VICE (2013) s04e17 Episode Script
Student Debt & Fecal Medicine
1 This week on "VICE": The debt crisis that's crushing America's students.
The student loan debt is creeping through every corner of the American economy.
About half of your monthly income - is going off to you paying off your student debt.
- Right.
How does it make you feel when you-- when you think about that? Hopeless! And then the new medical breakthroughs created by fecal transplants.
It's-- Yeah.
(theme music playing) Crowd (chanting): Hands up! Don't shoot! Hands up! Today, it's nearly impossible to get a good job in America without a college degree.
But with tuition costs soaring, 70% of all college students are taking out loans, and many are finding it impossible to get out of debt once they graduate.
And that could have a long-term socioeconomic impact on America for generations to come.
We're at High Point University in North Carolina, and we're here to go on a campus tour.
(classical music playing) Toboni: High Point University is pumping more than $2 billion into campus improvements.
There are seven pools, jacuzzis, beach volleyball, concierge service, valet, an arcade, a cinema, and a first-class airplane lounge.
As our tour guide told us, you can sit here and study so can get used to the real world, where you're gonna have to fly for your business meetings.
But perks like these come at a steep cost.
High Point has increased its tuition by nearly 70% over the last decade.
Luxurious amenities help attract more students, which means more tuition checks for the college.
Over the last 20 years, tuition at American universities has skyrocketed, and as a result, debt per student has doubled.
It's crippling borrowers like Chaitra McCarty, who attended Wheelock College.
Ever since I was little, I knew I wanted to work with kids.
So, when I decided on Wheelock, I knew that they had a great reputation.
And that school seemed like it was the perfect fit for me.
And was it sort of like, "We'll worry about the money later"? Yeah, absolutely.
Yeah.
Bianca, you did an amazing job.
Toboni: How much do you owe right now? I owe $158,000.
A month I pay 850 for my private loans and then the federal loans, I pay 472.
So, about half of your monthly income - is going to you paying off your student debt.
- Right.
How does it make you feel when you, when you think about that? Hopeless! Will you be able to pay that back? I mean, we don't have a choice.
Toboni: Compounding the problem is that Chaitra and her husband both needed Master's degrees to continue teaching.
With all those loans to pay off, they're stuck living with Chaitra's mom.
You guys together have around $290,000 in loans.
Yeah, it's-- it's crazy.
That-- that's a whole house.
You know, that's a-- that's a really decent house.
Yeah.
But we own that in loans, so.
Chaitra: By 30, I think I just-- I saw myself married with a house and with kids.
You have this student debt and you can't hit milestones like buying a house or even just living in a place that's yours, having children.
It's definitely really difficult.
I mean, you can't file for bankruptcy on student loans.
The system is not conducive to help individuals like us.
Toboni: Under US law, you can file for bankruptcy to free yourself from almost any kind of debt, but not from student loans.
So, those debts stay on the books forever.
Right now we've got about $1.
2 trillion in outstanding student loans owed by about 42 million Americans.
Ben Miller specializes in higher education policy at the Center for American Progress.
The student loan problem is ultimately a tuition problem.
Because states are spending less and less money on higher education, tuition keeps rising.
Family income stays stagnant and people have to borrow to make up the difference.
What that means is we've directly shifted the cost of college away from states onto the backs of students.
Toboni: To help students pay, the US government issues loans to every single applicant, good for tuition at any accredited school.
But 43% of the borrowing is to pay for tuition at public schools, which are supposed to be affordable, but which have been raising their tuition rates to make up for dwindling state spending.
Louisiana has cut more funding to its state schools than any other state in the country.
So, we spoke with the president of LSU about how these cuts affect higher education.
We've been dis-investing in higher Ed.
at a very, very rapid rate.
I'd say in '08, we were 70/30.
70% state, 30% student.
We're 80/20 right now.
80% student, 20% state.
When you lose that much state funding, I mean, how much has tuition gone up? Tuition has gone up significantly.
About 65% for us.
We're quietly privatizing public higher education.
throughout the country.
The children in elementary school are not gonna have a public, affordable option by the time they get out of high school.
Toboni: To find out why Louisiana is cutting more and more funding from its public universities, we spoke with Governor John Bel Edwards, who is dealing with the budget deficit of $600 million.
Toboni: While campaigning for this position, - you talked about investing more in higher education.
- Yes.
It's obviously something that's important to you.
Um, and still you're proposing budget cuts for schools like LSU that need the state funding.
'Cause I have a constitutional obligation to deliver a balanced budget, and the cuts have to come from somewhere.
So, the cuts are coming at the expense of higher education and also the expense of students in order to keep those universities afloat.
Students have access to money, so do lawmakers think, "Well, we won't put money towards this "'cause we know that students can take out debt and pay for their education that way"? Well, obviously that is happening to some degree not just in Louisiana, but around the country, and I find it very troubling.
Toboni: While public schools are increasingly reliant on student loans just to cover their costs, for-profit colleges are run as businesses, and many people believe they intentionally take advantage of the loan system.
While only about 10% of students who go to college in the US go to for-profits, but nearly 40% of students who default on student loans go to these schools.
We met with Maggie Scheel, who is struggling to make ends meet after taking out loans to attend a for-profit school.
Maggie graduated with honors from a four-year program in criminal justice at Globe University Minnesota's School of Business.
At the time, I was ecstatic and they sold me on this dream.
You know, and it just turned out to be a nightmare.
