captioning sponsored by macneil/lehrer productions >> ifill: bomb experts are studying an explosive device found after the c.i.a. thwarted another al qaeda plot to attack a u.s.-bound airliner. good evening. i'm gwen ifill. >> woodruff: and i'm judy woodruff. on the newshour tonight, margaret warner gets the latest on the foiled plans and assesses the reach of the terror network in the arabian peninsula. >> ifill: then, ray suarez reports on the hefty price tag for an ever heftier america. >> millions of us continue to gain weight forcing hospitals to invest in new equipment like this ambulance specially designed to handle patients up to 1,200 pounds.

>> woodruff: we talk with oklahoma senator tom coburn about his plan to tackle the nation's escalating fiscal crisis, as told in his new book, "the debt bomb." >> every one is going to have to sacrifice. every one of us. and if we delay putting off sacrifices, the pain is going to be much more difficult and much more severe. >> ifill: we look at which nations are best and worst at creating healthy mothers and children. >> woodruff: and we remember maurice sendak, the man who created the children's classic, "where the wild things are." >> it made my life pleasurable. i'm happy to have one book like that. pap pap pap >> ifill: that's all ahead on tonight's newshour. major funding for the pbs newshour has been provided by: >> citi turns 200 this year. in that time, there have been some good days and some difficult ones. but through it all, we persevered. supporting some of the biggest

ideas in modern history. so why should our anniversary matter to you? because for 200 years, we've been helping ideas move from ambition to achievement. and the next great idea could be yours. >> by nordic naturals. supported by the john d. and katherine t. macarthur foundation supporting a more just world. more information at 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.

>> ifill: the latest conspiracy to attack commercial aviation in the u.s. yielded a low-key official response today-- at least, publicly. margaret warner has the story. >> reporter: it seemed business as usual at u.s. airport it is day after news that the c.i.a. foiled a new al qaeda plot to bomb an airliner. white house counterterrorize... counterterrorism official tried to assure the public. >> people should feel confident intelligence services are working day in and day out to stop these i.e.d.s from getting anywhere a plane. >> warner: officials have said the recovered bombs contain nothing metal designed to fit inside underwear would not have been detected by magnetometers. it's unclear if the new body scanners would have picked it up. the f.b.i. is analyzing the device. >> this i.e.d. was a threat from

the standpoint of the design that we have been able to determine and so now we're trying to make sure we take the measures that we need to prevent any other type of i.e.d., similarly constructed from getting through security procedures. >> warner: there was no word on the fate of the would be bomber, but at a washington event with the newshour's ray suarez, secretary of homeland security janet napolitano said the plot represents a clear challenge. >> i think we have to acknowledge that our adversaries are very creative and they are very determined and they are very persistent. and that requires us to always be thinking proactively not just reactively. >> warner: authorities suspect the bomb was designed by yemen based ibraham asan al-hasry, the designer of a crude underwear bomb that failed to detonate on a plane in 2009 and devices found in printer cartridges seized in shipments from yemen to the u.s. in 2010. this latest plot underscored how

al qaeda in the arabian peninsula, a.q.a.p., has gained ground in yemen in the unrest that ousted president ali abdullah saleh. the u.s. responded with a stepped up drone campaign that killed anwar al-awlaki last fall and this past sunday a drone took out fahd alkouso, believed responsible for the bombing of the u.s.s. "cole" in 2000. for more, we turn to michael leiter, who was director of the national counterterrorism center from 2008 until the middle of last year. and ali soufan, a former supervisory special agent for the f.b.i. his cases included the bombing of the u.s.s. "cole" in yemen in 2000, as well as 9/11. al qaeda michael leiter, let me ge win with reports by the "new york times" and others that this plot was foiled that was a sting operation. that there was a saudi who posed as a would be suicide bomber and

managed to get ahold of the weapon. can you confirm that? >> i can't confirm it, margaret. i would say this is exactly what we expect and want our intelligence services to do but it's extremely hard to do in the a place like yemen. i think it probably represents a great partnership between the u.s. government and the government of saudi arabia but this information is incredibly sensitive and i think it's somewhat unfortunate that it's been widely reported because it reduces our ability to use these sorts of sources or this sort of methodology to exploit al qaeda and stop future plots which they are undoubtedly going to pursue. >> warner: mr. soufan, do you have any information about this? this latest development? >> no, i agree with mike and i don't think the situation at this point to divulge sources and method, it's a great success for the intelligence community, great success for the c.i.a. and i think we had a few good days

