captioning sponsored by macneil/lehrer productions >> woodruff: mitt romney took aim at president obama today, after sweeping three republican primaries yesterday. good evening, i'm judy woodruff. >> ifill: and i'm gwen ifill. on the "newshour" tonight, we assess the state of the campaign as both democrats and republicans pivot to the general election. >> woodruff: then, we examine the call by a group of doctors to cut back on some common medical tests and procedures. >> ifill: spencer michels has the story of an american doctor and a life-saving, solar-powered suitcase.

>> technology develops here in berkeley, california, is lighting up delivery rooms in low-income countries where the electricity is spotty. and it's all powered by the sun. >> woodruff: and in the aftermath of last week's health care law arguments, jeffrey brown gets some perspective on a tug-of-war between the president and the supreme court. that's all ahead on tonight's "newshour." major funding for the pbs newshour has been provided by: ♪ ♪ moving our economy for 160 years. bnsf, the engine that connects us.

and by the alfred p. sloan foundation. supporting science, technology, and improved economic performance and financial literacy in the 21st century. and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you.

>> woodruff: the fall presidential field moved closer to firming up today in the wake of tuesday's republican primaries. and, the man who's looking more and more like the g.o.p. nominee went after the man he hopes to oust from the white house. >> thank you to wisconsin, maryland, and district of columbia! we won them all! ( cheering ) >> woodruff: mitt romney's trifecta on tuesday night all but assured he'll clinch the republican nomination. and, it shifted his focus ever more toward the fall and president obama. in washington, romney told newspaper editors that the president indulged in distortions when he denounced republican budget ideas as social darwinism. >> president obama came here yesterday and railed against arguments no one is making and criticized policies no one is proposing. it's one of his favorite strategies-- setting up straw

men to distract from his record. and while i understand why the president doesn't want to run on his record, he can't run from his record either. this is not the tiime >> woodruff: the president had singled out romney by name, for supporting what he called a prescription for decline. >> one of my potential opponents, governor romney has said that he hoped a similar version of this plan from last year would be introduced as a bill on day one of his presidency. >> woodruff: but romney charged today it's mr. obama who has taken an economy in trouble and made it even worse. >> president obama's answer to our economic crisis was more spending, more debt, and more government. no president had ever run a trillion dollar deficit. the new normal the president would have us embrace is trillion dollar deficits and

8% unemployment. >> woodruff: the republican frontrunner aimed to stay on the attack against the incumbent, hoping his latest wins would finally put the primary season behind him. a look at the "newshour's" vote 2012 map center shows that in wisconsin, romney dominated the city of milwaukee and surrounding suburbs, helping him win the badger state 44% to rick santorum's 37%. in maryland, heefeated santorum 49 to 29. and he cruised to victory in the district of columbia, where santorum wasn't on the ballot. with romney's momentum building, pressure mounted on santorum, but in his speech to supporters last night, the former pennsylvania senator vowed to press on:

well, we'll threat other half of the republican party-- starting here in pennsylvania-- to go out in three weeks and during this period of time grab a yard sign, take a bumper sticker, spread the word and you can reset this election and give us the best chance not just to win but to govern conservatively in this country. thank you very much. >> woodruff: even so, the delegate math for santorum is daunting. it takes 1,144 delegates to win the nomination, and according to the latest count by the associated press: romney earned 86 delegates from yesterday's primary wins, bringing his total to 658. santorum took away nine delegates. his total is now 281. newt gingrich and ron paul did not win any delegates tuesday. they remain at 135 and 51, respectively. santorum has acknowledged that pennsylvania is a must-win for his flagging campaign. from there, he hopes to pick up

delegates in several southern primaries, including texas, in may. as the campaigns look down the road, what are the lessons learned so far, and is a fall election strategy shaping up? for more, we turn to dante chinni, director of patchwork nation-- a reporting collaboration with the "newshour" and others that examines economic, social and political trends. and "newshour" political editor christina bellantoni. so, dante, you've been looking at these results. what do you see there? what do you see that tells you how mitt romney pulls this off in these three contests, especially wisconsin. >> i think we've been waiting for a while with romney to see if there's a point, a tipping point, where he starts winning these voters he hasn't won. because he's had a hard time with people on the lower end of the income scale, a hard time with cultural conservatives and the way we break down the state of wisconsin, for example, at patchwork nation, we have a lot of small-town counties called

service worker centers. stloz gone heavily for roefrpl even in state he is lost. he won those counties by 9%. he won them by 2%. so they look like they're turning more toward romney now. >> woodruff: so you're says a distinct improvement in romney's perform performance. >> i think it's maybe coming to terms in... i don't know if he's winning these voters outright but they're deciding it's going to be romney and they're falling in line. >> woodruff: christina, before we talk about the general election and more about romney, what about santorum? we just heard him. it doesn't sound like he's going away. >> no, he's not going away. he may not even win his home state of pennsylvania. don't forget he lost his senate seat in 2006 by a large margin and even if he does you're still not talking about a whole lot of delegates. those numbers we showed on the screen really demonstrate how mathematically difficult it becomes for santorum here so he keeps talking about texas at the end of may. that's another state. it's so proportional the way

