SEVAL FOOTHILL COMMUNITS NEAR THE EDGE OF THE SAN BRIEL MOUNTAINS. ON CUL DE SAC IN SURBAN TUJUNGA, NANCY DERZAKARI, WHO HAD DEFIED THE EVACUATION ORDE, WELCOMED BACK ANN EPHERD.

>> WE STAYED HERE THWHOLE TIME. LAST NIGHT ICAME DOWN TO OUR HOUSE. THEY WERE RE ALL NIGHT.

>> Reporter: THE SPHERD FAMILY HAD FT RELUCTANTLY. FRK SHEPHERD AND DAUGHTER KIMMY FELT THEY HAD CHOICE.

>> WE WENT OUR OVERO OUR NIRB NANCYHOUSE AND LOED OUT HER BACK WINDOW AND THE FIRE WAS RHT THERE. THAT'S WHEN E POLICE STARD COMING UP HERE D SAYING, "EVERYDY OUT."

>> Repter: WHY DIDN'T U GO WHEN YOU WER FIRST TOLD TO GO? THIS IS MY HOME. THIS IS-- THIS IS-- THIS IS L WE HAVE. THE HOUSE AT THE END OF THE REET, IT'S CALLED THE A.T. HOUSE BECAUSE THAT'S WRE THE FILM WAS MADE. AND THE FI WAS GOING T KE IT, AND THEY G BACK THERE AND THEY FOUGHT AND THEYOUGHT, AND THEY STOPPED IT.

>> Reporter: OUTSIDE THE SHEPHERD HOM FIREFIGHTERS WITH THE U.S, FOREST SEICE PLANNED OPERATIONS TO MAKE SURTHAT BRUSH SURROUNDINTHE NEIGORHOOD DID NOT FLARE UP AIN. THE ORATIONS WERE SUCCESSFUL. WE KEPT IT OUT OF THE STRUCTES. EVERYTNG AT THIS POINT-- IT'S NOT GOING TO OW ANY MORE UNLESIT ROLLS OUT.

>> Reporter: ENGINEER JERR OLSON WAPART OF TEAM THAT COMBED THROUGH THEEARBY MOUJNMTAOUS TERRAIHOSING DOWN HOTSTS.

>> THIS IS CONINED AND OUR JOB IS TO KEEP ANYING HOT FROM HITTING THE ROAD AND LOW THE ROAD STARTING A FIRE. WE HAVE SEVAL PERSONNEL THROHOUT THE DIVISION HERE. AND OUR JOB TODAY IS JUST KEEP IT OUT OF THESE STRUCTURES.

>> Reporter: THE FIRE DESTROYED MORE THAN FE DOZEHOMES. TWO FIREFITERS ASSIGNED TO THE BLAZE LOST THEIR LIVES. THE U.S. PARKS SVICE SAID TODAY AN INVESTIGATION HAS DERMINED THEIRE WAS USED BY HADS, BUT IT'S TOO EAY TO SAY IF IT S STARTED BY ACCIDENT OR ARSON. >>ehrer: IN OTHER NEWS TODAY, TWO NEW GOVERNMENTEPORTS SHOWED WORKER PRODUCTIVI ROSE SHARPLDURING THE SPRING BY THE MOST IN SIX YEAR BUT FACTORY ORDERS ROSE SS THAN EXPTED IN JULY. ON WALL STREETTHE ECONOMIC NEWS UNDERNED ATTEMPTS AT A RALLY. THE DOW JONES INDUSTAL AVERAGE LOST NEAY 30 POINTS TO CLOSE AT 9280. THE NASDAQ FELL MOREHAN ONE POINT TO CLOSE AT 67. THE SECURITIES AND EXCHAE COMMISSIONEPEATEDLY BUNGLED ITS INVESTIGATIONS OF BERNAR DOFF. E AGENCY'S INSPECTOR GENERAL ISSUED TT FINDING TODAY. THERE WERE SIX SUBSTTIVE COMPLAINTS AUT MADOFF'S INVESTMENTPERATION FROM 1992 THROUG2008. BUT THE REVIEWOUND THE AGENCY NEVER DID A PROPER EXAMITION. MADOFF IS CURRENY SERVING 150 YEARS IN FEDERAL PSON FOR RUNNING A GIANT PONZI SCME. A PACIFIC EAN HURRICANE MOVED UP MEXICS BAJA CALIFORNIA COAST TODAY, A IT LOST SOME OF ITS POWER ONG THE WAY. MANY STREE ON PARTS OF THE PENINSA WERE FLOODED, BUT LOS CABOS, THE LARGEST RESORTOWN IN THEREA, APPEARED TO ESCAPE MAJOR DAMAGE. THE HURRICANIS EXPECTED TO WEAKEN OR THE NEXT TWO DAYS AS IT TRAVE FARTHER NORTH. AND STILL TOOME ON THE NEWSHOUR TONHT: THE FINES FOR DRUGMAR PFIZER; THE FIRES IN WASHINGTON STATETHE PUBLIC PLAN OPTION; AND TATING BLINESS. THAT FOLLOWS OUR AHANISTAN REPORT. GWEN IFILL TALD WITH DEXTER FILKINS OF THE "NEW RK TIMES" IN KABUL EARLIER TODAY.

>> Ifill: DEER, THANK YOU FOJOINING US. WHAT C YOU TELL US ABOUT THE SUICIDE BOING IN EASTERN AFGHANTAN THAT WE'VE BE READING ABOUT? Reporter: WELL, THERE WA A BOMBING TODAY, A SUICIDE BOMBING, KILLED I THINK 23 PEOPLE, ONE OF THEM ABDULLAH GMANI, THE DEPUTY CHI OF INTELLIGEN HERE. HE'S KNOWN TO BE A VERY CAPABLE GUY. THE IELLIGENCE SERVICE HERE IS VERY CPABLE. HE WAS SORT OF IN CHARGE OF-- HE WAS THE LIAISON WI ALL THE SERVICES IN TE VARIOUS PROVINCES. TH TALIBAN HAVE BEENTRYING TO KILL HIM FOR A LONG TIME. THEY BGD ABOUT ITODAY AFTER HE WAS KILLEG HE'S FROM-- HIS LAST NAME IS LAMMANIROM LAGMONT PROVINCE. HE WAS MEETING SME PEOPLE AT A MOSQU AND ASE WALKED OUT A SUICIDE BOMBER CE OUT NOWHERE AND PULLED THE PIN, BIG BOMB,IG BOMB, AND KILLED HIM AND 22 OTHER PEOPLE. THE TALAN PUT OUT A KUHN KAY ORTLY AFTEARDS SAYING WE DIDT. >>fill: WHAT WAS THE RGETING OF SUCH A SENIOR INTEIGENCE OFFICIAL TELL US ABOUT SECURITY THERE?

>> WELL, CABLE IS PRET SAFE. I'M IN KAB HERE. I JUST HEARD A COUPLE OF MORTAR EXPLOSIONS BEFOR- JUST A FEW MINUTES AGO BEFORE THE BROADCAST STARTED, BUT IT PRETTY SAFE HERE. HE'S OUTN THE COUNTRYSIDE, AND REALLY,WHENEVER YOU LEAVE THE CAPITAL,T'S NOT VERY SAYS. I ME, LAGMONTS SAFER THAN OTHER PLACES. BUT, YOU KNOW,HE TALIBAN HAVE BEEN HUNTIN THIS GUY FOR A LO TIME AND THEY WANTEDIM DEAD AND, YOU KNOWALL IT TOOK WAS JUST A BRIEF OPENING, AND IF YOU'RE WILLG TO BLOW YOURSELF UP, IT'S KINOF HARD TO PTECT AGAINST THAT SORT OF THIN I DOT THINK IT TELLS YOU MUCH EEPT THE TALIB ARE PRETTY RUTHLESS AND DETERMED.

>> Ifill: THE'S BEEN MUCH SCUSSION ON THIS SIDE OF THE ATLANTIC ABOUT GENERAL CHRYSTAL'S REPORT WHICH IS LAYING GROUNDWOR FOR NDING MORE TROOPS TO AFGHISTAN. HOW IS TT BEING RECEIVED, IFT ALL, ON THE GROUND? YOU'VE BEE SPENDING SOME TIME WITH E TROOPS.

