captioning sponsored by wnet >> thompson: on this edition for sunday, june 26. the potential costs of leaving the european union, for foreigners living and working in the u.k. and in our signature segment, unexpected medical bills that are not covered by your health insurance plan. >> i'm thinking there's no way i'm going to pay this. this is insane. >> thompson: next on pbs newshour weekend. >> pbs newshour weekend is made possible by: lewis b. and louise hirschfeld cullman. bernard and irene schwartz. judy and josh weston. the cheryl and philip milstein family. the citi foundation. supporting innovation and enabling urban progress. the john and helen glessner family trust. supporting trustworthy journalism that informs and inspires. sue and edgar wachenheim, iii.

corporate funding is provided by mutual of america-- designing customized individual and group retirement products. that's why we are your retirement company. additional support has been provided by: and by the corporation for public broadcasting, and by contributions to your pbs station from viewers like you. thank you. from the tisch wnet studios at lincoln center in new york, megan thompson. >> thompson: good evening and thanks for joining us. britain says it will set its own timetable for leaving the european union. following thursday's referendum, where a majority of british voters sided with exiting the 28-nation bloc, today britain's foreign secretary said the timing of the split is entirely for the u.k. to determine. meanwhile, an online petition to the british parliament calling for a re-vote has obtained three million signatures.

reporting from london is our own hari sreenivasan with the latest developments. hari? >> sreenivasan: good evening megan. i asked one of the members of the committee what this means, he said nig with 100,000 signatures gets a debate, it doesn't change the law. two or three million people decide to sign the petition that's all it means. >> while the european unio while the european union waits, there's no word on when the united kingdom will file its divorce papers. this was british foreign secretary philip hammond in an interview today. >> there is no imperative on us to serve the notice at any particular time. the referendum is an internal matter. the british government as a member of the european union is entitled to serve that notice. >> sreenivasan: scotland wants to stay in the e.u. and, and today, scotland's first minister, nicola sturgeon, said she is considering two steps-- blocking the brexit by withholding the scottish parliament's "legislative

consent" and scheduling a referendum on scottish independence from the u.k. >> what is going to happen with the u.k. is that there are going to be deeply damaging and painful consequences of the process of trying to extricate the u.k. from the e.u. i want to try and protect scotland from that. >> sreenivasan: while british prime minister david cameron, who led the remain campaign, has said he will resign, there are now calls for opposition labor party leader, jeremy corbyn, to do the same, for his shortcomings in the remain campaign. >> we need strong and effective leadership of the labour party. i told jeremy corbyn last night that i no longer had confidence in his leadership. >> sreenivasan: in rome today, u.s. secretary of state said the u.s. and its allies would work to provide continuity and stability in europe and minimize economic disruption. >> we will continue, the united states, to have a very close and special relationship with great britain. we value that relationship, that does not change because of this vote. >> sreenivasan: while the brexit

>> anxiety in the markets and it cause the british pound to plunge it also caused a lot of anxiety among the immigrants who are living and working here. they're trying to figure their way forward in a changing nation. the master diner in central london serves up hearty english meals to a steady stream of regular customers. manager sergio freitas originally from portugal, moved to britain 20 years ago. this was his land of opportunity. >> at the time that i came, it was very easy, because it was part of the e.u. until today, i've never done papers. i've only had the portuguese passport. exit, it's going to be much more difficult. we're going to need to apply for visas and everything, all of those stories. it's going to be much, much more difficult to go out and to come in. >> sreenivasan: since he arrived in 1996, sergio's work has been steady and upwardly mobile, and he lives near a large extended family, 80 cousins in all. >> the job has been the best

thing i have, which has been great. for 10 years, i've been working so i've got house, car, i've got everything, family. don't know exactly what's going to happen. >> sreenivasan: so many members of the service industry in london are foreign-born, and for them the referendum means uncertainty for their livelihoods and their futures. in london, almost three-quarters of hospitality sector workers are from somewhere else. 25-year-old waitress michaela faia emigrated from romania five years ago. she's three months pregnant with her first child and is now unsure, after her baby is born, if they'll be able to stay. >> i'm a bit scared in one way. i will see if i can apply for my residence, since i have already more than five years since i live here. >> sreenivasan: she hopes to obtain a permanent residency card, but if she does not get it, she does not want to go back to romania. >> it would be hard, because i don't have so many opportunities to find a job. but we'll see.

