Special Edition November 4 & 5 2017

Special Edition
Wednesday, January 3rd

November 4 and 5: A discussion with U.S. Rep. Tom Marino of the 10th District about support for controversial legislation that derailed his bid for drug czar; an interview with Dr. Perry Meadows of Geisinger Health System about the ongoing opioid crisis and a talk with Stephen Eide of the Manhattan Institute  about his Rust Belt Report.


Transcript - Not for consumer use. Robot overlords only. Will not be accurate.

Welcome to a special edition. A weekly look at these issues in the news and the personalities shaping the stories special edition is a production of Entercom communications. The views expressed by guests are not necessarily those of Entercom communications staff. Management or sponsors and now here's your host soon Henry. On today's program we'll hear from an area congressman. Who withdrew from consideration for a cabinet position. In the truck administration. After a story about legislation surrounding OP Lloyds. Painted him in an unflattering light he told us that story is not as it seems we'll hear from me physician in the guys in your health system. About the providers approach to addiction and how it's a personal situation for him. And his family and we'll get deet tails from the author of a recent report about the challenges communities in the nation's Rust Belt. Continue to face the United States congressman Tom Marino of the eleventh congressional district. Was an early supporter of candidate Donald Trump. Among his colleagues. And campaign but the future presidents throughout Pennsylvania his allegiance merited him make cabinet post nomination Ford director of the Office of National Drug Control Policy Connelly called drug czar. In Maine congressman Marino withdrew his name for consideration citing family issues president trump nominated him again in September in mid October 60 minutes in the Washington Post collaborated funny story featuring a whistle blower who alleged that a bill. Sponsored by Marino. Watered down the power of the Drug Enforcement Administration. To go after pharmaceutical distributors. Who were funneling unreasonable amounts of pills around the country Marino withdrew his name from consideration for the drugs are position. Days after the reports that the news cycle. This week he spoke to us about that situation. And explain the reasons behind the legislation. From his perspective. Below that is a little bit through. Visited a couple of pharmacy is an outside my district and heard from pharmacists and when it portraying. They were having a very difficult time. Giving the drugs they needed for there cancer patients. Senior citizens people who needed pain medication. Because. Just a terrible or constant issue there have been deal where. So I went back to miles and so as a demise staff flip flop in the world let's find out what's going on here. In him. We did extensive amount of research and we found. This is true that people pharmacists were. Been able to do the medication for the patients. And the reason that we found though that this was happening is because there was should be the agent who. Just went in to the distributor. Of pharmaceutical company not a pharmacy. Who went to the person who gets to drug. We're only entity due to drug from the pharmaceutical come in and sends it to the pharmacy or hospital. He was just shutting them down without any notice. But without any. I referred to in this indication that they are doing everything wrong. I'm not saying that that all distributors. Our play by the rules book. Most of them more in here and we found out of debt there's legislation. From years and years ago and it's. And the DA could go in and shook they distributed. Who. Because. Imminent danger well the problem with that is we found out eminent danger in legislation. Have no explanation as to what. Eminent danger men. It just sit imminent danger and you know legislation we have to explain everything so little. We have started working on legislation and then explained war eminent danger mean. There was also a report birdies. The general accounting office. The coach has me the Government Accountability Office put a report that's. There is uncertainty. Regarding north of the based on the fact that there's no explanation of what imminent danger is in congress needs to look at this and explain what it means my imminent danger. So we've been that the intended to you know high probability of the people. Or in danger or dying because. Open Dillard's. And we know that's securities. But this thing Detroit deleted to movie distributor instead. 1000. District attorney and used during it. How we follow things like this because we're prosecuted differently this the distributor would call to do with the youth detention. And there seems to be an increase speed and the order. These drugs because Mexico and things of that nature in a particular area. But we this agent who sit here being held responsible for this or shutting you down there have been told this agent was but of the disturbance why are you doing this. Because they can. And what what is the meaning imminent danger these incidents whatever it says it is I don't know what that does well in the law it's not up to an individual agent monitor that they are to determine what the meaning is. So we clarified that in the end with a fourteen. It went through the energy and commerce committee that jurisdiction over it. It's only a two and a half page. Double speed east peace legislation. That's simply limited dangerous. So the passed by voice vote. In the