>> Reporter: I'LL JUST COME FROM HELMUND PROVINCE, WHICH IS WHERE THE 10,000ARINES JUST WENT. BOY, IS VERY, VERY HARD THERE. YOU KNOW, I WAS EMBEDDED WITH SECON BATTALION THE EIGHTH REGIME. WE WERE JUST SOUTH OF CITY CAED GNZAR. THEYE FITING EVERY DAY. IT'S 125 DEGREES IN THE SHADE. I THINK THAT BATTALION HAS ONLY BEEN THER FOR SEVEN WEEKS W, AND I-- THEY'V LOST ABOU 15 GUYSI THINK. IT'S VERY, VERY HARD. AND I THINK IF YOU-- IF I JUST TAKE THE GUYS THAI WAS WITH,U, THERE ARE PROBABLY 250 GU. WAS BIGOMPANY OF RINES. AND THEY ARETRYING TO SECU AN AREA THAT BASICALLY GOES FOR ABOUT THREE KILOMETERS IN EACH DIRECTION, ANDHAT'S IT. I MEAN, THAT'S 250 GS AND THRECLICKS EITHER WAY. AT'S NOT VERYANY. AND ITUST SHOWS YOU KIND OF WHAT THEYE UP AGAIT.

>> Ifi: LET'S TALK ABOUT TH ELECTIONOUNT WHICH IS UNDER WAY AND HAS BEENNDER WAY FOROME TIME. ERE ARE PRETTY WIDESPRD COMPLAINTS ABOUT FRAUD. WH ARE YOU HEARING?

>> Reporter: WELL, I DID A STORY-- I DID A STORY FOR MY NEWSPAPER THIS MNING, AND I SAT WITH SOME PEOPLE YESTERDAY, AND I HAVE SAY, IT'S ABOUT THE MOST BRAZEN ACT OF CORRUPTION I'VE EV HAD FALL IN MY LAP IT'S THE SORT OF THING REPORTS DREAM ABOUT. HERE WAS DISTRICTGOVERNOR OF A PLE IN THE SOUTH, POINTED BY PRESIDENT KARZAI. ANHE LAID OUT,HE AND HIS RT OF FORMER-- HIS FELLOW TRIBAL ELDERS, HE JU LAID OUTIN GREAT DETAIL HOW RZAI'S PEOPLE CAME IN, DIDN'T LET ANYONE VOTE, SEQUESRED ALL THE BALLOTS, STNGARMED EVERYONE AND BASICALL FORG23,900, ALL FOR PRESIDENT KZAI AND SENTHEM TO KABUL. TH'S ONE CASE IN ONE DISTRICT HER AND CAN TELL YOU, I HAVE HEARD OF DOZENSF CASES LIKE TT. I REALLYON'T HAVE TIMETO LOOKT THEM ALL. I AN, I THINK-- THE DANGER HERE IS THAT YOU'RE GOING HAVE A GOVERNMENT THAT COM TO POWER HERE, WHETH IT'S MR. KARZAI,R SOMEBODY ELSE DER A VERY DARK CLOUD. AND FOR THE NEXT FIVEEARS, THEY'RE NOT ING TO BE CONSIDERED LEGITIMATE BY THE GHAN PEOPLE. AND THINK THAT'S THE RISK HERE. UNLESS SOME OF THESERAUD ALLEGATIONS GETLEARED UP. I WENTOVER TODAY TO THE-- THERE'S A COMMISSION HERE TH'S INVESTIGATING SOME OF THESE COMPLAINTS. IT'S GOT, I THINK, THREE TO FIVE MEMBERS AAPPOINTED BY THE UNITEDATIONS. AND THEY RECEIVED I THINK 2,700 COMPLAINTS, MORE THAN 600 OF THEM, TH SAY, ARE SUBSTANTIAL ENOU THAT THEY COULD AFFECT THE OUTCO OF E ELECTION. YOU OW, THAT'S JUST AN ID OF KIND OF THE SCALE LEAST OF THE ALLEGED FRA, AND I THINK JUST FROM OWN LOOKING OUND HERE, SOME OF IT SEEMS PETTY REAL.

>> Ifill: WHAT HAS PRESIDENT KARZAI RESPONSE BEEN TO THESE ALLEGATIONS? WELL, HE'S DENIED EVERYTHI, AS YOU WOULD EXCT. AND,OU KNOW, HE'S KINDF HUNKEREDOWN IN THE PALACE AND NOT REALLY SAYING MUCH OF ANYING. THINK WHAT WAS INTESTING INHE CASE THAT I LOOKED AT YESTERY AND WROTE ABOUT THIS MORNING WAS IT ALL HAPPED IN KANDAHAR PROVINCE. KANDAHAR PROVIE IS WHERE KARZAI'SROM. HIS YOUNGER BROTHER, AHMED WAHLEES KNOWN AS THE KING OF THE SOUTH. THERE ARE MANY, MY ALLEGATIONS OFCORRUPTION COMING OUT OF KANDAHAR PROVINCE, THOUSANDS D THZ-- INVOLVING THOUSANDS, TENS OF THOUSANDS OF BALLO, AND I THINK-- SO, YOU KNOW, THE MOST OF THOF THESE ALLEGATION AT LEAST MOST OF THE ALLEGATNS I'VE HEARD ABOUT, HAVE BEEN DIRECTED AT KARZAI. AND BEUSE HE-- YOU KNOW, HE'S THERESIDENT. HE HAS THE APPARATUS OF THE STATE TO USE AT HIS DIOSAL. HE HAS THE POLICE, AND SO THERE YOU HA IT. I MEAN, I THK-- THE DANGER HERE-- ACTUALLY, I THINK THE LIKELIHOOD HERE IS TT THIS GOING TO TAKE MANY, MANY WEEKS TO SOR OUT. THERE E 650 REALLY SUBSTANTIAL COMPLAINTS O CORRUPTION TT HAVE TO BE VESTIGATED BEFORE THEY'RE GOING TO DECLAR WINNER. SO, I MEAN,, YOU KNOW, THAT COULD KE A LG TIME. 'S HARD TO GET TO SME OF THESE VILLES WHERE SOME OF THESE THINGS HAVEBEEN ALGED. I MEAN, IF YOU TAKE CHURBAK WHERE I TALKED TO THE PELE, THEY'RE IN THE MDLE OF NOWHERE. IT'S THE FOURTH CENTURY HERE.

>> Ifill: IS THERE A NNECTION TO BE DRWN BETWEEN TROUBD POLITAL TUATION AND THE TROUBLED MITARY SITUATION ON THE GROUNDOW?

>> Reporte I DON'T THINK IT'S A DIREC CONNECTION BUT OF COURSE E TWO ARE CONNECTE THE POLITICS YOU KNOW, THE CONTUATION OF POLITICS BY OTHER MEANS. I THINK TH- THERE A A LOT OF UNHAPPY PEOPLE IN THIS COUNTRY AND SOME OF THEM AREILLING TO TAKE UP ARMS AGAINST THESTATE. AND I THK HOLDG AN ELECTI IS A KIND OF-- IT'S A BIGTTEMPT TO BRG SOME OF THESE PEOPLE INTO THE TES. AND TO THE EXTENT THATHAT ELECTION IS MARKED B FRAUD, THAT TENT START TO LOOK ETTY SHABBY.

>> Ifi: DEXTER FILNS, FR THE "NEW YORK TIMES", ASLWAYS, THANK YOU FOR YOUR GREAT REPORT.

>> Reporter: THANK YOU VERY MUCH. APPRECIATE IT.

>> Lrer: NOW, THE PFIZER STORY. THE WORLD'S LARGEST UG MAKER REED TO PAY A RECORD $2.3 BILLION IN CIVILND CRIMINAL PENALTIES. AFTER A FOUR-YEAR INVESTIGION, THE GORNMENT SAID PFIZER ILLEGALLY PROMOTEDOUR PRESCRIPTION DRU, INCLUDING THE PAINILLER BEXTRA. ASSISTANT ATTORNEY GENERAL TY ST SPOKE AT A PRESS CONFEREN THIS MORNING.