they award the delegates which is how romney amasit is big lead as it is. so what you're hearing from santorum is a shift in his language. he's picked a very specific thing to go after romney with and that's the health care issue. he's saying we need someone with a big difference with president obama on health care and not somebody with a small difference with president obama. that's very different than some of the nastier language you heard a few weeks ago. so perhaps he's thinking about his own future within the party and he's not spending much money. romney has outspent him every place that's campaign sod far so he's able to campaign in a fairly affordable way. >> woodruff: christina, how does romney's strategy change now? can he afford to ignore sfloerpl >> i think the campaign isn't telling us what they want to do but they've made a very direct pivot to president obama and to ignoring santorum. just a few days ago they were attacking him, calling him rick

spendtorum and now they're looking at obama. they're also starting to look at well, okay, pennsylvania, three weeks away, we have time to build up a campaign and we have the advantage that it's a battleground state. that's one reason we spent so much time in wisconsin. the campaign was confident there but they know that's a swing state they need to look at in the general. >> reporter: dante, in terms of romney and what he needs to do going forward. what do you see in yesterday's result that show what his challenge is. >> romney... everywhere he's gone so far he's done very well in wealthy suburban areas and cities. those have been his core constituencies and he held them again in wisconsin and he built on them which is great what we don't know going forward is he's going to be battling obama. these big cities and wealthy suburbs. those were obama's strongest areas. the wealthiest suburbs, obama won them by 12 percentage points in 2008 john kerry won them by

one percentage points in 2004, al gore by three percentage points in 2000 so this was huge for him. so they'll be fighting over the same turf. romney has shown he can win the republican voters there. the challenge he's going to face is he needs to fifth to the general election. to win independents he's going to have to... nobody wants to talk about shaking the etch a sketch or whatever but he's going to turn his campaign a bit and start talking more about moderate independent issues... issues for independent voters, things like that. he has to make that term. i would do it sooner the better for him. >> woodruff: what about organization, christina? and the kind of ground operation. let's talk about the general election. what do you know in brief that the obama campaign and the romney campaign have on the ground? >> today is the one-year anniversary of when he lodged his reelection bid so that gives you an indication of how long

they've been plotting this. they have campaign offices in every state, in some cases dozens. >> woodruff: in a single state. >> expanding the map. north carolina is a strong one. virginia, nevada. and the romney people are not able to do that but because he's doing this new transitioning where he's allowing joint fund raising with the r.n.c., basically the r.n.c. has offered this to any candidate, you can do joint fund-raising, that money goes to the r.n.c. and allows them to build their state by state organization. they're adding staff in virginia north carolina, florida. looking at hispanic outreach directors in these states because they understand that one of romney's issues-- this is one advantage he has for the long primary. it's revealed he's starting to lose women voters to obama and he has a problem with hispanic voters so they have time to make a correction there. he's also turning a bit to foreign policy. >> woodruff: this mention of hispanic and women voters dante gets to a piece you wrote for the "washington post" this past week end where you talk about this practice that many of us who cover politics are guilty of. >> myself included. myself included.

and we talk a lot about women in particular. it's such a massive part of the electorate. half the voting populous, a little more. and you know look, does romney have a problem with women? when you look at women as a whole, yeah, he does. but there are some women that are more conservative than others and the big one is you talk about hispanics. this is a really bad habit we have in the media talking about hispanics for latinos because the idea that, well, he could bring on rubio, rubio would hem him as a vice president and help him win hispanics. you know, rubio would help him in... senator rubio would help him in florida but the idea that that's going to matter to arizona, mexico, colorado, not all hispanics and latinos are the same. they have different issues, they come from other parts of the world before they came here. >> woodruff: there are different types of latino, hispanic voters, many different types of women. >> many different types of men. >> and young people. >> woodruff: so finally, christina, just another word about the obama camp.