Maggie: I missed a lot of time with Jon, you know, being a single parent, to think that we were gonna get somewhere, and so to end up here, it's sad.
Toboni: Maggie said that admission officers urged her to take out loans and that they gave her unreliable information about the value of the degree she'd be getting.
What did the director of admissions tell you in that first meeting? I wanted to do probation.
He really pushed that they had almost 100% placement in criminal justice.
So you were pretty much guaranteed that you would get - job placement once you graduated.
- Right.
Toboni: Despite having a four-year degree and good grades, the only job that she's been able to get doesn't require a college degree at all.
I owe just over 38 now.
38,000.
Last month I made $650.
Can I ask how much money you have in your bank account right now? 16 cents.
- Right now 16 cents? - Yep.
And we're about two months behind on all of our bills.
But, so, like, literally, how do you pay your loans? I don't.
I'm defaulted right now.
They took my taxes this year.
It's just a constant struggle.
Maggie is now working with the state attorney general, who is suing the school for misleading potential students.
We sat down with the two of them and Jason Jensen, a former Globe admissions officer.
What they're doing with people is using the job placement rate to make the school sound like it's a sure bet.
With regards to business administration, we had the school counting people as being placed, even though maybe they were working as a barista at Starbucks, which is a business.
Did you feel like you had to exaggerate the benefits of this education? Oh yeah.
My goal was to find the prospective student's pain.
So, if you were a single mother with two or three kids at home, are you making enough money to provide for your family? Furthering your education, doesn't that sound like a great option for you? Toboni: Globe University didn't respond to our request for comment, but they deny the attorney general's allegations, and have previously said that they are "fully compliant" with Minnesota law and that the placement numbers they share with prospective student are regularly reported to the accrediting body that oversees the school.
The problem here is this is students' lives and it's their futures.
They're saddled with student loans that can't be discharged in bankruptcy.
They are going to be with them for-- forever.
If the student ends up defaulting, then the American taxpayers pick up the tab for that.
Taxpayers lose, the students lose, but the school gets paid.
Toboni: Under our student loan system, the government is the lender.
So, when students default, it's the taxpayers who are on the hook.
And the schools they attended get to keep he money.
The federal government tends to take the approach of assuming all these colleges are doing the right thing, when what we see repeatedly is they don't.
Miller: Almost every major for-profit college has been under some sort of investigation.
And it's still getting several billion dollars a year from the US taxpayers.
You know, it's almost like the same situation we saw with the banks around the recession where no one was really held for account for what they did.
And the same thing is happening here.
Toboni: The astronomical levels of debt and default are getting the attention of a growing number of federal lawmakers.
This is truly an economic emergency.
Elizabeth Warren is leading the fight to change the way we finance higher education.
So we now live in an America where an education is necessary to push this economy forward, to push this country forward, and yet the debt to pay for that education, it's holding us back.
How will this affect the economy long-term? Young people are not moving out of their parents' homes at the ages we would expect.
They're not buying cars, they're not buying homes, they're not starting small businesses.
We have never had a moment like this before in America.
Toboni: The problem isn't just that students are getting into debt at record levels, it's that the quality of the education they're paying for is slipping, too.
On average, do we as Americans get the best education - compared to other developed countries? - We don't.
Miller: Our most prestigious schools, that are the best in the world, mask a lot of problems that are going on for the broad base set of the Americans that go to college.
We spend about $23,000 a year per person on higher education.
The international average is about $10,000.
So, we're spending a lot more money than most other countries.
Toboni: Two decades ago, the US was first in graduation rates compared to other developed countries.
Today, we're 15th.
And across several core indicators, we're losing ground in the quality of our higher education.
So, we're spending more on education than any other developed country.
We're putting millions of students in debt, and we're still not competing internationally - the way we were in the past.
- That's correct.
That's a lot of money to spend to just get mediocrity.
Toboni: But even as our students fall behind other countries, one state is fundamentally changing the system.
Republican Governor Bill Haslam of Tennessee started an innovative program called Tennessee Promise.
The program allows any high school graduate to attend an in-state community college debt free for two years.
It's been such a success that President Obama wants to implement programs like it nationwide.
Now we've actually got a cut of the cost of college.
Providing two years of community college at no cost for every responsible student is one of the best ways to do that.
(applause) We had to shock the system.
We had to have people who thought that college wasn't for them realize that it could be for them.
What kinds of students are with Tennessee Promise? We're seeing a lot of lower-income students.
We're seeing a whole lot of first generation students in terms of nobody in their family has ever been to college before, and we're seeing remarkable results.
Toboni: Mercedes Cruz and her mom, Hilda, say the program has been a game-changer for their family.
Because of the Tennessee Promise, like, I feel, like, more relaxed.
Like, "Okay, I can do this now.
" I don't have to worry about, "Hey I gotta pay for the next month or else I am not going to class," you know? Toboni: Mm-hmm.
I know it's gonna pay off later on with a degree.
Oye.
(laughing) (both laugh) Toboni: We grew up hearing about the American Dream, and if you work hard and you get an education, you can pull your family into the middle-class, and it just doesn't seem realistic for so many people.
Education is becoming a place where people get more and more separated over time.
For a young person whose family can afford to write that check and can graduate without a penny of debt, they're in a very different place than everyone else who had to take on debt just to be able to complete their education.
That puts us in a very dangerous place going forward where the top smaller and smaller fraction do very, very well, but everyone else gets left behind.
