i'm. a trove of classified documents is found in a rubbish bin in london. to the u.k.'s top secret chemical lab facility porton down an investigation has been launched. i'll go and you commission president slams the lack of transparency when his likely successor was agreed on. that questions regarding. the wrong says it. was illegally seized by the u.k. and its release britain insists the vessel was bound for syria. sanctions. child of america's youngest ever congresswoman deletes social media accounts of the

reportedly receiving death threats from supporters of alexandria. from washington came before. socialism to socialism let me. first. get more all stories on all back in an hour's time right now though it's a new episode of the big picture. on this week's show happy birthday oncle sam 6 months down 6 to go as we pause for the 4th of july weekend the 2019 halftime report but 1st as the immigration debate royal. stations are implementing new ways to help those who make it here in

life threatening circumstances and it's summer time summer time some some summer time and based on how stressed many of us are at work vacation can't come soon enough i'm holland cook in washington this is the big picture on our t. america. unless the economy tanks the 2 biggest issues in the 2020 presidential campaign now unfolding are likely to be health care and immigration and the intersection of both controversies are undocumented immigrants who comprise 3 percent of the usa population and are 27 percent of america's uninsured of them an estimated $6500.00 people are suffering kidney failure according to the national institutes

of health and anyone who's on dialysis knows that it's expensive what kind of care these immigrants get depends on where they live whether they get health care is the political half of the story but as for the medical issues let's ask dr rajiv raj of them a board certified internist and just who practices in the houston area and teaches at the baylor college of medicine dr welcome. thank you thank you for having me much of the health care that the uninsured undocumented immigrants get is in the emergency room where since 1986 the federal government has required that patients receive care regardless of their immigration status or their ability to pay docked before we zoom in on the kidney issue the wide angle shot even for patients who pay is not the e.r. the least expensive way to get health care. no you're absolutely right the emergency room is definitely inefficient and

a lot of it is it's very easy you know if you don't have insurance or if you have insurance that's very restrictive and not except in a lot of places all you have to do is pop into the mergence room you may wait a while but you know you're going to be seen the problem with that is that it leads to long lines in the mergence room and so a lot of patients will show up with non-emergent conditions and these take up a lot of valuable resources plus there's poor follow up if you're treated with high blood pressure diabetes in the merge and serum you rarely going to get a follow up appointment to help manage those and so you keep showing up in the mergence the room being treated for these chronic conditions so it's very inefficient i misspoke a minute ago i said least expensive but you're caught my point at least efficient now about those 6500 who are dialysis dependent fewer than half receive treatment only in life threatening circumstances rather than the ongoing treatment the insured receive and i have read that after just a couple weeks so many toxins have built up that these folks end up in the hospital

overnight to be dial ised twice the cost of which is some $300000.00 per person per year now cost aside what is a life like for someone who's walking around in need of regular dialysis that they're not getting. yet kidney failure is a terrible disease and so there's about 600000 individuals in this country who are citizens who are getting dialysis and basically for all of us whose kidneys are working 100 percent of the time we're filtering the toxins out of the body were making urine but if you're on dialysis the only time that you're actually getting that done is when you're connected to a machine which can be as short is just 12 hours a week so during that time that you're not on the machine these toxins are building up they're making you feel nauseous sick you have to be on a very restricted diet on average patients on dialysis are taking about $15.00 to $20.00. hills per day just to kind of do the jobs that the kidneys normally do so

when you add to it this conundrum of patients who fall through the cracks because of their lack of citizenship they're getting only on emergency basis so they have to be life threatening critically ill showing up to the mergence room to get a single dialysis treatment and if they're not they're just walking around like zombies. yes that's true quality of care status quo depends on where you are in washington state the medicaid system includes what's called the a.t.m. alien emergency medical care which pays for dialysis and chemotherapy for undocumented patients and illinois was the 1st state to pay for organ transplants for undocumented immigrants doc as i said up front we can talk about the politics of this issue another time but from the standpoint of health care delivery don't programs such as these states are offering straining the entire health care system

less than the ad hoc life and death status quo elsewhere. yeah that's true so there's about 38 states that use emergency only dials it's only 12 states in the country have used their state resources medicaid primarily to cover dialysis and or organ transplantation with illinois being the only state that's passed it so correct as you point out going to the merchant's room is much more costly it's less efficient and for these individuals it's really hampering their way of life and so providing scheduled dialysis or even organ transplantation regardless of your political views is a more cost effective you more cost effective way of treating these patients as a have prepared to chat with you about this i've been reading up about home dialysis is this a technology breakthrough. home dialysis has been around for a long time patients who do dialysis at home primarily do it's called peritoneal dialysis which is the dialysis that uses essentially or own body as