how do they see this next phase in the campaign >> well, they're all patting themselves on the back because as the entire republican primary unfolded over the last six months there were a lot of ups and downs that they were laser focused on romney as the beginning. they were looking at him as most likely to win the primary nomination but also the person who's their toughest foe. so they've been chipping away at his image. his positives have gone remarkably down. that's not just the primary campaign. you can expect to see them ramp up fund-raising for the president and shore up these organizational areas and you'll see more ads on t.v. they've already sussed that up. you'll see it even more. >> woodruff: it won't be dull. christina bellantoni, dante >> ifill: still to come on the "newshour": the debate over medical testing; solar power in a suitcase and the president and the supreme court. but first, with the other news of the day. here's hari sreenivasan. >> sreenivasan: the people

around the dallas-fort worth, texas region took stock of tornado damage today and counted their blessings. a barrage of tornadoes yesterday damaged or destroyed 650 homes, but there were no deaths and only a few serious injuries. the wrath of one of tuesday's tornadoes was clearly visible today in forney, texas. but as bad as it was, the city's mayor acknowledged it could have been much worse. >> it's difficult to look at the damage to the homes and look around the town and call this a situation where we're blessed but if you really think about it the fact that everybody that woke up in forney yesterday morning is still alive today in forney that's a real blessing. >> sreenivasan: more than 70 homes in forney were damaged or destroyed by two twisters that ripped through the town. >> oh, wow. power flashes! oh, my goodness! >> sreenivasan: this enormous funnel cloud ripped through lancaster with winds up to 165 miles an hour. the red cross estimated 40 homes were damaged there. >> amazing that we're still living. terrible!

>> sreenivasan: a news helicopter captured another twister's fury as it touched down near arlington. >> look, look, look! these huge trailers, these huge rigs, the back ends of tractor are literally being picked up and thrown hundreds of yards. >> sreenivasan: the storms knocked out power for thousands. in arlington, 14,000 residents were still in the dark today. and about 1,400 people slept at dallas- fort worth international airport. the storms canceled hundreds of flights tuesday and that, in turn, snarled schedules today, with another 500 flights scrubbed. in all, the national weather service said as many as a dozen twisters touched down in north texas. wall street had one of its worst days in a year. a lackluster bond auction in spain revived concerns about europe's debt problems, and that set off a wave of selling. the dow jones industrial average lost nearly 125 points to close at 13,074. the nasdaq fell 45 points to close at 3,068. the president signed a bill

today that bars members of congress from using inside information to profit on the stock market. the new "stock act" also affects the president himself, and thousands of federal employees. mr. obama said the statute would ensure that everyone plays by the same rules. internet giant yahoo will lay off 2,000 employees, about 14% of its work force. the announcement today was part of the company's plans to re-deploy resources and boost revenues. yahoo estimated it will save $375 million a year from the cuts. this is the sixth, and largest, mass layoff for yahoo in four years. in afghanistan, three american soldiers were killed in a suicide bombing in the north. seven afghans died as well, and at least 20 people were wounded. it happened in the capital of faryab province. onlookers and troops viewed the carnage after the bomber rode up on a motorcycle and triggered his explosives. a top militant leader in pakistan was defiant today, after the u.s. offered a $10 million bounty for his arrest. hafiz mohammad saeed founded the group lashkar-e-taiba.

he's been accused of orchestrating the 2008 bombings in mumbai, india that killed 166 people, including six americans. he appeared at a news conference today in rawalpindi, pakistan and mocked the u.s. bounty. >> ( translated ): to be honest, i am surprised that america doesn't know where i am. these threats, putting money on my head to help my arrest, are for people hiding in mountains and caves, and no one knows about them. but, with the grace of god, i am here in front of you people and tomorrow i will be in lahore and will release a schedule for the day after tomorrow, so america can contact me whenever it wants to. >> sreenivasan: in washington, state department spokesman mark toner said finding saeed is not the issue. he said the bounty is for information that will bring a conviction. >> what's important here is we're not seeking this guy's location. we all know where he is. every journalist in pakistan and in the region knows how to find him. but we're looking for information that could be useful

to convict him in a court of law. >> sreenivasan: the government of pakistan said today the u.s. must provide concrete evidence if it wants action against saeed. the military trial of the alleged 9/11 mastermind will resume soon at guantanamo bay. khalid sheikh mohammed's trial was put on hold two years ago when president obama tried to transfer it to a civilian court. congress blocked that effort, and today, military officials set an arraignment in may. mohammed and four others are charged with terrorism and murder. five former police officers in new orleans were sentenced to prison today in the shootings of unarmed civilians during hurricane katrina. the sentences ranged from six to 65 years, on federal civil rights and firearms charges. two people were killed, and four more wounded in the shootings, on new orlean's danziger bridge. new research has shed light on genetic changes that raise the risk of autism. the journal "nature" published the results of three studies today, involving hundreds of families with autistic children. the studies showed that spontaneous mutations can increase the chances of autism.