1/3 because it's smaller.
Antibiotic resistant bacteria are one of the most urgent threats to human health.
What is a post-antibiotic era like? Like, what does that mean for medicine? The failure of antibiotics could be devastating for the practice of medicine.
Smith: As these bacteria proliferate, they're causing infections that are almost impossible to treat.
But now, medical science may have figured out how to fight them in a new and surprising way.
Woman: Okay.
Morton: Mm-hmm.
So Stephanie is the patient who suffers from Clostridium difficile, which is C.
diff.
, which is an intestinal infection often acquired at hospitals, and which has a tendency to develop drug resistances, which makes it extremely difficult to treat with antibiotics.
It basically learns how not to be affected by the drugs.
Stephanie's banking basically her entire intestinal health on this procedure, which took all of, I feel like eight minutes.
So it's strange, but this could be the-- basically the new frontier of medicine.
People's shit.
Morton: Before a transplant, Stephanie's colon had been taken over by C.
diff bacteria, causing her frequent and painful diarrhea, and potentially requiring the removal of her entire intestine.
Hi! How are you? How are you doing? Much better now.
Good.
Okay.
Dr.
Khanna had, uh, he was very impressed by how clean your-- your colon is.
Oh.
For what that's worth.
Very many complimentary things while he was up there.
How-- how do you feel right now? Are you able to-- are-- Can you tell there's something in ya? No, not really.
No? Just normal? I actually feel pretty good, yeah.
And did you guys watch it on, like, the video monitor? - Yeah.
Yeah.
- Yeah? I saw it go in.
It was just like a squirt gun.
Just-- That's cool.
Kinda weird.
It kind of looks like a-- like a video game - 'cause you see the hose come out.
- Yeah, yeah, yeah.
And on the screen it kind of looks like those games where you have the gun.
Yeah.
Like, that is, like, the weirdest video game ever.
How long will it be before you know - if it works? - They said to expect to feel better within, like, one to three days, but it could take up to a week, so hopefully within one to three days, I'll feel much better.
Okay.
Who'd have ever thought this is, like, the cure for Who'd have ever thought that it was, like, if you just put other people's poop in you, it works? Right? Morton: While human feces can transmit many bacterial diseases, not all the bacteria that reside in our stool are bad for our health.
The basic principle behind the fecal transplant is that by putting healthy stool inside an unhealthy gut, you reintroduce all the good bacteria and help restore it to health.
Think of it as a probiotic, but like a nuclear-level probiotic.
Dr.
Sahil Khanna is Stephanie's gastroenterologist.
He's performed hundreds of fecal transplants at Mayo.
What's the, uh, kind of effectiveness rate for fecal transplants to-- on C.
diff? So our effectiveness rate has been a little over-- over 90%.
You say a 90% effectiveness rate or success rate.
That seems like-- that seems very high to me.
Oh absolutely, it's very high.
There's not a lot of things that have 90% or higher success rates.
Do you see this, uh, fecal transplant as being kind of a part of a new wave of medical thinking? Oh, absolutely.
I think we're in an era where we are learning so much about this gut microbiome that it's going to keep us busy for the next few decades trying to figure out how does this play in health and disease.
Morton: Before the fecal transplant was proven highly effective as medicine, someone had to take the risk of using the dirtiest product of the human body as a healing implement.
That man was a Danish-American doctor from up the road in Duluth.
Morton: Um, thank you, guys, for letting us come here.
Before we start, um, how-- how do I pronounce your last name? "Ohs.
" "Ohs.
" Okay.
Well, I'll make sure I get that right.
We've been doing a thing on fecal transplants.
I was curious, uh, how long was the idea around? We had a friend who was a veterinarian and he told Johannes about the fact that veterinarians had been treating diarrhea in horses with stool from healthy horses for a long time.
For probably 400 years.
Was it ever, like, a hard sell on people in the medical community to undergo, uh, such a novel treatment? Yeah, you-- you took a lot of flack from your colleagues.
Yeah.
But then within six months, they called him up and wanted to know what his protocol was.
So, it must have (laughs) - you know, it stirred some interest.
- Yeah.
Morton: Since the medical establishment has come around on the procedure, it's been performed thousands of times at hospitals and clinics across the country.
So much so that it's led to the creation of the first independent stool bank called OpenBiome right outside of Boston.
So in order to have a fecal transplant, obviously you need good feces, which means donors have to be of a certain level of health.
It's 5:00 in the morning right now, which is when one of the donors in Boston, a guy named Joe, I guess wakes up normally.
Morton: You usually go to OpenBiome before work or-- Yep, so I try to - get primed - Right.
by drinking the coffee.
- I run into OpenBiome, so-- - Okay.
- The run always does the trick.
Does-- - Yeah.
That'll definitely get the bowels moving.
- Yeah.
- For sure.
Oh.
Huh.
330 grams is the largest? Oh.
That was a big day.
- That's-- - Yeah.
Yeah.
That's huge in street value.
I guess an apple weighs 55 grams.
That's kind of the way they lay it out.
That's the same way they measure things in Hello Kitty's universe there.
She's three apples tall and she weighs two and a half apples.
You a big Hello Kitty fan? I read that on an airplane that was-- Um, it was Taiwan Air, so they were like, they had a Hello Kitty themed plane.
Before they're paid 40 bucks for their morning dump, stool donors like Joe undergo an extremely rigorous screening process to make sure their feces is up to snuff, including a 109-question quiz about their diet, medical history, and daily behavior, as well as blood tests to make sure they and their shit don't contain things like Hep-C or HIV.