house Republicans and Democrats. Nobody opposed that then it went over to the senate within 14%. Of really did nothing about it so then or just before fortunate enough there was that we've we submitted to begin with energy and commerce. Voted energy and commerce again in the house voice vote no one voted against it passed on the floor through and vote for him. Sent it to the senate and meanwhile I want to make clear that we were working whereas the DC on this language. What religion duplicates but the did you people that we are working and we had we can live with this. So that was settled for the planet and as the senate usually doesn't change things a little bit and senator hatch a Republican served in the White House. Worked on a little bit they worked with the DEA. And the Justice Department and then they tweaked they imminent danger language a little bit more. Checked with this is down nearly problem there's no that's fine clothes and everybody onboard everybody onboard PA. Just blooming in a way to the president and he's signed it in any given time as Senator Clinton stuff that in its tracks. The growing did and now because a couple of senators are up for reelection over there. Below detail between their legs because this. Bogus sixteen minute and Washington Post reports. That I colluded with the drug industries. Because. They donated Human Rights Campaign well volunteers who donate my campaign it has no effect on her actual like blood drug dealers and put programs together my whole career for people that were addicted to drugs and I'm greed I'm proud of the way that worked because had a big in these important that the drug association. Well my plan was. To really go after the prevention. Intrusion treatment and throw around the country and city where money is what's happening with the money and following the budget split this. They engines look removed from his position on sixty minutes he's city had 600 people are 400 people those who voted. And an understated manner he found out and who to root slept and didn't have a phobia anymore. So they they agent that you are reference saying I'm assuming is the sixty minutes whistle blew our is that right. Yeah in little bloated is not a whistle blower. The story was calls us way use. That would really understand that in the whistleblowers pills when something goes wrong. The guy has an axe to grind he liked the idea that he was removed and now this so called whistler blower who is saying that's. Who were and also is that any of us who voted for this are helping drug dealers were supporting drug dealers you know me better than that when it comes to particular drug dealers Apollo. Those people away and helped a lot of people who are addicted but this kind of so is that DOJ. Upper Sloan put pressure on him not to do his job which is ridiculous because I've worked with BI agents. All my life in the best they can there and that all of the law I have no problem with the food and he's who he mysteriously resigned and now he's working for plaintiff lawyers. Who are suing the pharmacy companies it is. Retainer as a consultant. Who together criticized. Other people we're going to work for the georgians street and look where he says he's. Is a complete the play the lawyers are trying to make big money. And also the language that we put in for. Imminent danger is the same type of language. And I'm using this as an analogy using years ago to government agreement shut coal mines down again without any particular. And we're all saying what that evidence they had to to shut it down so if we do same thing. The coal industry and it's working fine and the DEA agents have told me since then. That the great relationship because smell these distributors. Bringing information to the d.s attention and you go to the DEA in all but you don't go through distributors to hold them responsible. What they sort this should've done this study should have benefited. Tell me what pharmacies are ordering these drugs who are ordering these drugs what hospitals. And when you go to the pharmacy as a hate. Why are you ordering so many of these. And who is prescribing them and what doctors in the post most doctors are over prescribing but there are those throughout their dominance. And at least every other designs DEA. Have the latitude right now. To do what you're saying which is go to pharmacies that are receiving big shipments. Of hope you aides to find out what do they have the latitude to do. They haven't been kind of an alternative. Oppose the war. The legislation. There you we're not shutting down this specific area of large amount of open or it's being sent around the country. After our legislation. We'll plant there are Democrats in the house who were on this legislation community cosponsored it and in the senate. Republicans and Democrats and it was brought up and hearing. The other day when one of the Democrats in the house who looked on the bill with me completed it will look before our bill. You had. This loan amount. Addressing this issue after our bill the numbers went up in this actually helped you. And to be easy when questioned last week. Look ask people what does this bill hinder you. And that would be deputy assistant. There won't move the testifying Serb. No instances the bill hinder us doing our jobs. At some of who the democratic. Representative. Who who asked that question what any hearing was best. The hearing was an energy and commerce hearing. Li the chairman best. Uh oh on this issue what are the problem is this something prevented you from doing your job complexity here it