and, fathers are four times more likely to pass on the mutations. dr. thomas insel is director of the national institute of mental health, which helped fund the studies. i spoke with him earlier. hexagon dr. insel, thanks for being with us. help us understand what a spontaneous mutation is. we have millions of these happening already, right? why is this connected to autism? >> well, we all have changes in our genomes that amazingly were present in either our moms or dads. these are spontaneous. and they occur perhaps at random. we don't actually know entirely how they occur but all of us have them. one possibility here is that those people who have autism have random mutations like this spontaneous that are occurring in just the wrong part of the genome, affecting genes that you need for neural development. >> sreenivasan: what about the correlation between aging fathers and autism? what do these studies reveal there? >> well, these studies suggest

that the risk is somewhat higher in dads over 40. now, we have known that for some time that especially dads over 40, boys with autism are about six fold more likely to have a father over 40, girls with autism about 17 fold more likely to have a father over 40. but let's be clear that that's a very small part of the risk for autism that contributes in a very minor way. >> sreenivasan: there's always been a raging debate in the autism community on whether it's a genetic cause or an environmental cause. what do these studies... do they shed light on either of those? >> i think they do. the reality here is that some autism is truly genetic and it's certainly likely some autism is going to be more due to environmental causes. what these new studies suggest is that the two may fit together. the environment may be affecting the risk for autism by influence the genome itself and increasing

the likelihood of these spontaneous mutations. >> sreenivasan: dr. thomas insel director of the national institutes for mental health, thanks for your time. >> thank you. >> sreenivasan: baylor university took the ncaa women's basketball championship last night and made history in the process. the lady bears' 80-61 victory over notre dame completed a perfect season and gave them 40 wins. it's the first time a college team of either gender has won that many games in one season. those are some of the day's major stories. now, back to gwen. >> ifill: next, a call and a plan to reduce the number of routine medical tests and procedures. nine medical specialty groups say many of these tests are unnecessary, costly and even risky. among the group's recommendations: avoid using x-rays for lower back pain in routine cases. limit stress tests or e.k.g.s in annual physicals. cut back on prescribing antibiotics for minor sinus fections. and scale back on some treatments even for some cancer patients. according to some estimates, nearly one third of the money spent on u.s. health care is devoted to these types of tests,

procedures and visits. you can find the rest of the list on our website. for more on the group's recommendations, we turn to dr. glenn stream, president of the american academy of family physicians and dr. eric topol, a cardiologist and chief academic officer of the scripps health system. welcome to you both. dr. stream, how widespread would you say are the incidents of this overtesting, overuse? >> well, as you described, estimates are somewhere in the 30% up to a full third of the costs of delivering health care to the people in our country are expended on health care testing and treatment that doesn't contribute to their health and well-being. >> ifill: but don't people expect to get the best care possible to get to the bottom of their complaints? >> yes, they expect to get the best tests and they should. but sometimes the issue is that more testing and more treatment isn't in their best interests, doesn't add to their health, and many times can adversely affect their health and cause even serious complications.

>> ifill: dr. topol, in your practice, how often would , u say that you get pressure from patients to prescribe things you wouldn't recommend and how often is it that doctors are overprescribing? >> i think it's very much tipped to the doctors overprescribing issue, gwen. i don't think it's too often that patients are demanding or strongly requesting scans and procedures. it's usually the other way around. >> ifill: what drives then that, then? why do doctors overprescribe? is it because... i don't know. why would it be? >> well, part of this is knee-jerk. there's... we live in this kind of tech nocentric world in the medical community so it's entrenchment in this. part of this is this is what makes the reimbursement model in the united states work. unfortunately. in hospitals and the medical system this is what drives it. >> ifill: let me ask you and then i want to ask dr. stream this, too. how does a patient know-- who trusts his or her doctor-- how do you know what the best test

is? how do you know when someone says go get an e.k.g., it seems like a good idea when they don't need to? >> i think the issue there is we need to individualize things. so to have these blanket guidelines across these various professional societies, to try to cut costs and unnecessary things is fine. each individual needs to be carefully assessed and that should be a shared decision between the physician and the patient. so you don't want to see things standardized because that's, in fact, what has been largely the problem. every individual deserves special consideration. >> ifill: dr. stream, you're my doctor, i trust you implicitly and you tell know do something. am i to say to you... according to your guidelines am i expected to be as a patient empowered to say to you no? >> i believe you should be empowered and i see this effort today and applaud the american board of special medicine foundation to bring this group together. it's a shared effort to physicians and patients to have

that information, to have good shared decision making because you should be able to say if i recommend a particular test or treatment, is that the right thing for you and what's the chance that will help you and what's the chance that might harm you? i think perhaps the experience is different in different specialties. i as a family physician, i often see patients who ask for specific treatments. antibiotics for a sinus infection is one of the examples or, you know, i've had terrible back pain for a week, don't i need a x-ray? and it can be difficult to explain to patients that an x-ray if they don't have certain warning signs is not likely to contribute to their treatment but could involve not just unnecessary expense but unnecessary x-ray exposure. >> ifill: what about potentially life threatening diseases like cancer. don't you want to take as many tests as possible to rule out possibility or catch a cancer early, which is what we have been told has to happen? >> even in those serious illnesses and in the cardiology realm and i'll certainly defer

