'Never a good idea': Security expert slams Saudi nuclear deal

0:00Support for Here and Now Anytime comes from MathWorks, creator of MATLAB and Simulink software, to design and develop engineered systems, accelerating the pace of discovery in engineering and science. Learn more at mathworks.com. WBUR Podcasts, Boston. This agreement in particular, as it's been discussed thus far, does give priority access for American companies and the Saudi nuclear energy program, which will ultimately benefit American industry workers and supply chains. So the deal that has been discussed thus far and will continue to be discussed absolutely puts America first. And that's obviously very important to this president.

0:39Why does the White House want to help Saudi Arabia start a nuclear energy program?

0:53It's Thursday, July 23rd, and this is Here and Now Anytime from NPR and WBUR. I'm Chris Bentley. Today on the show, utility bills are rising fast. Are rate payers, aka you and me, shouldering too much of the cost burden? Power companies are making updates to their grid. They're making expansions to accommodate these data centers, and the costs are being passed on directly to consumers. Also, former employees of a telehealth company say they were under pressure to dole out prescriptions to weight loss drugs fast, even if it meant cutting corners on patient safety. This is a big concern, especially since we're going to get more and more powerful weight loss drugs coming.

1:40That story coming up in about 10 minutes. But first, the president is pushing a new nuclear deal in the Middle East. Not in Iran, which had an agreement to develop civilian nuclear power that Trump ripped up during his first term, but in Saudi Arabia. Whereas that Iran deal required snap inspections by the International Atomic Energy Agency, Trump is offering the Saudis help developing nuclear energy and possibly future uranium enrichment in the country with just a bilateral safeguards agreement. So the US, not the UN, would be the ones making sure the Saudis don't pursue nuclear weapons. The Trump administration says it's making the offer to entice Saudi Arabia to sign a peace deal with Israel.

2:29There were nuclear negotiations with Saudi Arabia under the Biden administration, with the same goal of softening their stance on Israel. But Trump's announcement Wednesday came as a bit of a surprise to many watching the region, including Jim Walsh of MIT. He stopped by our studios in Boston to share his initial thoughts with Indira Lakshman on. The U.S.'s closest ally in the Middle East, Israel, and U.S. nuclear non-proliferation experts have raised serious concerns about it because of the risks of an arms race in the region and also the fact that Saudi Arabia doesn't recognize Israel. Is this deal now already at risk of falling apart less than a day after it was signed?

3:12Well, I mean, part of this is with Trump. There's always some uncertainty about how long anything will last. But when you sign an agreement, you sign an agreement. You don't unsign it. Now, there are always provisions where parties can withdraw. But this is probably more short-term message managing. Remember, Biden also had his own wacky and unwelcome plan to help the Saudi nuclear program. It contained a provision where they would have to recognize Israel. And so he's probably reacting to criticism that Biden's deal is better. I think what's done is done. And the U.S. is pledging to help, I almost said Iran, Saudi Arabia's nuclear program.

3:55and that's where it's headed. Well, I guess presumably if the president decides it's not going to go through, he could abrogate it or Congress could abrogate it. But let's talk about what has been signed. NPR has reviewed the deal that was signed. It does not prohibit Saudi Arabia from enriching uranium. President Trump said today that it did prohibit that. The signed deal also does not include strict oversight from the International Atomic Energy Agency. So what are your biggest concerns, Jim, about the terms of the deal that we know of that have been signed? Well, as I understand the deal, there's going to be, quote, a study, unquote, of whether enrichment's a good idea.

4:35That's a two-year study, which just coincidentally ends before Trump's term in office. So they have a two-year study, and then they jointly recommend whether to go forward with enrichment or not. My guess is Trump will recommend that they do go forward with enrichment if the promise is to build a lot of U.S. plants. And there we go. We're off to, you know, let's see how Israel, Iran, which already has a nuclear program, but hasn't crossed the nuclear weapons threshold, how Turkey reacts. There's just nothing. This was never a good idea. It was a terrible idea under Biden. It's a horribly terrible idea under Trump in a region where we have multiple wars going on.

5:14And do we really think that building nuclear power plants in a region where they are being bombed is a good idea? Yeah. My main concern, though, is proliferation. What is the likelihood that Saudi Arabia will use this as a pathway to the bomb? And then where are we? Well, of course, a lot of Gulf states are concerned about Iran's nuclear ambitions. And there's been a lot of talk for years about how to rein in an arms race, a regional arms race or proliferation. Of course, there was a deal between the U.S. and the United Arab Emirates that ensured restrictions. Now, you've been to Saudi Arabia, Jim.

