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You Will Eventually Be Forgotten. ( )

Song Premiere: Empire! Empire! (I Was A Lonely Estate), 'A Keepsake'

by Lars Gotrich
Jul 22, 2014

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Lars Gotrich

If emo has cheerleaders, they're Keith and Cathy Latinen. Since 2007, the Michigan-based husband and wife have tirelessly run the Count Your Lucky Stars label during a time when the genre didn't have many vocal supporters. Many of its releases have inspired bands in the now-thriving young scene to take up the '90s Midwest emo sound and do what they will.

The Latinens are also behind the complicatedly named Empire! Empire! (I Was a Lonely Estate), which has released EPs and split seven-inches with the likes of Dikembe, Modern Baseball, and Football, Etc. The band's last full-length album dates back to 2009, making the forthcoming You Will Eventually Be Forgotten worth the long wait. The lilting "A Keepsake" gets a premiere here, with a guest verse sung by Braid's Bob Nanna.

A straightforward storyteller, Keith Latinen works in details and similes, not abstraction and metaphor. It's part of what makes Nanna's verse so charming, as he smiles at a canoe trip's memory without being smothered by it:

We split up in two canoes

I imagined us as Lewis and Clark

charting acres of unspoiled land

as the Mainstee opened up like a canvas

You Will Eventually Be Forgotten comes out Aug. 19 on Topshelf Records and Count Your Lucky Stars Records. It will be paired with a graphic novel based on each of the songs, illustrated by Ben Sears.

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Ben Watt. (Courtesy of the artist)

Ben Watt On World Cafe

Jul 22, 2014 (WXPN-FM)

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World Cafe's guest today is Ben Watt from Everything But The Girl, the band he led with his partner (now wife) Tracey Thorn in the '80s and '90s. He has a new solo album called Hendra, which he recorded with Suede guitarist Bernard Butler.

Watt has had a fascinating career; he turned to underground DJing as Everything But The Girl disbanded, prompting him to eventually form his own house-music label. He's recently tabled pursuits and turned to writing instead. Watt's new book, Romany and Tom, is about his parents and the life he discovered they'd led. His first book, 1996's Patient, was written as he recovered from the rare Churg-Strauss Syndrome, which landed him in the hospital for two and a half months.

In this World Cafe session, Watt touches on these topics and performs songs from Hendra.

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Piggy bank and savings. (Topp Yimgrimm/iStockphoto)

States Experiment With Health Savings Accounts For Medicaid

by Michelle Andrews
Jul 22, 2014 (Kaiser Health News)

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If all goes according to plan, next year many Arkansas Medicaid beneficiaries will be required to make monthly contributions to so-called Health Independence Accounts. Those who don't may have to pay more of the cost of their medical services, and in some cases may be refused services.

Supporters say it will help nudge Medicaid beneficiaries toward becoming more cost-conscious health care consumers. Patient advocates are skeptical, pointing to studies showing that such financial "skin-in-the-game" requirements discourage low-income people from getting care that they need.

The states of Michigan and Indiana have already implemented health savings accounts for their Medicaid programs, modeled after the accounts that are increasingly popular in the private market.

In Michigan and Indiana, people can use the funds, which may be supplemented by the state, to pay for services subject to the plan deductible, for example, or to cover the cost of other medical services.

The program particulars in each state differ. But both states - and the Arkansas proposal — require beneficiaries to make monthly contributions into the accounts in order to reap certain benefits, such as avoiding cost sharing for medical services. Funds in the accounts may roll over from one year to the next, and participants may be able to use them to cover their medical costs if they leave the Medicaid program.

"We believe in consumerism," says John Selig, director of the Arkansas Department of Human Services. By requiring Medicaid beneficiaries to make a monthly contribution to a Health Independence Account, "we think they'll use care more appropriately and get a sense of how insurance works."

Under the health law, states can expand Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level.

Arkansas is one of several states, including Iowa and Pennsylvania, that is experimenting with using Medicaid funds to enroll new Medicaid-eligible beneficiaries in private health insurance through the Affordable Care act marketplace.

For 2015, Arkansas wants to expand its experiment by introducing the Health Independence Accounts. Nearly all beneficiaries earning between 50 and 138 percent of the poverty level ($5,835 to $16,105 for an individual) would have to participate through monthly contributions of between $5 and $25, depending on their income, or face cost-sharing requirements capped at 5 percent of income by Medicaid rules.