>> WHEN A DRUG I APOVED FOR AN INTENDED USE, IT MAY NOT BE MARKETED OR PROMOTED FOSO-CALLED OF-LABEL USES. THAT IS, A USE THAT IS NOT SPECIFIEIN THE APPLICATION APPROVED BY THE F.A. NOW, IN THIS CASE, PFIZER ASKED THE F.D.A. IF IT COULD PROTE THE SALE OFECK TRA, AN ANTI-INFLAMMATY DR, FOR CERTA OTHER US D IN DOSES HIGHER THAN THE APPROVED MAXUM. THE F.D.A., TING SAFETY CONCERNS, SA NO. BUT PFIER MARKED BEXTRA FOR THOSENAPPROVED USES ANYWAY WHENFF-LABEL MARKETING LIKE THIS OCCURS, PATIENTS' HEALTHND LIVES ARE PUT AT RISK, D THOSE WHO CAUSE THAT RISK MUSBE HELD ACUNTABLE.

>> Lehrer: RAY SUAREZ TAS IT FROM THERE. >>uarez: HERE TO TELL US MORE ABOUT THE CASE ANDHE RECORD FINE PZER AGREED TO IS SCOTT HENSLEY, T HEALTH CORRESNDENT FOR NATIONAL PUBLIC RADIO'S HEALTH OG. SCOTT, LET'S START WITH SOME MORE DETAILS. WHAT THE GOVERNMENT SAID PFIZERID AND WHAT THE COMPANY TIMATELY PLED GUILTO.

>> SURE. PFIZER, AS THE INTRO SAI, WAS TAKING DRS APPROVED BY THE F.D.A.OR ONE THING AND TRYING TO INDUCE DOCKETS, ACCORDING TO THE GOVNMENT, TO USEHEM FOR OTHER THINGS. A PHYSICIAN IS FR TO PRESCRIBE A MICINE FOR ANY US THAT HE OR SHE SEES FIT, AND THE PROBLEM S THAT IZER WAS TRYING TO GET DOCTORS TO DO THIS I A SYSTATIC WAY.

>> Suarez: FOR INANCE, LET'S TAKE BEX TRACK, THE NOW-WITHDRAWN PAIN DRUG. IF YOUAW COMMERCIALS ON TELEVISION-- MANY DRUGSARE WIDELY ADVERTISED TV NOW-- COMPANIES WOULDN'T SUGGEST OFFLABELSES ON TV OR RADIO OR PRNT AD. HOW D THEY GO OUT MARKETING IT FOR OFFLABEL USE?

>> FOR BECK TRA, FOR INSTANCE, I MYSELF WAS AT SOMEMEDICAL MEETINGS WHERE BEXTRA WAS BEING SHOWN ASN ALTERNATIVTO THE-- PFIZER'S HER PAIN-KILLING DR CELEBREX AND IT W IMPLD AS BEING STRONR THAN CELEBREX ANDVAILABLE FOR USE IN TREATING ACUTE PAIN, BUT THAT WSN'T THE CASE, ACCORDING TOHE EVIDENCE, AND IN FACT, THE F.D.A. HAD NOT AROVED IT FOR REGUR, OLD PAIN TREATMENT. IT WFOR OEOARTHRITIS RHEUMATOID ARTHRITIS, D MENSTRUAL PAIN. ONE OF THETHER ARS WHERE PFIZER ALLEGEDLY W GETTING INTO TROUBLE WAS PROMOTING THE DRUG FOR USE IN TREATING PAIN AFT SURGERY,ND IN FACT, THERE WERE CLINICA UDIES THAT SHOWED THERE WERE RISKS, CARDIOVASCULAR RISKS, HEART RISKS FOR PATIENTS GETTING BEXTRA AFR SURGERY, AND THAT'S WHY THE F.A. DIDN'T APPRE IT FOR THAT USE.

>> Suarez: SO HERE THE COMPANIS BEING ASKEDTO PAY A MITARY BILLIODOLLAR FINE. ARE DOCTORS ARE IN JEOPARDY FOR PRESCRIBING T OFFLABEL USES? >>HE QUESTION CAME UP TODAY ATHE NEWS CONFENCE WHETHETHE GOVERNMENT HAD LOOKED AT THE DOCTORS AND WAS GOING TO DO SOTHING ABOUT THEM AND THEY REAL SAIDHE FOCUS WAS ON THE COMPANY AND ITS BEHAVI. SOMEF THE THINGS THAT DID COME OUT ABOUT THE DOCTORS PFIZER ENLISTED PHYSICIA TO HELP SELL TO OTHER PHYSICIANS. THEY PAID SOME DOCTORS TO BE CONSULTANTS FOR THCOMPANY AND COME TO MEETINGS AND TALKTRATEGIES ON HOW THE COANY COULD GET OTHER DOCTORS TO U THE DRUGS FOR THESE THINGS THE F.D.A. H T PROVED. >>uarez: BUT DON'T DOCTORS GIVE PEOPLE DRUGS FOR FLABEL USES ALL THE TIME?

>> SE, IT'S COMMON. CANC DRUGS, FORNSTANCE, ARE OFTENPPROVED ON DATA FOR A PARTICULAR INDICATION, AND THESTUDIES ARE DONE D PATIENTS AREIN DIRE STRAITS, AND PHYSICIANS SAY THIS COULD HELP YOU, AND IT'S WORTH A TRY. WHAT IS DIFFERENT SHEER CONCERTED EFFORT BY A COMPY TO GET PHYSICIANS TO DO IT RATH THAN DOCTS COMING TO THOSECONCLUSIONS ON THEIR OWN.

>> Suarez: HOW IS $2.3 BILLIO ARRIVED AT AS AN AMOUNT F A FINE ANDHERE DOES T MONEY GO?

>> IT'S A GRE QUESTION, BOTH PARTS. I THK PART OF THE REASON THAT THE FINE W SO BIG WAS DESCRIBED IN THE NEWS CONFERENCE TODAY. THIS IS THE FOURTH AGREEMENT BETWEEN PFIZER ANDHE FEDERAL GOVERNNT TO DO A BETTER JOB ON MARKING AND TO COMP WITH WITH T LAW WHEN IT DOMZ ALTH FRAUD PROVISIONS. AN SO I THK THEY WERE SAYING, LOOK, Y'VE HAD YOUR CNCES. THIS WAS BIG ONE. WE WANTO MAKE SE THAT PEOPLE RLLY TAKE NOTICE THAT PFIR AND THROUGHOUT E INDUSTRY THAT WE MEAN BUSINESS.

>> Suaz: SO THEY WERE ALREADY IN TROUBLE FOR DOG SOMETHING SIMILAR EAIER?

>> YES, THERE WERE VARIOUS AGREENTS, THE NEXT BIGGEST ONE A FEW YEARS BA INVOLVED A EILEPSYND PAIN DRUG CALLED NEURONTIN, FOR OFFLABELUSES, MY OF THE SIMILAR KIND OF PRACTICES AND THE TING U.S. ATTORNEY WASNVOLVED IN THAT CE AND MENTIONED TODAY THATE WASERY FRUSTRED TO LEARN THAT TER THE COMPANY-- WHILE THE COMPANY HA BEEN NETIATING WITH HIM ON HOW TO DO A BETTEROB RELATED TO THAT SE, TSE THINGS WERE HAPPENG IN ANOTHER PART OF THEOMPANY. Suarez: AND THEFINE, WHERE DOES THE MONEYO?

>> THE FINE LL GO TO WHISTLEBLOWERS, ABOUT100 MILLION IS GOING T GO TO A HA DOZEN OR SO PEOPLE WHO TO THE GOVERNMENT, "HEY, KNOW ABOUT THIS STUFF, PRESENT EMOYEES," AND THEY BROUGHT RWARD EVIDENCE THAT WASEALLY CRUCIAL TO THE GOVNMENT'S VESTIGATION AND THAT REALLY GOT THINGS ROLLIN SOME OF IT WI GO BACKO MEDICARE A MEDICAID, WHICH ARE THE MIN FEDERAL PRRAMS THAT WERE FINCIALLY HURT BY THIS MISREPRESEATION, MONEY SPENT ON THINGST SHOULDN'T HAVE BEEN SPENT ON. AND SOME, I BEEVE, GOES TO THE EASURY.

>> Suare AND THIS IS A RNING TO OTHER DRUG COMPIES, TOO, THE SIZE OF THFINE?

>> ABSOLUTELY. I THINK IT'S THE BIGGES BY A LONG SHOT. THE NEXT CLOSESTAS AN AGREEMEN TAT Y LILY GAGED IN FOR $1.4 BLION, SILAR KINDS OF ALLEGATIONS AROUND THE MARKETIN OF A DRUG CALD ZYPREYIA DRUG THAT ALSO HADIDE EFFE ISSUES.