>> sreenivasan: another concern is the weakening of the british pound since the referendum. that could lead to inflation, pinching workers' pocketbooks. >> everything is going to go up. prices, i don't know what's going to happen, but i think it's going to be a catastrophe. >> sreenivasan: george, who gave only his first name, is a regular customer here, and sees e.u. membership differently. he voted for britain to leave, hoping his future might be more like his past. >> i voted for it. >> why? >> why? well, i don't think we should be doing what others countries tell us to do. i think life was better before 1974, when i was younger. >> sreenivasan: george believes immigrants, often willing to work for lower wages, cost the native british jobs. >> i think there's too many immigrants over here. i don't mind them. they're doing their job, but they're still doing english

people out of work. >> it is absolutely incorrect to say that 'ie.u. immigrants that are taking my jobs away from me.' >> sreenivasan: london school of economics professor swati dhingra says historical evidence shows otherwise, and actually foreign-born restaurant workers are among those likely to feel the "brexit" effects acutely. >> the service sector is 80 percent british economy, so we're talking about something happens in services it will be felt everywhere. >> sreenivasan: paul scully is a conservative party member of parliament representing a borough in south london that voted to leave the u.k. he split with prime minister david cameron to support the leave campaign too. >> we need to manage our immigration numbers, but in a fair way. >> sreenivasan: m.p. scully says he expects immigrants already in britain will be safe. >> we went to a shop yesterday where the manager has been here from portugal for 20 years. his waitress is from romania, she's been here for five. she's pregnant with her first child and now there's a cloud of

uncertainty she going to stay, her child is going to be british or not. >> yeah, i think there's been a lot of rhetoric in this campaign. i don't think anyone in the mainstream is saying that we would do anything with the people who are already here. who are already providing services that are supporting our economy, enriching our culture and communities. they need to be welcomed. and actually they need to hear the message-- that they are very welcome. >> sreenivasan: but for foreign workers like sergio, the coming separation from the e.u. leaves him feeling uneasy. >> i'm really not sure what's gonna happen, but everyone at this point is very scared of it. so we're going to see what's going to happen. for the future. >> sreenivasan: as you can see megan it's a tense time for people here in britain. >> thompson: hari sreenivasan, we'll see you tomorrow on the program, thanks hari. >> sreenivasan: thanks megan.

>> thompson: in a 2014 referendum, scotland decided to remain in the u.k., but now scottish leaders are calling for a do-over, pushing to exit the u.k. in order to preserve scotland's membership in the e.u. 62% of scots voted last week to remain in the e.u., and one poll published today finds 59% favor independence from the u.k. earlier, i spoke with newshour special correspondent malcolm brabant who is in the scottish capital of edinborough. >> scots voted overwhelmingly to remain in the eu. what's behind that? >> you can't believe the sort of anger there is up here with this whole outcome. when the scots decided to have a referendum two years ago to vote whether or not to stay in the united kingdom the reason why so many of them decided to stay is that they have been convinced that it is the united kingdom within europe were a better place to be than outside it they would be stronger within. now they feel as though they've been kicked in the teeth by the english especially and they want to stay. >> what have you been hearing from some of the scots you've been talking to? >> for example, a woman from

women for independence, they believe that scotland is much pert off within the european union. also somebody from the scotland business association, they believe that scoot -- scootish business and industry will be so much better within. they're really concerned about what's going to happen. they really believe that the english and the welch voted whelming to get out of the union. they led by the bliedly they're really disturbed by the whole situation and young people in this whole referendum issue that feel that their future has been sold by the river, by all the people voting for no, si nostalr britain that perhaps never existed. >> the first minister nicolas sturgeon said that perhaps