Only some 3% of applicants make the cut.
- Morning.
- Hi.
Woman: Oh, hi! Good morning! Good luck.
Thank you.
Morton: Joe seems like a specimen.
You can tell obviously how healthy he is just from kinda, like, looking at him and seeing him run.
One can only imagine how healthy his specimens are which he is expelling right now.
It's, uh, it's enviable to see a man of that kind of health and regularity.
Morton: Yikes.
This is, like, the juice press of my nightmares.
(gasps) (doorknob turning) Hey.
Wow, that was quick.
Hello.
Morning.
(chuckles) How are you? Morton: 100 grams or so.
Good morning's work.
Mm-hmm.
Well, cool.
And that's it and then you're just off to work? Then I, uh, start the day.
How noble and good.
More done for medical science by your first morning dump than most people do in at least several decades.
That's great.
Morton: I provided my own sample to see how OpenBiome turns solid waste into fecal medicine, which just to be clear, will not be put up anyone else's ass.
Um, your sample was 227.
3 grams.
Mm-hmm.
First things first, I like to pour the buffer in there.
We're gonna uncap that and we'll just scoop it into here.
How did this one scoop? That was a pretty solid plop.
(mixer clanks) So this will mix up for two and a half minutes.
I know, it looks looks even better than you can imagine, right? It's-- Yeah.
And then this goes straight to the hospital, right? Yep.
We'll freeze it, put it on dry ice, and then that goes straight to them just like that.
Amazing.
Morton: OpenBiome may know what to look for in healthy stool donors, but what exactly makes their stool healthy is still a major mystery.
The average person's body harbors trillions of bacteria, fungi, viruses and other microscopic foreign bodies that make up what scientists call the microbiome, and which they are learning affects not only our digestion, but our immune system, our liver health, possibly even our mood.
It's practically its own organ system.
Dr.
Rob Knight oversees the American Gut Project, which collects samples, mostly stool, from volunteers across the country and sequences them to learn what exact bacteria we're carrying around and in what proportions.
So the most important thing with it, that we've found so far, is, uh, what happens when you have C.
diff infections.
So you can see that these patients are in - in a totally, totally different region.
- Right.
and then they get this transplant, and they move from that bad part of the map into this good part of the map where they look relatively similar to the donor.
So, it's amazingly transformative.
Morton: Right now there are a number of clinical trials going on trying to prove that you can treat more than just C.
diff with fecal transplants, or as they're officially called, fecal microbiota transplants or FMT.
While the early findings of this research is promising, getting the FDA's approval to use FMT for different conditions is still a long way off.
Dr, Knight: Any substance that modifies your body's activity in a way that impacts health, that is considered by the FDA to be a drug.
And so by that definition, a stool is a drug.
And while it's amazingly effective for C.
diff, we might be completely missing out on all kinds of other things that it's effective for.
because we now know that the microbiome is linked from everything from irritable bowel syndrome to rheumatoid arthritis to cardiovascular disease and colon cancer, and then if the work in mice turns out to translate to humans, even things like depression, autism, Parkinson's.
And so by restricting the use of stool transplants, it makes it impossible to even find out whether it can be effective for all of those other diseases.
Morton: Because the early research has been so promising, people suffering from debilitating diseases have looked to fecal transplants as a potential treatment.
But as the FDA only allows doctors to use it for C.
diff, they feel they've been left in the lurch and some have resorted to sourcing their own feces and performing the procedure themselves.
PJ Ramstack is a Washingtonian who suffers from severe ulcerative colitis, which he treats with his neighbors feces.
So what I'll do is I'll take the raw stool, Mm-hmm.
I'm gonna put it into the Ziploc baggy.
(coughs) Excuse me.
Yeah.
(chuckles) All right, I think that's good.
(taps on glassware) I just always put a little bit onto the tube itself, and then actually put a little bit up into the rectal area.
just to make it a little bit easier.
Got it in? Yep.
Some people can do this really fast.
Just kind of inject it in, and this will probably take me close to 10 minutes each to just kind of sit here and really slowly go through.
How often would you have to-- would you have diarrhea in like a day? On bad days, I'd be in the bathroom anywhere 15 to 20 times a day.
Prior to starting FMT, my-- the mental side of it, the anxiety and the depression were so bad that I don't think I ever could have got there with-- (coughs) Excuse me.
Without FMT.
I don't think that would have been a possibility.
I would go through these stages where all, every day, I'd have suicidal thoughts.
And it was-- It just scared the hell out of me.
That was kind of rock bottom for me and that's when I knew I had to find something for myself.
But, you know, for me to have seen such extraordinary results from fecal transplant when I saw very little to no results from anything else, I feel like in the end, it's gonna be a big part of what gets me into remission.
Morton: While DIY fecal transplants are a stop-gap solution for the desperate, further research is needed to get people like PJ back to proper health, and hopefully with less disgusting means.
Instead of doing it with the feces, being able to pull out just the right kinds of bacteria and deliver them maybe in a pill or something more palatable.
Morton: Despite coming from shit, the advances Dr.
Knight's team is making with the microbiome may stand on par with the discovery of penicillin or the creation of germ theory in shaping the future of medicine and human health.
Dr.
Khanna: There's studies going on for obesity, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, and then there's associations between the gut microbiome and lots of different diseases.