5:52You spoke with the kingdom's then foreign minister and the heads of their energy and nuclear departments. What did that visit reveal to you about Saudi Arabia's nuclear ambitions? I mean, my first thought is they're a petro state. They have some of the biggest oil reserves in the world. Why do they even want nuclear energy? I got to say, I went there. I had a lovely time. They were gracious hosts. The food was surprisingly good. And what they told me shocked me. What they told me, I've never heard from a senior government official from any country. I've been to a lot of countries. They said, Jim, this is a direct conversation.

6:26Jim, yes, we need a nuclear program. You know, we have all this oil and the more electricity we have, the more oil we can sell. And also, you know, Iran might get the bomb and we want the option of building one ourselves. So they said the quiet part out loud. They said the quiet part out loud. They are a member of the NPT, the Non-Proliferation Treaty. You join that by saying, I pledge never to pursue nuclear weapons. In return for that pledge, I am entitled to receive civilian nuclear help and technology. Not the other way around, where you join the club, get the technology, then turn around and use it for a bomb.

7:04And the fact that they didn't even recognize that they were saying something they shouldn't be saying was deeply troubling. Well, Jim, of course, we have to clarify that this was a former foreign minister, a then foreign minister, the then heads of the Energy and Nuclear Department. So we can't say what the current leaders are saying. Well, yes, we can, because those are the same policy lines echoed by the crown prince. He has repeatedly said in public the same thing. If Iran got a nuclear weapon, they would follow suit. And so in some ways, he was saying, the person who told me this to my face was basically repeating what the king had said or the leader had said.

7:42All right. Tell me, what message does this send that the U.S. and Saudi Arabia signed this deal yesterday at the same time that the U.S. is engaged in a war with Iran over that country's supposedly nuclear energy program that the U.S. has always said is no, a secret weapons program? The shortest of stories. Way back years ago in decades, there were American presidents who wanted to build up the nuclear program of a favored ally in the Middle East. He was a dictator, but he was aligned with U.S. interests. He was the Shah of Iran. Atoms for peace. Iran sent many of its best scientists to MIT, my institution, where they trained, they went back, they started that program.

8:24Decades later, I was on a stage with the head of Iran's nuclear program, and we both talked small talk about being from MIT. I mean, that's enough. Decades later, we're bombing the country whose nuclear program we helped. I mean, we're setting up for a repeat of the same story. So much history. Jim Walsh, here and now security analyst, thank you so much for sharing it with us. Senior researcher at MIT's Security Studies Program. Thanks, Jim. Thank you.

8:55Coming up next, are your utility bills going up? The Pew Research Center found three-quarters of Americans say their home energy costs have gone up in recent years, and most of them said those costs went up a lot. In just a minute, we'll talk about why those costs might be rising, and what might help stem the tide.

9:24What you pay for electricity and other household energy depends a lot on where you live and what utility delivers that energy to your house. But the trend line for those costs over the past few years has been pretty universal. They're going up. There's no single person or policy to blame for that. That's probably not much solace if you're one of the growing number of Americans struggling to pay utility bills. A new report from consumer advocate groups the Century Foundation and Protect Borrowers found energy bills are rising as much as three times the rate of inflation, and the trend has only gotten worse since last year.

10:05Julie Margetta Morgan is president of the Century Foundation. She's formerly with the Consumer Financial Protection Bureau, and she told Indira Lakshmanan more about their findings. Yeah, one of the things that was really interesting in doing this report is that we often think of energy bills as spiking in kind of the coastal states or in states where it's really warm or really cold. And what our report found is that there were about 10 states where bills rose more than 20 % under President Trump. And in particular, certain states really stood out. So for example, Montana has seen a 52 % increase in its energy prices under Trump.

10:40And so we are seeing these states where the majority of constituents really supported Donald Trump actually, you know, being harmed by his policies. I'm curious, why in Montana, Arkansas, South Carolina, Tennessee, why have utility bills spiked so much? Well, you know, it's a little bit idiosyncratic by the state, but we're all suffering from some of the policy choices that we've seen the Trump administration make over time. I think the big ones that are in the headlines every day are the war with Iran, which has driven up fuel costs, the tariffs, which have spiked costs across the board. But there are a few that have flown under the radar.

11:21And in particular, in the budget reconciliation bill, which is sometimes referred to as the one big, beautiful bill, the Trump administration worked with congressional Republicans to actually cut back on tax incentives for electricity on programs like LIHEAP that help people cover their electricity costs and, you know, generally inserted a lot of chaos and uncertainty into the market for energy costs altogether. Well, we hear about inflation every day. It was one of the things that President Trump campaigned against. You've just explained some of the reasons why you say his policies have worked against pushing down utility costs.

12:02But to be fair, utility costs were already high in places like California. Is it right to lay all of this at the president's door? You know, I think there are a lot of parties who are responsible here. That means there are also a lot of parties who can step in and act. Certainly the president is one. And I think many of us would really like to see some federal leadership where the president is taking responsibility for the affordability crisis that's really squeezing families and then using every lever he has to drive down those prices. But there are other actors as well. To your point, we can see state regulators step in to disapprove rate hikes by utility companies.