a filter for fluid comes in the body in fluid leaves is different than he dialysis which is a blood based type of dialysis appeared you know this has been around for a long time it's done at home so you do it on your own schedule it's cheaper option as such the main resource constraint is that you have to have the space and. house to to do contain all the fluids in the machine and a lot of undocumented patients just don't have that space and so in states that have expanded medicaid and allow patients to do dialysis who are undocumented either at home or in a clinic a lot of times the resource and the space is what constrains them from doing home dialysis tech to receive raghav then in houston thank you for joining us on the big picture the wall street journal reports that employee health benefits cost starbucks more annually than coffee beans general motors spends more on them than on steel but beyond that giant budget item every company's business practices

affect the physical and mental health of its employees the centers for disease control and prevention is called stress the number one workplace health problem head of physical inactivity and obesity it affects both blue and white collar jobs across a wide range of incomes and it's a leading contributor to turnover absenteeism and productivity losses why and how to whistle while you work let's ask mark rutherford a licensed psycho therapist in private practice in south florida you may have seen his ted talk on you tube mark welcome back to the big picture. welcome thank you for having a human resources professional gave me a new buzzword it's not absenteeism it's present t.v. ism meaning you're at work physically you're just not on your game why are employees dragging. life. they're worried about

they're worried about their productivity of work but they're also worried about their home life and their relationship and their kids and getting everybody to soccer practice and what they are going to have for dinner that night and all of these things kind of are always kind of a whole ruminating that's spinning around in the back wheel of their brain and so when they are thinking about all of these things they might be there are work but they're not really doing the work mental overload is this why sometimes your mind seems spinning even when you're sleeping. yes it's why oftentimes professionals say turn the screens off at least a half an hour before you go to sleep you know don't answer e-mails while you're in bed try to find some way to disconnect because in this world of overly connected people we're looking at her e-mails and we're looking at instagram and we're looking at twitter and we're checking you know checking checking checking always fearful of missing something and when we're fearful of missing something back

really of our brain is always going ok when what did i miss when did they miss it how am i going to recoup and try to relax with that going on and it becomes a hard process meanwhile in the workplace corporate consolidation has complicated life in many industries in my business radio broadcasting the typical downsizing involves the fired workers job landing in a surviving worker's lap that person gets more responsibility more work no extra dough ray me from a psychological standpoint even a full employment economy are overworked workers making a mistake just sucking it up rather than testing the waters elsewhere. i think that's a really it's a slippery slope because yes from a mental health standpoint you want to you know relieve or reduce the amount of stress kind of going on and the correct answer is disconnect you know take some time for yourself said. or boundaries but the reality of the situation is that the

workplace often times like in your business in radio broadcasting in the many other industries it's kind of squeezing the worker out and so they do have a very legitimate reason to worry about these things so it becomes a kind of internal battle between the the frontal lobe the intellect and the you know a kind of a reactive brain it becomes this kind of tug a tug of war between what we think and what we feel what we're halfway through summer and not using use a more lose on vacation days is a big mistake isn't it. you know i have patients that come in and say i have 4 months of vacation pay and i'm just afraid to take it because you know this deadline is due and i'm working on 6 different projects and i know i'm supposed to take a break i haven't had a vacation in 2 years my kids are complaining it's summer they're out of school my my my spouse would like to take a vacation to see their family but i can't extract myself from being able to do

that so they know they know the right thing to do but it's fear of loss fear of of you know loss of project productivity fear of loss of their placement in the job strata that keeps them hanging on to the right we're all afraid to seem clueless at work thank you again mark rutherford for joining us on the big picture. coming up think the 1st half of the year was a blur grab the armrest or 2019 halftime report is next this is the big picture on our t.v. america. dish you will not obey the voice of the lord you're going to do all the school long months and the state you come onto this day. then all these curses shall come upon

you and overtake you on legs and then the white people the stolen property and death what must pretend to get people if they get rid of whites only problems will go away. the financial need to with and remove what communal as president of the free will. wide farmers in so they're free go be a day for every single day. people being tortured to death expression the elderly people in the wooden don't come barfs manias somebody of my funky enough company. not been you and that nice white horse will find themselves affected by a crash and we are also affected pointedly deflect means in dreams it's all sweats and a lot of. what are you going to have for dinner today we don't need anything i'm asking for a night made bad feelings towards civil war in south africa easy never to.

