THE RACHEL MADDOW SHOW
February 28, 2014
Guests: John Reitmeyer, Steven Pifer>
RACHEL MADDOW, MSNBC ANCHOR: And thank you for joining us this hour. OK,
our lead story tonight is an exclusive. You will not hear this story
anywhere else. And to get this story this week, we sent some producers
from the show basically to the end of the world. Technically, we just sent
them to the end of the country. We sent them to the Rio Grande Valley, at
the tippy toe of Texas. This is part of the country that is so far south,
it is south of Mexico. If you want to get to Chihuahua or Nogales or
Tijuana in Mexico, you go north from the Rio Grande Valley in Texas. And
it`s a really big place. You know how people say that the state of Texas
is about the size of France? Well, the Rio Grande Valley alone is about
the size of the state of Connecticut.
It`s just a huge, huge place. And when you`re there, you are kind of far
removed from not just the rest of the country, but the rest of Texas.
You`re not near anything else. The Texas City of San Antonio is 250 miles
away from the Rio Grande Valley, it`s not an every day trip. So, Rio
Grande Valley is remote. And it is beautiful. And it is very, very poor.
The four countries that - excuse me, the four counties that make up the Rio
Grande Valley are all quite profoundly poor. The two biggest cities there
rank first and second for poorest in the nation. Along with that
remoteness and that poverty come health troubles, preventable, treatable
diseases at rates that do not seem like they should happen in the United
For example, women who live on the Texas border are a third more likely to
die of cervical cancer than women in other parts of this country. Poverty
has its own health risks and in far south Texas those risks are compounded
by it being hard to access medical care there. And in the year 2011, Texas
Republicans made that uphill fight even more uphill. They cut state
funding for health clinics that serve women specifically. And they didn`t
just trim that funding. They basically got rid of it. They cut it by two-
thirds. To be clear, these were not cuts in abortion services. These were
cuts in everything else, in preventive care and cancer screenings and birth
control. The effect was immediate. Dozens of family planning clinics
closed right away. And because so many women lost access to birth control,
which people tend to get through clinics like that, because so many women
lost access to birth control, the state of Texas saw a rise of almost
30,000 unintended pregnancies over what they would have expected had those
clinics been able to stay open. 30,000.
Texas is having an unplanned pregnancy baby boom, not because of the end of
a war or something, but because of the end of birth control. And not
everybody who got pregnant without wanting to went ahead with the
pregnancy. The following year a University of Texas study found that
nearly half the women who ended a pregnancy in Texas that year said they
had been unable to get the contraception that they wanted to use. But
birth control is apparently a problem now in Texas. And Texas Republicans
were so bent on not spending anything for family planning that even with
the cuts that shut down those dozens of clinics, they held back even the
little bit of state money that was still left, they left more than $2
million just sitting there in the account that used to pay for those
services, while dozens of clinics turned off the lights and w Texas omen
stopped getting cancer screenings and preventive care, and tens of
thousands of Texas women got pregnant when they didn`t want to. Because
they lost access to the kinds of contraception that they used to be able to
get through health clinics.
What Texas Republicans did to health care, specifically for women in that
state, was kind of a policy debacle, a policy debacle on the national
scale, just embarrassing, even for Texas. In 2013 Texas Republicans
brought some of that funding back. But for a lot of the clinics and a lot
of the women, it was too late. In the Rio Grande Valley, specifically,
they lost nine clinics. More than one in four of them shut down. And you
can still see that damage today. This used to be a family planning clinic
in the border town of Brownsville, Texas. This particular clinic belonged
to Planned Parenthood. They used to hold open days, kind of festivals in
the parking lot for neighborhood women in Brownsville. So, come by, we`re
in the neighborhood, get your checkup, find out about birth control. It
was a neighborhood place, very open. It was their place. And then Texas
cut the funding and their place closed. Our producers (INAUDIBLE) and Kent
(INAUDIBLE) went in Brownsville, Texas this week. They introduced us to
Paula Saldana, who works at that Brownsville clinic, teaching women about
birth control until the budget cuts forced that clinic to shut down and lay
off people like her. But the amazing thing about Paula Saldana is that
even though Texas lawmakers effectively ended her job, she kept going on
with her work. Watch.
(BEGIN VIDEO CLIP)
PAULA SALDANA, THE NATIONAL LATINA INSTITUTE FOR REPRODUCTIVE HEALTH:
There`s a lot of places that talk about diabetes and the importance of
eating healthy, exercising, but, you know, nobody wants to talk about
reproductive health. And I think that it`s because it involves sex .
SALDANA: And nobody wants to talk about sex. I do know for a fact that a
lot of them would go to the clinic, get their services, they were super
happy, but then when the cuts started happening, they panicked. They were
worried where would they go now. Before we had an option of going into
Mexico to get birth control and things like that, but right now with the
insecurity and things like that, there`s no way we can go.