>> Suarez: IN PFIZER'S PLEA, IN ANYTHING THAT COM FROM THE GOVERNMENT, HAS THERE BEEN ANY INDICATION TAT ANYBY WAS HURT, MADILITY, INJURED IN ANY WAY BY OFFLABEL USE OF THE DRUGS?

>> IT'S A OD QUESTION. AGAIN, IT CAME UP TODAY AND THE GOVERNMENTAID THE FOCUS HAD NOT BEEN ON LOOKING FOR THE INDIVIDAL PATIENT HARMS BUT INSTEAD LOOKING AT THE PACTICES AND MARKETING APPROACH THE COMPANY, AND DOING SOMETHING ABOUT THAT. THERE WERE CERTAIN RIS. THE BEXTRA MECINE, THE FOCUS OF TS ACTION, WAS WITHAWN FROM THE MARKET FOUR YEARS AGOECAUSE THE F.D.A. CCLUDED THA THE RISK PROFILE, EVE FOR THE APPROVED USES, NOT EVEN INCLUDING E ONES WE'RE TALKING ABOUT HERE, WERE NOT OUTWEIGHEDY THE RISKS OF SOMEERY SERIOUS SKIN REACTIONS AND SO THE CARDIOVAULAR PROFILE.

>> Suarez:COTT HENSLEY FROM NPR, THANKS A LOT.

>> MY PLEARE.

>> Lehrer: NOW, A SECOND STO ABOUT LDFIRES IN THE WEST. IT'S ABOUT LKS TO WARMING TRENDS. E REPORTER IS HEIDI CULLEN, CLIMATOLOGIST D CORRESPONDENT FOR CLIMATE CERAL, A NON- RTISAN RESEARCH GROUP OF JOURLISTS AND SCIENTISTS.

>> Reporter: THIS ENRE FORESTAST OF THE CASCAD MOUNTAINS HAS BEENUT AT RI BY TIN PINE NEEDLES EATINGHEIR WAY INTO THE TISSUE OF TREES.

>> FIND IT AMAZING THAT SUCH A SMALL, NONDESCRI LITTLE BEEE CAN REEK SUCH HAVOCN FOREST SYSTEMS.

>> SUSAN PRITCHARD STUDIES BEETLES AT T UNIVERSITY THE OF WASHINGTO

>> IT'S ONOF THESE YELLOW SA CONCENTRATIONS, IS A SITE WHERE THEPINE NEEDLE S BORE INTO THE BARK AND THEN IT WILLAY EG AND ITSUR VIE WILL FEEON THE LIVING TISSUE OF T TREE. HERE, CH ONE OF THESE CENTERS IS AN EXAMPLE OF THE TREE TRYING TO KIC OUT THE BEETLE. THACTUAL SAP OF THE TREE HAS RESI THAT ARE TOXIC TO THE BEETLES, AND THEN, ALSO THEY PHYSICALL PUSH THE BEETLE OUT OTHE TREE.

>> Reporter: THIS TREE IS LITERALL FIGHTING.

>> FIGING FOR ITS LFE.

>> Rorter:EETLES THRIVE IN WRM WEATHER, MILDER WINTERS, EARLIER SPRIS, AND LONGER SUMMERS MEAN MORE BEETLES. SO THERE IS A CLITE LINK, FORSURE. WHAT WE'REOTICING IN WASHINGT STATE, EVEN TODAY, IN THE LAST YEARS, WITH WARMER CLIMATE, WARMER DOCUMENTED CLIMATE, THERE HAS BEEN AN INEASED INCIDENT OF MOUNTAIN PINE BEETLES.

>> Reporter: SCIENTISTS SAY IF THE BEETLES KILL ENOUG TREES, EVENTUALLY MORE AN RE OF THE FOREST VULNERABLE TO WILIRES.

>> IN THE LATE 1990s BE A PREDTABLE EVENT OCCURRED. MOUNTAIN PINE BEETLE STARTED TO HAVE A RGE OUTBREAK, AN AFTER THE OUTBREAK OCCURRED OR ABOUT 10 YEARS, THERE WERE ACCULATIONS OF BOTH DEADPRUCE FROM SPRUCE BEETLE AND DEAD PINE FROM MOUNTA PINE BEETLE THAT WERE SUSCEPTIBLE TO BIG FI EVENTS.

>> Reporter: SHE BELIEVES I SETHE STAGE FOR WHAT HAENED THREE YEARS AGO THE SO-CALLED IPOD FIRE. IN 2006, THE TRIP COMPLEX FIREGNITED BY ALIGHTNING STRIKE BURNED SOME 180,000 RES COSNG WASHINGTON STATE TENS OF MILLIO OF DOLLARS. LOCARESIDENTS ARE BRACING THEMSELVES FOR MORFIRES LIKEHIS ONE.

>> TH'RE SO SCARY BECAU EY'RE APT TO REPEATGAIN. WE HADSH FALLING FROM THE SKY. WALKING THROUGH TOWN VISILITY WAS PROBABLY 20-25 FEET.

>> Reporter: SHE OWNED A MOUNTAINSPORTS STORE THE TOWN OF WINTHROP. R WORRYS-- MOR WILDFIRES WILL DRIVE AWAY THE BIKERS, BACKPACKERS, AND SKIERS.

>> IT RTAINLY HAS A HUG PACT. I THINK THE BIGGEST NCERN FOR US IS THE CATASTROPHIC RES. MEANINWHEN THEY START THEY'RE GOING TO GO ALL SUER LONG, VER LARGE AREAS, AND THE FIRE I SO HOT THE TRAS MAY NOT OPEN FOR A COUPLE OF YEARS AND IT LIMITS OURECREATION AND IT'S UAFE.

>> WHEN I SEE A FIRE LIKE THAT IT'S A VERY PAINF EXPERIENCE AND YOU WANT TO PUT IT OUT.

>> Reporter: HE MONITORS ALL OF WASHINGTON STATE. HIS CONCN THE LONG-TERM CONSUENCES OF FIRES.

>> IT'S A GE HEALT IMPACT ON THE RESIDENTS ALL ARND. AND IT'S SCARRING THAT LANDSCAPE FOR RLLY A CENTURY ON THE EAST SIDEF THE MOUNTAINS WHERE PRECIPATION IS VERY LOW AND RECOVERY IS VERYAINFUL, VERY DESTRUCTIVE.

>> Reporter: FIRE ERUPT DURING DRY, HOT MONTHS. MORE AND MORE COMMON WEAER PATTERNS FOR WASHINGTON STATE. AVERAG SPRING TPERATURES HAVE RISEN THREE DEGREES SINCE 1950. THE ACTUAL VIABILITY MAKES SOME YEA COOLER OR HOTTER, BUT RECORDS SHOW AN ORALL WARMING TREND. FOLLOWING A COOLPRING, THIS JULY'S WAS AMONG T HOTTEST, AND UNUSU LOW RAINFA LEFT MUCH OF THE STATE IN DROUGHT.

>> THIS PART OF EASTERN WAINGTON WHERE MY RANCH IS AND ERE THE TRIPOD FIRE WASVER THREYEARS AGO, IT BEEN HISTORICALLY DRY HERE AND HAS BEE ON THE NATION'S WIFIRE MAP FOR BEING ONE THE AREAS MOSTç# ENDANGER.

>> Reporter: ME THAN 800 WILDFES IGNITED IN WASHINGTON WELL ABOVE THE YEARLY AVEGE. ONG THEM TH 10,000 ACRE FIRE IN LATE AUGUST. SINCE E LATE 80s, FAR MORE LA HAS BURNEDOMPARED TO THE PREVIOUS TWO DECADES. A PATTER IS SEEN ACROSS THE WEST. NOT EVERYONE LIEVES WARMER TEMPATURES ARE CAUSING T SPIKE IN FES.

>> AFTER LING HERE R 16 YEARS, ONEF THE THINGS I'VE NOTICED IS FIREIN THE VALLEY ARE BASICALLY LIKE RAIN IN SEATTLE.

>> YOU GUYS NEED HELP.

>> Reporter: DOUG MOORE OWN'S A SWEET SHOP. FOR HIM, THEOREST SERVICE PRACTIS ARE CAUSING FIRES TO GET BIGR.