in yemen. >> warner: mr. soufan, staying with you, how alarmed should we be by this plot? either the discovery that this kind of ploting is still going on and from what we are told a more sophisticated device. >> well, i think we shouldn't be surprised at all, al qaeda in the arabian peninsula is the closest to bin laden's version of al qaeda. all these individuals were with bin laden in afghanistan, served with bin laden. they are not one of these al qaeda groups that were franchised after 9/11. those people definitely have the commitment, they have the intent and rain him al asiri is providing them with the capability so they are very dangerous and i think we should keep in mind that they will always try to accomplish their goal. if i mean, al qaeda tried to do a shoe bomb and then an underwear bomb, a printer bomb and they will continue to work hard to inflict damage to the

united states. fortunately, our intelligence community and the c.i.a. have their eyes on the ball in yemen and it's a great success what they were able to do in the last 24 hours. >> warner: michael leiter, let me ask you, when john brenner said today "this i.e.d. was a threat from the standpoint of the design," what is he talking about? >> well, this bomb and also the bomb that the bomb maker asiri is probably responsible for back in 2009, the first underwear bomb and then the printer cartridges bombs that were detected in 2010 represent a real challenge for screening. with no metal pieces at all, a standard magnetometer, metal detector, won't detect that. so what you have to have instead are much more advanced screening techniques at airports to find that. fliers see that all the time here in the united states now. they're less prevalent overseas. of course we need to make sure the same techniques that we know are working here are applied overseas as well.

what i would also add, margaret, is none of these detection methods are perfect. all of these require good intelligence to penetrate the organization, screening of individuals who are applying to visas to come to the united states, screening getting on to planes. it's all of these pieces that fit together. none will be perfect, laul reduce the likelihood of a catastrophic attack. >> warner: back to you about al qaeda in the arabian peninsula and in yemen. you describe them as a very potent group. what did the year of political unrest which finally ended this past spring with president saleh leaving, what did that do to their relative strength both inside yemen and their ability to strike at the u.s.? >> well they gained a substantial amount of territory, especially the area of south yemen. there was a few towns under their control. they were able to recruit more individuals from different tribes in yemen and recently we

we've seen retaliating in from the yemeni government. for instance, after the man was killed in the drone on sunday, they retaliated against a military base in a town caled zanzibar in yemen killing about 30 soldiers. so that gives you an idea about the capabilities that they have today, the weapons that they have and let's not forget that many of al qaeda in saudi arabia because they were defeated on the hand of the saudi services they escaped to yemen and mr. asiri is one of them. so the number to guy in al qaeda in the arabian peninsula, those are saudis. and it seems that al qaeda now in yemen is trying to establish some kind of sanctuary for their operations and to launch attack against the united states. >> warner: mr. leiter, what does the u.s. effort against al qaeda in the arabian peninsula in yemen look like?

we know about the drone strikes, what else? >> it's a very close partnership between the intelligence services and the government of yemen but also as is suggested with saudi arabia. it's been threatened by al qaeda in the arabian peninsula in the past, they threatened to kill the deputy interior minister and more broadly there's a close partnership which was disrupted for some period... >> warner: military partnership. >> exactly. the military training that's gone on between the u.s. department of defense and military services. in the long run it's that sort of training enabling the yemenis to govern especially southern end of the country which i think is going to be so critical to maintaining some sort of stability in that country and eliminating the safe haven which unfortunately now exists. >> warner: back to asiri, the bomb maker, tell us just a little bit about him and why with all these resources, u.s. resources now trained on yemen is he so hard to apprehend? >> well, it is difficult when

these individuals are hiding in the mountains or hiding in far away places and al-asiri is wanted not only by the united states but he's also wanted by the saud dis. remember, al-asiri recruited his own brother, abdullah, as a suicide bomber in order to assassinate prince mohammed, the deputy prime minister... the deputy interior minister in saudi arabia using an underwear bomb if i recall. he's a very dedicated individual. he's a very evil individual and he's one of those people who basically were from the members original al qaeda under bin laden. he was arrested in saudi arabia at one point then was released from jail and after he was released he was able to escape to yemen and he set up a base in yemen with other yemeni members of al qaeda and saudi members of al qaeda.