UNIDENTIFIED FEMALE: You mean the violence?
SALDANA: With the violence and stuff, yeah. After the cuts and after I
was laid off in 2011, I just loved the impact the information would have on
women and I would like to see how they would react and learned and about
their bodies, about their anatomy that I just had to continue doing it,
even if I wasn`t getting paid.
MADDOW: Pretty much every day now, Paula Saldana and her volunteer
colleagues, they are not being paid, this is not a job, but pretty much
every day now, they are holding community meetings in and around
Brownsville, where they are teaching women about birth control and how to
take care of themselves. And she let us come along to one of those
meetings in her town, and you can see, the women gathered around on the
patio, and they are singing, and they are playing bingo, they are playing
games. And they are getting informing about family planning. Information
that used to be available to them at that local clinic. They learn how to
take care of themselves and each other, but they also learn how to watch
out for their political interests.
SALDANA: We find this hard-to-reach women, women that would normally not
even stick their nose out the window. We knock on their door and I`ve seen
the transformation on how we start giving her a pep talk. We tell her you
know, you`re an advocate because you advocate for your family every day and
then we start softly talking about leadership skills, we empower her, we
organize her and by the time you know it, she`s out there talking to
political leaders, asking for change.
(END VIDEO CLIP)
MADDOW: So it starts out being about health care and understanding your
health care needs and making your own decisions about your health and
whether or not you get pregnant and what happens if you do get pregnant.
But getting information about those things and taking control of those
decisions for yourself isn`t just a health outcome. It`s about power,
right? It`s about agency. Sticking up for yourself and not getting pushed
around or getting taken advantage of. Speaking for yourself.
The fact of these women as a political force may not yet be apparent in the
Texas state capital, but block by block, person by person, they really are
building their part of the new Texas. Hand to hand right there on the
backyard patios of Brownsville. And that is not all the news from the Rio
Grande Valley. We actually have some news to break here tonight.
If you look at the map again, you can see Brownsville, see there on - right
on the border, hard on the border with Mexico. Half an hour north is the
city of Harlingen, Texas. And in Harlingen, Texas, that`s one of just two
places in the whole valley where you can get an abortion. That clinic is
run by a guy who you do not want to push around. He`s the don`t mess with
me Texas doctor named Lester Minto. Doctor Minto gets so many death
threats because of his work that he carries a pistol and he wears a bullet
proof vest. The part of his daily carry, his daily routine for getting
dressed for work.
On top of cutting all the clinics funding in 2011, Texas Republicans passed
a sweeping new law last year designed to close most of the abortion clinic
in Texas. When that happened, Dr. Minto told the local paper in Macallen
(ph) that the law was "an insult to women`s intelligence," in his words.
He said he would "continue to perform abortions, whether that means under
the cover of a mesquite tree, on a shrimp boat, or going to Mexico." "I
didn`t say I`d stop doing abortions," he said. I`m not going to give this
up. I`m not going to abandon these girls.
The first part of that new antiabortion Texas law requires that any doctor
who wants to provide an abortion in Texas, they have to get admitting
privileges at a hospital near to where they`re going to be providing that
abortion. And Texas hospitals are not exactly eager to hand out admitting
privileges, let alone to doctors who do abortions. And so Dr. Minto has
not been able to get those admitting privileges. And so, Dr. Minto hasn`t
been able to perform abortions at his clinic since November. Instead, what
he`s been doing, is he has turned to helping women who have been trying to
end their own pregnancies on their own without a doctor.
South Texas women have been crossing the border to go to Mexican
pharmacies, to buy drugs to self-induce their own abortions or they`ve been
buying those same drugs on the local grayish/black market at flea markets.
And when they run into trouble because they have no doctor when they self-
induce their own abortion, when they run into trouble, they come to see Dr.
Minto. And that has been his work since the new Texas law went into effect
in November, which stopped him from providing abortions. Instead of safely
providing abortions, he has just been trying to save women who have been
trying to do it to themselves.
And now tonight we can tell you that he will not be doing even that
anymore. We spoke to Dr. Minto this week and he told us that today,
Friday, February 28th, he has closed his clinic forever. He closed it
today. He said he`s never been a rich man and he cannot afford to keep
going. He has now put his building up for sale, he`s turned his last
patients away. He told us this tonight, "It`s heartbreaking. It makes me
want to cry. It`s my life. I`d a whole lot rather be helping women, but
Texas has made it impossible. I just think it`s so sad in Texas how little
respect we have for women." And just like that this already isolated and
poor border region with really poor health outcomes, just like that they`ve
lost one doctor, one more place for women to turn. Not because women do
not need or want the help, but because the state of Texas has legislated
that help off the list of possible choices.
We`re going to have more reporting from Texas and the Rio Grande Valley
next week. We`ve got a story coming out of there that is more amazing than
this one that we were able to tell tonight. It is an amazing place that is
in the middle of an amazing fight, and an amazing story. And we`re going
to be right back.