>> T FOREST SRVICE N LONGER FIGHT FIRES. EY MANAGE THE FIRES. ONCE THE FIRE GETS TO A CERTAIN SI, THEY' MORE INTEREST IN CONTROLLING ERE THE FIRE GOES AND WHERE BURNS AS OPPOSED TO TTING IT OUT.

>> Reporter: ROGER TOWEND, A DISABLE LOGGER W LIVES IN NEAR TOWN, BLAMES MORE FIRES ON A DECLININ THE TIER BUSINESS.

>> THE EIRONMENTALISTS, THEY THINK THEY'RE PROTECTING THE FOREST, BUT BY PROTECTING IT, KEEPING THE LOGGERS OUT, LETTG THE DISEASE AND THE BUGS GO RAMPANT, THEY'VE DONE MORE DAMAGE THAN THEY'VE DONE GOOD. I CONSID MYSELF A KRVGIST, BUT-- CONSERVT, BUT YOU HAVE TO USE COMMON SENSE, AND IS A CROP. YOU HAVE TO TE CARE OF IT. IF YOU DON'T, NATU IS GOING TO, AND CATASTPHIC LDFIRES ARE A RESULT. T SCIENTIS SAY RESEARCHHOWS THERE IS A LINK BETWEENLIMATE CHANGE AND THE SPIKE IN WILDFIRES. HE IS A PROFESR OF FOREST RESOURCES AT THE UNIVEITY OF WASHINGTO

>> WE KNOW UNDER EITHER WARMER OR DRIECONDITIONS, THAT BOTH LIVE VEGETATION ANDEAD VEGETATION-- THAT IS, LI AND DEAD FUEL-- BECOME DRIER.

>> Reporter: THE TIMING IS CRUCIAL, HE EXPLAINS. SPRING ARRIVG ONE TO REE WEEKS EAIER, THEFIRE SEASONENGTHENS, GIVING FOREST VEGETATION LONGER TO DROUT. RECOS SHOW YEARS WITH EARLY SNOWMELT HAVE MORE WILDFIRES THAN THE YEARS WHERE THE SNOWE MELT IS LATE.

>> IF YOU THINK ABOUT E OPPORTUNY, LET'S SAY, F A LIGHTNING STRE TO T DRIER EL,E CAN GET 20 FORCE0% MORE FIRES OCRRING ON THE LANCAPE. SOME OF IT IS NURAL VARIABILITY, B WHAT WE'RE ANCIPATING IS THAT IS GOING TO BE SHIFTIN TOWARDS A PRETTY CNSISTENT EARLIER SNOW MELT AND ARETTY COISTENT LONGER FIRE SEASON AND BECAUSE OF THAT MUCH MORE AREA BURNED, D MUCH ME SEVERE BURNED AREA Reporter: CLEAING AWAY DRY VEGETATION--HAT IS POTENTIAL FUEL IS ONE STRATEGY TO TAMP BACK FIRES. THISTUFF IS ADAPTED T BURN.

>> Rorter: IT'S PART OF THE MISSION FOR THE U. FOREST SERVICE.

>> THE DRY FEST STRATY KES A LOOK ATBOUT TWO MILLION ACRES OFOUR FOREST THAT WCONSIDER TO BE IN A DRY VEGETATIV TYPE,IKE THE PONDESA PINE, WHERE THE VEGETATION HAS BEEN ACCUSTOMED TO FREQUENT FIRE D WHERE IT'S NECESSARY FOR TO US TN, REMOVE T SMALLER EES THAT ARE COMPETINWITH THE LARGE, HEALTHY TREES, AND UNDERBURN-- AGAIN, TO CLA THE FOREST FOOR TO PVIDE A RESILIEN SITTION FOR THEREE TO GROW.

>> Reporr: BETTER FOREST MANAGEMENT CAN HE ECONOMIC BENEFITS AND ALSO RELEASE GREENHOUSE GAS EMISSIONS.

>> I TOOK THE INIATE TOYS FOR TS LEGISLATURE AND ASKED FOR TEIR CONCURRENCE AND REEMENT ON MY BIOMASS ITIATIVE WHICH IS BACALLY AN EFFORT TO CONVERT WOODY BIOMASS- EITHERILES FROM LOGGING OR-- AND REMOVE THAT MATERIAL OUT AND TURN IT INTO FUEL.

>> Reporter: TAKES FAR LONGERHAN ONE FI SEASON TONOW FOR SURE IF IT WILL MAKE A DIFFERENCE. MEANWHILE, THEECENT UPSURGIN FIRES HAS ALTERED THE RESTS AND LIFESTYLES OF THE PEOPLE WHO ENJOY THEM MOST. LAER

>> Lehrer: ON OUR WEB TE, NEWSHO.PBS.ORG, LEARN MORE ABOUT HOWARMING TRENDS ARE AFFECTING THE SEVETY OF LDFIRES, AND FIND A LINK TO CLIMATE CENTRAL'S WEB SI. PRESIDENT OBAMAILL SPEAK TO CONESS NEXT WEDNESDANIGHT. ONE OF THE ISSUES BEING CLOSELWATCHED, WILL THE PRESIDENT CALL FOR INCLUDG A BLIC AN OPTION. THAT DEBATE OVER THE PUBLIC PLAN IS WHE OUR CONVERTION SERIES PICKS UP TONIT. LAST NIGHT WE SPOKE T AN ADVOCATE. TONIGHT, AN OONENT. JEFFREY BROWHAS THAT.

>> Bwn: ANDHAT VIEW COMES FROM A FORMER INSURANCEXECUTIVE, NOW PRIDENT OF THE HEALTH POLICY AND STTEGY ASSOCIATES. WELCOME TO YOU.

>> THANK YOU.

>> David: ONE CRITICM IS THAT IT WILL NOT JUST MPETE WITH THE PRIVATE SECTOR BUT CROWD IT T.

>> ONE OFHE THINGSHE PRESIDENHAS SAID ABOUT THE PUBLIC OPTION COMPTINGITH INSURANCE COMPANIE, IS WHY INSURANCE COMPIES ARE RRIED. AFTER ALL, UPSND FEDE DOT HAVE A LOT OF TROUBLE COMPETING WITH THE POFS OFFICE. THE DIFFERENCE HERE IS MEDICARE, UNILATELLY, SETS THE PRICES IT PAYS FORHE SERVICES THACOMPOSE MEDICARE SO IF MEDICARE SETS ILATERALLY THE PRICE IT PAYS AOCTOR, IT PAYS A HOSPITAL, IT PAYS DRUG COANY, THAT WOULD BE LIKE THE POST OFFCENILATERALLY TELLING ITS LABOR UNIONS THAT IT'S GOINGO PAY 20% LESS THAN PREVAILING MARKET RATES, THAT IT'SOING TO PAY 20% LESS FOR ITS- IT'S GOINGO PAY 20% LESS FOR THE ELECTRICITAND THE HEAT AND E LIGHTS. IF FEDEX AND UPS HAD TO COMPETE WITH A GOVERNMENT ENTITY PAYING0% TO 3 LESS THEY COULDT POSSIBLY COMPETE. >>rown: JAKEOK HACKERT WAS ON YESTERDAY AND HE WAS YING THESE ARE RESOURCEFUL COMPANIES, 170ILLION CUSTOMERS, BND NAME LOYALTY, ANDIN MANMARKETS, NOT EN ALL THAT MPETITIVE. HEAS WORRIED-- INSTEAD OF WOIED ABOUT THEM-- WHETHER A GOVEMENT PLAN COULD EVEN FIND ITS WAY IN.

>> WELL, DO YOU THINK UPS AND FEDEX COULD CPETE WITH THE POST OFFICE IF IT COULD PURCHASE SPACE ON AIRPLANES AT A GORNMENT-MANDATED PRICE 20% TO 3 LESS THAN WHAT THEARKET PAYS? THAT'S THE FUNDAMENTAL PRLEM IS THAT GERNMENT IN MEDICAREIGHT NOW UNILATERALLY TELLS DTORS D HOSPITALS WHAT THEY WILL PAY R THEIR EXPEFRS HOW CAN ANYONE COMPETE WITHHAT ND OF SUATION IN ANY BUSINESS?

>> DRAW US A PICTURE O WHAT WOULD HAPPEN UNDER PUIC OPTIONLAN. WHAT WOULD T SYSTEM LOOK KE?