one good profit from one where our search for an n.h.l. not be in the tone of your hand to get to. you know world of big partisan group logged for years and conspiracy it's time to wake up to dig deeper to hit the stories that made stream media refuses to tell more than ever we need to be smarter we need to stop slamming the door on the path and shouting past each other it's time for critical thinking it's time to fight for the middle for the truth the time is now for watching closely watching the hawks.

don't blame you'll miss everything you know to date has been a blur what happened and what happens next let's ask on the left which caesar former florida democratic party chair and on the right conservative new york radio and t.v. pundit and our contributor steve malzberg welcome hello there how are you let's do the lightning round in the biggest most consequential issue goes 1st war from the recent presidential debates here is u.s. representative tosi gabbert an army major twice deployed to the war in iraq who says war with iran would be much worse. let's deal with the situation where we are where this president and his chickenhawk cabinet have led us to the brink of war with iran this is why it's so important that every one of us every single american

stand up and say no war with iran we need to get back into the iran nuclear agreement and we need to think oh she ate how we can improve it which you said steve if we were as the president says 10 minutes away from attack before he inquired about iranian civilian casualties no less are not even you grin and bear it trump support are concerned about how little it would take to trigger a war there or anywhere we were in close to attack we were close to retaliate atory attack we were attacked our drone was attacked in international waters after rand put mines on $22.00 ships i mean this is provocation after provocation and that itching for a war with iran but let's call it what it is if we respond to. let terry provocation from iran then they get what they deserve and by the way i'm

very disappointed that if trump is going to fight if we get in a war god forbid if he's going to fight that war the way we've been fighting wars by saying well let's figure out do they own dayton damage and they kill 2 of our people if we kill 5 of theirs that's this proportionate don't even bother if you're going to fight a war fight a war to win or don't fight it well steve you talk about provocation and we were in the neighborhood to begin with mitch all our lives we baby boomers have seen the news footage of angry crowds in the streets of countries around the world chanting yankee go home stop me if this question is naive but mitch what if we rebooted the j c p o a nuke deal with which iran was in compliance and we quit and we otherwise just left iran alone. well you know you bring up an interesting point because we are baby boomers if we were products of the sixty's and the vietnam war

where a lot of folks were against the war i even hear a hint of that from steve you know when i grew up i was i always learn in effect being from the sixty's not to trust the generals but based on the fact that trump has no foreign policy that really exists with anyone and literally the generals are the only ones left that i do trust specifically how do we respond to this is the question do we do it by cyber techniques do we do with ground troops do we do with cloak and dagger or do we go back to the original agreement remember trump likes anything that dismantles anything or president obama had to do with right so if we pulled out of the iran nuclear deal do we go back into it was it perfect no democrats have said that all along but is but there is no such thing as perfection in this world and perhaps we'd be better off than we were i will agree maybe shockingly with steve that if we do get into something we have to decide what the calculations are and one final point and that is that when the president said i

believe not truthfully that shocking for me as well and not that he said he decided 10 minutes left reminds of the old movies from the sixty's with peter sellers and everybody else showing my age most specifically that he decided because what the casualties were all the generals and retired generals 2 stars 3 stories fours came on t.v. of every a very stripe and said that's absolutely not true that's not how it's done they give an assessment they do a balancing act what the possible casualties are for the other side or the be for us what suppose you're is so this didn't happen with 10 minutes left even in a time of possible war the president can't be truthful with the american public all right also from those recent democratic debates there were some heated exchanges but there sure was consensus on this issue listen. existential threat is climate change we have to confront it before it's too late. climate change the climate change. mitch you are at ground 0 florida is more vulnerable to rising sea levels

and anywhere else in the usa and we read that real estate values are already being impacted how much do people there talk about miami turning into venice. actually all the time very specifically miami beach which is exposed more which is literally minutes from we were sitting right now they get water on dry days when it doesn't rain you know the oceans are rising because of rising heat issue because the glaciers are melting it's affecting us for is a peninsula you're surrounded 3 ways on by by water and the problem is that it is affecting real estate prices and investors it seems from all scientific information that it's accelerating and remember it was not only as you indicated talked about by all the democrats but people forget 4 years ago in the republican debate it was talked about by the republicans a threat is