i think what makes him extremely dangerous that he provided the capability and he provides today actually capability of a lot of our people who have so much evil intentions to be directed against the united states. >> warner: final we do you. to what degree is the new government in yemen cooperative of the u.s. or too much? >> i think they're remarkably cooperative. many people thought the cooperative nature was going to reduce after ali abdullah saleh left that hasn't been the case. that shows a broad coalition in yemen. >> warner: michael leiter and ali soufan, thank you both. >> thank you. >> thank you. >> woodruff: still to come on the newshour, the high cost of obesity; defining and solving the debt crisis; the well-being of mothers around the globe; and remembering the creator of the "wild things." but first, the other news of the day. here's kwame holman. >> holman: a bill to continue low-interest rates on federal student loans stalled in the u.s. senate today. democrats wanted to cover the cost by raising taxes on wealthy

stockholders in privately owned companies. republicans blocked that plan. instead, they favor taking money from a preventive health fund in the health care reform law. the two sides traded jabs after the vote. >> they're simply unwilling to allow the wealthiest americans to pay a single penny more in the aid to recovery of this economy. instead of closing the tax loophole, republicans want to pay for this effort by going after funding for child immunizations and diabetes prevention and preventing chronic diseases. >> the best way to resolve this would be to sit down and discuss the way to resolve the differences between the house and senate and pass it. so this hardly warrants the kind of effort we've seen once again to create a controversy where none exists. >> holman: the interest rate on the so-called stafford loans is

set to double on july 1 to 6.8%. political leaders in israel formed a new coalition government today, giving prime minister benjamin netanyahu a huge majority in parliament. netanyahu emerged from a meeting with the chief opposition party, kadima, and announced an alliance. he also dropped plans for early parliamentary elections. the move could give the government more latitude in dealing with the palestinians or contending with iran. >> ( translated ): the goal was stability which will enable actions, the goal was not the elections. as i said, i'm willing to go to elections-- i'm not thrilled about it-- but if it will be imposed on me i will do it. if there is a possibility to establish a very broad national unity government, that is better. >> holman: netanyahu's current coalition had splintered over demolishing some west bank settlements, and drafting ultra- orthodox jewish men into military service. the blind chinese activist who set off a diplomatic tussle now says beijing has promised to investigate alleged abuses of

his family. chen guangcheng spoke to the associated press today, from his hospital. he escaped last month from house arrest in his village, and said officials had repeatedly beaten his relatives. chen took refuge in the u.s. embassy before leaving last week. greece remained in political limbo today after an election that yielded no one a mandate. we have a report from james mates of independent television news. >> until two days ago, the leader of a tiny left wing faction today elected and visited the president of greece and was asked to try and form a government. he will probably fail. it's not clear that any party can govern greece at the moment. but his program, spelled out at a press conference this afternoon of reneging own greek debt, scrapping all cuts and reforms is pretty much what two-thirds of greeks voted for on sunday. his party is almost defying the euro zone to throw them out.

>> there's no official ruling in any of the european treaties predicting the exit of a member state from the european... from the ruhr roe zone. in contrast the only way for the country to exit the euro zone is (inaudible) so we are not willing to sacrifice our last and biggest negotiation. >> remember me! greece is only the beginning. >> reporter: sitting across from the far left in parliament will be this man, the leader of the neo-nazi party called golden dawn. you don't to talk to him for long to find out what he's about. >> all the illegal immigration out! out of my country sglfrjtsz out of my home! >> reporter: their party emblem is an adapted swastika. new and this time decisive elections are expected as soon as next month. >> we're in a very dangerous zone and greek people must now decide what they want to do.

if they want to stay in the euro zone or not. i think this would be the big question of the next election. >> you think it would be a vote on do we stay in or get out? >> i'm sure about that now. >> reporter: the greek people wanted to protest but they may not have meant to go this far-- the country ungoverned and ungovernable, neo-nazis sitting in the national parliament. little wonder ordinary greeks are questioning what they've done with papers full of dire warnings from the rest of europe of what may follow a dissent into extremism. >> holman: the news from greece sent stocks falling everywhere today, including on wall street. u.s. stocks retreated despite word that employers in march had posted the most job openings in nearly four years. the dow jones industrial average lost 76 points to close at 12,932. the nasdaq fell 11 points to close at 2946. those are some of the day's major stories. now, back to gwen. >> ifill: public health experts have long warned of a growing obesity epidemic in america. this week, government officials and others have launched a major

campaign to say those long- feared consequences are at hand. in a 474-page report issued today, the institute of medicine called for systemic policy changes. from overhauling farm policies and the way food is marketed to building more walkable neighborhoods, to ensuring children get at least 60 minutes of physical activity a day. our health unit has an in-depth look tonight, beginning with a ray suarez report on the rising toll. >> suarez: americans are fat and continue to get fatter. today two out of three adults in this country are overweight or obese. >> in 1960, the average height for a man was 5'8 and the average weight was 165 pounds. today the average height for a man has gone up one inch to 5'9 and the average weight has gone up 25 pounds to 190 pounds.

