When the United Kingdom voted to leave the European Union last month, the seaside town of Port Talbot in Wales eagerly went along with the move. Brexit was approved by some 57 percent of the town's residents.

Now some of them are wondering if they made the wrong decision.

The June 23 Brexit vote has raised questions about the fate of the troubled Port Talbot Works, Britain's largest surviving steel plant — a huge, steam-belching facility that has long been the town's biggest employer.

Solar Impulse 2 has landed in Cairo, completing the penultimate leg of its attempt to circumnavigate the globe using only the power of the sun.

The trip over the Mediterranean included a breathtaking flyover of the Pyramids. Check it out:

President Obama is challenging Americans to have an honest and open-hearted conversation about race and law enforcement. But even as he sits down at the White House with police and civil rights activists, Obama is mindful of the limits of that approach.

"I've seen how inadequate words can be in bringing about lasting change," the president said Tuesday at a memorial service for five law officers killed last week in Dallas. "I've seen how inadequate my own words have been."

Mice watching Orson Welles movies may help scientists explain human consciousness.

At least that's one premise of the Allen Brain Observatory, which launched Wednesday and lets anyone with an Internet connection study a mouse brain as it responds to visual information.

The FBI says it is giving up on the D.B. Cooper investigation, 45 years after the mysterious hijacker parachuted into the night with $200,000 in a briefcase, becoming an instant folk figure.

"Following one of the longest and most exhaustive investigations in our history," the FBI's Ayn Dietrich-Williams said in a statement, "the FBI redirected resources allocated to the D.B. Cooper case in order to focus on other investigative priorities."

This is the first in a series of essays concerning our collective future. The goal is to bring forth some of the main issues humanity faces today, as we move forward to uncertain times. In an effort to be as thorough as possible, we will consider two kinds of threats: those due to natural disasters and those that are man-made. The idea is to expose some of the dangers and possible mechanisms that have been proposed to deal with these issues. My intention is not to offer a detailed analysis for each threat — but to invite reflection and, hopefully, action.

Alabama authorities say a home burglary suspect has died after police used a stun gun on the man.  Birmingham police say he resisted officers who found him in a house wrapped in what looked like material from the air conditioner duct work.  The Lewisburg Road homeowner called police Tuesday about glass breaking and someone yelling and growling in his basement.  Police reportedly entered the dwelling and used a stun gun several times on a white suspect before handcuffing him.  Investigators say the man was "extremely irritated" throughout and didn't obey verbal commands.

It can be hard to distinguish among the men wearing grey suits and regulation haircuts on Pennsylvania Avenue in Washington. But David Margolis always brought a splash of color.

It wasn't his lovably disheveled wardrobe, or his Elvis ring, but something else: the force of his flamboyant personality. Margolis, a graduate of Harvard Law School, didn't want to fit in with the crowd. He wanted to stand out.

Montgomery Education Foundation's Brain Forest Summer Learning Academy was spotlighted Wednesday at Carver High School.  The academic-enrichment program is for rising 4th, 5th, and 6th graders in the Montgomery Public School system.  Community Program Director Dillion Nettles, says the program aims to prevent learning loss during summer months.  To find out how your child can participate in next summer's program visit Montgomery-ed.org

A police officer is free on bond after being arrested following a rash of road-sign thefts in southeast Alabama.  Brantley Police Chief Titus Averett says officer Jeremy Ray Walker of Glenwood is on paid leave following his arrest in Pike County.  The 30-year-old Walker is charged with receiving stolen property.  Lt. Troy Johnson of the Pike County Sheriff's Office says an investigation began after someone reported that Walker was selling road signs from Crenshaw County.  Investigators contacted the county engineer and learned signs had been reported stolen from several roads.

Pages

Bertolini: Health Care Waste Fix Would Trim Deficit

Nov 21, 2012
Originally published on November 21, 2012 9:49 am

Transcript

RENEE MONTAGNE, HOST:

In Washington, lawmakers are trying to work out a deal to keep the economy from going over the fiscal cliff. Many economists predict those automatic tax hikes combined with deep spending cuts set to go into effect on New Year's Day would throw the economy back into recession.

A group of top CEOs has been urging lawmakers to reach a deal to keep that from happening. Mark Bertolini is one of them. He's CEO of the health insurer Aetna and he said tax increases are as important as spending cuts. We called him to talk more.

Good morning.

MARK BERTOLINI: Good morning.

MONTAGNE: So let's begin with something you have made public recently. And that's that Aetna is preparing for layoffs if the government does go over this fiscal cliff. Is that your way of sounding the alarm to both sides of Congress?

BERTOLINI: Well, you know, I think that connotation to my words is overblown. What I did say is that when companies go into a recession, one of the consequences of that recession are layoffs. And to the degree we go into a deep recession as a result of going over the fiscal cliff, that is an option that we would be prepared to exercise, as well as many other employers.