So, it's a-- it's a completely wide open science right now.
The student loan debt is creeping through every corner of the American economy.
About half of your monthly income - is going off to you paying off your student debt.
- Right.
How does it make you feel when you-- when you think about that? Hopeless! And then the new medical breakthroughs created by fecal transplants.
It's-- Yeah.
(theme music playing) Crowd (chanting): Hands up! Don't shoot! Hands up! Today, it's nearly impossible to get a good job in America without a college degree.
But with tuition costs soaring, 70% of all college students are taking out loans, and many are finding it impossible to get out of debt once they graduate.
And that could have a long-term socioeconomic impact on America for generations to come.
We're at High Point University in North Carolina, and we're here to go on a campus tour.
(classical music playing) Toboni: High Point University is pumping more than $2 billion into campus improvements.
There are seven pools, jacuzzis, beach volleyball, concierge service, valet, an arcade, a cinema, and a first-class airplane lounge.
As our tour guide told us, you can sit here and study so can get used to the real world, where you're gonna have to fly for your business meetings.
But perks like these come at a steep cost.
High Point has increased its tuition by nearly 70% over the last decade.
Luxurious amenities help attract more students, which means more tuition checks for the college.
Over the last 20 years, tuition at American universities has skyrocketed, and as a result, debt per student has doubled.
It's crippling borrowers like Chaitra McCarty, who attended Wheelock College.
Ever since I was little, I knew I wanted to work with kids.
So, when I decided on Wheelock, I knew that they had a great reputation.
And that school seemed like it was the perfect fit for me.
And was it sort of like, "We'll worry about the money later"? Yeah, absolutely.
Yeah.
Bianca, you did an amazing job.
Toboni: How much do you owe right now? I owe $158,000.
A month I pay 850 for my private loans and then the federal loans, I pay 472.
So, about half of your monthly income - is going to you paying off your student debt.
- Right.
How does it make you feel when you, when you think about that? Hopeless! Will you be able to pay that back? I mean, we don't have a choice.
Toboni: Compounding the problem is that Chaitra and her husband both needed Master's degrees to continue teaching.
With all those loans to pay off, they're stuck living with Chaitra's mom.
You guys together have around $290,000 in loans.
Yeah, it's-- it's crazy.
That-- that's a whole house.
You know, that's a-- that's a really decent house.
Yeah.
But we own that in loans, so.
Chaitra: By 30, I think I just-- I saw myself married with a house and with kids.
You have this student debt and you can't hit milestones like buying a house or even just living in a place that's yours, having children.
It's definitely really difficult.
I mean, you can't file for bankruptcy on student loans.
The system is not conducive to help individuals like us.
Toboni: Under US law, you can file for bankruptcy to free yourself from almost any kind of debt, but not from student loans.
So, those debts stay on the books forever.
Right now we've got about $1.
2 trillion in outstanding student loans owed by about 42 million Americans.
Ben Miller specializes in higher education policy at the Center for American Progress.
The student loan problem is ultimately a tuition problem.
Because states are spending less and less money on higher education, tuition keeps rising.
Family income stays stagnant and people have to borrow to make up the difference.
What that means is we've directly shifted the cost of college away from states onto the backs of students.
Toboni: To help students pay, the US government issues loans to every single applicant, good for tuition at any accredited school.
But 43% of the borrowing is to pay for tuition at public schools, which are supposed to be affordable, but which have been raising their tuition rates to make up for dwindling state spending.
Louisiana has cut more funding to its state schools than any other state in the country.
So, we spoke with the president of LSU about how these cuts affect higher education.
We've been dis-investing in higher Ed.
at a very, very rapid rate.
I'd say in '08, we were 70/30.
70% state, 30% student.
We're 80/20 right now.
80% student, 20% state.
When you lose that much state funding, I mean, how much has tuition gone up? Tuition has gone up significantly.
About 65% for us.
We're quietly privatizing public higher education.
throughout the country.
The children in elementary school are not gonna have a public, affordable option by the time they get out of high school.
Toboni: To find out why Louisiana is cutting more and more funding from its public universities, we spoke with Governor John Bel Edwards, who is dealing with the budget deficit of $600 million.
Toboni: While campaigning for this position, - you talked about investing more in higher education.
- Yes.
It's obviously something that's important to you.
Um, and still you're proposing budget cuts for schools like LSU that need the state funding.
'Cause I have a constitutional obligation to deliver a balanced budget, and the cuts have to come from somewhere.
So, the cuts are coming at the expense of higher education and also the expense of students in order to keep those universities afloat.
Students have access to money, so do lawmakers think, "Well, we won't put money towards this "'cause we know that students can take out debt and pay for their education that way"? Well, obviously that is happening to some degree not just in Louisiana, but around the country, and I find it very troubling.
Toboni: While public schools are increasingly reliant on student loans just to cover their costs, for-profit colleges are run as businesses, and many people believe they intentionally take advantage of the loan system.
While only about 10% of students who go to college in the US go to for-profits, but nearly 40% of students who default on student loans go to these schools.
We met with Maggie Scheel, who is struggling to make ends meet after taking out loans to attend a for-profit school.
Maggie graduated with honors from a four-year program in criminal justice at Globe University Minnesota's School of Business.
At the time, I was ecstatic and they sold me on this dream.
You know, and it just turned out to be a nightmare.
Maggie: I missed a lot of time with Jon, you know, being a single parent, to think that we were gonna get somewhere, and so to end up here, it's sad.
Toboni: Maggie said that admission officers urged her to take out loans and that they gave her unreliable information about the value of the degree she'd be getting.
What did the director of admissions tell you in that first meeting? I wanted to do probation.
He really pushed that they had almost 100% placement in criminal justice.
So you were pretty much guaranteed that you would get - job placement once you graduated.
- Right.
Toboni: Despite having a four-year degree and good grades, the only job that she's been able to get doesn't require a college degree at all.
I owe just over 38 now.
38,000.
Last month I made $650.
Can I ask how much money you have in your bank account right now? 16 cents.
- Right now 16 cents? - Yep.
And we're about two months behind on all of our bills.
But, so, like, literally, how do you pay your loans? I don't.
I'm defaulted right now.
They took my taxes this year.
It's just a constant struggle.
Maggie is now working with the state attorney general, who is suing the school for misleading potential students.
We sat down with the two of them and Jason Jensen, a former Globe admissions officer.
What they're doing with people is using the job placement rate to make the school sound like it's a sure bet.
With regards to business administration, we had the school counting people as being placed, even though maybe they were working as a barista at Starbucks, which is a business.
Did you feel like you had to exaggerate the benefits of this education? Oh yeah.
My goal was to find the prospective student's pain.
So, if you were a single mother with two or three kids at home, are you making enough money to provide for your family? Furthering your education, doesn't that sound like a great option for you? Toboni: Globe University didn't respond to our request for comment, but they deny the attorney general's allegations, and have previously said that they are "fully compliant" with Minnesota law and that the placement numbers they share with prospective student are regularly reported to the accrediting body that oversees the school.
The problem here is this is students' lives and it's their futures.
They're saddled with student loans that can't be discharged in bankruptcy.
They are going to be with them for-- forever.
If the student ends up defaulting, then the American taxpayers pick up the tab for that.
Taxpayers lose, the students lose, but the school gets paid.
Toboni: Under our student loan system, the government is the lender.
So, when students default, it's the taxpayers who are on the hook.
And the schools they attended get to keep he money.
The federal government tends to take the approach of assuming all these colleges are doing the right thing, when what we see repeatedly is they don't.
Miller: Almost every major for-profit college has been under some sort of investigation.
And it's still getting several billion dollars a year from the US taxpayers.
You know, it's almost like the same situation we saw with the banks around the recession where no one was really held for account for what they did.
And the same thing is happening here.
Toboni: The astronomical levels of debt and default are getting the attention of a growing number of federal lawmakers.
This is truly an economic emergency.
Elizabeth Warren is leading the fight to change the way we finance higher education.
So we now live in an America where an education is necessary to push this economy forward, to push this country forward, and yet the debt to pay for that education, it's holding us back.
How will this affect the economy long-term? Young people are not moving out of their parents' homes at the ages we would expect.
They're not buying cars, they're not buying homes, they're not starting small businesses.
We have never had a moment like this before in America.
Toboni: The problem isn't just that students are getting into debt at record levels, it's that the quality of the education they're paying for is slipping, too.
On average, do we as Americans get the best education - compared to other developed countries? - We don't.
Miller: Our most prestigious schools, that are the best in the world, mask a lot of problems that are going on for the broad base set of the Americans that go to college.
We spend about $23,000 a year per person on higher education.
The international average is about $10,000.
So, we're spending a lot more money than most other countries.
Toboni: Two decades ago, the US was first in graduation rates compared to other developed countries.
Today, we're 15th.
And across several core indicators, we're losing ground in the quality of our higher education.
So, we're spending more on education than any other developed country.
We're putting millions of students in debt, and we're still not competing internationally - the way we were in the past.
- That's correct.
That's a lot of money to spend to just get mediocrity.
Toboni: But even as our students fall behind other countries, one state is fundamentally changing the system.
Republican Governor Bill Haslam of Tennessee started an innovative program called Tennessee Promise.
The program allows any high school graduate to attend an in-state community college debt free for two years.
It's been such a success that President Obama wants to implement programs like it nationwide.
Now we've actually got a cut of the cost of college.
Providing two years of community college at no cost for every responsible student is one of the best ways to do that.
(applause) We had to shock the system.
We had to have people who thought that college wasn't for them realize that it could be for them.
What kinds of students are with Tennessee Promise? We're seeing a lot of lower-income students.
We're seeing a whole lot of first generation students in terms of nobody in their family has ever been to college before, and we're seeing remarkable results.
Toboni: Mercedes Cruz and her mom, Hilda, say the program has been a game-changer for their family.
Because of the Tennessee Promise, like, I feel, like, more relaxed.
Like, "Okay, I can do this now.
" I don't have to worry about, "Hey I gotta pay for the next month or else I am not going to class," you know? Toboni: Mm-hmm.
I know it's gonna pay off later on with a degree.
Oye.
(laughing) (both laugh) Toboni: We grew up hearing about the American Dream, and if you work hard and you get an education, you can pull your family into the middle-class, and it just doesn't seem realistic for so many people.
Education is becoming a place where people get more and more separated over time.
For a young person whose family can afford to write that check and can graduate without a penny of debt, they're in a very different place than everyone else who had to take on debt just to be able to complete their education.
That puts us in a very dangerous place going forward where the top smaller and smaller fraction do very, very well, but everyone else gets left behind.
1/3 because it's smaller.
Antibiotic resistant bacteria are one of the most urgent threats to human health.