a real threat irrespective of donald trump's denial or whatever it is so no here it's a real threat even in fort lauderdale where i live that's still every still exposed to water in the coast i'm just a bit inland so we're very very concerned about it's a real threat is not the only denier steve rush limbaugh calls climate change all hopes scoff if you will but as the late great tim russert told us florida florida florida steve is president from vulnerable on this issue in that imperative win state no he wasn't here when you talk about 4 years ago when the republicans said it was a concern. and trump won florida and there was a national election and national election was a senate u.s. senate election and a gubernatorial election in florida most recently and the republicans won that so you look al gore according to him we were we'd all be underwater by now every dire prediction it is

a hoax. it's nonsense the climate is always changed we have very little if anything to do with it and it's going to keep changing and by the way the glaciers are melting i mean this is such ridiculous nonsense but of course the media says it's accepted science so we can't even talk about the other point of view because it's a scam and it didn't hurt the republicans in florida with trump didn't hurt with the senate didn't hurt the governor's race it's not going to hurt trumpet 2020 issue 3 at the end of 2019 no matter what happens in the next 6 months this will be among the most powerful news photos of the year it's disturbing enough that we're going to blur the image you see but you'll get the picture and you can go online and see the actual photo oskar alberto martinez ramirez just 26 years old in this daughter valeri a drowned in the rio grande steve what cameras have not been permitted to film

where the inside of that texas holding facility where detained immigrants are warehoused and god awful conditions how do we fix this immigration thing well you don't know what the democrats did it their debate on n.b.c. and m s n b c and everybody raise your hand for decriminalizing breaking our laws and coming in and invading our country number one and then raising your hand and saying medicare for all yes for illegals to of course they're not illegal so in other words what the democrats just did was they gave a neon sign to every country where people want to leave and putting the country where those who unfortunate people came from saying come on no crime health care and god knows anything else you want for free driver's licenses come on down big mistake death knell for the democrats for the election but more importantly based on what we're talking about right now germane to this topic is it. it's going to

exacerbate this situation more people will now come mitch how about it immigration what's the fix. well it's interesting because the country's torn because there's 3 different camps is those which are the hardcore trump by to say we don't want anybody coming in because a drain resources which reminds of the old movie soylent green and they were all worried about their resources going we know how that ended up the 2nd group of those who were on there were void of brain drain which of those who are on the extreme top and allow them in if they have special talents and the 3rd group of those who want to allow folks in who have lesser talents and would be willing to do your jobs that americans don't want to do currently in america so there's a lot of divides over that you know you have the acting head of the border patrol i think it was who just resigned to replace a different acting guy you were placed a different acting guy right so the problem is also the troubling mistake that mr asian really has no particular policy on this he's blaming the democrats it's a german kratz fault if they would only do these things the last time i checked the

republican president the chief executive is sitting there and so is a republican senate so come up with a proposal out of the senate and mitch mcconnell who stomps on everything and let's have it so is gushing or a debate about it how do you blame democrats when you control most of the branches of government no status vote nonsense and you know that that's not all that we have just enough time to squeeze in one more topic so i need your distilled answers he's back after telling us he had nothing to add to his $400.00 plus page report reluctant special counsel robert mueller will answer questions before congress under subpoena next month match mahler's report is damning but you would have to read it to see so and few americans have culturally we tend not to read the book we'd rather watch the t.v. show but mensch what is left to learn from him 30 seconds what's left real quickly is whether he actually gets to read passages into the record most specifically

where he had the common. more or less that said if we believe the president was innocent of obstruction we would have said so that'll be must see t.v. remember the attorney general barr gave his own version which was totally i'm sorry insane and inappropriate moeller will add context and actually again if he gets to the words of key points of the report i think it will have some impact if he had done it earlier in the process before barr entered it would have had tremendous impact steve apologies but we're out of time thank you steve malzberg and mitch caesar and that you do for watching the big picture if you see us somewhere else you can now also watch r t america live youtube dot com slash r t america and we're live on direct t.v. channel 321 on the supercool pluto t.v. 132 and on dish 280 and all of our shows are available anytime anywhere on any device at youtube dot com slash the big picture our team on holland

cook in washington back here same time next week and in the meantime i am at holland cook on twitter where if you follow me i'll follow you question more.

it's. so. tough.

and very well now can see you watching us in such a. we have to be expectation that when we lifted people out of poverty when we became rich then we'd become. and i think valley's what a lot of people off structuring with now they expected that once they reached a certain level of income then they would be happy. and yet we create new size we create new things we want and i think sometimes we run out of explanations for why we feel unhappy.