>> suarez: one of the most striking things about this change is most people are aware of it, understand what causes it yet nothing seems to stop it. >> in spite of the fact that people get lots of information it hasn't changed their behavior in the ways we've been trying to change it. so i guess it tells you that more information does not necessarily mean better behavior >> suarez: new research from universities, think tanks and the federal government has tried to put a dollar cost on tens of millions of pounds of excess weight. in getting heavier and heavier passengers from place to place on public transportation and burning millions of excess gallons of gasoline in private cars. and jet fuel in the air. in lost productivity and increased absenteeism at work and the tremendous impact obesity has on medical costs year after year the annual price tag for all of it? one estimate puts it at $190 billion a year. >> the numbers are just enormous

and giving our long-term budget situation it's important to address this issue as soon as possible. >> this health care economist and former deputy secretary of health and human services says: >> let's look at a 12-year-old kid around today and between ages 10 and... 12 and 22, so over a ten-year window. he won't change that much in terms of the cost he has on society but if you look at a 25-year window the costs that might be imposed could be potentially huge in terms of earlier hospitalizations, less productivity at work, less ability to pursue and achieve his dreams. >> suarez: look at this animation for the centers for disease control. it tracks the increasing incidents of obesity in america state by state from 1985 on ending at today with a large swath of the country-- centered on the southeast and midwest-- in red meaning more than 30% of adults are obese.

russ hammond has been studying the economic impact of obesity for the brookings institution. >> part of the difficulty with something like obese city that it's the accumulation of action over long period of time that leads to obesity. if you eat a cheeseburger today you won't necessarily a heart attack today but over many, many many days of eating unhealthily and gaining weight you might. and because of that time angle it becomes harder to think about in your daily routine what the long-term consequences are. that's harder for people. >> suarez: just how hard is apparent to this doctor who, in 33 years practicing medicine, has seen a change in his hospital's patients. he's medical director of the operating rooms at med star hospital operating center. >> oh, my god, it's been pretty dramatic. >> how so? >> years ago we wouldn't have patients over 300, 400 pounds very often. now we're seeing them daily. it's become an operational

problem at times. >> suarez: dr. finelli's specialty is bariatric surgery, limiting the size of the stomachs of severely overweight people. the scales in his office are specially built to handle patients hundreds of pounds overweight as are the exam tables. even the surgical instruments, now supersized to reach through larger bellies in order to operate one particular cost driver of excess weight is diabetes. according to the c.d.c. someone with diabetes costs an average $6,600 per year to care for than someone without diabetes and collectively diabetes cost about $150 billion a year. >> when someone gets diabetes it increases their risk for all kinds of other problems, heart disease, kidney disease, eye disease, also makes them more prone to infection, makes them more prone to arthritis. so as patients become obese and get diabetes, it's really

important to get the weight off them because you can completely reverse that the disease processes by getting the weight off the patients. it's just.... >> suarez: just through weight loss you can become an ex-die bet snick >> yes. for type two diabetes just by weight loss you can become an ex-diabetic. >> suarez: but millions of us continue to gain weight forcing hospitals to invest in new equipment like the ambulance driven by richard bee beyond di specially designed to handle patients up to 1,200 pounds. >> the size of the vehicle is tremendous. it's the size of as recrew squad for many fire departments everything else here is custom. have this entire ten-foot-long ramp system. there's a winch system in the front. stretcher is especially designed to accommodate patients that size and just the overall size inside the ambulance accommodates them as well. >> suarez: the winch alone usually used in trucks is $8

the stretcher designed to hold patients over a thousand pounds is $9,000. the ambulance alone costs $180,000. he says the super obese are often confined to bed by their weight and wait until the last minute to call for help. helping such a patient from an apartment can take three full ambulance crews. when he looks at the downstream costs of obesity to medicare and medicaid tef vi troy says the added costs could break the bank. >> it's a large and living issue and something that threatens to cause huge problems for our budget situation. our budget situation is quite perilous and quite difficult. medicare is facing over a $35 billion annual budget deficit. that's more than the total budget deficit of greece. >> suarez: the terrible costs physically and financially of america's growing obesity problem hasn't been enough to get us to stop gaining weight.