schand could block this is she realistic? >> i believe she's doing everything she can to remain within the european union. but that idea has been poo pooed by experts and there is no way the scottish parliament can veto it. >> thompson: how about the chance for another independence vote in scotland? >> that's certainly what many people want here and even those who voted against the referendum last time has said, let's vote for indiana. >> thompson: thanks so much for being with us. >> thanks megan. >> thompson: one in five working americans with health insurance say they have problems paying medical bills, and they frequently use up savings, increase credit card debt, or

borrow money to pay them off. the bills are part of a growing frustration-- the unpleasant surprise when your plan pays less than expected, sometimes because you saw a doctor who, unbeknownst to you, was not in your insurance company's network. in tonight's signature segment, i went to new jersey, where patients, doctors, hospitals, and insurers are at odds over how to solve the problem. >> reporter: after suffering a heart attack 20 years ago, leigh lehman of hillsdale, new jersey, does what he can to eat right and stay in shape. but the 64-year-old computer consultant still has occasional health scares. last summer, doctors told him he needed a quintuple heart bypass. before the procedure, he confirmed both the valley hospital, in ridgewood, new jersey, and his surgeon, accepted his aetna insurance, which he gets through his employer, a small consulting company. >> but a few weeks later, after the surgery, i got a bill in the mail. >> reporter: the surprise bill

was for nearly $2,200. it was from a critical care doctor in the intensive care unit who did not accept lehman's insurance. >> out of nowhere, somebody who you never heard of, i don't remember meeting, sends a bill. why is he not accepting the insurance? why is he out of network? >> reporter: lehman says he contacted the hospital and insurance company, but they told him there was they nothing they could do to reduce the bill. so he dug into savings to pay it. >> it's a little stressful. you're trying to recover. it's major surgery. i mean, i felt like i was hit by a truck. >> reporter: something similar happened to andrew heymann, an accountant from hackensack, new jersey, who had health insurance through his employer from anthem blue cross-blue shield. >> there was blood and glass all over this part of the parking lot. >> reporter: two years ago, when he was helping a neighbor move, a large glass table shattered, and a shard of glass sliced into heymann's left ankle. an ambulance took heymann to the

closest emergency room-- at hackensack university medical center-- which he knew was in- network. his ankle wound was so deep, the e.r. called the plastic surgeon on duty. >> and he came in, and sewed up my leg in probably about 10 minutes. >> reporter: but that surgeon did not accept his insurance. heymann received what's called " balance bill." the doctor charged close to $6,000. blue cross covered about $860. and heymann was stuck owing $5,000. >> i'm thinking there's no way i'm going to pay this. this is insane. and it's kind of almost like, whatever if you want to call it, false advertising, when you get some kind of a crazy bill from someone who's not in the network, and you really had no control over the fact that they would be there. >> reporter: the hospital wouldn't discuss the specifics of heymann's case, but said it recognizes "the current system is not optimal." after six months of fighting his bill and appealing with his

insurer, heymann discovered his employer, a large education company, was supposed to cover the charge, and the company paid it off. chuck bell, programs director at consumers union, the advocacy arm of consumer reports, says the frustration of surprise medical bills is growing. >> we've received, literally, thousands of stories from consumers all over the country that are having this problem. >> reporter: last year, "consumer reports" found that 30% of americans with private health insurance have received a bill where their plan paid less than they expected. of those, 23% said they got a bill from a doctor they did not expect to get a bill from. and 14% said they were charged higher "out-of-network" rates by doctors they thought were in- network. bell says one reason for surprise medical bills may be that insurers are increasingly offering "narrow networks;" cheaper insurance plans that give patients fewer doctors to choose from. >> but the problem has been that it's very hard to actually use your narrow network in practice. when you actually go to a hospital or an emergency room,

you inevitably run into physicians and providers that are out-of-network, and then those costs quickly mount up. >> reporter: bell says surprise bills have been a problem for a long time, but it's possible more people are getting them, because more people are insured. since the affordable care act passed in 2010, 20 million more americans have health insurance. >> and probably most of those patients do not have very rich or generous out-of-network coverage. so, when they get a bill, they may have to pay the whole thing by themselves. >> reporter: leigh lehman's $2,200 bill for his heart bypass wasn't his first surprise bill. the year prior, he was hit with a $4,500 bill for a visit to an emergency room that turned out to be out-of-network. lehman sold some property and used money set aside for his daughter's college tuition to pay his bills. you make a good salary. >> yeah. >> reporter: you have what you called good health insurance. >> yes. >> reporter: did you ever think you'd be struggling to pay medical bills? >> no. it's probably going to take a couple of years before we get

back on track. >> reporter: we wondered how patients like lehman end up seeing out-of-network doctors at an in-network hospital. neurologist john nasr has a private practice in new jersey and sees patients at the valley hospital, where lehman got his bypass. but nasr is not on staff there. instead, to get paid what he thinks is a fair rate, he has to negotiate his own insurance contracts. as a result, he's not in-network with every plan the hospital accepts. >> over the years, insurance companies have typically reduced payment, year after year, to the point that many insurance plans pay below what medicare pays. and this becomes unsustainable. doctors can't practice like that. >> reporter: nasr says even when he is in-network, some patients with high deductibles are surprised by what they owe. when he is out of network, nasr is permitted to bill at a higher rate to the insurance company and patient. so, a patient's done his or her research. they found a hospital that's in- network. they've found a provider that's

in-network. but then they end up seeing a doctor like you, who's not in- network. the patient would probably say," this isn't fair." >> yes, it is not fair for the patient, i agree with you. as a practice, our policy is to work with the patient on out-of- network payment. so, we understand it is a hardship for the patient when they are seen urgently by a provider who's out-of-network, and they did not anticipate that. >> reporter: doesn't the doctor then have a responsibility to inform the patient, 'ihey, i'm not in your network?' >> if i'm taking care of you in an emergency, i don't even look at your insurance. because we don't want anything we do to be swayed by insurance. >> reporter: and neither do hospitals, says joe devine, the president and c.e.o. of kennedy health, a chain of hospitals and clinics in southern new jersey. he says kennedy can only require its contracted doctors to participate with the same networks it does. >> we cannot legally force the independent doctors to participate in contracts. unfortunately, what's happened

is they're sending bills to patients, and what we'd like to do is come up with a solution where we do not put the patient in the middle of this. >> reporter: when a patient walks through your doors, doesn't the hospital have an obligation to say to them, "hey, you may be in-network at this facility, but not all the doctors you see may be in network." >> in the emergency situation, most people are not thinking about it. we're not going to have all of a sudden someone come over and say, "well, you know, you may get an out-of-network bill." that's not what we're here for. when they've decided to do an elective procedure, the hospital does have notification forms that actually allows them to understand it and what they may be responsible for. >> reporter: what does that look like? is it a letter, a phone call? >> we have a voluntary sheet that kind of shows them that they're out-of-network and what their responsibilities would be. we also have it on our website. >> reporter: however patients are notified, doctors still complain that they're out-of- network because insurers don't pay them enough. but kevin conlin rejects that argument. he's the chief operating officer of horizon blue cross blue shield, new jersey's largest health insurer. >> more than four out of every five physicians in the state are

in-network with us. so, four out of five find what we make available to be reasonable. >> reporter: conlin says carriers also take a hit when doctors and hospitals charge them at out-of-network rates, because there's no limit to what they can charge. he estimates new jersey's insurers pay around $2 billion a year to cover out-of-network care. >> it contributes significantly to our premium expense that's absorbed by all new jerseyans. >> reporter: and that's why insurers are pushing the state legislature to limit the amount doctors and hospitals can charge but doctors and hospitals strongly oppose that. >> so as an industry, we need to make sure we protect the ability for the individual hospitals to be able to negotiate fair rates with the insurance companies. >> reporter: this stand-off is largely what's holding up a broader bill in the new jersey legislature. it's one of 28 states considering protections for patients against surprise medical bills. four others-- illinois, florida, new york and connecticut-- have already passed laws. >> for so many new jersey