to dr. topol as well, but there's such a thing as too much testing. the american college of cardiology and their five items for this effort identified those things so even for someone with established heart disease, what's the interval of time at which they should have certain follow-up tests because overtesting and overtreatment can truly be harmful. >> ifill: dr. topol, this is not the first time that the medical academy has tried to scale back on testing. wherever there was a report that comes out about slowing down a number of mammograms, for instance, there's always an outcry. why would this be different? >> well, you know, this is a long overdue issue and this is not an emotional thing, this is overuse of testing... go back for a second to something dr. stream was commenting on. in cardiology, all too often every year we have nuclear stress tests orded as a routine

knee jerk thing and that exposes each individual to a lot of radiation. equivalent to thousands of chest x-rays and this is crazy and it's continuing and it's about time we saw professional societies like cardiology and these others start to make a statement that this is not the acceptable norm. it might be right for individual patients but it shouldn't be for all patients in each of these disciplines. >> ifill: i guess my question is why is it doctors are paying more attention to these recommendations than they have to recommendations like this in the past. >> well, i think that the advantage is this concerted effort not just in one specialty but the specialties working together. i believe that we have better information available from medical studies just over the last several years that highlight the issue of overtreatment and it's not intended specifically as a cost-saving effort. it's really truely to use the best care when necessary and avoid treatment and testing that's not helpful. but the consequence will be to

save a significant amount of resources that then can be directed to those people that need those services. >> ifill: dr. topol, what about doctors who worry that if they don't make every available test that they will be more vulnerable to malpractice claims? >> well, that's a concern. it's unfortunately a legitimate one and that's one of the excuses all too commonly used for this overtesting problem. really what could be considered a long standing epidemic. but i don't think in most cases that that would come into play. i think it's too often used as an excuse to cover things but just... normally you have this particular condition, i'm going to do these tests and order these procedures or prescriptions and it's just not enough of this one-to-one

matching of what the patient's real needs are with what ought to be done. >> ifill: is this one of the conversations that came up in your recommendations and you're thinking this through in your group, dr. stream, that perhaps doctors might reist? >> it really wasn't brought up that much in our group and i think the reason is that the idea of using this information to enable that shared decision make willing enable the patient to feel input and some control over what testing and treatment they have as opposed to a whatever you think, doc, sort of an approach where then there is second guessing after the fact. i think if patients are given good information, here's your condition, here's an option as far as testing or treatment, here's the ben f.i.s. and risks and choose the right treatment. >> ifill: how do you weigh the benefits an risks. >> it's difficult. we all r all patients at some point in our life. if it's an area outside of your specialty it's hard to believe

fully informed but i think it's the responsibility of physicians to do the best they can to explain that risk and benefit to patients about various tests and treatments that are being recommended. >> ifill: dr. topol, is this something which can take hold immediately or is this something that will take a whole change in the way we approach our doctor/patient relationships and treatment relationships? >> i wish it would take place quickly, gwen, but the reality is that the medical community moves incredibly slow. it's ultraconservative, resistance to change. so these things are long overdue they're in the best interest of patients and certainly for the... addressing the health care crisis economic issue. so the problem is there's no enforceability so it's unlikely ho srt term.substantive change >> ifill: at least not in the short term. dr. eric topol, dr. glenn stream thank you very much. >> thank you.

>> woodruff: next, a california couple develops a small and innovative solution to a power problem that's causing thousands of deaths a continent away. "newshour" correspondent spencer michels has the story. >> reporter: in crowded hospital emergency and delivery rooms the pressure is on and so are the lights. in fact, electricity powers dozens of medical devices keeping patients alive: heart monitors, refrigerators for bags of blood, ventilators. but imagine if a doctor was delivering a baby or performing an operation and the lights suddenly went out. >> this baby is about five minutes old. welcome to the world. whoa! and the lights just went out. ( baby crying ) we estimate that 300,000 health facilities do not have reliable electricity around the world. so this is a huge problem. >> reporter: berkeley, california, obstetrician dr. laura stachel has witnessed power outages and their often

tragic consequences in health facilities throughout africa. >> i watched c-sections where the lights would go out and the doctors literally finished with my own flashlight. i watched women fighting for their survival in the labor room with complications such as and the only light was a kerosene lamp during that barely provided any illumination. >> reporter: after a back injury ended her career delivering babies, stachel visited a maternity ward in northern nigeria in 2008 to learn why so many african women were dying in childbirth. nigeria has one of the highest maternal mortality rates in the world. tens of thousands of women die there each year while giving birth. >> i had expected that maybe women were dying from very unusual conditions. but what i saw were conditions that i had treated as an obstetrician for years in this country but i had never associated with death. things like high blood pressure can be treated with medication, someone who has a baby too big to fit through the birth canal can g a c-section for delivery.