In addition, Medicaid enrollees with incomes over the poverty level could be refused services if they don't make their monthly contribution and don't make a copayment. (This year, those with incomes between 100 and 138 percent of poverty already have copays.)

Each month that a beneficiary would make a payment to his or her account, the state would contribute $15. Unused amounts would roll over from one year to the next up to a maximum of $200, which could be used by the beneficiary for health care costs if he or she leaves Medicaid for private coverage.

At least 40 states charge premiums or cost sharing for at least some beneficiaries. These beneficiaries already have skin in the game, advocates say, and they question the value of these special accounts that add a whole new layer of complexity for people who may not ever have had insurance before.

"We're creating these incredibly complicated administrative structures, and I don't think people will understand them," says Judith Solomon, vice president for health policy at the Center on Budget and Policy Priorities.

Copyright 2014 Kaiser Health News. To see more, visit http://www.kaiserhealthnews.org/.

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Two young girls watch a World Cup soccer match on a television from their holding area where hundreds of mostly Central American immigrant children are being processed and held at the U.S Customs and Border Protection Nogales Placement Center in Nogales, Ariz. on June 18. (AP)

The Immigrant Kids Have Health Issues — But Not The Ones You'd Think

by Linda Poon
Jul 22, 2014 (Kaiser Health News)

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Close to 60,000 children have crossed illegally into the U.S. since last October. They've sparked a crisis. But is it a humanitarian crisis or a public health one?

The children carry "swine flu, dengue fever, Ebola virus, and tuberculosis" and can spread the disease to the U.S., wrote Rep. Phil Gringrey (R-Ga.), a retired obstetrician-gynecologist, in a July 7 letter to the Centers of Disease Control and Prevention.

Gingrey's concerns have been widely circulated as part of a public campaign by folks who share his view that the kids should be sent back. And some of the points he's raised have been widely rebuffed. The current Ebola outbreak has been confined to Africa, as have past outbreaks. And neither dengue nor the "kissing bug" disease known as Chagas, which was brought up by others, spread from human to human. Transmission involves bugs and dogs.

But some health issues in this contentious debate require closer examination. There have, for example, been a handful of reported cases of TB among the children. And concerns that the children may not have been vaccinated - or may harbor scabies and lice - aren't as absurd as the Ebola claims.

A TB epidemic is perhaps one of the biggest concerns, since the U.S. doesn't vaccinate against the disease. The fear of a fatal respiratory disease that attacks the lungs and can spread through the air is understandable.

But the facts on the ground do not back up such worries. All children who arrive at a border station are screened for TB with skin tests and chest x-rays; those infected are immediately isolated and treated. So far this year, only three TB cases among unaccompanied children have been reported by federal officials to the Texas Department of State Health Services, says spokeswoman Carrie Williams. And only one case in Arizona, according to a report by Pima County Health Director, Francisco Garcia.

Such low numbers are not cause for alarm, given that Arizona already sees about 200 cases of TB a year, and Texas sees nearly 1,300.

What about the possibility that the children could spread measles and mumps? Gingrey wrote that many children come from countries that lack basic vaccinations, which would pose a risk to unvaccinated Americans.

The general public may well believe that vaccines are hard to come by in low- and middle-income countries, but that's not always the case.

"The primary care system in developing countries is more effective than in the U.S. — better than people think," says Irwin Redlener, a pediatrician at Columbia University and cofounder of the Children's Health Fund, which provides health care to the disadvantaged.

Indeed, in Honduras, Guatemala and El Salvador, where roughly 80 percent of the children have come from, immunization for measles has 93 percent coverage, according to the World Health Organization.

To be on the safe side, all children are vaccinated during their short stay at processing facilities in Texas and Arizona. That happens at least three days before they're sent to different shelters around the country, says Kenneth Wolfe, a spokesman for the Department of Health and Human Services, in an email.

"Like any shelter system, when you have a group of people or children living [together], there's always theoretical risk of spreading diseases," says pediatrician Alan Shapiro, who cofounded an immigrant youth clinic in New York, called Terra Firma. But those risks, he adds, usually remains within the shelter and won't spread to the community as long as good primary care is provided.