families, they just can't afford it. >> reporter: state senator joe vitale is a sponsor of new jersey's bill. it would mandate most doctors to participate in the same networks as the hospital, require doctors and hospitals to notify patients if they are not in network, ban doctors from balance billing and set up an arbitration system to press providers to defend their bills, and insurers to defend their rates. >> in the end, there's going to be an understanding, you know, what bill is going to be fair, and what reimbursement will be fair. and if you are extreme in either one of those circumstances-- whether you're the provider or the doctor or the insurance company-- you're not going to win. >> reporter: but after years of pressure from consumer groups, and negotiations, including a state assembly hearing this past week, the bill has gone nowhere. why hasn't this passed? >> well the interest groups, whether it's the hospital system, or the medical society, or the insurance company, we kind of try to, we get to where we're close to an agreement,

suddenly the goalpost shifts a little bit. >> reporter: so until new jersey passes a law, patients like leigh lehman are largely on their own. the hospital where lehman had his bypass wouldn't discuss the specifics of his case, but said, more than 90% of its physicians accept the same insurance that it does, and, it informs patients about the other doctors who may not. after newshour contacted aetna, lehman's insurer, the company reviewed his case. it told us lehman was not, in fact, responsible for the $2,200 balance bill he received. and that it will be reimbursing him for what he paid. but, lehman is still paying off that earlier $4,500 emergency room bill. >> it gets a little crazy. it gets to the point where you're reluctant to go see the doctor. >> thompson: read more stories about surprise medical bills online at pbs.org/newshour. >> this is pbs newshour weekend, sunday.

>> thompson: in california, a wildfire raging since thursday has now consumed 200 homes, including that of an elderly couple who died. more than 1,700 firefighters, taking advantage of light winds today, established a perimeter around the 58-square mile blaze, which is only 10% contained. 2,500 homes are threatened by the fire, an hour east of bakersfield and two hours north of los angeles. president obama has declared a state of emergency in three west virginia counties overwhelmed by flooding, triggered by 10 inches of rain over two days last week. the declaration will allow residents who lost their homes to apply for aid from the federal emergency management agency. at least 24 people died in the deluge. 18,000 homes and businesses in west virginia were still without power today.

eight survivors of the mass shooting at a gay nightclub in orlando, two weeks ago today, are still being treated for gunshot wounds at the orlando regional medical center. yesterday, they received a special group of visitors from boston, ten survivors of the 2013 boston marathon bombing. boston survivor celeste corcoran said, people who try to spread hate do the opposite, that hate brings together strangers and makes us more tolerant of people. there was a moment of silence to recognize the 49 people killed and 53 wounded in the orlando mass shooting at the start of today's gay pride parade in new york city. more than 1.5 million people were expected to attend the 46th annual celebration of the city's gay, lesbian, bisexual and transgender communities. and there was a heavier than usual police presence. san francisco, seattle, chicago, cities holding pride parades this weekend. june is gay pride month.

and finally tonight, the italian coast guard set it recognize night more than 3,000 migrants on the mediterranean sea, 25 rubber dinghies who drifted 25 miles north of the libyan coast. italy has received 2500 immigrants by coast. that's all for this edition of pbs newshour weekend, i'm megan thompson, good night. captioning sponsored by wnet captioned by media access group at wgbh access.wgbh.org >> pbs newshour weekend is made possible by: lewis b. and louise hirschfeld cullman. bernard and irene schwartz.

judy and josh weston. the cheryl and philip milstein family. the citi foundation. supporting innovation and enabling urban progress. the john and helen glessner family trust. supporting trustworthy journalism that informs and inspires. sue and edgar wachenheim, iii. corporate funding is provided by mutual of america-- designing customized individual and group retirement products. that's why we are your retirement company. additional support has been provided by: and by the corporation for public broadcasting, and by contributions to your pbs station from viewers like you. thank you.

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