MONTAGNE: I'm interested in knowing where you see talks going.

BERTOLINI: Well, I think the talks are hopeful right now. I've been, you know, involved in a meeting that we had at the White House last week. But I've also have been very involved with the Fix the Debt Campaign for the last couple of years, and we do have a bipartisan approach. And that balanced approach is both taxes and entitlement reform.

MONTAGNE: Would you consider yourself an outlier among CEOs, that tax increases is not just inevitable but a good thing?

BERTOLINI: No, I think I'm actually in a majority of people in my socio-economic class and in my position. I would tell you that as long as we work on working down the debt, and the cost of working down the debt is really to pay more taxes, I get that. That's important. That invests for the future.

Think of it like war bonds. You know, we're paying for the future when we're helping the country get through a difficult time.

MONTAGNE: I'm speaking with Mark Bertolini, CEO of the big insurer Aetna.

Let's turn now to the fundamental issue, the ballooning government debt. One of the main causes is rising health care costs. It would be something you know quite a bit about. What do you see as key ways to lower health care?

BERTOLINI: I think the fact that we waste $750 billion a year on the health care system, about 30 percent of what we spend. So if we just fix the waste in the health care system, over 10 years that would pay back half of the nation's deficit. So, for example, today there is no data connection about Mark Bertolini across multiple providers, and if I'm having a significant health event, I see one doctor now and then I see another doctor in a few weeks from now - they may order the same tests.

Why shouldn't that information be widely available on the tests that I've had done? Why shouldn't there be a profile on recent exams that I've had? Why shouldn't that information be available in some way? And if it's available, then physicians begin with a better base of information and can move forward versus having to reinvent the history.

MONTAGNE: Let me ask you about fixing the delivery system so that costs and payments are based on outcomes, not procedures done.

BERTOLINI: I think that is a very important step. In today's system we pay for each unit of service provided and there is an incentive then to do more units of service, particularly when the government cuts back on the reimbursement for units of service. Medicare and Medicaid pay well below physician's costs for reimbursement. So to the degree we change the system to where we pay for better outcomes, improving their health, then I think the system changes its focus.

MONTAGNE: But if you somehow manage to get a system where it's based on better outcomes, wouldn't many doctors, given a choice, choose patients that are healthier so that they offer that physician an opportunity at achieving a better outcome?

BERTOLINI: I would argue that people with multiple chronic diseases in the Medicare population, the opportunity to improve their care and make headway is much more dramatic than dealing with a healthy person. What we need to do is set up a system where we're reimbursing based on the underlying illness of the individual. So in the Medicare population the premium is $1,200 a month. In the healthy population it's $300 a month.

If we can improve care by 10 percent in the elderly population, that's $120 a month of opportunity versus $30 a month in the commercial population. So I think those are dramatic impacts, and we've seen 10 percent of the Medicare fee for service population driving 50 percent of the health care costs in Medicare, which is 50 percent of the nation's health care costs. And if we can have an impact there, we can make much better progress.

MONTAGNE: Could you give us an example?

BERTOLINI: I'll give you a great example. Congestive heart failure patients are the most expensive patients to take care of. We have given them a scale with Bluetooth technology and we told them to go home, stand on the scale in the morning and take your medication. And we monitor their weight over time. If their weight goes out of tolerance, because that means they're putting on water weight, which causes the congestive heart failure, then what we do is we send a nurse to the house.

The nurse makes sure their taking their medications. If they're taking their medications, they call the doctor to update them because they're not working as well as they should, and before they leave, they roll up the loose rugs in the house 'cause people shuffle when they walk when they've got water weight. We've reduced congestive heart failure readmissions by 43 percent. That's huge.

MONTAGNE: Roll up the rugs because people shuffle, so have also eliminated some percentage of falls?

BERTOLINI: That's right, 'cause they break their hips. And so there are example after example after example of having an impact there. You know, congestive heart failure admission can cost $80,000. And so if we can avoid one, we've not only improved the patient's quality of life dramatically, because they're still at home, but they're not in a hospital where they could get sicker, which is often what happens.

MONTAGNE: But of course would you have been saying this, or some of your colleagues in related industries, even 10 years ago?

BERTOLINI: No. And I think, you know, as time goes on, as we see the impact on health care, not only on this country's deficit, but on nations around the world, health care is central to the economic vibrancy around the globe. So I think we've come to the realization that this is very, very important. How do we do it better? Because it's unsustainable on its current path.

MONTAGNE: Mark Bertolini is the CEO of Aetna. Thanks very much for joining us.

BERTOLINI: Thanks, Renee. Transcript provided by NPR, Copyright NPR.