was supposed to send any report. All. It was a six months they've been or yearly basis on how things were going and they never sent that. So they were really taken to task. By the committee the Republicans and Democrats and it was the Democrat who brought this up to the DA is saying. Well look you're doing more work now with our legislature what's the problem the company to a question wanna make it clearly the the government accountability. The Wall Street corner let's fix it and we did. End. The people who do do but it has to do just the pleasure of the president really that you are doing their work at all and they you know this guy go because you get an ax to grind. And he goes to open some like sixty minutes from the Washington Post. Come on and or that you didn't who's a Republican in the senate. And so that are more analysis with Democrat who sponsored it over there. And the like this and usually does that take care bill and change but there anymore and I never had a problem with that. And they had some real nice. The Washington Post and others saying this is nothing but. A couple of senators over there. Who are worried about being reelected. And so without even reading my legislation. To they have pages double spaced. We're the only language was changed those two lines in a paragraph. And they simply didn't have a chance to read it well they voted for. And the one senator says. Well I raised team with my staff and hold them you know he's blaming the staff and the person an elected official who blame their staff. It's pathetic. Because even more of a suspension vote we you know lists. From the what votes. In committee and on the floor during debate were voted on unanimously. Meaning no one voted against it. And it's there for them to read it just did they agreed it. They didn't take the time period it and they blame. Their staff which is I think is it's it's the hypocrisy is extraordinary. And so because they're in trouble in other states but it figured. Well look the laughter. With bill. That they didn't even read and they just paid attention to some weapons there it to their attention. Being Merlino they're giving money from a these Georgia mr. A lot of people lobbyists the people in my particular around the country to donate to my campaign. And if you have a look back to their senators. And this campaign he heck of a lot more money from me than me let's look ministry which says. Are you from portrait yeah. Aipac desktop based upon what you said there which seems to to make some sense than they've had some hearings why didn't you. Fight this more vigorously. Where when it could have been five in the aftermath of the sixty minutes piece and biting you explain it. To keep pure name in contention as drugs are. Because Lou what is normally done it was ready to go before. These. Senate judiciary committee for confirmation. And what is tradition always told to the person going to the community. Do not do any of your interviews do not do any speeches do not doing it. They've sometimes even playing not to vote but I don't go to DC and vote. And it was. You're gonna come up we're hearing you can explain all of this at this hearing. Do not say a word about the. What did you feel compelled to withdraw your name. Because. I wouldn't want. If they do in the way. The other work that we're pursuing. Thank you the detection of budget to reducing the taxes. You know the president has and also being thrown around him but but the it's what's best for me to step aside so they can use mutilate me grow up because you have to get the business of this country going. And one of the most important thing is doing this tax bill growing. And that's why did that in the in the resident said the being. Look closer and so and also we didn't do as good now let's just stick to. The security of business. And then sometime down the road. If confirmed interested viewer and I'll talk but. Is but I would've been a good. Drug czar because of my past. Experience of going after the drug dealers. And the way this helps so the drug court in my academy the oil sort of the education and their programs in the schools. And how passionately and in. Look to bring this epidemic which means the people that I was thinking about sitting around me we could've done this. Planning on running for office again Tom. And I have work to do and still sticking with these working on bill viewing issues which serve. Very important to me. I have been working on Oprah's doing this Jews were the longest time since they've been in you know. If congress I mean there are bill that. That I've worked well I was. One of the original. Spoken global recall the comprehensive addiction Recovery Act. That the group that a government sent down to the State's large amounts of money for prevention in for law enforcement. That's US congressman Tom Marino of the eleventh district. Talking about controversial legislation. Voted on unanimously by his colleagues and signed by President Obama. That leader derailed his nomination for US drug czar. You're listening to special edition on Entercom communications. You were listening to special edition on intercom communications. Hosted by sue him ring. Northeastern Pennsylvania has been decimated by the nationwide appeal it epidemic lack of on and loser in counties have been singled out along with ten other counties. By Pennsylvania attorney general Josh Shapiro. Has among the hardest hit in terms of fatalities from the crisis. Which killed 4642. People statewide last year. Doctor Carey meadows medical director of government programs for the guys in your health plan. Decide it last year to talk about how this epidemic has visited his own doorstep. He does so during governmental testimony. Public forums held across the state and to his own patients. He recently joined us to share information. On how one of the area's largest medical providers is approaching this issue on a number of levels well. It's actually started double spin. 1617 years ago and now my stepson had to work related injury and was put on medication he had multiple surgeries and so that's so long after you've got to help. And was going and we continue getting increasing. Various medications including opiates and business and the team. And when the doctor finally cut him off he. He switched over an error at that time he's had multiple overdoses he's been you know in and out of mall full rehab. Unfortunately. Follow in the classroom and enable her because. When your parents what to do anything and everything you can have your children Paula but I made a lot of mistakes we we admit that. We learn from our mistakes and the one of the big reasons that I speak out uses to help others try to learn from my mistakes. I think that's a good thing to do it and a lot of people have been held back by Stanley secrets and the drug addiction addiction in general is so shameful to so many different people that. They often suffer in silence so. Come to hear that you have that kind of connection. At least it shows that others I believe document a should start. Speaking publicly as well about what they're going through because this not only impacts someone in their family but also you and your wife and your children. Right that I mean it was serious suspect on the children actually mine. Son. When. Pictures sold at the time and he is only doing CPR on his. Older brother in the hallway when you had an overdose of our home in Cincinnati. And that has caused some significant issues over the years and he's been to California he's had a lot of a lot of pain from that incident. I think that's that's truly help me is speaking out there for the longest time I didn't speak out the reason I didn't speak out because I didn't want anybody you know. Then I realized last year when I start talking about it but it was actually healing for me and it is allowed me to connect with a lot of different people who are in the same situation and I. Like he says that that this disease that doesn't discriminate based upon. Gender socioeconomic. Status race. It can affect anyone and everyone. We have those seen some things happen in their recently where the president has come out and declared the open the only crisis. A health emergency. And I think. That a lot of people were already aware of that doctor meadows but as. As a medical provider NN's system how how do you see the announcement by the president to the country that this is a very serious issue. I think the big thing with CB announcement. Really puts it in the forefront there're there're still a lot of people believe it or not that's. Don't see this loses. As big an issue is really is right now if you look at numbers nationwide. In the time that we've been talking to. Which is well five minutes now who won at least one person in the country inside from over those seven or eight people die every hour from an old. The of the announcement puts it in the forefront is really but there's but the force for the federal government back behind it mail. The final report from Europe Buick with the commission that the president of established a few months ago it was supposed to be out later this week or. And actually a very interest in this see what what the final recommendation bars held those recommendations are implemented. Geographically. Our region of the country Pennsylvania proper where we are northeastern Pennsylvania doctor meadows we've really been. And slammed. By this and maybe that's why. It makes it says very personal for a lot of people Hampshire and other parts of the country it's not quite. What we have you had any idea or. Any kind of knowledge as to why. This area at northeastern Pennsylvania Pennsylvania proper. Has been no struck so predominately by the us. As far as pivotal Pennsylvania proper I really. Really don't have any firsthand knowledge of why I mean I could I could speculate. The first of multiple made major metropolitan areas if you look at. The economy is some would consider to be down a little bit of I mean I'm I'm originally from West Virginia and it west west Virginia's been very hard hit west Virginia's right over direct pipeline from the midwest then for the then significant economic downturn analysts suggest yeah. And that's that's what. That's always blame me blame it on down here I think a lot of the lot of the same. Same factors play into the northeast if you look at our guys think your health plan membership. Two thirds of the people that have a diagnosis of I hope he used disorder doesn't lose learn a lot on her who have addresses within our system that was unlocked on account at. That's a lot and I know it as a system view and the other administrators of your system have been looking for some ways to change this paradigm one of the things that I read on the on the Internet about disguising her it is that they. Are looking very seriously. About the long term. Efficacy. Of using both the ways to treat pain. So peace talk a little bit about that because we people who called our show doctor meadows and they said to us. We are responsible. About our medications. We've been on the for a long time and now our doctors are given us grief over them so I