On Monday, September 9th, just before 8:40 in the morning, there was an
accident, a serious car accident at the intersection of Brinkerhoff Avenue
and Juanita Place in the town of Fort Lee, New Jersey.
(BEGIN VIDEO CLIP)
DISPATCHER: 911, what is your emergency?
MAN: 911! Fort Lee! Fort Lee. A big accident over here!
DISPATCHER: Where is over here?
MAN: In uh .
DISPATCHER: Take a deep breath. Brinkerhoff?
MAN: Fort Lee.
DISPATCHER: Brinkerhoff and what`s the other street?
MAN: It`s uh .
DISPATCHER: I can`t hear you. Calm ..
MAN: Juanita Place.
DISPATCHER: OK. Is somebody hurt?
MAN: Yes! Yes!
DISPATCHER: We`ll get somebody right there.
MAN: OK. Right away.
(END VIDEO CLIP)
MADDOW: Exactly one minute later, another witness to that same car
accident calls 911 for help.
(BEGIN VIDEO CLIP)
DISPATCHER: 911, where is your emergency?
WOMAN: Yes, good morning. I`m calling to report an accident on
DISPATCHER: And Juanita?
DISPATCHER: OK. We are on the way. People are injured?
WOMAN: I think so. Yes.
DISPATCHER: OK, about how many?
WOMAN: It seems like there`s two.
DISPATCHER: Two people? OK. We`re in route. We`ll be there shortly.
(END VIDEO CLIP)
MADDOW: People are injured? Yes. OK. We`ll be there shortly. Here`s
what we know happened after those 911 calls on the morning of Monday,
September 9th. We know that it was not two, but actually four people who
were taken to the hospital as a result of that car accident. We know that
it took emergency responders more than twice as long to respond to that
accident than it should have under their normal protocols. It took them
nine minutes to get to the scene of that accident. It should have taken
them less than four minutes. And we also know why it took emergency
responders and ambulances so long to get to those injured people in that
accident -- it was traffic. Emergency responders were stuck in absolutely
This is a letter from the head of emergency services in Fort Lee to the
mayor of that town. This letter is dated September tenth. So, it`s the
day after the EMS coordinator was not able to get to the scene of that big
car accident on time. In the letter the EMS coordinator explains to the
mayor of that town that because of the terrible traffic, because of the
terrible traffic he had to jump the curb and drive on the sidewalk in order
to reach the injured people at the scene of that big car accident and still
he could not get there on time. Now, we have this letter from the EMS
coordinator to the mayor before today. What we did not have before today
was those 911 calls. What we did not have was a sense of what it was like
for the people who were waiting for help.
(BEGIN VIDEO CLIP)
MAN: 911, Fort Lee! Fort Lee! A big accident over here!
(END VIDEO CLIP)
MADDOW: The city of Fort Lee released these calls today in response to
open records requests from media outlets and other groups that were looking
for information about how the manufactured traffic jam that week in Fort
Lee, that one that was created by shutting down that town`s access lanes to
the George Washington Bridge, people were looking for information on how
that traffic jam affected emergency services. Well, today we got 28 hours
of 911 calls and police dispatch records detailing how emergency responders
and police officers struggled with the gridlock over those four days. And
even though we`ve known for a long time that the traffic inflicted on that
town was really bad, we didn`t know quite how bad it was. Nor did we know
what the consequences of it were like in real time.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: The G.W. Bridge is totally gridlocked. If you can come
up maybe Fort Lee road or something to that effect.
UNIDENTIFIED MALE: That`s backed up probably all the way back into
UNIDENTIFIED FEMALE: Ten-four. We`re getting calls from irate motorists.
UNIDENTIFIED MALE: Please be advised the traffic starts at the G.W. It
backs up all the way through Palisade Avenue though the end of town.
UNIDENTIFIED MALE: You are aware the town is a total gridlock, right?
(END VIDEO CLIP)
MADDOW: The head of Emergency Services in Fort Lee sent his letter to the
mayor on September 10th on Tuesday. That was day two of the traffic mess.
On Thursday, day four, September 12th, the mayor of Fort Lee Mark Sokolich
sent this letter to the Port Authority, specifically to Bill Baroni,
Governor Christie`s top appointee at the Port Authority. He told Mr.
Baroni that ambulances and other emergency services in Fort Lee were
experiencing tremendous response time delays. He said whatever the Port
Authority was up to, it was, quote, "negatively impacting public safety in
Fort Lee. He sent that letter to Bill Baroni during the lane closures, on
September 12 of last year. Also, during the lane closures, on the first
day of the closures, Bill Baroni received this email with the subject line,
"Phone call, Mayor Sokolich regarding urgent matter of public safety in
Fort Lee." So, Bill Baroni knew what was going on. And yet, after all of
that when Bill Baroni appeared before the state legislature to explain what
had happened on that bridge, before, of course, he knew that one day the
whole world would have all his emails and letters to him about this
debacle, before he knew that all that was going to become public, but after
he had been alerted to exactly what happened on that bridge, Mr. Bill
Baroni described thusly what happened to Fort Lee.