doctors say one thing that's holding us back might be the notion-- mistaken-- that we have to lose all the weight we've gained since we were teenagers. but if you just lose 7% to 10% of your body weight-- start small-- the tendency toward hypertension, heart disease, and diabetes drops precipitously. how do you get people to change their habits? >> well, you know, the thing that's so interesting about it is that i have... >> reporter: this woman is the chair of a huge and comprehensive report of the measures under way to fight back. accelerating progress in obesity prevention, solving the weight of the negotiation from the institute of medicine. incremental steps like using dinner plates with measuring markers to control portion size. a modest daily exercise program, bringing p.e. back to the school day. they work. >> it can't just be that, you know, researchers or scientists say this would be a good thing to do. your mays have to believe it. the families whose children are

in school have to believe it. teachers have to believe it. it has to be more widespread than an individual doctor telling a particular family how to handle an obese child or telling you or me we should take off 20 or 30 pounds. >> suarez: the report is part of a series of initiatives by the national institutes of health and the centers for disease control and hbo will air a four-part documentary next week. it features dozens of top experts exploring the causes and solutions for obesity in the u.s. >> i don't want to be fat for the rest of my life. i've got diabetes. >> sleep apnea. >> high blood pressure. >> i get dizzy when i get up. >> everything's hurting now. >> suarez: new numbers out this week from duke university predict one in nine americans will be more than 100 pounds overweight by 2030.

unless individuals and institutions begin pushing back on current trends, the cost of what we devour will eventually devour us. we get more on the personal health conditionss of obesity and the call for changing the larger environment that contributes to the epidemic. one problem, an ever-growing b.m.i. or body mass index. we turn dr. francis collins, director of the national institutes of health. the n.i.h. is one of the leading partners in this week's efforts. dr. collins, a lot of our conversation in this area goes to the superobese. a lot of the statistics that are most troubling come from those people who have gained a huge amount of weight. but aren't there real health dangers that come from gaining a small amount of weight over a long amount of time? >> well, there are significant health consequences even for those who are not in what you would call the severely obese category. that would be somebody with a

b.m.i. over 40. but if your b.m.i. is even over 2025-- and that's easy to do if you're just eating maybe an extra couple hundred calories a day over what you would need to maintain a normal weight-- that can put stress on a number of systems more importantly it stresses your system as far as how to handle sugar and that results in over the course of time difficulties in producing enough insulin to keep your sugar in the normal range and lots of people who are not really obese in a major way already have pre-diabetes. that is if you test their glucose tolerance it's already abnormal. 79 million people in the u.s. have prediabetes. most of them don't know it. most of them have a chance of going on to full-blown diabetes in five years. it's as high as 40% or 50%. that doesn't require you to be massively obese. other things happen also as you begin to gain weight. obviously it puts a stress on your joints. interestingly, it also increases

your risk of cancer which many people have not really recognized phenomenon recently. we don't understand all the mechanisms for that but it's a very serious concern. >> suarez: one interesting finding that's emerged in this new research is the that kids are eating hundreds of calories per day more than they did a generation ago. are we seeing diseases we used to see in older people in ever-younger children? >> when you look at the public health crisis here's what's happening with kids. fully a third of kids are overweight or obese. about 17% of them are obese. we know from studies that n.i.h. has done over many years, including the heart study in louisiana, that an obese child has a 77% chance of becoming an obese adult and that means these kids are already on a pathway towards a lot of trouble and there are kids now getting what we used to call adult on set

diabetes, so called type two diabetes at ages as young as 10, 11, 120r. we never would have seen that and those kids it turns out are hard to treat as was recently shown in a study that was just published a week or so ago and they if not successfully treated may find themselves in real trouble with heart disease, diabetes, kidney failure as young as age 30 we are there are facing for the first time the chance that the current generation may have a shorter life span than their parents or grandparents because of this obesity epidemic. >> suarez: for years we've been telling people this is the case, that they have to change the way they're living and just telling them so hasn't been enough apparently. the report has a much broader set of suggestions for how to reengineer the way americans eat and live and get through the day. talk us through some of that.

>> well, clearly the moralistic finger shaking at people is not the way to get the results that we hope our nation can achieve and we've spent too much time doing that for considering that somehow if people just took initiative to watch their diet and exercise everything would be fine. it's going to have to be much more than that. and the institute of medicine report outlines that, it's going to take sure the efforts of individuals, we all are going to have to take some additional responsibility for our part but that's not sufficient. it will take families working together. it will take your own social network. it's interesting, your friends can make you fat, it's pretty clear the way in which individuals interact with each other influences things like body weight. i guess your friends can make you thin. think about that. i think it will be for local governance for mayors and other leaders to work on providing the environment that makes it easier for individuals to find ways to exercise safely schools are a

critical part of this and it's recommended that physical education should be 60 minutes a day for children which it hasn't been for a long time in many schools. and then on top of that industry has a role to play, we're barraged by advertisements for foods that are high in calories and otherwise may be low in nutrients value and we need to systematically think about how we are surrounded by those options. we need a place where the healthy choice is if easy choice. it's not a matter of self-deprivation but the desirable choice. right now the way things look that's not how it is. >> suarez: dr. collins, thanks for joining us. >> nice to be with you, ray.