guess there's another end of this to the we've been hearing. Can you explain a little bit about that particular research. What we've always been here Geithner either back the tennis declining you know you're prescribing. And over over time. It had it's not just the recent start and a lot of that is been with education providers. Education parents you're patient. Also we continue to look at alternatives. Or use of opiates with the treatment of thing. OK and when you do that to is that at that we also heard from people that there might be out further limitations. On prescriptions of OP Lloyd's in the guys in your system and the New Year's that right eaters that not right. Wellington. In August. Department in the services that. Runs the Medicaid program in Pennsylvania. Required all health plans to implement prior authorization criteria for her appeal is catching your health plan have a significant. Medicaid membership in the northeast. So I'm sure you've you've heard about now policy went into effect for adults. September 15 so it was a it was a big change for providers members and the help went up. They Canada said these were these changes were mandated. By Medicaid. And we have implemented them. We're starting this he would decrease since some of the bottle so I think providers are getting more comfortable with a I think members are. Getting more comfortable with it. As a as a position myself. The main thing for me is that individuals get the medication they needed the time they needed the proper goes to the proper form we wanna make sure that people receiving. Best quality care possible. Have you received complaints from members though doctor meadows that they had cannot get their pain medications like they used to and that they truly need them and this has become. Something where they feel. Eat either and punish or. That the people are looking at them with a jaundiced eye because they receive these medications and they do use them properly. You know I I have heard some of that. In a lot of instances. When we're doing prior authorization reviews we don't we don't receive. A lot of the information we need me in a number of cases when we do receive information would go in the present. You're right here there are a lot of people out there have been on the medications for a while they do take it responsibly. And those of the people that we that we need to work we have to make sure that they don't fall between the cracks that they do continue to get the medication that they need. In terms of to using two millennia of these drugs that I was at a presentation. A different one than we wrap that they said. To any of these pills at once can actually lead to more pain for a patient is that an accurate statement. That is correct just a crack at so I so what we need to start doing doctor man Moses partners and Hollis is just saying to people. Look at the way you're doing this and make sure that you're not sabotaging your recovery further. OK so we need a lot. A lot of a lot of that involves. Education we need their educator community we needed care providers one of the things that I'm. Very intimately involved with probably more involved and with anything else right now with a lot of community education programs but only like the one you attended that in a variety of formats informed. Do you appeal and any of these community presentations. To. They young generation. Come to see if again these things can somehow in their minds. Up age equate to something that that may be dangerous or deadly to them I mean what is the strategy. For. You know looking at this with young generation. And now I'm getting them to to see it as a potential problem and in their future. But there it's it's interesting that you bring up. Younger generation we've been working with. Greater Susquehanna valley united way how to fund Barry. And a non profit out of Lewis Burke called DK choices. What we've done is that we have. Worked with these two. Organizations to develop school based programs and we've just completed. The number of programs in various schools and northumberland county region is we're. As for trying it out and seeing what's what method of delivery works. Involved. He used to. Rock music is interspersed with the videos that contained statistics and information. On substance abuse my prayer part of the show is. What about that entire part of the shows the laser lights. We also has videos of individuals. In recovery we just did one it should blaming high school Friday afternoon and we had two people on video. They had told their story in recovery. They only have one mother who lost her phone a year ago and she's just started speaking out the last couple of weeks. Once they hear the story in the room goes dark. And then the lights come up and these these folks that they saw on the video actually come out onstage. And speak speak for the kids and and they they're available afterwards order critic is the talk through. And offenses some of the student afterward that not only the wanted to check the women but the ones. That we've done in other other schools in the area. It's it's very powerful when they actually see these people in person and it's made a big impact has been quite a few students that have come forward ask for help or. Referred others for help as a result of these programs. Where am really happy to hear about that because there I I think that that educational component and what was discussed of trying to break this problem during a particular generation is such a wonderful idea I also know that. Doctors send and pharmacists. And others are. I think starting to view these medications in a different way and I we spoke I think it was you but I can't remember specifically. We talked a little bit about your own. Medical training in how back in the day. Doctors didn't spend too much time during their training. Considering. Substance abuse of any kind ray. Well not only that the fact when I trained. Thirty years ago we were thought the pain was that this vital site not only did we have to assess Spain but that patient had a right to be pain free. And we were taught that we. Should do whatever we could because. Your patience paid for and turned out now that they be treating pain as the fifth final fine it was not. The most appropriate thing to do. I also understand that a patient satisfaction. Surveys in the past had. Some questions about. Whether or not. Individuals who were hospitalized. Thought that they were in it in a good stayed in it in other words. You know what what was their pain like while hospitalized is there any attempt by guys singer to revisit. Patient's satisfaction in regard to that you are you looking at it a different way to assess the the quality of treatment a patient receives in the hospital or elsewhere. Without are relying so much on those questions. I can't really speak to what the hospital is doing themselves but I know the I'm a patient. In the guys in your system my primary care doctors here ninth I know that this survey is that I receive. Don't talk about pain don't talk about medication they talk about. Demeanor and service and quality. There are. Much more generic surveys that they really seemed to get to the heart of what we would wanna know about the quality of care that you received that at the office. They're singer also obviously asked to work in conjunction with its partners to approve. The rehabilitation. Treatment of certain initial staff to man doesn't we know that we often hear twenty. Days and sometimes that doesn't even in Japan now it's more like fourteen year or whatever but it is there changing philosophy. About so trying to decide what kind of treatment and for how long patients who are sincere about a recovery. Get using their plans. You know I I think it varies depending on what region of the country here in employment. What the retardant so resources are that are available. In that area I know here in you're in the Danville area there really aren't a lot of water resources available or. People in terms of inpatient services there's sort of there's a limitation on the number of inpatient facility know we have. We really didn't outpatient services down here and the northeast we have we have got a finger. Facility Omar word which is an inpatient facility that also have an outpatient services they base to have very good job but that's often difficult to get a bad there. But the point one of things that we need to work toward as a nation is having the appropriate level of treatment available. Or the appropriate person you brokered they've from from personal experience with my stepson. He'll walk in it's they are ready to get help. But that would that window of opportunity may only last for an hour or two and there were quite a few times when you ask for help we couldn't. Find a place to get him help with that at the time yes or and then the window was gone. Doctor Perry meadows is medical director of government programs for the guys in your health plan. You're listening to special addition on Entercom communications. Your listening to special edition on intercom communications. Hosted by sue Henrik. Industrial decline in former manufacturing hubs. Has been a big problem for cities in places like Pennsylvania. Although the industries have gone. There are pension obligations. Debt issues and other financial struggles facing some areas. That haven't been able to replace that base. And in climbing poverty. And it's a recipe for concern. On the part of municipal leaders. Stephen I'd senior fellow for urban and policy. At the Manhattan institute. Recently joined us to discuss report he authored on revitalization. In the Rust Belt. Tired from work because funding for state and local fiscal issues so I've looked dead you know the problems of the dead taxes tension simply don't like California Detroit Michigan in your New York City. On the in this report they take you kind of broad look at its fiscal challenges as they exist. On the new spelled in the former industrial areas and the midwest and northeast. IAEA to be selfish about the stuff but don't Pennsylvania does appear in this report so curious how we give us a little bit of an insight into that. Oh that's how does that play this Blake spear even more readying Scranton and in Pennsylvania are facing art in many respects similar to what's going on in Michigan Ohio and even Connecticut Massachusetts found. It's a long term decline in in the manufacturing jobs and the taxpayers are related to that the same time that the population has been declining. And also the poverty Erie has been increasing in these places under debt load their per capita debt load in inflation adjustment to get adjusted terms has been increasing. And that's also been increasing the amount they go for pension and retiree health care liabilities notes at the same time that. There and basically increasing the promises there long term fiscal problems is that they're making. Under the tax base that's been behind this promises has become weaker and weaker raising questions about. Yeah way up well the penny in some cases but I'm you know you'd pat these seem bankruptcies and insolvency. But