>> I THINK THERE ARE TWO KINDOF FEARS. ONE IS I TALK TO PEOPLE WHO N HEALTH INSURANCE MPANIES, EEN NOT-FOR-PROFIT HEALTH INSURANCE COMPANIE AND THEY TELL ME IF MEDICARE COMES INTO THE MARKPLACE AND CUTSHAT IT PAYS DOCTS BY 20% AND CUTS WHAT IT YSOSPITALS BY 30%-- ICH IS WHAT MEDICARE DO IN THE PVATE MARKET N-- TH THE INSURANCE COMPANY WILL HAVE NOCHOICE IF IT'S GOING SURVIVE BUT TO GO TO THE DOCT AND HOSPITAL AND DEMA THE SAME PRICES. THAT WOULD CREATE A WHOLESALE PROBLEM IN TMS OF T RELATIONSHIP BETEN DOCTS AND HOSPITALS. THE OHER PROBLEM IS IF THE GOVERNMENT PUBLIOPTION DID IN FACT GET MUCH LOWER PRES FROM DOCTORS AND HOSPITALS, IT WOULDHAVE MUCH LOWER PRICES IN THE MARKETPLACE. AND SO, PEOP WHO WERE POOR WHO COULDN'T AFFORD E MOST EXPEIVE HEALTH INSURANCE, EMPLOYERS WHO COUL'T AFFORD TO BUY THE MO EXPENSIVE HEALTH IURANCE FOR THEIR RK EMIGHT RY WELL END UP BEING IN THAT PLAN. WE COULD VERY EASILY HE A O-TIERED HEALTH CARE SYSTEM IN THIS COUNTRY. YOU KNOW, THERE'S OICE IN BRITAIN DAY. TOY YOU CAN BE IN THE GORNMENT PLAN. YOU CAN BE IN T PUBLIC HEALTH INSURANCE PLAN. 20% OF THE POPULATIOOF THE UNITED KINGDOM IS IN PRIVATE HEALTH INSURANCE.

>> Brown: A UPLE OF THINGS. A TWO-TIERED SYSTEM-- SOME PEOP WOULD SAY THAT'S WHAT WE HAVE W. WE HAVE PEOPLE WHO CAN FORD GOODNSURANCE AND MANY CAN'T AND AREEFT OUT OF THE SYSM. THEY WOULD BE RIGHT, BUT TODATHE MIDDLE CLASSS IN THE TOP TIER AND THAT'S THE FFERENCE. IF YOU HAD AWO-TIERED SYSTEM TODAY WHEREOME PEOPLE DON'T HAVE INRANCE AND ARE IN MICAID AND T REST OF US ARE IN PRITE INSURANCE THAT'S A O-TIERED SYSTEM. WHAT IF 80% OF THE PEOPLE WERE IN GOVERNME HEALTH INRANCE AND 20% PRIVATE? THAT WOULD BE O-TIERED SYSTEM, TOO. I'M NOT SUGGESTING THE SYSTEM WE VE TODAY IS THE BEST ONE WE'VE GOT BUT DON'T WANT TO VE TO THE OTHER KIND OF TWO-TIERED SYSTEM. Brown: I WANT TO YOU EXPLAIN ABOUT THE FEARF THE CUTS BECSE IN PRINCIPLE E IDEA OF A PUBLIC PLAN FOR EVERYBODY-- IS TO CUT COSTS, GHT?

>> GHT.

>> Bro: AND THAT'S THE IDEA. SO YOU WT TO BRING-- U NT TO BRING--

>> YOU WANT TO CUT PRES.

>> Bro: WHY IS THAT A PROBLEM?

>> THE BIGGEST PROBL IN THAMERICAN HEALTH CARE SYSTEM IS NOT PRICES. MOST EXPERT WILL TELL YOU THAT T REASON THE AMERICA HEALTH CE SYSTEM COSTS SO MUCH IS BECAUSE OFEXCESS TREATMENTS PROCEDURES AT THE TIME THEY'REONE, OR ADMINISTRATIVE COS. THE BIGGEST PRLEM WE HAVE IN THE AMERIC HEALTH CARE SYSTEM IS WARDS OF 30% OF ITS WASTEF, AND THERE'S E STUDY AFTER ANOTHER THAT BRIN US TO THAT CONCLUSION, AND I THINK OPLE ON BOTH SIDES OFHE AIS WOULD AGREE WITH THAT. AT WE NEED TO BE AB TO DOAN THE AMERICAN HEALTH CARE SYSTEM IS PRESEE THE 70% THE SYSTEM THAT IS VERY EFFICNT AND VERY EFFECTIVE ANHIGH IN QUALITY AND TRY TOGET RID AS MUCH AS OF THE 30% OF THE SYSMHAT'S WASTE. WE'RE NEVER ING TO GET RID OF ALLF IT, BUT THAT'S WHAT WE HA TO FOCUS ON. THPROBLEM IS IF YOU JUST DRIVE PRICES WN, I YOU NEGOTIATE MUCH LOWER PRIC WITH DOCTORS AND HOSPALS, YOU'RE GOING TO GO TOHE MAYO CLIN AND I RECOLLECT CLEVELANCLINIC, TWO OF THE BETTER HEALTH CA PROVIDERS IN THE COUNTRY, AND WE'RE GOINTO TELL THEM THEIR REBURSEMENT JUST GOTUT 20% OR 3 AND THEN WE'RE GOINTO GO TO THE HOSPITAL THAT'S EFFICIENT AND YOU'REGOING TO CUT THEIR REIMBURSEMT 20% OR 30%. WHAT GOOD DOES IT DO TO CUT THREALLY GOOD HEAH CARE PROVIDERS 20% OR 30%? WH WE NEED TO DO ISO CHANGE THE INCENTIVES IN T SYSTEM. THE INCENTIVES WE HAVE NOW AND THE WA PEOPLE ARE PAID, SO WE'RE FOCUSED ON KEEPING TH 70%s THAT'S QUALITY AND THE 30% THAT'S WASTE CUTTINEVERYBODY'S PRICES ISN'T ING TO GET THAT JOB DONE

>> Brown: WHAT Y'RE TALKING ABOU WOULD IN EFFECT PUSH PRIVATE INRERS TO CUT COSTS. THE QUESTION I- AND I ASKED IS TO JACOB HACKERT-- WITHOUT A BLIC OPON, WHAT PUSHES TEM TO ACT BECAUSE INGS IS RIGHT NOW, ST PEOPLE WOULD S, THEY ARE NOT CUTTING COSTS. EY'RE NOT COVERINGNOUGH PEOPLE.

>> TT'S RIGHT. ONE OFHE THINGS I'MEALLY GRATIFIED ABOUT WITH THE LIBERALS A PROGRESSIVES WHO THINK THE PUBLICPTION IS IMPTANT, I HEAR THEM SAYING IF WE DON'TAVE SOMETHININ THE HEALTH CARE REFORM TO CHANGE T COST AND THE QUALITY OUTCOME,F WE DON'T HAVE SOMETHING THAT PUSHESND MAKES THIS CHANGE, WE REALLY DON'THAVE HEALTH CARE REFORM. THAT'S EXACTLY RIGHT. RIGHT NOW, NONE OF THE DEMOCRATIC BILLSAVE ANY REAL DECENT COST CONTAJMENT IN THE I THINK THE PBLIC OPTION PEOPLE A BARKING UPHE WRONG TREE. THEY'RE GOING AFR PRICE CUTS. WH THE PROBLEM IS UTILIZATION. AND WASTEFUL VEUS EFFECTIVE UTILIZATION.

>> Brown: I HA TO ASK YOU-- CO BACK TO MECARE, BECAUSE YOU BROUT THAT UP A FEW TIMES.

>> YES.

>> Brown: JACOB HACKERT YESTERDAY EXPCITLY TALKED ABOUT TAT AS A MOD PEL. BUT TO YOU IT'S A BAD MODEL. TO HIM IT'S A OD MODEL. HE SAID IT PROVIDAISE BROAD CHOICE OF DOCTORS AND HOSPITALS FOR PEOPLE, IT'S A BENCHMARK KEEPING PRICES DOWN. 'S A SYSTEM THAT HAS COVERED MILLIONS OF PEOPLE.