What is a post-antibiotic era like? Like, what does that mean for medicine? The failure of antibiotics could be devastating for the practice of medicine.
Smith: As these bacteria proliferate, they're causing infections that are almost impossible to treat.
But now, medical science may have figured out how to fight them in a new and surprising way.
Woman: Okay.
Morton: Mm-hmm.
So Stephanie is the patient who suffers from Clostridium difficile, which is C.
diff.
, which is an intestinal infection often acquired at hospitals, and which has a tendency to develop drug resistances, which makes it extremely difficult to treat with antibiotics.
It basically learns how not to be affected by the drugs.
Stephanie's banking basically her entire intestinal health on this procedure, which took all of, I feel like eight minutes.
So it's strange, but this could be the-- basically the new frontier of medicine.
People's shit.
Morton: Before a transplant, Stephanie's colon had been taken over by C.
diff bacteria, causing her frequent and painful diarrhea, and potentially requiring the removal of her entire intestine.
Hi! How are you? How are you doing? Much better now.
Good.
Okay.
Dr.
Khanna had, uh, he was very impressed by how clean your-- your colon is.
Oh.
For what that's worth.
Very many complimentary things while he was up there.
How-- how do you feel right now? Are you able to-- are-- Can you tell there's something in ya? No, not really.
No? Just normal? I actually feel pretty good, yeah.
And did you guys watch it on, like, the video monitor? - Yeah.
Yeah.
- Yeah? I saw it go in.
It was just like a squirt gun.
Just-- That's cool.
Kinda weird.
It kind of looks like a-- like a video game - 'cause you see the hose come out.
- Yeah, yeah, yeah.
And on the screen it kind of looks like those games where you have the gun.
Yeah.
Like, that is, like, the weirdest video game ever.
How long will it be before you know - if it works? - They said to expect to feel better within, like, one to three days, but it could take up to a week, so hopefully within one to three days, I'll feel much better.
Okay.
Who'd have ever thought this is, like, the cure for Who'd have ever thought that it was, like, if you just put other people's poop in you, it works? Right? Morton: While human feces can transmit many bacterial diseases, not all the bacteria that reside in our stool are bad for our health.
The basic principle behind the fecal transplant is that by putting healthy stool inside an unhealthy gut, you reintroduce all the good bacteria and help restore it to health.
Think of it as a probiotic, but like a nuclear-level probiotic.
Dr.
Sahil Khanna is Stephanie's gastroenterologist.
He's performed hundreds of fecal transplants at Mayo.
What's the, uh, kind of effectiveness rate for fecal transplants to-- on C.
diff? So our effectiveness rate has been a little over-- over 90%.
You say a 90% effectiveness rate or success rate.
That seems like-- that seems very high to me.
Oh absolutely, it's very high.
There's not a lot of things that have 90% or higher success rates.
Do you see this, uh, fecal transplant as being kind of a part of a new wave of medical thinking? Oh, absolutely.
I think we're in an era where we are learning so much about this gut microbiome that it's going to keep us busy for the next few decades trying to figure out how does this play in health and disease.
Morton: Before the fecal transplant was proven highly effective as medicine, someone had to take the risk of using the dirtiest product of the human body as a healing implement.
That man was a Danish-American doctor from up the road in Duluth.
Morton: Um, thank you, guys, for letting us come here.
Before we start, um, how-- how do I pronounce your last name? "Ohs.
" "Ohs.
" Okay.
Well, I'll make sure I get that right.
We've been doing a thing on fecal transplants.
I was curious, uh, how long was the idea around? We had a friend who was a veterinarian and he told Johannes about the fact that veterinarians had been treating diarrhea in horses with stool from healthy horses for a long time.
For probably 400 years.
Was it ever, like, a hard sell on people in the medical community to undergo, uh, such a novel treatment? Yeah, you-- you took a lot of flack from your colleagues.
Yeah.
But then within six months, they called him up and wanted to know what his protocol was.
So, it must have (laughs) - you know, it stirred some interest.
- Yeah.
Morton: Since the medical establishment has come around on the procedure, it's been performed thousands of times at hospitals and clinics across the country.
So much so that it's led to the creation of the first independent stool bank called OpenBiome right outside of Boston.
So in order to have a fecal transplant, obviously you need good feces, which means donors have to be of a certain level of health.
It's 5:00 in the morning right now, which is when one of the donors in Boston, a guy named Joe, I guess wakes up normally.
Morton: You usually go to OpenBiome before work or-- Yep, so I try to - get primed - Right.
by drinking the coffee.
- I run into OpenBiome, so-- - Okay.
- The run always does the trick.
Does-- - Yeah.
That'll definitely get the bowels moving.
- Yeah.
- For sure.
Oh.
Huh.
330 grams is the largest? Oh.
That was a big day.
- That's-- - Yeah.
Yeah.
That's huge in street value.
I guess an apple weighs 55 grams.
That's kind of the way they lay it out.
That's the same way they measure things in Hello Kitty's universe there.
She's three apples tall and she weighs two and a half apples.
You a big Hello Kitty fan? I read that on an airplane that was-- Um, it was Taiwan Air, so they were like, they had a Hello Kitty themed plane.
Before they're paid 40 bucks for their morning dump, stool donors like Joe undergo an extremely rigorous screening process to make sure their feces is up to snuff, including a 109-question quiz about their diet, medical history, and daily behavior, as well as blood tests to make sure they and their shit don't contain things like Hep-C or HIV.