in all cases Isa which you see is more and more money from the budget going to pay for the cost of perhaps of the patent restricting services in the present. Yeah you got a smaller pie and you have. Increasing Harvard me it's just. It seems like that. Have a recipe for. Disaster. Need in terms of of where we go from here because I think it says in your report that a lot of these places that are Rust Belt areas and cities they've held their own. Loan unless and in its like I guess trying to tread water when you're drowning them into what's the prognosis for the future well. Now everybody is gonna have the added that off this place Pointe Michigan and Youngstown Ohio on Detroit I mean these are places where the big town just turn it into poverty rate is much lower than those places. But that's the same time Scranton is pretty far off from where New York City and Boston and are right now I mean there's a real vibrant comebacks studies so the city to kind of find themselves on the spectrum by. Yet they have to be very realistic in terms of what they can expect it. And then near term and also what they can effected by means the policy I mean there's just they're just so many factors that they cannot be influenced at this that the local level. OK so and should they hate to say things like this should they be looking to other levels to help them solve. You know if they if they can't afford it do you think those they'll have to I don't know deeply in Britain's case Stephen which is the last thing about a lot is they've been in a distressed city for very long time somehow you have suggested that perhaps certainly the one thing that might be able to save them as a bankruptcy filing but then people say. Well Scranton files bankruptcy it gives a judge kind of leverage to come in and slapped. Taxes on on people that they can't afford some late they're kind of stuck between a rock and a hard place. I mean Pennsylvania into my knowledge have not been never had so it's. Law and bankruptcy mean there have been studies that tried to file for bankruptcy like Harrisburg Scranton it's kind of this you know per touch this cycle of brinkmanship or they're almost on the verge of consultants have been somehow it's. They've got caught. It's gonna give it a certain point and the fundamentals are so weak my I mean I prefer state oversight what you're talking about a bankruptcy or not I'd prefer to see state government can step up and take take control. I mean indicate depend on May need you have a history as well I think government trying to do something for many cities but. You know people are dissatisfied with how far that that has gotten so maybe at a certain point Pennsylvania is gonna need to need to think about need to revisit its purse to state oversight as well. And a Pennsylvania of course as this eight. Has its own deepening. Fiscal challenges based upon the kind of things that you just talked about which are pension obligations. CD's I need that the situation in Connecticut as well where you have a city that Hartford the capital now on the verge of bankruptcy but the state also has one of the worst funded pensions system. And the nation and so local officials are part of the the first thing women you guys are gonna comment and told Medicare finances in shape like ooh look at certain books but. On the and that's a pretty legitimate criticism. Because this state could have been so they're physically derelict and so anyway it's. You know at the local level sometimes it just becomes a political logjam and politically speaking they just can't. In this summon up the strength they need to return to make a decision that need to make. I stepped a statement when this state come bend in the play is willing to be the bad guys sometimes they create a little bit of political space. On the air ultimately I think if they pictures just in all the states flat one way or the other the federal government is not coming to the rescue. It's just a question of whether one end of the states intervened and now. And also Pennsylvania and it is saddled with I'm a business tax that is one of the highest in the country so even trying to say to people. Listen and who comes in Pennsylvania. It just seems she's such a tall order of course Pennsylvania has also shed a lot of manufacturing. Nom but you know locally we've we've shed some things not as obvious says so does the class of the steel industry for say in the western part of the state Iowa where we live over the years I mean we've had that the slow decline where we used to have a vibrant. Mining. Situation because we have anthracite coal we had. Also production factories that made things like that dresses. Flat screen TVs. And now our TV screens now seems not as optimistic. That you know industry wants succumbed to Pennsylvania at all. Yeah and then in terms of the tax situation there's a lot of uncertainty that manufacturing mean you know maybe SM manufacturing could come back and able if you're talking about higher do you know manufacturing of higher quality you know fewer jobs. I know this but. The tax issue which the first point you raised what. When you have these elevated debt in retirement benefit liabilities and didn't this slightly seated as a tax increase waiting to happen and if you're dead is very very high. It's difficult to lower taxes. And if anything it looks like. There is gonna have to go at a certain point so you know to keep to at least hold the line on taxes. You got to somehow under terms of these petite legacy cost burden. And that's something that you don't Indian cities do