Since October, Shapiro's clinic has provided physical and mental health care to nearly 50 unaccompanied children now living with a family or sponsor. He says there's no need to worry about a spread of contagious diseases. "The children that I see for the most part have a good experience in the shelter," he says. "The facilities have been more than adequate and they are seen by medical personnel and getting vaccines."

Some kids have even brought immunization records from their home countries, he says. At the processing centers, vaccinations are updated: everything from measles, mumps and rubella to tetanus, whooping cough and polio.

As a cautionary measure, all detainees are evaluated right at the border to stop any potential disease from spreading as early as possible.

They're screened at least once - first by a border patrol and then by physicians, if necessary — for signs of any disease. This includes rash, fever, persistent coughing, vomiting and diarrhea, says Jessica Maxwell, a spokeswoman for the Department of Homeland Security, which works with border patrols.

The incidence of infectious diseases is very low, she says. The more common issues are related to traveling: dehydration, heat exhaustion, foot and ankle injuries, lice and scabies, which are treatable. Children who have medical problems may be transferred to a hospital for treatment.

Aside from the TB cases, there have been there have been three flu cases and a few gastrointestinal and respiratory issues at the McAllen Processing Center in Texas, says Williams. Of the 4,000 unaccompanied minors processed in Nogales Processing Center in Arizona, there were two flu cases and two chicken pox cases, reports Garcia, who noted that the risk of spread beyond the shelters is low.

That's not to say there are no health issues among the kids; it's just that none pose a threat to the public.

The centers haven't been perfect. Texas health officials who visited the McAllen facility two months ago reported overcrowding as well as a lack of full medical scans and hand-washing stations. But Williams says better care is now being provided, partly because fewer immigrants are arriving.

Meanwhile, the "fear mongering," as Shapiro calls it, takes attention away from the bigger issue at hand: mental health.

"These are children who are coming over to escape the violence that absolutely pervades the community [back home]," he says. During their journey they are at risk for abuse by Mexican gangs. In the U.S., they must adjust to a new environment and unfamiliar faces.

"There's such incredible amount of change that these children have to go through during a relatively short period of time," he says. "The amount of trauma or stress cannot be understated."

Copyright 2014 NPR. To see more, visit http://www.npr.org/.

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Two young girls watch a World Cup soccer match on a television from their holding area where hundreds of mostly Central American immigrant children are being processed and held at the U.S Customs and Border Protection Nogales Placement Center in Nogales, Ariz. on June 18. (AP)

Detroit Pensioners Approve City's Bankruptcy Plan

by Eyder Peralta
Jul 22, 2014 (Kaiser Health News)

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Detroit moved one step closer toward bankruptcy after crossing a major hurdle on Monday.

With a large margin, retired police and firefighters approved modest cuts in their pensions that are part of the city's bankruptcy plans.

The Detroit News reports:

"About 82 percent of retired and active Detroit police and firefighters who voted overwhelmingly approved the city's plan to reduce their inflationary increases but preserve their base pensions, according to balloting results filed late Monday night in U.S. Bankruptcy Court.

"Members of the General Retirement System approved the city's plan on a margin of approximately 73 percent yes, 27 percent no during a historic 60-day vote that ended July 11, the results show. Detroit's plan calls for base pension cuts for GRS members of 4.5 percent.

"Detroit also got 88 percent of retirees owed lifetime health insurance benefits to accept $450 million for a $4.3 billion liability — one of the biggest debts the city could shed if the reorganization plan is approved by U.S. Bankruptcy Judge Steven Rhodes."

The Detroit Free Press reports that city retirees also endorsed the city's plan to allow the Detroit Institute of Art "to spin off as an independent institution."

The support of city pensioners was seen as a major hurdle toward a successful bankruptcy. As the News puts it, a year ago, this kind of support was seen as "inconceivable."

The Free Press quotes University of Michigan bankruptcy law professor John Pottow as saying that the city's emergency manager Kevyn Orr must be very happy.

"Orr's got to be having a little celebration tonight," Pottow told the paper. "It's not over yet. They've got to go to court and have another fight. But the big pieces are falling into place. This is exactly what Judge Rhodes is going to want to see."

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