>> MEDARE IS A GOOD SYSTEM, BUT WHEN WE OK AT MEDICARE, WHAT WE FIND IS- FOR EXAMPLE, THE STUDIES THAT HAVE BEEN DONE ABO WHETHER WEE WASTIN DOLLARS OR NOT, WHERE'S THE MT WASTE IN THE SYSTEM? THE MOSTSIGNIFICANT STUDY WAS DONE B THE DARTMOUT MEDICAL SCHOOL, CLED THE DARTMOUTH ATLAS. AT ANY RAT, THEY TOOK A HARD LOO AT H MUCH WSTE WE HAD IN THE SYSTEM. THEY FOUND ENORMOUS DIFFENCES BETWEEN THE WAY PEOPLEERE TREATED IN ONE PARTF THE COUNTRY AND ANOTHER, BETWEEN EFFICIENT ANDNEFFICIENT HEALTH CARE. 100% OF TH DATA USED IN THAT STUDY SEDICARE TA. MECARE'S GOT SERIOUS, SERIOUS PRLEMS. IT'S NOT STAINABLE. 'S GOING BANKRUPT. THERE ARLOTS OF GOOD INGS ABOUT MEDICARE. T IT'S NOT SUSTAINABLE. IT'S JUST AS WASFUL AND GEE, GOLLY, WHIZ, IF MEDICARES THE SOLUTION, IF MAKING THE REST HE HETH CARE SYSTEM LOOKIKE MEDICARE WHY IS ITOING BANKRUPT? DON'T THINK THE QUESTION IS MEDICARE OR PRIVATE CTOR. WE HAVE PRLEMS THROUGHOUT IS SYSTEM. IN TERMS OF STE AND INEFFICICY. THAT WE'VE GOT TO GET AT IN ORDER TOAKE IT AFFORDABLE.

>> Brown: JUST IN OUR LAST MINUTE, HERE WE ARE TODAY, THE PRESIDENT SAID HE'S GOING COME BACK NEXT WE. THERE DON'T SEEM TO BEHE VOTES, AND PEOE ON JACOB HACKERT'S SIDE SAID WE'R NOT GOING TO GET EFFECTIVE HEALTH REFM AT PULL. YOUR SAURMT WE CAN STRIP THAT OUT ANDTILL HAVE EFFECTE REFORM? >>O, I THINK WH O THOUT THE PUBLIC PLAN, WHATE'RE ON OUR WAY TO DOING IS EXPANDIN THE HEALTH CARE ENTITLEMENT BY $1 TRILLION. CUTTING $500 BILLION FROM DOCTORS AND HOSPITALS AND INSURANCE COMPANS, WHICH IS ABOUT 1 OF WHAT TEY'RE GOING TO GET OVER THE NEXT 10 YEARS. 'RE CUTTING THEM-- IT'S-- AND EN WE'RE RAING TAXES $500 BLION TO PAY FOR THE REST. BUT WE'RE DOING NOTHINGO CONTROL COSTS.

>> Brown: RAISING TAXES IN SOME OF THE PLAS?

>> ALL OF THE HEALTH CARE PLANS--ALL OF THE DEMOCRATIC PLANS WOUL RAISE TAXES E WAY OR ATHER ABOUHALF A BILLION DOLLARS. THE PRESIDENT SAID WE'LL PAY HALF BY SAVINGS THROUGH THE MECARE AND MEDICID SYSTEM AND HALF BY NEW REVENUE WHICH IS NEW TES. SO WE'RE HALF D HALF-

>> BrownHE HAS SAIDT WILL ONLY BE ON CERIN --

>> THE HOUSE BILL HAS A $550 MILLION MILLIONAE'S TAX IN IT, TO BE SPECIFIC. I THINK ONE OF E THINGS THE PRESIDENT'S GOTTO ANSWERS THE PRESIDENT SAYS NEED TO BE DEFIC NEUTRAL IN WT WE DO FOR HEALTH CARE REFORM. WHY? WE'VE GOT A HEALTH CARE SYSTEMHAT'S 17% OF G.D.P. TODAY GOING TO %. $2.5 TRILLION, GOING TO $4.5 TRILLION IN 10 YEARS. WHY WOULD YO WANT DEFICIT-NEUTRAL ALTH CARE REFORM? THAT MEANS IT ISN'T GOING TO COST ANY MORE BUT IT'S NO GOINTO COST ANY LSS. IF YOU HAVE HEAH CARE BILLS IN THE SYST COST NO LESS HOW IS THAT REFORM?

>> Brown: ALL RIGHT, ROBERT LASZEWI, THANK YOU VERY MUCH.

>> YOU'RE LCOME.

>> Lehrer: FINALLY TONIG, INGING SIGHT TO MILLIONS OF PEOPLE WHO SUFFER OM EYE DISEASE. SPECIAL CORRESPONDENT FR DE SAM LAZAROETURNED TO AN EYE HOSPIT IN INDIA THAT HE FIRST VISITEIN 1989.

>> THE LARGEST EYE CAR CENTER IN THE WOD. THE SURGICAL FACILITS ARE AS MERN, THE ERROR LATE AS LOW AS ANY ACE IN AMERICA. THE B DIFFERENCE IS THAT ITS PATITS ARE AMONG THE WORLD'POOREST PEOPLE WHO RARELY GET TREATED F EYE DIASES. 45ILLION PEOPLE HE PREVTABLE OR REVERSIB BLDNESS. 12ILLION ARE IN INDIA ALONE, WHERE THE EXTREMEUN ANDGENETICS ARE BLAM. MANY PEOPLE LOSE THEIR SIGHT AND LIVELIHOOD BY THEIR EARLY 50s. THE BUSINESS SUCCESSND SOCIAL MSION HAVE LONG MADE IT A MOD NEL PUBLIC ALTH TEXTBOOKS. 20EARSAGO, TH MUCH YOUNGER REPORTERAME TO THEANGIENT TEMPLE SEA. EVERYONE CALD HIMR. V. HE RETIRED FROM A GOVERNMENT HOSPITAL IN 1976 AND S OUT TACKLE WHAT HE CALLED DISABLING CATARACT BLINDNESS. IT WAS A VERY SMALL OPERATION WHEN DR. V. ARTED IT WITH 11 D AND FOUR DTORS. THE IDEA OF THE MPLE-- THEY WOULD SERVE PATIEN WHO COULD PAY. THE#é PROFITS WOULD AFFORD FREE CARE TO THE MANMORE PEOPLEHO COULDN'T AFFORD EVEN THE BUS FARE. SO TY SET OUT TO FIND PATIENTS, MAINLY THROUGH SCREENING MPS IN SURROUNDG RURAL AREAS. GROUPS LIKE THE LIS CLUB PROVIDED BUSES TO BRING THOSEEEDING SURGERY TOHE HOSPITAL. THEY ENTERED ARISK ASSEMBLY LINEPERATING ROOM. DR. V.'S ROLE MODEL WAS McDONA'S OR AMERICAN CHAIN STORES IN GENERA

>> YOU ARESITTING HERE AND YOU ARE SITTING THERE TALKING ABOUT McDONALD. DR. V. DIED IN 2005 BUT HIS OFFICE IS LEFT UNTOUCHEDAS A SHRINE TO HIM. HIS NEPHEW, AN OTHALMOLOGIST MANAGES A SSTEM THAT'S GROWN TO FE REGIOAL HOITALS AND 25 SATELLITE CLINICS. THIS IS THE FIRST ONE.

>> WE SEE 1500 PAENTAISE DAY. Reporter: IT'S $1 FOR DOCTOR'S APPOINTMENT THAT HELPS FUNDTHER PATIENTS. THERE'S NOT MUCH PROFIT MARGIN SO AHEAVY VOLUME OF PAYING PATIENTS SATISFIED PATIENTS AND EFICIENCY ARE CRITICAL THE DOCTORWHO ALSO HAS AN B.A. FROM THE UNIVERSITY OF MICHIGAN, HAS PRODUCTIVI REPORTS AT HIS FINGERTIPS PATIENTS ARE OMISED A COMPLETED APPOINTMENT IN T HOURS ANA BROCHU DETAILING WHAT THEY CAN EXPECT.

>> THISIS SORT OF LE A PATIENTS' LL OF RIGHTS, ALMOST?

>> EXACY. SO THEY UNDERSTAND WHAT'S HAPPING.

>> THEIR PUTATION IS DRAWING PAENTS FROM FATHER D FATHER AWAY. >>HENEVER YOU S EYE OPERATION, EVERYONE SAYS GO TO MATARAI. Reporter: IT'S THENLY REASON THIS 55-AR-OLD WAS COAXED OUT OA TEE-YEAR DEPRSION THAT BEGAN WHEN CATARACTS STARTED CLOUDI S VISION. HE BECAME COMPLETELBLIND THREMONTHS AGO. HEND HIS WIFE ENDURED A TWO-DAY TRN JURN TOW GET HE.