check out a map of obesity rates across the united states. >> woodruff: and to another kind of crisis, a fiscal one. last week, we talked with congressional scholars thomas mann and norman ornstein about their book, "it's even worse that it looks." they put the blame for they put the blame for congress' inability to resolve budget and other problems primarily on republicans. for a different perspective, i sat down earlier today with another author, republican senator tom coburn of oklahoma. senator tom coburn, thank you very much for talking with us. >> i'm happy to talk with you. >> woodruff: you've written a book entitled "the debt bomb." what is it? what caused it? >> both parties have caused it. careerism has caused it. you're seeing it played out today in washington before this election. nobody wants to make the hard choices. nobody wants to be totally honest with the american people

when, in fact, we can get reelected without doing so so we've built programs-- well intentioned, compassionate hearts and haven't put the revenues to pay for them and haven't done the oversight on things we've done with good intentions to clean them up and make sure they're not wasteful. so what we've created is a situation where the next generation is really at risk. this generation is at risk. if you have an i.r.a., for example, and you plan on retiring in five or six years, with the inflation that's coming it's not going to be good. so what we've done is lived the last 30 years in this country off the next 30 and the bills do >> woodruff: so much of this book is about what should be done. tell us in a nutshell what you think should be done? >> as a physician, i see symptoms that manifest from a

disease. the disease is the political class-- both parties-- in this country and their desire to be careerists. the symptoms are all these problems that we have with all these programs. most americans don't realize that the federal government's twice as big as it was ten years ago in terms of the dollars that it pends. so there are tons of problems that we could address if we would be honest with the american people but most politicians don't want to tell you you can't have something in the future when they're coming up on elections. >> woodruff: you advocate big cuts in discretionary spending, you talk about a hatchet to discretionary spending. when people hear that they think what does that mean? you talk about making a sacrifice in order to have future prosperity. which americans would sacrifice? >> everybody. the only way to do this is to make sure it's seen as everybody sharing in the sacrifice to get our country back where it needs to be.

we haven't lost the american spirit. if we had leadership that pulled this country together around what the problems are and said here are the problems, medicare's unsustainable, social security is unsustainable, discretionary spending is unsustainable, our department is unsustainable, here are the problems and here are the options that we can fix them and if we delay putting off thosing ary nices and, in other words, taking some of the pain, the pain will be much more difficult and more severe especially the people that are highly dependent on the rest of us for their aging years or their medical needs right now. >> one of the things you talk about is i think you save $3 trillion over a period of years just by cutting out duplication, waste. every president i can remember has come into office saying "we need to do something about waste fraud, and abuse." but once they've gotten here they found out it's more

complicated than that. >> well, it isn't. what has happened is it's not presidents, it's congress. and that's the point i make in the book. here's medicare. we're worried about medicare and we can document that there's at least $100 billion in fraud and medicare. why? why would he have... if the system is designed to be defrauded, why haven't we changed the system? >> woodruff: what about the role that the tax cuts have played that came in under the previous administration under president bush and the two wars, all of which have contributed enormously. >> there's no question that they have contributed but you need to look at their scope. the war is $1.2 trillion, all right? we have unfunded liabilities of $131 trillion in medicare and social security alone. that's with... here's the other thing that most people don't know. government uses government accounting. if you use generally accepted

accounting principles our unfunded liabilities right now that your kids, my kids, and our grand kids are going to have to pay for us is $131 trillion. that's a million dollars per child born today in this country >> woodruff: a big part of the argument, as you know very well, is many democrats say there needs to be some parity between spending cuts and taxes. that revenues have got to go up. >> i agree with that. >> woodruff: but your party doesn't agree with that. >> my party does agree with it. paul ryan put revenue on the table. pat toomey in the supercommittee put revenue on the table. bowles-simpson put revenue on the table. the gang of six put revenue on the table. the key is do you create a tax code that will, in fact, enhance investment which will grow our economy rather than use the tax code to take those decision makers who have capital now and

make them not players in the economy. >> woodruff: you also write, senator, about what's happened in europe. you talk about the international welfare state, the collapse of that, the disincentives to work. now, what we've seen lately in europe is governments have reacted to that with these so-called austerity programs and now the voters are saying it's too much, it's too far. is austerity a sound economic policy? >> no, you have to have both. you have to incentivize growth but you have to have austerity. but my contention in our country is we don't have to have austerity, we just need to have common sense. when you have 47 different job training programs that we spend $19 billion a year on all but three of them overlap one another. there's no met trik say... as a matter of fact, the proof is they're not working and we continue to do the same thing. the american people say why would you do that? why would you have 47?