(BEGIN VIDEO CLIP)
BILL BARONI: At all times during the week of the study the Port Authority
police department monitored traffic on the George Washington Bridge. They
were alert for any emergency vehicles in the area and prepared to further
alter traffic patterns in the event of an emergency.
(END VIDEO CLIP)
MADDOW: Not true. We now have people`s voices on those 911 calls proving,
again, that that is not true. And Bill Baroni was not the only Chris
Christie ally advancing that untrue story about how nothing that happened
on the bridge that week affected public safety. Paul Nunziato who is the
head of the Port Authority police union and a close ally of Governor Chris
Christie, here`s how Paul Nunziato defended the lane closures, quote, "Was
there any ambulance delay? No. Was there any police service delay? No."
Yes, actually. Yes to both of those questions. There were ambulance
delays, there were police service delays in Fort Lee as a result of that
fake traffic study, which was actually some politically motivated vendetta
against that town that still hasn`t been explained. Paul Nunziato has
since reduced his role as head of the Port Authority police union. He says
he hasn`t stepped down fully from that job, but he`s apparently reduced his
role in that job. For his part, Bill Baroni who no longer works at the
Port Authority, he`s resigned there.
And so we learned some things today about this still evolving, still at its
core basically unexplained story. We learned that when Governor Christie`s
deputy chief of staff Bridget Kelly ordered up those traffic problems in
Fort Lee, boy she really got what she wanted. They ordered that up and
that really is what they`ve got. And in many cases it had serious
consequences for people living in and around that town. It may have been a
lark to the Christie`s staffers and allies, but it was serious to the
people who were involved in those accidents, those four people who waited
more than double the amount of time they should have waited before they
were taken to the hospital after that car accident. It was serious to the
people who were trying to respond to those accidents, trying to get
emergency personnel to help people in trouble. But the other thing that we
learned today was about not so much what happened on the bridge in the
first place, but about that cover-up.
The cover-up in the bridge scandal was in part about convincing people that
there was really nothing to see here, that this was just - not just a
traffic study, it was an innocuous traffic study, there was no negative
impact here. The people who tried to sell the cover story knew that it was
not true. We know that they were informed about the public safety problems
that this thing caused, but they tried to tell this fake cover story
anyway, that there were no public safety consequences. They tried to
convince everyone that their actions did not negatively impact public
safety, but they did. Today we got even more proof that they did. Joining
us now is John Reitmeyer. He`s a statehouse reporter for the "Bergen
Record." Mr. Reitmeyer, thanks to see you again. Thank you for being
JOHN REITMEYER, THE BERGEN STATE HOUSE REPORTER: Thank you.
MADDOW: You know, we know that a traffic jam is not a capital crime. We
know that people get stuck in traffic for all sorts of innocuous reasons
and it`s a sort of nuisance of modern life.
REITMEYER: It`s New Jersey.
MADDOW: It`s New Jersey daily life. How does having the actual 911 tapes
add to our understanding of what this jam really meant for the people of
REITMEYER: Well, I think listening to some of these recordings today, it
put color on the canvas. You know, it gave us the vibrant details. I
remember writing about the traffic, the motor vehicle accidents. I
remember writing about the delayed ambulances, but listening today to the
callers over and over and over again reporting their car accidents, hearing
the chaos in their voice, the panic, listening to the one woman, I think
she called two, three, maybe four times to the dispatcher saying "Is the
ambulance coming, is the ambulance coming?" And hearing her voice. And I
think you could even hear in the dispatcher`s voice back some of the
frustration responding like, yeah, they`re on their way, they`re on their
way. And you hear this inner change. So, I think what we knew like you
said - we knew a lot of this, but this sort of brought it home. If there`s
two things that I think people in north Jersey have responded to on this
story, one is the utter gridlock and helplessness that you feel when you`re
in traffic. Not in traffic for the typical New Jersey traffic jam, but for
this traffic jam.
The other thing, I think, is the public safety angle and that`s the one
that I`ve measured a lot of response from readers is this idea that we were
delaying or somehow hampering on a 9/11 anniversary, were somehow hampering
public safety efforts. And maybe, you know, nothing catastrophic happened
as a result and I think we`re all happy about that, but, you know, even
when you walk down that path of disrupting that in any way, I think that is
where some of the serious questions get raised.