12:43We can see and we have seen some governors step in to put in place temporary rate freezes to sort of slow the effects of these rate hikes on families' bills. So there are certainly a lot of places where we can see families get some support. Well, we've also got an outdated energy grid. Electricity demand is on the rise, especially with data centers and AI. So I want to ask you, is this a problem that can be solved in the short term or by one administration? Or do we need to expect that we're going to have high utility costs for some time to come? Well, we certainly do have an outdated grid, and there's no question that data centers are requiring a lot of improvements and expansion in capacity.

13:28The question here is who pays for that? Because what we're seeing happen right now is that power companies are making updates to their grid, they're making expansions to accommodate these data centers, and the costs are being passed on directly to consumers. There are different ways to do this, and we need our leaders to step in and create plans that actually manage those costs for families rather than having them bear all the burden. That's Julie Margetta Morgan, president of the Century Foundation. Julie, thank you so much. Thank you.

14:06Coming up, another story where profits are pitted against consumer welfare. Former employees of a telehealth company say a popular prescriber of weight loss trucks pushed unnecessary medication, risking patient safety to make more money. More in just a minute.

14:32Lots of people are seeing doctors remotely. Telehealth can be a great thing for people without a doctor nearby, or who need a prescription and don't want to wait weeks or months for an in-person appointment. With the increase in demand for weight loss drugs, Many people are turning to telehealth companies to rate them prescriptions for GLP-1s. But former employees of one such company told reporter Elaine Chen of STAT that they were being pressured to put profits ahead of patient safety. Elaine Chen told Scott Tong what the former employees said. There were various examples they gave me. For example, two former employees said that at times there was the expectation to review the cases of 25 people per hour based only on electronic forms that the patients filled out.

15:20Let me pause you there. 25, so a patient every two minutes, something like that? Yeah, that's roughly how it breaks down. Wow. And they also told me that the company also discouraged providers from asking what they thought were medically relevant questions to patients so that prescriptions could happen faster. They also were concerned that some providers were not charting properly, sometimes having almost blank notes on patients, which made it hard, especially if providers are seeing other people's patients. I should note that the company LifeMD denies these allegations. You write that GLP-1 drugs are generally considered safe.

16:04Were there specific risks to patients that these former employees mentioned? Like, what could go wrong? What did they say could go wrong? I think that if a patient isn't monitored closely while taking these drugs, there are risks of developing eating disorders or losing too much weight too quickly, which can lead to a bunch of different problems like pancreatitis, gallstones, malnutrition. And specifically, the former chief operating officer of LifeMD filed a lawsuit alleging that he was prescribed GLP-1 drugs by the company's chief medical officer in an inappropriate way, resulting him to develop this rare inner ear condition that's led to long-lasting debilitating side effects like memory loss, cognitive decline, and constant ringing in his ears.

17:01So that's one specific alleged case. We should note LifeMD is a publicly traded, kind of listed company. You interviewed the CEO of LifeMD. What did the company say? They strongly denied the allegations. They said that they do not push providers to prescribe. They said that providers do ask follow-up questions to patients. They said that if they actually wanted to run a pill mill, then there could have been a lot easier ways for the company to do it, given that they do hire full-time providers and train them and monitor them. So they strongly deny the allegations. Yeah. Yeah. And more broadly, beyond this telemedicine company, beyond the specific drug maker that it's linked to, are there broader concerns about clinical oversight from people you talk to?

17:54Yes. I think that there are a lot of concerns about the whole industry of telehealth companies that prescribe GLP-1 drugs. It's an industry that's grown very rapidly over the last few years. It's very loosely regulated. There have been studies where researchers have have gone to look at the various intake forms and found that they're very insufficient and they're not following proper prescribing practices. So this is a big concern, especially since we're going to get more and more powerful weight loss drugs coming. They are coming down the pike as you write in your piece. We've been talking to Elaine Chen, a reporter at STAT, our editorial partner.

18:35Elaine, thanks very much. Thank you. We reached out to LifeMD and Novo Nordisk for comment. LifeMD did not respond. Novo Nordisk said, quote, we continually review our collaborations to ensure they reflect our commitment to patient safety and responsible prescribing under the supervision of a qualified healthcare professional. Our expectation of any entity we collaborate with is the same, end quote.

19:04That's it for the show today. Here and Now Anytime comes from NPR and WBUR Boston. Today's stories were produced by Sam Rapelson, Hafsa Qureshi, and Jessica Carissa. Welcome to the show, Jessica. Today's editors were Todd Mutt, Mikaela Rodriguez, and Michael Skata. