tonight on "nightline," the little princesses. makeup and spray tanning. tiaras and tantrums. we go inside the competitive world of child beauty pageants. but does the pressure to win come at a serious cost? and are parents going too far? . and as the debate over healthcare spins out of control, president obama tries to take hold of the message and a new film offers a blunt diagnosis. money, not medicine, is driving the american healthcare system into the ground. plus, the heist. a dapper pair walk into a store in broad daylight and walk off with tens of millions in expensive gems.

no hollywood movie. the biggest heist in britain's history. captions paid for by abc, inc. tonight on "nightline," the little princesses. makeup and spray tanning. tiaras and tantrums. we go inside the competitive world of child beauty pageants. but does the pressure to win come at a serious cost? and are parents going too far? . and as the debate over hecare spins out of good evening, everyone. i'm terry moran. we are going to begin about a story about the children who compete in beauty pageants. ever since the still unsolved killing of jonbenet ramsey, that world of glamorous wardrobes and swimsuit competitions for little girls and boys has come under severe scrutiny. you'd think less parents would allow their kids to participate in that, and you'd be wrong. the pageants roll on as andrea canning reports. ♪

>> they're pint size beauty queens. with big attitudes. >> i am -- >> you better stop that. i'm going to get that -- >> i don't like doing this. >> and at a pang end in austin, texas, the bigger the better. >> we like all the glitz and the glams. we like the rhinestones, we like the sequins and the big, beautiful hair in texas. >> 50 boys and girls even babies as young as two weeks old are competing for a shot at the tiara and $2,000 cash. how important is winning to you? >> very important. >> when you don't win? >> sad. i should have done better, i should have done better. >> 4-year-old eden wood who is featured on tlc's "toddlers and tiaras" is considered the beauty to beat at this pageant. she has been on the circuit most her short life. >> i like being pretty, up on the stage with my makeup on. >> when we visit her at home, it

was clear she loves winning. which one is your favorite crown, eden? >> this one. >> why do you like that one so much? >> because it's so big. >> her mother a former beauty queen herself says being the best doesn't come cheap. pageant officials admit some families have gone into debt. some even paying entry fees before paying the rent. but wood says she can afford the $70,000 she spent on necessities like professional photos. spray tanning and coaching. the dresses alone cost over $3,000 each. is that existive? >> it probably is. but there's no telling how much we have invested in our child's aspect, through all the lessons. why can't i spend it on my child if that's -- if that's what i

want to do? >> they have travelled to austin to defend eden's title, and if she wins she's promised a puppy. she has some fierce competition. pageant watchers have pitted her against newcomer, 5-year-old tarilyn eschberger of texas. >> they're running neck and neck. >> how serious is this competition? >> very serious because there's big money on the line. you're looking at a beautiful baby doll which is eden and looking at tarilyn which is a top notch bubbly professional. >> a lot of pressure for a little 4-year-old who mickey says her little diva. she has a secret weapon or two. >> i'm pamela anderson. >> i don't know who i am. >> when she's having a bit of a diva moment, do these puppets help? >> yes. they definitely help. it takes her mind off of whatever. she's going to have tantrums. they're going to have bad days. they're going to have i want to's and i don't want to's, but

that has nothing to do with pageants. >> the puppets help calm eden down for day one of the pageant, the talent portion. it's clear that the parents have done some practicing of their own. the parents yourself included on the sidelines, doing this, doing the twirls. calling their names. are you afraid they're going to forget the routine or is it to make them better? >> i seem to get a little bit too much into it sometimes myself and i don't even realize i'm doing it. you go to the ball games and the moms and dads will be in the stands and go get 'em, what are you doing, get 'em? so to me it's no different than us being up coaching our girls. >> but judge kathy petty says sometimes the parents go too far. >> when your child is on stage and they don't perform the way you want them to, don't spank

them, or hit them. i have seen that in the past, where the parent starts yelling at them or the parent is actually spanking the child. i don't that's encouraging. >> day two of the pageant focuses on their bodies and beauty and that's what concerns the child psychologists the most. they contend that the girls learn to see themselves as objects to be looked at and evaluated for their appearance. >> the study links it to eating disorders, low self-esteem, depression in the future. does that concern you at all? >> it's playing dress-up. it is an expensive doll. >> some might say that's a dangerous game of dressup. >> if that is all we preach to her, yes, then i'd agree 100%, but this not our lives, this is our hobby. >> pageant owner annette hill

believes america's backlash against pageants all began with the precocious images of jonbenet ramsey parading across the stage in 1996. ♪ ♪ >> next on "larry king live" -- >> she says the media tends to focus on the negative. >> do you want to go into child protective services? >> as do movies like "little miss sunshine". ♪ >> some people in america are disgusted by these pageants. >> we well, i think that's their opinion. we're not going to stop doing them. parents enjoy showcasing their kids. what is wrong with that? as long as you keep it in a positive aspect, i don't think anything is wrong with that. >> the spray tans, why is it so necessary? why can't children be beautiful the way they are? >> the tan, i mean, i just think it looks pretty to be tanned. you know? swimsuit models, whatever.