a number of the conditions i saw they need antibiotics, but all of those things depend upon procedures that depend upon light. >> reporter: the hospital stachel visited was actually connected to the local power grid, but as in many low-income countries, electricity was unreliable. and worse, most rural health facilities aren't even connected to a power grid. stachel decided to enlist the help of her husband, hal aronson-- a self-taught solar expert and teacher to help light the maternity ward. >> i thought, wow, what an opportunity for solar. it's very simple to do, a standalone solar electric system that will keep the lights on all night. >> reporter: in the backyard workshop of their berkeley home, aronson quickly began designing a solar powered battery system laura could take back to the hospital. >> so i built something that was basically like this which is just a piece of plywood, we'll turn it over so you can see it. it took just about maybe a

couple of hours to put together. stachel insisted on a few refinements. >> i said could you please make this easy enough for me to use? and make it small enough that it will fit in my suitcase cause i'm hoping to get through customs without a lot of raised eyebrows. >> reporter: the prototype she delivered to the hospital and a subsequent larger solar installation which powered lights and a communications system had dramatic effects. she says maternal mortality rates in the hospital dropped by nearly 70%. >> what we were told was that they were able to provide care through the night much more easily, nurses told us they were no longer afraid to go to work at night, that more patients began to come to the clinic, they didn't delay certain procedures until the morning. >> reporter: three years and six models later, aronson and stachel have turned their creation into a rugged, self- contained system they call a

solar suitcase. and they've founded a nonprofit to build and distribute them called we care solar. 160 of the devices are currently being used in 17 different countries, including haiti after the 2010 earthquake. >> when you open it up, you have a complete solar electric system. there's a solar panel right here, um, over here's the battery. this is the charge controller, and then these are the lights. and if you want to turn the lights on all you have to do is hit the switch. so you've got the light here, and this is the switch. >> reporter: is this enough light to deliver a baby? or do a c-section or whatever? >> absolutely if it was dark i could show you this will actually light up a small room. >> reporter: currently each of the suitcases costs $1,500. and they contain two solar panels that are installed on the roofs of clinics. the panels charge the battery in the suitcase, which can be mounted on a wall or kept portable.

when fully charged, the battery can power two l.e.d. lights for nearly 20 hours. the case also provides outlets to charge communications equipment like walkie talkies and cell phones. the system was designed to be easy to install and operate, by local health workers. and to withstand heat, rain, and harsh treatment. >> i'll turn this on and check this out. this is a reasonably durable light. if they drop it, it still works. and that was very important because you know lights can be dropped. this light will work for 20 years. >> reporter: but some experts say there are serious issues that need to be addressed when exporting such technology. >> developing countries are a graveyard of well intentioned technologies from the first world. >> reporter: environmental engineer ashok gadgil has been consulting with we care solar.

he developed the darfur stove, that has revolutionaized cooking in the developing world. he's a senior scientist at the lawrence berkeley national laboratory. he says he's impressed with what he's seen so far, but he says if stachel and aronson are to succeed, they must address how the system will be maintained over the long term. >> no single technology, no single piece of machinery has infinite life. when one wants to introduce a technology into society it needs social placement. the technology needs links and threads that connect it to a way if spare parts dealers or maintenance people or diagnostic technicians which will keep it going. >> reporter: how do you know that after a year this thing isn't going to get rusted or break or whatever? >> that is a major concern of

ours so what we've done is we've chosen the best quality components. the battery technology is our main area for improvement. so this is a standard sealed lead acid battery. and it should last a couple of years. the rest of the system is designed to last ten, 20 years. we would love a battery that could hold up for five, 10 years. >> reporter: initially assembling the suitcases one-by- one in their backyard with the help of friends and volunteers, they are now working with a nearby manufacturing plant to produce 30 a month, still a far cry from the massive worldwide need. they admit that their small- scale operation must ramp up. for now, private donations and several foundations are supporting their efforts. they want to eventually lower the cost of the suitcase, and enable it to power other medical tools, such a suction device.

but getting the solar suitcase into dark delivery rooms is stachel's first priority. >> i think it is an outrage that women in other countries suffer 100 fold higher risk of dying in childbirth than women in this country. so it's really important to me that the most vulnerable populations which are women, childbearing women and their newborns that they're at the front of the line. but it doesn't mean that other populations aren't important as well. schools have asked for these, community centers, refugee camps, so we think that we're really just sitting on the tip of an iceberg. >> reporter: stachel and aronson are looking to up the production of solar suitcases to meet the demand and they're getting help from the world health organization, which is helping them study the impact of the new technology. >> woodruff: watch more of spencer's interview with dr. stachel and see images of the solar suitcase in action in africa and afghanistan. our slide show is on the rundown.