have authority over their budgets like let's let's talk about that. And let's stop speculating about you know the global economy which is going to be influenced by some of these things some of the other factors that. That can't be controlled the municipal level. When you say coming to terms what is that what you mean by that I mean in in their car they just gonna have to in the future of thumb. Now open contracts or when contracts are upbeat much more harsh when it comes to the negotiations of these municipal contracts. I think in many blues stable situation which is a common which is what you had throughout the Rust Belt and com government unions do you have more influence over that that they're pop and we'll take engines and their compensation packages excuse me that is. They benefit the common good we're gonna have to have a discussion about that in in terms of the ports kind of benefit promised says look if you if you pop a few that haven't been any substantive economic progress over the last few decades if it's a really bad idea for you to be making pension promises. They're not gonna come due in like fifty years it's good where you'll be in fifty years and we simply won't be that much worse off. Are you going to be like substantially better are you going to be back to where you're in the 1950s. Probably not a let's start budgeting for the near term instead of pushing his legacy costs. Well into the future you know Japan economically it only carried I think that's that you're gonna be able to pay these. Appeared to be better position to pay these things off fifty years from now and then you are now. So they address in your report. Property taxes and and how much of that of that income as states are dependant on end and where we live Steve I must say that that issue is so very important to the people who live it in in our area of Pennsylvania although in other areas not so much. Tom how does that play in to your report. A couple ways that the property tax issue becomes. You know salient in these debate but the feature Rust Belt being disputed property taxes there are very high and and need it and Connecticut New Jersey but upon property tax politically very charged issue could or would be very fine people don't want to see him go higher. Issues like what is happening your property tax base that the economy has changed more and more the tactic and notices that issue in Michigan Pennsylvania and has been occupied by not tax exempt institutions. Tyre red medical centers. They don't pay property taxes. And done the they've been growing they provide lots of you know well paying jobs that great but. They built there they don't provide the same amount of benefit in terms of the city's budget so. Having this it is just discussions about pilot Serbs you know where to find. An adequate level of revenues and so much of your tactic to get all the action in your tax basis on the non profit level. And your profit the profit side not a lot happening then good does tend to create a kind of imbalance and you know very few cities have come to really adequate solution without issue. And I what are the day you will come when. Those entities that are quote unquote non profit. Are. Just put on the tax rolls like like other properties are and what that could mean. To this cities who often find themselves financially strapped because entities are are buying everything. It's really complicated because when he talked about you know go to hospitals even some of their money is coming from the government in directly one way or the other so whether it's you know Medicaid or some other Medicare. So if you're you know you're taxing them and you know it may be hearing increasing the revenue is coming into city government which you would be increasing costs for government on some other end so. It's a very complicated issue you know when we. You know came up with the idea to keep cheer pub securities example property taxes we didn't envision the type situation you'd have now we have you know executives make millions of dollars a year. You know these protests have to get enterprises. But just kept letting your property tax on them impacting them. I'm like you would any other businesses. You know and probably not a good idea and certainly not practical in the near term. Tarrant and based upon your arm. Reading of this report did anything inherent surprise you dramatically here was this pretty much we expected to find. Well I would think that there was some what I expected defined in the you know I think they're right like I think there's an important discussion to be had about. You know what it is that there are differences between these cities. Combat poverty is not necessarily doesn't mean there are. Port cities that are doing OK some city near Pittsburgh has had just catastrophic. Population want from the yet you know most people think that's burgers and one the most successful. Aren't you for the most inspiring comeback these stories and the nation so. You know we can't just be totally fatalistic quickness to government officials can't prepare can't that they would expect that China is gonna bury us. We have to focus something that we can't control and try to make improvements even if this prudence are gonna be marginal and they are gonna bring it back to the good old days. That's Steve denied senior fellow for urban policy with the Manhattan institute. You're listening to special addition on Entercom communications. Thanks for listening to special edition. A weekly look at these issues in the news and the personalities shaping the stories.