you want to have a nice glow to you. >> but she's 4. >> but she's 4. >> look in the bathroom -- >> as for the over the top costumes? many people are concerned they're sexualizing these very young girls. do you think the show girl outfit is appropriate for a 4-year-old? >> she's covered everywhere. when i think of a show girl, i think of a gorgeous, glamorous woman. to me, it's old hollywood. the glamour. not sexualizing my child. >> mickey wood admits showcasing her child is the ultimate high. >> that's when you won little miss arkansas. >> but maintains that eden is still just a kid. >> we live in the country. we play. i assure you, my child is not missing out on friends.

on playing. on school. i'm teaching her values that have nothing to do with pageants. >> on the final night of the pageant, eden and tarilyn are still neck and neck. the judges say eden is tired and off her game, but tarilyn has lost points for being too spray tanned. >> we have been too light, we have been too dark. finding that happy medium, you never know. >> you said that eden was a little tired. >> yes. >> do you think that affected -- >> i know it did friday night, definitely. and then i flubbed some of her stuff up with her talent laying it out, you know, that's my fault and i accept responsibility for that. >> in the end, there was only one winner. tarilyn. >> i mean, yeah, i'm disappointed. i wouldn't be, you know, a normal person if i wasn't a ttle bit disappointed. >> for the woods, the pageant is

would have 25 they'll be competing in this year. and in a world where bigger is better they have their eye on the biggest of them all. ♪ here she comes, miss america >> we should tell you that even though eden didn't win she still got that puppy. and we're happy for her for that. thanks to andrea canning. when we come back, how money has strangle hold is on america and president obama goes into the fight head on. (announcer) .it's that time of year again they're going back it's back to school timeat staples over 7000 supplies at guaranteed low prices ♪

staples. that was easy. prepare your mouth for a battle against germs. protect your mouth right with crest pro-health rinse at night. it kills 99% of germs that cause gingivitis, plaque, and bad breath, without the burn of alcohol. for a healthier mouth that's cleaner in the morning. we're shopping for car insurance, and our friends said we should start here. good friends -- we compare our progressive direct rates, apples to apples, against other top companies, to help you get the best price. how do you do that? with a touch of this button. can i try that? [ chuckles ] wow! good luck getting your remote back. it's all right -- i love this channel. shopping less and saving more. now, that's progressive. call or click today.

when she realized she forgot to pick up a movie. she needed to get to a video store fast or all the good dvds would be gone. if trish had netflix, she could even watch some movies instantly on her tv. ( panting ) take the drama out of renting. announcer: netflix. dvds by mail-- plus some movies instantly on your tv. only $8.99 a month.

announcer: netflix. dvds by mail-- plus some movies instantly let's turn now to the wild and woolly healthcare debate where things are getting down right ugly. one democratic member of congress cancelled a town hall meeting after saying he received death threats.

it is taking the focus off the central problem. so as president obama tries to cut through what he calls the noise, a new documentary seeks out the root cause of the nation's troubled medical system. right now, the healthcare debate has turned into a free-for-all. >> no obama care! no obama care! >> the shouting. >> you work for us. we are your employers. >> and shoving. >> no, just say no! >> and screaming. >> i don't want -- >> it all seems to be drowning out a more reasoned debate which is the point. today president obama waded into the town hall waters in new hampshire and tried to offer a calmer case for his ideas. >> there's been a long and vigorous debate about this. and that's how it should be.

i do hope that we will talk with each other and not over each other. >> that's the hope, and so in the middle of all of the hollering, here comes a calm, quiet new documentary movie that offers one diagnosis of what's really ailing the country's healthcare system. >> medicine has become a business. physicians are reimbursed for doing things. we are not reimbursed for talking to patients. >> it's called money driven medicine. >> how many units of care can you deliverer? >> a lot of americans might agree with that. but is it really that simple? what the system we have does better than anything else is to generate waste, pro -- procedures that are not needed, expenses way out of control.