Only some 3% of applicants make the cut.
- Morning.
- Hi.
Woman: Oh, hi! Good morning! Good luck.
Thank you.
Morton: Joe seems like a specimen.
You can tell obviously how healthy he is just from kinda, like, looking at him and seeing him run.
One can only imagine how healthy his specimens are which he is expelling right now.
It's, uh, it's enviable to see a man of that kind of health and regularity.
Morton: Yikes.
This is, like, the juice press of my nightmares.
(gasps) (doorknob turning) Hey.
Wow, that was quick.
Hello.
Morning.
(chuckles) How are you? Morton: 100 grams or so.
Good morning's work.
Mm-hmm.
Well, cool.
And that's it and then you're just off to work? Then I, uh, start the day.
How noble and good.
More done for medical science by your first morning dump than most people do in at least several decades.
That's great.
Morton: I provided my own sample to see how OpenBiome turns solid waste into fecal medicine, which just to be clear, will not be put up anyone else's ass.
Um, your sample was 227.
3 grams.
Mm-hmm.
First things first, I like to pour the buffer in there.
We're gonna uncap that and we'll just scoop it into here.
How did this one scoop? That was a pretty solid plop.
(mixer clanks) So this will mix up for two and a half minutes.
I know, it looks looks even better than you can imagine, right? It's-- Yeah.
And then this goes straight to the hospital, right? Yep.
We'll freeze it, put it on dry ice, and then that goes straight to them just like that.
Amazing.
Morton: OpenBiome may know what to look for in healthy stool donors, but what exactly makes their stool healthy is still a major mystery.
The average person's body harbors trillions of bacteria, fungi, viruses and other microscopic foreign bodies that make up what scientists call the microbiome, and which they are learning affects not only our digestion, but our immune system, our liver health, possibly even our mood.
It's practically its own organ system.
Dr.
Rob Knight oversees the American Gut Project, which collects samples, mostly stool, from volunteers across the country and sequences them to learn what exact bacteria we're carrying around and in what proportions.
So the most important thing with it, that we've found so far, is, uh, what happens when you have C.
diff infections.
So you can see that these patients are in - in a totally, totally different region.
- Right.
and then they get this transplant, and they move from that bad part of the map into this good part of the map where they look relatively similar to the donor.
So, it's amazingly transformative.
Morton: Right now there are a number of clinical trials going on trying to prove that you can treat more than just C.
diff with fecal transplants, or as they're officially called, fecal microbiota transplants or FMT.
While the early findings of this research is promising, getting the FDA's approval to use FMT for different conditions is still a long way off.
Dr, Knight: Any substance that modifies your body's activity in a way that impacts health, that is considered by the FDA to be a drug.
And so by that definition, a stool is a drug.
And while it's amazingly effective for C.
diff, we might be completely missing out on all kinds of other things that it's effective for.
because we now know that the microbiome is linked from everything from irritable bowel syndrome to rheumatoid arthritis to cardiovascular disease and colon cancer, and then if the work in mice turns out to translate to humans, even things like depression, autism, Parkinson's.
And so by restricting the use of stool transplants, it makes it impossible to even find out whether it can be effective for all of those other diseases.
Morton: Because the early research has been so promising, people suffering from debilitating diseases have looked to fecal transplants as a potential treatment.
But as the FDA only allows doctors to use it for C.
diff, they feel they've been left in the lurch and some have resorted to sourcing their own feces and performing the procedure themselves.
PJ Ramstack is a Washingtonian who suffers from severe ulcerative colitis, which he treats with his neighbors feces.
So what I'll do is I'll take the raw stool, Mm-hmm.
I'm gonna put it into the Ziploc baggy.
(coughs) Excuse me.
Yeah.
(chuckles) All right, I think that's good.
(taps on glassware) I just always put a little bit onto the tube itself, and then actually put a little bit up into the rectal area.
just to make it a little bit easier.
Got it in? Yep.
Some people can do this really fast.
Just kind of inject it in, and this will probably take me close to 10 minutes each to just kind of sit here and really slowly go through.
How often would you have to-- would you have diarrhea in like a day? On bad days, I'd be in the bathroom anywhere 15 to 20 times a day.
Prior to starting FMT, my-- the mental side of it, the anxiety and the depression were so bad that I don't think I ever could have got there with-- (coughs) Excuse me.
Without FMT.
I don't think that would have been a possibility.
I would go through these stages where all, every day, I'd have suicidal thoughts.
And it was-- It just scared the hell out of me.
That was kind of rock bottom for me and that's when I knew I had to find something for myself.
But, you know, for me to have seen such extraordinary results from fecal transplant when I saw very little to no results from anything else, I feel like in the end, it's gonna be a big part of what gets me into remission.
Morton: While DIY fecal transplants are a stop-gap solution for the desperate, further research is needed to get people like PJ back to proper health, and hopefully with less disgusting means.
Instead of doing it with the feces, being able to pull out just the right kinds of bacteria and deliver them maybe in a pill or something more palatable.
Morton: Despite coming from shit, the advances Dr.
Knight's team is making with the microbiome may stand on par with the discovery of penicillin or the creation of germ theory in shaping the future of medicine and human health.
Dr.
Khanna: There's studies going on for obesity, primary sclerosing cholangitis, Crohn's disease, ulcerative colitis, and then there's associations between the gut microbiome and lots of different diseases.
So, it's a-- it's a completely wide open science right now.