MADDOW: On the public safety issue, I find it striking and unsettling to
hear these very blunt assertions from a couple of people who advanced the
sort of traffic study cover story that there were no public safety
consequences, that people were monitoring for that, as if they sort of had
a safety net there. Maybe if they ever got caught for having done this in
a way to try to hurt Fort Lee, at least they didn`t want people seriously
hurt. I can`t make sense of that except as just telling a lie. One more
thing about the cover story that wasn`t true. How do you take that?
REITMEYER: I think there`s two phases. There`s the phase of where they`re
doing this not thinking that this is going to become a big news story where
everybody`s going to be reading emails, listening to 911 tapes and the
evidence is going to become clear. And then I think phase two is once this
started, remember this kind of trickled out in September, a little bit in
October and then really hit not until after the election in December and
then in January with the publication of the emails, "time for some traffic
problems." So, I think that`s an entirely different phase. That`s sort of
the, OK, we`ve got this problem now.
MADDOW: We`ve got to clean it up.
REITMEYER: What do we do with it? And I think there`s varying degrees of
damage control and I think some probably got too far out ahead of, you
know, for whatever reason, if they were misled or if they did it
intentionally, they got too far out ahead of it. And we wrote early on
sort of a debunking of this traffic study theory or at least a traffic
study by the normal protocol for the Port Authority.
MADDOW: That`s right. Yeah, this is from the time when they were trying
to say stop covering this story and they were trying to make - minimize it
in order to do that. John Reitmeyer, state house reporter for "The Bergen
Record." Thank you very much for helping us, sir, through this. You`ve
done great reporting on this from the beginning. Thanks.
REITMEYER: Thank you.
All right, if Russian President Vladimir Putin wanted to test President
Obama`s limits, he has succeeded. That, and a lot more still to come
tonight including a doozy of a story out of Georgia that has Republicans
really mad unintentionally at Ronald Reagan. Stay with us.
MADDOW: In the state of Georgia, right now, that state`s Republican
governor is leading a revolt against the tyrannical socialist policies of
that noted pinko president Ronald Reagan. According to the governor of
Georgia, 25 years after the end of the Reagan`s presidency, Reagan`s
bleeding heart liberal policies are still wreaking havoc on the great
conservative state of Georgia. Yes, it`s that weird. That story`s coming
MADDOW: After his usual morning president staff, President Obama today had
a full schedule of things he needed to show up for in the afternoon, and
places he had to make speeches. At 3:45 he hosted the first-ever student
film festival at the White House. The president made remarks there. About
an hour later President Obama was due to speak at the annual winter meeting
of the Democratic Party, the Democratic National Committee. Now, he was
speaking at another closed door Democratic Party fundraiser. He had a lot
of stuff lined up late in the day on his schedule today, which we all knew
as soon as we woke up, because it was all on the official presidential
daily schedule. What was not on the official presidential daily schedule
today was his unexpected appearance at the podium of the White House
briefing room this afternoon whereupon he talked about Ukraine. And though
it`s not the Cold War anymore, but any time a U.S. president steps up to
the podium and tells Russia to back off the way President Obama did today,
you can be forgiven for feeling a little bit of a chilled wind in the air.
(BEGIN VIDEO CLIP)
BARACK OBAMA, PRESIDENT OF THE UNITED STATES OF AMERICA: Throughout this
crisis we have been very clear about one fundamental principle. The
Ukrainian people deserve the opportunity to determine their own future.
And we are now deeply concerned by reports of military movements taken by
the Russian federation inside of Ukraine. Russia has an historic
relationship with Ukraine, including cultural and economic ties. Any
military facility in Crimea, but any violation of Ukraine`s sovereignty and
territorial integrity would be deeply destabilizing, which is not in the
interest of Ukraine, Russia or Europe. It would represent a profound
interference in matters that must be determined by the Ukrainian people.
It would be a clear violation of Russia`s commitment to respect the
independence and sovereignty and borders of Ukraine and of international
laws. And just days after the world came to Russia for the Olympic Games,
it would invite the condemnation of nations around the world. And indeed,
the United States will stand with the international community in affirming
that there will be costs for any military intervention in Ukraine.
(END VIDEO CLIP)
MADDOW: There will be costs. President Obama not pledging today to go it
alone in a fight against Russia over Ukraine, but saying that Russia will
effectively be crossing an international red line if they move militarily
into another sovereign country. And it kind of looks like Russia is moving
militarily into another sovereign country.
Crimea is a very pro-Russian part of Ukraine, but still, it`s Ukraine. And
in Crimea today, armed men in camouflage uniforms with no insignia on them
whatsoever, carrying military style assault rifles, took up positions at
two airports in Crimea. They refused to say who they were or explain their
actions. It started with about 50 men in the initial force, but then more
started to arrive. By late afternoon they were setting up roadblocks and
check points near two airports in that region. Locals on the ground
started filming and posting videos like this one, which is not an outtake
from "Red Dawn." This is something from YouTube, from the region
reportedly showing Russian military helicopters flying at low levels into
Ukrainian airspace. A newspaper in Kiev reported that at least five
Russian transport planes landed at a Russian Naval airstrip in the area
Russia does have a military presence in that part of the world anyway.