>> ifill: finally tonight, as the affordable health care act hangs in the balance, law, politics and the supreme court are on a collision course. jeffrey brown explains. >> brown: protests swirled last week, as the u.s. supreme court found itself the center of national attention, during three days of arguments on the health care reform law. the sessions fueled speculation that the justices might strike down some or all of the statute. and on monday, after meeting with the leaders of canada and mexico, president obama warned the court would be overreaching, if it does that.

extraordinary power that the court has exercised significant restraint in deference to our >> brown: a day later, addressing newspaper editors, the president returned to the subject. >> the point i was making is that the supreme court is the final say on the constitution and our laws and all of us have to respect it, but it's precisely because of that extraordinary power that the court has exercised significant restraint in deference to our duly elected legislature, our congress and so the burden is on those that would overturn a law

like this. >> brown: but republicans, like presidential hopeful mitt romney, suggested mr. obama had gone too far in directly challenging the nation's highest court. >> it's really quite a curious turn of events for him to start complaining about an activist court. a court defers tot he constitution. an activist court is one that departs from the constitution in this case the court is doing the job it was put in place to do and this will opine as to whether obamacare violates the constitution. >> brown: this tug of war between the branches of government isn't new. in the 1930s, a conservative- dominated court threw out a number of president franklin roosevelt's new deal programs. roosevelt answered with a plan to replace aging justices-- the so-called "court packing" scheme. in a 1937 radio chat, he explained his purpose.

by bringing into the judicial system a steady and continuing stream of new and younger blood problems younger men who have had personal experience and contact with modern facts and circumstances under which average men have to live and work. this plan will save our national constitution from hardening of the judicial arteries. >> reporter: some 20 years later, chief justice earl warren and a liberal majority ordered desegregated schools and ended school prayer. that sparked a wave of impeach earl warren billboards, especially in the south. in 2000, the court was again in the spotlight, deciding the presidential election in favor of republican george w. bush. and in his first state of the union address, president obama chastised the court's decision allowing unlimited corporate spending in national elections. >> with all due deference to separation of powers, last week the supreme court reversed a century of law that i believe

will open the floodgates for special interests, including foreign corporations, to spend without limit in our elections. ( applause ) >> brown: as the president spoke, justice samuel alito appeared to mouth the words not true. the voices of dissent-- from protesters, and perhaps, the president-- may well be louder this summer, when the supreme court rules in the health care case. and we join some of these issues now, with louis michael side- man, author of the book "on constitutional disobedience." he's a former law clerk to supreme court justice thurgood marshall. and randy barnett, author of "restoring the lost constitution." he represented the national federation of independent businesses in its challenge to the health care law. and they're both professors at georgetown law school. randy barnett, i'll start with you. what struck you in hearing the president earlier this week? how does it fit into the past examples we've heard that >> well, i think what the president said on monday was

flat out wrong. as evidence of that i'll cite what he said on tuesday in which he took it back. on tuesday he said something that comes closer to being accurate and it was a cleared a mission that what he said on monday was a grave distortion of the role of the judiciary relative to the presidency or the congress. and so... but i think this is part of a broader problem of the politization of whatever's going to come out of the supreme court in june. >> brown: michael seidman, wrong on monday? >> i thought he was right on monday, he was right on tuesday. what he said seems to me to be completely unexceptional. >> brown: unexceptionable given past... >> yes, as long as there has been a supreme court there have been political attacks on the court. some of our most revered presidents-- as your setup piece mentioned-- in addition to roosevelt, thomas jefferson ran against the court in 1800. abraham lincoln, his entire platform in 1860 was against the

court and what the court had done. so there's nothing unusual about this. the president didn't threaten anybody, he didn't try to pressure the court. he's excited to his about the constitutionality of the health care bill and he... it may not be tactically wise for him to say what he said but he certainly has a right to say it. >> brown: why do you see this as different from these past examples? >> well, he said it's somehow improper for a group of unelected people to strike down a law that has been passed by the congress. that's literally what he said. as we all know, since "marbury v. madison" that's perfectly okay. on tuesday he refined what he said on monday and he was more clear about the basis on which he was criticizing it. but with these historical examples-- maybe mike knows, i don't-- i don't know any of these that were while the a case was under submission to the supreme court. >> brown: before it was decided?

>> before it was decided. roosevelt was vocal in criticizing decisions of decisions of the court but not deliberations of the court. that's something new and different. >> first of all, roosevelt did... the word medial measures were before the court at the time roosevelt was criticized in the court. secondly randy barnett is my good friend but he misquoted the president. i don't think he said it was improper, he said it was unprecedented and there are almost no precedents that i can think of of a supreme court striking down a... the major domestic legislative accomplishment of this sitting president. even the new deal confrontation involved relatively peripheral medial measures or, in the case of the national industrial recovery act, a measure that was about to expire. rightly or wrongly i think the president had it about... whether the court is right or

wrong the president had it about right. this would be unprecedented or close to unprecedented. >> brown: now you brought up the broader politization. the president certainly has been criticized by some, and you just made the argument, the court has been taken a lot of hits for being overly political. i'll cite one of many. maureen dowd in today's "new york times" column "the court has squandered even a semiillusion that it is the unbiased honest guardian of the constitution." she said the conservative majority's reasoning seem "shaped more by a political handbook than a legal brief." >> and what is she responding to? she's responding to questions asked during an oral argument. that's the supreme court's reasoning she's talking about. she's not waiting for the supreme court to issue a ruling, write an opinion and read the opinion to see if the opinion makes sense as compared to the legal arguments of the opposition. that's exactly what we're seeing. i have an article for from the daily beast that says "impeach the skosht justices if they

overturn the health care law." regardless of what they say or the basis on which they rule. that is wrong. >> brown: go ahead. >> look, i'm not in favor of name calling. i think there's way too much of that and people ought to be civil when they talk about this. at the same time i think you have to be extraordinarily naive to think that politics has nothing to do with what the court is... what the court's deliberations in this case. we're asked to believe that it's just coincidence that all of the questioning hostile to the case came from judges... justices appointed by republican presidents and all of the questioning favorable to the law came from justices appointed by democratic presidents. i just can't... i'm not quite able to believe that that's just a coincidence. >> this goes to a broader question and i think people still wonder about this. to what extent is it fair to

think of the court as a political institution in some sense? >> well, they're appointed by a politically elected president and senate so they do come from different perspectives based on the views of the president who appointed them. but i would say if there's one thing that would be political for this court to do it would be to uphold this law because it is the signature piece of legislation by the president. if that was the reason why those conservatives on the court who think it's unconstitutional change their vote in order to uphold the law, that would be a political decision, it would not be a legal one. >> brown: you're shaking your head. you think it's inevitably in the political arena? >> of course it is. first of all, if people were skeptical about the non-political nature of the court they have nobody to blame but themselves. these the people who gave us "bush v. gore" where a majority of the court disregarded all of the theoretical and doctrinal positions that they're normally

associated with in order to hand the presidency to george bush. secondly we have just many, many examples throughout our history of courts that have been influenced in one way or another through electoral politics. we know that now because records are available, the conference notes are available. it would be really surprising if this court uniquely among courts in american history was completely apolitical and just... in a disinterested way following the law. >> so there's nothing to complain about then. since all courts are political they're political when they vote for you; they're political when they vote against you so therefore it's okay for them to be political. >> i'm not complaining. i think it's inevitable that when the court interprets very broad language in the constitution where where there's not a clear meaning to it that political bias is going to affect the interpretation and that's true of liberal justices,

it's true of conservative justices. we ought to grow up and understand that that's what's going on. >> brown: but part of your other point is that this is now part of the political narrative of... we're in a campaign season, right? >> i think what's happening is a number of people primarily on the left are trying to create a political narrative that they can use if they get an adverse ruling in this case and i guess they must think they're going to or they wouldn't be starting today. >> brown: briefly. >> of course randy thinks people on the right haven't used this as a political issue at all. >> i totally don't think that, mike. (laughs) >> good. >> brown: on that agreement, randy barnett, miked seidman, thank you very much. >> thanks for having me. >> ifill: again, the major developments of the day: mitt romney took aim at president obama, after sweeping three republican primaries on tuesday. he accused the president of distorting republican positions, while hiding his own beliefs. the people around the dallas-

fort worth, texas region took stock of tornado damage-- a day after a dozen twisters damaged or destroyed 650 homes. and wall street had one of its worst days in a year. the dow industrials lost nearly 125 points. online, we look at al qaeda web sites that have been offline for more than a week. hari sreenivasan explains. hari? >> sreenivasan: we explore what it means for the international jihadi movement if the chat rooms and forums stay dark. that's on our world page. do you read and write a second language? if so, you can help out the "newshour" translation team as we caption and subtitle videos this political campaign season. and on art beat, we have a different take on the impact of new technology. watch a video on the art of video games, part of an exhibit at the smithsonian american art museum. all that and more is on our website: newshour.pbs.org. judy? >> woodruff: and that's the "newshour" for tonight. on thursday, the "daily download" examines how the presidential campaigns are using

pinterest-- a place to share photos and more online. i'm judy woodruff? >> ifill: and i'm gwen ifill. we'll see you online and again here tomorrow evening. thank you and good night. major funding for the pbs newshour has been provided by: and the william and flora hewlett foundation, working to solve social and environmental problems at home and around the world. and with the ongoing support of these institutions and foundations. and... this program was made possible by the corporation for public broadcasting. and by contributions to your pbs station from viewers like you. thank you. captioning sponsored by macneil/lehrer productions captioned by media access group at wgbh access.wgbh.org