>> and he and reporter and author who wrote the book that inspired the film say that the biggest problem in healthcare in america is that what gets paid for in our system is not results. not health. but process. treatments, tests, surgeries and pills that may or may not make a patient healthy. >> the way that the system is set up, the financial incentives are perverse. we pay the doctors for doing more. what we should be doing is paying them for quality. for better outcomes. for effective care. instead, we're paying them for quantity. >> it is called supply-driven demand. meaning the more supply you create, the more people demand. >> alex is a filmmaker who has tackled tough subjects before. >> my memory of him was chained up with a hood on, no sleeping. >> his film about the murder of

an innocent taxi cab driver won awards last year. among his other movies, enron, the smartest guys in the room which told the story of the greed and criminality that brought down the giant energy company. >> it said they can't be making this much money legitimacy. >> so now, gibbny has focused his documentary lens on healthcare. is there a bad guy in this film, in your notion of the healthcare system? [ laughter ] >> is there a bad guy? i mean, i think in a way the bad guy is all of us in the sense that we have allowed this to just morph into something that's become kind of like a frankenstein monster. >> dying is not no big deal for me, but people have to go through a lot to get there. >> what makes money driven medicine compelling is how the film listens to patients and even more to doctors. >> take some nice, deep breaths.

>> i do a lot of shoulder injections because and i get paid far more for that than talking about diabetes and hyper ten. >> so they were saying it's broken. we've got to fix it. well, when you -- you know, who are you going to listen to but falydocto the thing i miss most is sitting in a room and talking to patient for an hour. you know, 15 minutes is a long time these days. basically, you get on the assembly line. >> that assembly line is give -- is driven is by a profit not by making sure they're well. >> it's interesting how hospitals advertise. who would make a decision about where to have their baby our being treated for cancer based on an ad they saw on tv? >> a magnet hospital. >> hoospitals e a adverting to

doctors. >> and as the movie shows, more and more doctors are branching out, becoming part owners of hospitals and testing centers they send patients to. a potentially sharp conflict of interest. do you believe that greed is one of the things driving the dysfunction in our healthcare system? >> you said greed, right? >> greed. >> greed. certainly part of it. certainly not consciously on a part of most doctors. most are doing the best they can. but you have the drug makers and device makers trying to sell them the most expensive drug and device. you have a hospital that wants them do as many procedures as possible. >> what's the fix? they do not take a specific stand on the contentious parts of the healthcare debate but on a doctor whose daughter is

stricken with leukemia. >> if we put it back in the hands of the doctors instead of the insurance companies we'll be a lot better off and it would be at a lower cost. >> the devil is always in the details. when we come back, two minutes in, two minutes out. how these two men pulled off an elaborate jewel heist and got away with millions.

according to a study presented by better homes and gardens, definity color recapture. it corrects the look of wrinkles and discoloration. 50,000 voters. one brilliant winner. ♪ i always feel like (announcer) it's right here, it's easy... ♪ somebody's watching me. ...it's the money you could be saving with geico. ♪ who's watching? ♪ tell me who's watching. !(muffled music), (announcer) it's right here, it's easy... "♪ i always feel like somebody's watching me. ♪ it's the money you could be saving with geico. for the first time in history, more people live in cities than anywhere else.

which means cities have to get smarter. new york has smart crime fighting. paris has smart healthcare. smart traffic systems in brisbane keep traffic moving. galway has smart water. smart meters in dallas, houston... and a smart grid in copenhagen keep energy flowing. smart ideas are happening... all over the world. i want to bring them all together in your city. a smarter paris. a smarter stuttgart. sao paulo. copenhagen. kyoto. a planet of smarter cities. that's what i'm working on. i'm an ibmer. let's build a smarter planet. you know why i sell tools? tools are uncomplicated? nothing complicated about a pair of 10 inch hose clamp pliers. you know what's complicated? shipping. shipping's complicated. not really. with priority mail flat rate boxes from the postal service shipping is easy. if it fits, it ships anywhere in the country for a low flat rate. that's not complicated. come on. how about...a handshake. alright. priority mail flat rate boxes only from the postal service. a simpler way to ship.

what a brazen robbery went

down in london today. reads like a hollywood screenplay. debonair guys in cars got away and this is no movie caper and they're on the hunt for who pulled off this staggering jewel heist. >> the get away. captured on cell phone. the bad guys leave the store, hostage in hand, as the woman is being hustled down the street. when they fire a shot, the guy shooting the video ducks. by the time he looks up t robber and the car and the jewels are gone. a robbery seemingly impossible in one of the highest end shopping districts, in broad daylight. in a jewelry store known for its ultra rich clientele. police say as they left, they

fired and they left with 43 pieces of jewelry valued at $65 million. in all, 43 items and they knew what they wanted. earrings with 84 diamonds, a ring with 179 diamonds. and a necklace with you guessed it, diamonds. 272 yellow and pink ones. a robbery that might impress the boys from oceans 11. >> we're set. >> we're set. >> they arrived at the shop in a normal london taxi. >> went into the jewelry shop. >> no maps. all business. it went down like clock work. the robbers out of the shop and into a waiting bmw. a bag was handed off to the accomplice on a motorcycle. the pair jumped into a silver mercedes and then they switched cars again, a black ford.

all this in less than half a mile. the biggest gem heist in british history. blink an eye and you'll miss it. for "nightline," i'm miguel marquez in london. >> wow. that is not your average stickup. thanks to miguel marquez.