They have a major naval base in Crimea. And so, there is Russian military
traffic in that part of the world, even at normal times. But these clearly
are now anything but normal times. Joining us now for the interview
tonight, is Steven Pifer. He was the U.S. ambassador to Ukraine from 1998
until 2000. He`s now director of the Arms Control and Nonproliferation
Initiative at Brookings. Mr. Pifer, thank you very much for being with us
STEVEN PIFER, FMR. U.S. AMBASSADOR TO UKRAINE: Thanks for having me.
MADDOW: So, this show of force by what seems to be Russian military and
paramilitary forces in the Crimea region, does this represent a violation
of Ukraine sovereignty?
PIFER: Yes. And back in 1994 in a trilateral agreement with the United
States, Ukraine, Russia and actually Britain, all four countries in the
memorandum basically confirmed their support for Ukraine`s independence,
sovereignty and territorial integrity. As you said, there are Russian
forces in Crimea, but you are now beginning to get reports that additional
forces are coming in from outside and those forces in Crimea are now doing
things that are not associated just with the Russian presence at their
bases, such as setting roadblocks up around
MADDOW: From the Russian perspective, sort of crawling inside the mind of
President Putin, what are Russia`s realistic options here? What do you
think they`re - the range of things is that they are considering? And what
do you think they are most likely to do?
PIFER: Well, I think this goes back to what happened last week in Kiev
when after Viktor Yanukovych, the president of Ukraine, fled the country,
and a new government came in, which would like to bring Ukraine closer to a
(INAUDIBLE) in the European Union, I think there`s been a decision taken in
Moscow to look at ways to sort of destabilize that government. And they
had various tools, one of which is try to introduce separatist tensions in
Crimea. And they`re playing I think a very dangerous game here.
MADDOW: Could we be looking at armed conflict between Ukrainian forces and
Russian forces inside Ukraine?
PIFER: Well, so far the Ukrainians themselves have been extremely
restrained. There`ve been no reports that I`ve seen of any Ukrainian
military units moving towards Crimea now. The Ukrainians actually do have
some military bases in Crimea in relatively close proximity to the Russian
forces. But there is no evidence to suggest that those unions look out to
challenge any of these checkpoints. But again, when you have these sorts
of things going on and the Russians - almost it`s like the Russians are
trying to provoke something and then when that doesn`t work, as early this
morning, they ratchet it up a bit. And it looks like they`re almost trying
to provoke a fight.
MADDOW: When we found out this week that President Putin had ordered a new
large scale ground exercise in western Russia, so fairly close to Ukraine,
it previously not had been announced, that rang bells for me about Russia
versus Georgia in 2008, the war between Russia. The war in 2008 there.
Should we see parallels between that previous conflict and what`s happening
PIFER: Well, I think it`s becoming increasingly hard not to see those
parallels. I mean the exercise that you referred to was actually pre-
notified by the Russians as per various requirements, but still, it`s a
spectacularly bad idea given the current situation in Ukraine to go forward
with that exercise. Now, my own guess is that the Russians are playing
some games in Crimea. I don`t think that exercise is going to be a pretext
for a larger invasion of Ukraine. Because - and the Russians know this.
When the Ukrainian military would fight and there are nationalists in
western Ukraine who I think would be prepared to go and become guerrillas
in any kind of an extended conflict. It could get very messy. But the
Russians seem to treat Crimea as a special case, because of the historical
connection back to Russia. And because that`s an area where there`s a
relatively - it`s actually the only area in Ukraine where ethnic Russians
are the majority of the population.
MADDOW: Steven Pifer, former U.S. ambassador to Ukraine. Now, director of
Arms Control and Nonproliferation Initiative at Brookings Institution. It
was really, really clarifying to talk to you about this. Thank you for
setting this straight on the pre-notification on that military exercise to
you. Thank you for being here.
PIFER: Thank you.
MADDOW: I appreciate it. All right, much more to come tonight. Including
an important note about something that is about to happen on this show in
the next few days that you might have heard about today, but you can hear
it from the horse`s mouth. That`s still to come. Stay with us.
(BEGIN VIDEO CLIP)
CHUCK HAGEL, U.S. SECRETARY OF DEFENSE: We expect other nations to respect
Ukraine`s sovereignty and avoid provocative actions.
JOHN KERRY, U.S. SECRETARY OF STATE: Every country should respect the
territorial integrity here, the sovereignty of Ukraine. Russia has said it
will do that and we think it`s important that Russia keeps its word.
OBAMA: There will be costs for any military intervention in Ukraine.
(END VIDEO CLIP)
MADDOW: This is Democratic Congressman Jim McDermott of Washington, first
elected in 1989. He`s member of the Progressive Caucus and Congressman Jim
McDermott in the 1990s was one of the Democratic Party`s leading voices,
specifically on the issue of health care. Now, this is before Obamacare.