>> ( translated ): I WAS A SPORTS MAN. I USED TO SWIM. AFTE THE CATARACTS I COULD NO LONGER MOVE AROUND. WAS STUCK AT ME AND I HAD PROBLEMS BEING OVERWEIGHT AND I HAD HIGH BLOOPRESSURE." Reporter: ALREA DOZENS OF PATIENTS HAD NE AHEAD OF H. YOU'VE DONE 15 PATIENTS IN TWO HOURS?

>> THE SURGEO IN SEVERAL OPATING THEATERS WERE WORKING THE ROUTINE, MOSTLY CATARACT CES. THE MOREOMPLEX ONES, LI GLAUMA AND CORNAL SURGERY, WOULCOME TER.

>> I'M SEEING THPATIENT FOR THE RST TIME. AND E CHALLENGING CASES THEY SHOED TO ME EARLIER. WERE ABLE TO ENTIFY THEM.

>> Reporter: ONE PATIENT'S HYR TENSION POSED EXTRA RISKS.

>> AMARGIN OF SAFETY OF 10 MINUTES TO GET THE SURGERY DONE.

>> Reporter: ABOUT 10 NERVOUS LATER, HE REMOVED A PARTICULARLY TOUG LEATHERY CATACT.

>> THINGS WENT WELL. WHEN WE SEEHIM TOMORROW, WE'LL SEE A DIERENT MAN. MORE CONFINT.

>> Reporter:Y THE END OF THE DAY, TH DID ABUT 300 SURGIES. ABOUT HALF OTHEM WERE FREE OF CHARGE. INCREASILY, HOWEVER, PATIENTS ARE SEE OUTSIDE THEHOSPITAL. TELE-MEDICINE COECTS DOCTORS TO SATELLITE CLINI AND TODAY'S EYE-CAMSFFER MUCH MORE SIGHT FROM GRINDINGYE GLAS LENSES T DIGIL SCANS. THE SATEITE TRKS BEAMS HIGH-RESOLUTION IMAG TO DOCTORS AT THE HPITAL. IT'S ESPECIAY USEFUL IN DIAGNOSING INDIA'S GROWI PROBM OF DIABETES-RELATED EYE SEASE. TECHNOLOGY HAS IMPROVECARE AND BROUT DOWN COSTS NOTABLY FOR THE INAOCULAR LENSES, PLANTED DURING CATARACT SURGERY. TH USED TO BE IMPORTED. THEY BEGANAKING THEIR N INTRAOCULAR LENSES BACK IN THE EAY 1990s. THEY USED TO COST BETWEEN $50 AND100 EACH. TODAY THEYRE MADE IN THIS FACTORY FORS LITTLE AS $2 APIECE. THEY ARE EXPOED TO 120 COTRIES AND OWN 8%F THE GLOB MARKET IN INTRAOCULAR LENSES. WHETHER 'S SUPPLIES OR PEOPLE, THE GOAL IS TO BE SELF-SUFFICIENT. THEYAVE EXTENSIVERAINING PROGRAMS FOR RECENT MEDICAL GRADUATES AND TRAINS MID-LEVEL PROFSIONALS, MOSTLY WOMEN FROM RROUNDING RURAL COMMUNIES. SO 250 HOSPITALS ACROSS INDIA AN40 OTHER COUNTRIES HAVE ADOPTED THEIR METHOD

>> THIS INSTITUT, WE TRAIN ORGANIZATIONS TO BECE MORE EFFICIENT. WE OPEN UP OUR SYSTMS, PROCESSES, HOW MUCH WE CHARGE THE PATIENTS AND OUR RECORDS.

>> Reporter: IT'S THETHOS SET BY HIS UNCL DR. NEVER TOOK A SALARY. IN FACT,E MORTGAGED HIS HOME TO START THE CLINIC. AND HE COAXED MEMBERS OF HIS EXTENDED FILY TO WORK HERE, STARTING IN 1976 WITH HIS SISTER ANDER HUSBAND. BOTHEFT SURGICAL CAREERS IN AMERICA TO WORK HERE FOR ABOUT $20 A MONTH.

>> TODAY OH, MY GOD, VERY, VERY HAPPY. IN FACT, BACK THEN, IN THE 80s, WE WERE NOTAPPY. EVEN THOH DR. V. WAS HAY, THE FAMILY LIFE, LI ME AND MY HBAND, TWO CHILDREN, IT WAS NOT EASY FOR US. BACK THEN WE DN'T APPRECTE S VISION.

>> Reporte: S SAYS THE SATISFACTION OF SEEING PATIENTS RESTORD TO FULL LIVES MAKES UP F ANY MATERIAL PRIVATION. OV THE YEARS, SAL VEEZ GREATLY IMPROVED FOR THE 220 DOCTORS ANSOME 2500 OTHER STAFF.

>> THE CHILDREN ARE STARTING SCHOOL, SI WANT TO GET GOG.

>> WE'LL GIVE YOU SOMEARK GLASSES, JUST LIKE A HOLLYWOOD TOR.

>> Reporte HE'S ONE OF 27 MILLION PATIENTSHO HAVE BEEN TREED AND 3.4 MILLION WHO HAVE HAD SUERY, SURGERY THAT NOW COSTS JUST A FEWOLLARS MORE THAN A MEAL AT McDONALD'S.

>> Lehrer: THERE'SORE ABOUT THE ARIND CLINICS ON OUR WEB SITE, NEWSHOUR.PBS.ORG. SEE SLIDESHOW OF IMAGES. READ A REPORR'S NOTEBOOK AND TCH FRED'S EXCLUSIVE ONLINE ALS OW.ABOUT THE PTNERSHIP AGAIN, THE MOR DEVELOPMENTS OF THE DAY: OFFICIALS INALIFORNIA SAID THAT SUBSTANTIAL PROESS HAS BEEN MADAGAINST THE WILDFIRES AFFECTING LOANGELES AND SUOUNDING COUNTIES. A TALIN BOMBER KILLED A TOP INTELLIGENCE NATNAL IN AFANISTAN, AND MORE THAN 20 OTHERS AND THE U.S. JUSTE DEPARTMENT ANNOUNCED DRUG MAKER PZER WOULD PAY A RECORD FINE OF $2.3 BILLIOFOR ILLEGAY MARKETINSEVERAL DRUGS. ON NEWSHOUR.PBS.ORG,WO ONLINE- ON FEATURES TONIGHT. YOU CAN LISTEN TO A REPORT'S PODCAST OUT THE DEAL TO ALLOW THE U.S. MITARY TO USE BASES IN COLOMBIA. AND ON OUR GLOL HEALTH PAGE, THERE'S A STORY ON EFFORTS T LOWER THDEATH RATE FOR WOMEN IN CHIBIRTH IN TANZANIA. WE'LL SEE YOU ONLINE AND AGAINERE TOMORROW EVENG. M JIM LEHRER. THANK YOU, ANDOOD NIGHT. MAJOFUNDING FOR THE NEWSHOUR WITH JIM LEHRER IS PRODED BY:

>> THIS IS THE ENGINE AT CONNECTS ABUNDT GRAIN FROM THE ERICAN HEARTLAND TO HARAN'S BEST SELLING WHEATWHILE EPING 60 BILLION POUNDS OF CARBON OUT OF THE ATSPHERE EVERYEAR. BNSF, E ENGINE THAT CONNECTS US.

>> CHEVRON. THIS IS THE POWEOF HUMAN ENERGY AND THE NATIONAL SCIENCE FOUNDATION. SUPPORTING EDUCATION AND RESEARCH ACROSS ALL ELDS OF SCIENCE D ENGINEERING. ANWITH THE ONGOING SUPPORT OF THESE INSTITUTIONSND FOUNDATIONS. AN.. THIS PROGRAM WAS MADE POSSLE BY THE CORPORAON FOR PUBLIC BROCASTING. AND BY CONTRIBUTIONSO YOUR PBS STATIOFROM VIEWERS LIKE YOU. THANYOU. Captioning sponsod by MacNEIL/LEHR PRODUCTIONS Ctioned by Mediaccess Group at WGBH access.wgbh.org S