why not have three, put a metric on it and see if it works? we have a job training program that's designed to keep people in the job training business employed but not to train people for jobs that are available in our economy. >> woodruff: so you're not concerned that the kind of... that the austerity move that we saw in europe if they happened here could create the same kind of backlash? >> i would tell you that if you actually do the work and know what's going on in our government that you could easily take $250 billion a year out of our government and transfer that to flattening the code so that the average middle-income taxpayer, hard-working middle income taxpayer pays less in taxes and you will get a boom to our economy. in other words, not spend it here and transfer it to the middle income taxpayer and you will get a boom. we're getting no economic return for it. that's the problem. >> but you're talking about a culture, a kind of conduct on the part of members of congress

how much do you change that senator much to do something about this debt crisis? >> you change who's here. it's term limits. i'm self-imposed in term limits. i know that this place changes people and these people are great people here. they're well intentioned but they're double minded, get reelected. that's what is number one goal. fix the country becomes number two because you can't fix the country because you're here. and what i wanted to do with this book is expose the american public what is going on here and why we've not addressed the problem and what the consequences are going to be. >> woodruff: senator tom coburn the author of the new book "the debt bomb." thank you for talking with us. >> thank you, pleasure to be with you. >> woodruff: we turn now to a new report which ranks the countries where mothers and

their children are at the most and the least risk. the international nonprofit save the children finds norway the healthiest for the third year in a row. the worst: the west african nation of niger. it replaced afghanistan, which moved up one spot from last year. the united states ranked 25th. for more on the report, we're joined by save the children president and c.e.o. carolyn miles. welcome, ms. miles. >> thank you, gwen. >> ifill: give us a sense of what measures you're using to come up with these rankings. >> well, we looked at a wide variety of measures, really looking at things like child mortality, maternal mortality, the education of women and girls economic empowerment of women, even the political involvement of women because all of those give us a good indicator of the status of women in those countries which really impact what is it's like to be a mom there. we also looked at things like maternity leave. so all sorts of factors. >> ifill: what's the difference

in the end in the rankings between the top ten and the bottom ten? >> well, it's interesting. they're really kind of almost a mirror of each other. so all those indicators i talked with about are great for the top ten and they're poor for the bottom ten so an example would be if we compare norway and niger, number 165 so in niger only one in three births are attended by any kind of skilled attendance. and some of these births are women giving birth all by themselves whereas in norway virtually everybody birth is attended by a skilled birth attendant. things like education rates for girls so about four years on average in nij, 18 years in norway. probably me as a mom the most shocking statistics actually from this year's report is that in niger virtually every mother

will lose a child before the age of five, will lose one of her children. so that to me as a mom is a pretty shocking statistic. so really across the board. >> it's a shocking static and i wonder how much of this is driven by malnutrition not only involving the mothers but also the children. >> yeah, we really looked at malnutrition this year as a huge factor and looked at hunger. 170 million kids across the world are malnourished. that's about one in four children and that has a big, big impact on child health so of the seven and a half million kids that die under the age of five about a third of them are malnourished. so when a child gets sick they die from very common illnesss if they're malnourished. >> i was also interested in the report about educational attainment for girls. you wouldn't think about that as having to do with health

necessarily. >> well the reason it's a key indicator in this report is that we've actually done a lot of work on this issue. the longer you keep girls in school the longer they delay having their first child and that child will be much healthier. a girl who has a baby at 14 is a much higher risk pregnancy and a much higher risk far baby than if the girl waits until she's 17 or 18 and if she stays in school it's much more likely she'll wait until she's old sore that's why girls' education is important. >> ifill: i was also interested in the status of afghanistan which was dead last last time we took the report and now has moved up. what happened in afghanistan? >> well there are good bright spots in this report and afghanistan is one of those. afghanistan did move up. it doesn't sound like a lot but moving up from last to not being last anymore is big. and a lot of that have was driven by education rates

actually. so the years and years that people have been working on getting girls into school is really starting to show up in terms of the health of mothers and babies there. >> ifill: and also the proliferation of community health centers i think from 2,500 in 2008 to 22,000 now. that's a lot. >> that's right. and a lot of these health centers are in the places where moms and babies do die. kind of at the end of the health system, if you will. at the end of the road really remote areas where these moms are often times giving birth at home. so having a health clinic close at hand really saves lives. >> ifill: finally i have to ask you why is it the u.s. ranks 25th? you would assume if it wasn't number one it would at least be in the top ten or top 20. >> i think the number 25 for the u.s. is really surprising. actually, the u.s. moved up six spots this year so we were 30... the u.s. was 31 last year.