This was when the Clinton administration was trying to reform health care.
And in April 1993, Jim McDermott had a big meeting scheduled at the White
House with then first lady Hillary Clinton. The goal was to get
Congressman McDermott on board with the Clinton administration`s approach
to health reform as they tried to get it passed through Congress. And the
day before that meeting, Hillary Clinton`s staff, we now know, sent her
this memo prepping her for that meeting with Congressman McDermott. Look
at this, quote, "We need to keep him happy and on our side." Quote, "As
staged and as presumptuous as this is, I might suggest that you consider
throwing out all of the staff at the end of the meeting to hold a five
minute private meeting with him. This will signal to him the closeness of
your relationship with him."
It`s like reading the stage directions on "House of Cards" or "West Wing,"
maybe. Less murders. The efforts by the Clinton White House to woo
certain members of Congress are kind of fascinating to read about in this
gritty level of detail. These details are spelled out in a big trove of
documents that were just released by the Clinton library. Just released
today. Over the next few weeks, 33,000 pages of internal documents from
the Clinton White House are going to be made public. And who knows if it`s
going to be just cutler like that thing with Jim McDermott or if it`s going
to be anything substantive that we didn`t know already about the Clinton
years. So far most of what`s been released seems like mostly color. But
gaining access to these sorts of documents, internal administration
deliberations, honestly, it`s gold for trying to understand unexplained
questions in modern history. It`s almost always internal documents, things
prepared without an eye toward ever being released to the public, it`s
almost always internal documents that solve the mysteries, that can tell us
why certain decisions were made, what the thinking was behind those
decisions, what the strategy was, what the motivations were. It`s almost
always the documents that the public cannot see until years later that end
up shedding the most light on the biggest unanswered questions.
And so with that in mind, I have a very important programming note. This
is something that we have been working on basically forever. It feels that
way at least. It ended up being something that I`m really, really proud
of. Please set your DVRs for next Thursday night, March 6th. Next
Thursday, at 9:00 p.m. Eastern, we`re going to premiere a brand new MSNBC
documentary that`s called "Why We Did It." I`m going to have more for you
about it next week, but in case you have not seen this yet, here`s a quick
little tease that we just put together.
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: The Iraq War was presented to us to stop Saddam Hussein
from getting the weapons of mass destruction.
UNIDENTIFIED MALE: We didn`t go into Iraq to get access to the sand.
MADDOW: What was the reason that spurred the U.S. government to invade
Iraq? Newly obtained documents and insight from key players provide for
the first time an answer to the question of why we did it.
UNIDENTIFIED MALE: "Why We Did It," hosted by Rachel Maddow, Thursday at
9:00 on MSNBC.
(END VIDEO CLIP)
MADDOW: I didn`t want you to hear it from somebody else. I wanted you to
hear it from me. But that is next Thursday night. I think that this is
probably the most controversial and maybe the most important thing that
I`ve been part of since I have been here at MSNBC all these years. I`m
really excited about this documentary. I wanted you to know it`s coming.
Thursday night, 9:00 p.m. OK. Programming note over. We`ll be right
MADDOW: In 1986, that noted socialist President Ronald Reagan signed this
bill into law. It`s called the Emergency Medical Treatment and Labor Act.
Congress passed it and President Reagan signed it because of increasing
reports and increasing concern around the country about hospitals dumping
patients. People turning up at hospitals with treatable injuries or
illnesses, women turning up at the hospital in labor, but hospitals were
turning away those patients rather than treating them. Unless people could
prove that they could pay for their care. Or prove that they had insurance
that could pay for their care. Patient dumping they called it, and it was
a growing and fatal problem in the United States, which Congress and the
Reagan administration decided they were going to address in 1986. The
Emergency Medical Treatment and Labor Act required hospitals to do two
things. If they received any federal funding at all from taking Medicare
patients or anything else. They had to do two things under this law. If
somebody turns up at the hospital emergency room, the hospital must
medically screen that person to see if they are, in fact, having a medical
emergency. If so, then the hospital must stabilize that person and their
medical emergency before discharging them or transferring them somewhere
else. So in other words, if you`re in the middle of giving birth, if
you`re in the middle of labor, the hospital can`t throw you out even if you
can`t pay. If your heart has stopped, there`s no sending your family out
to the ATM or running a credit check on you before they agree to do CPR and
get you stable. Hospital emergency rooms have to treat people who are
having medical emergencies no matter who they are and regardless of whether
or not those patients can pay for the care.
It was a humane thing to do, that law. And it`s also an expensive thing
for hospitals, right? I mean the federal government does give some help to
hospitals to help them cover those costs and the states have various ways
of helping hospitals cover those costs, but in a lot of cases, the
hospitals just end up eating those costs.