we have very high rates relatively of maternal mortality in the country, one in 2,100 births result in the death of the mother. and we still have some very high rates of child mortality as well so it's because of poverty in the united states the big gap between health care that's available for well off women versus very poor women and that's really a huge gap still in the united states. >> ifill: carolyn miles of save the children, thank you so much. >> thank you, gwen. >> ifill: you can find >> ifill: you can find a slideshow of the best and worst places for maternal and child health our web site. >> woodruff: finally tonight, remembering writer and artist, maurice sendak. he died earlier today after suffering a stroke. jeffrey brown talked with him in 2002. sendak is the author of scores of books, including "where the wild things are."

their conversation began with sendak discussing the challenges of creating books with pictures for readers of all ages. >> very difficult form. it is like balancing pictures with words. it is rhythm. it is syncopation. it is where you stop writing and start drawing. it is a continuous thread: words, pictures, words, pictures. it has a tempo, almost a metronome on it. why would children go into a book? so you need to pack stuff into that metronome right from the start so they syncopate with the book. you know that children hum and move when they are reading a book, turning pages, looking at pages. the timing has to be intuitive to an incredible degree. >> brown: but the key to reaching children, you're saying, is this whole interaction? not, say, the story or grabbing them with an image? it is more? >> i'm not doing this because it is designed to entice children.

i don't know how to write for children. i don't think anyone knows how to write for children. and those who say they do and are thus marketed are frauds, basically. we can't get into the very complex brain of a child. i don't know how to do that. and if it works, fine, but it usually works for adults as well. >> brown: you are not writing books for children, but addressing... >> me. we do this for ourselves-- me as me. there is probably something wrong with that. there is probably more child living in me than adult. and that is not a peter pan thought at all, because it is quite hurtful and strange. you know you are an adult, so you have to act as much as you can as an adult, but to be driven by something else internally which is riotous and

strange, which we call the kid. >> brown: i know you have studied art history, but picture book art as art-- in what way is it art? >> in any way that art is. it is just another form of art. it is extremely beautiful art. you started by asking what is the relationship to this and poetry? it is as crafted as poetry. it is as erudite as poetry. yet it is as simple as your face. >> brown: in a number of the books-- and i think you've talked about this-- the action centers on a moment of distraction, or a moment of chaos, when something changes. >> i'm fascinated in my own life every day. but what is the little thing that happens, the little slide, that little turn you take, sort

of like alice falling down the rabbit hole. why? it is arbitrary. why? it is what you make of the little slip in time or strange moment in time. max has this scene all the time, and his mother usually laughs, and she enjoys it. this is a bad day for her. we don't know why. we don't have to know why. and he does the same thing he's been doing all the time, but she doesn't like it this day. and he is not prepared for her not liking it. why has it changed? why is she angry? why is she upset? why does she drive him to frantic distraction that he has to yell at her? he's frightened. this is a change of enormous proportion. >> brown: his mother calls him...

>> how many people have a five-year-old child care for their fathers all through his life? not many kids have made my life pleasurable. not many people who v children who are so financially dependable. which also has allowed me to invest all kinds of experimental work. one should be happy to have one book like that. >> woodruff: that was maurice sendak talking with jeffrey brown in 2002. sendak died today at age 83. president obama read "where the wild things are" at the easter egg roll at the white house last month. that video is on our art beat page. >> ifill: again, the major developments of the day. bomb experts studied a bomb recovered after the c.i.a. thwarted another al qaeda plot to attack a u.s.-bound airliner.

and senate republicans blocked a democratic bill to keep interest rates low on federal student loans. the two sides disagreed over how to pay for the effort. we'll be tracking primary results online this election night. kwame holman explains. >> holman: our politics team will update the republican contest in indiana, where senator richard lugar is in the political fight of his life. and on our homepage, find gwen's earlier reporting on that race. as part of the "food for nine billion" series, our public media colleagues at marketplace report on one man's mission to avoid a water crisis in india. find a link on our homepage. all that and more is on our web site, newshour.pbs.org. gwen? >> ifill: and that's the newshour for tonight. on wednesday, we'll look at the winner of that indiana primary. i'm gwen ifill. >> woodruff: and i'm judy woodruff. we'll see you online, and again here tomorrow evening. thank you, and good night.

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