Maybe that`s fine in the long run, particularly if your hospital has a fat
margin, right? If most of the other people who go to your hospital are
paying patients, patients who have good insurance. But if that`s not the
case, if you`re a hospital in a poor area and not many of your patients
have insurance at all, and so everyone who turns up for care is A, waiting
for a medical emergency to arise before they try to get care and B, totally
unable to pay for that care in any way, but you, the hospital, are obliged
to provide it, eventually that`s going to catch up to you, and your
hospital is going to go broke.
In rural Georgia, eight hospitals - eight have closed since the year 2000
and half of them have closed just in the past two years. The latest one to
close was just this month, the Lower Oconee Community Hospital in the
southeast part of Georgia. It`s a place called Glenwood in Wheeler County,
Georgia. Wheeler County, Georgia has 23 percent of its population without
health insurance. That`s, like, Texas level terrible. The number of kids
living below the poverty line in that county is 41 percent. And they`ve
just lost their hospital. So, if you are in Wheeler County and you have an
emergency, hope you can hold on for a 30-mile ride to the nearest medical
facility. Because the local one is gone now. This is a really big problem
for Georgia. You can`t lose eight hospitals and have it not affect your
state overall. The Organization of Rural Hospitals in Georgia says if
Georgia doesn`t figure out how to stop what`s going on, how to keep its
hospitals open, that state is going to create, a, quote, "third world
nation health situation in rural parts of the state."
Now, one way to fix this problem, of course, is to get the poor people who
live in rural parts of that state to have health insurance. So then they
could go to the doctor before things became an emergency, and when they did
go to the doctor, the doctor and the hospital would be paid for the
treatment. Radical idea, I know, this whole health insurance thing. The
federal government has told Georgia that it will pick up 100 percent of the
cost of getting health insurance to 600,000 people in that state who are
currently uninsured. The federal government will pay 100 percent of the
cost of that for three years and 90 percent of the costs thereafter. And
even though Georgia`s hospitals are dropping like flies losing the fight to
stay open as they struggle to treat that state`s poor rural population,
which doesn`t have health insurance and can`t pay for the treatment out of
pocket, even as that`s happening and they`ve lost eight hospitals, Georgia
Republicans have said no. They said no to covering 600,000 more people in
the state at no cost to the state. They`ve said no to that deal.
The Governor of Georgia`s name is Deal. It`s Nathan Deal. And now the
governor Nathan Deal of Georgia has proposed a new solution to Georgia`s
vexing problem of all its hospitals shutting down. "If the rural hospitals
are shutting down because they have to treat people at the emergency room,
but none of these uninsured patients can pay for that treatment, if that is
the crux of the problem, well, rather than turning those uninsured patients
into people who can pay by giving them insurance, Governor Deal has
decided, you know what? Let`s fix the other side of this problem. Let`s
fix the Ronald Reagan side of this problem. Let`s repeal the requirement
that hospitals have to treat people. That`s his big idea. That would do
it. Georgia Governor Nathan Deal has now proposed this. He`s turning down
the option that would get 600,000 more people in his state to have health
insurance. He`s turning that down and instead is proposing that the
solution to Georgia`s problems is for the federal government to repeal the
Reagan-era law that says if you turn up at the hospital while you`re in
labor or while you`re having a heart attack, that hospital has to treat
you. That`s a federal law. He`s asking federal officials to move to
repeal it because that would be good for Georgia. The governor said
revisiting that specific law is what Congress should do, quote, "if they
really want to get serious about lowering the cost of health care in this
When the paper in Noonan, Georgia, this paper is called "The Noonan Times
Herald" when they published Governor Deal`s proposal on that issue this
week, when they said that what the governor wants to do is get rid of the
rule that says emergency rooms have to treat sick people, the first comment
on that article was this. "Why, yes, that is a way to cut medical
spending. Let the poor die." And on a purely mathematical basis that is
right. And the governor is right. If you turn women in labor and people
having heart attacks away at the hospital door, hospital costs will go
down. The logic is inarguable. And that inarguable logic is now the
Georgia Republican plan for health care in that state. As they lose
hospital after hospital after hospital after hospital. Their new plan is
that emergency rooms should turn people away. And you know what, that plan
will totally work, if we can all just agree from here on out, and we all
have to agree that nobody in Georgia from here on out is allowed to have a
heart attack or break a leg or need to ever deliver a baby as long as
you`re in Georgia unless you can pay out of pocket for the costs. And good
people of Georgia, if you keep up that end of the bargain then boy, does
Governor Nathan Deal have a deal for you. Deal versus Reagan. That does
it for us tonight. Thanks for being with us tonight. We`ve as I said got
more on our exclusive from the Rio Grande Valley in Texas coming up early
next week on the show. We will see you again on Monday. In the meantime,
though, rest up, you`ve got an important stint to do in prison.
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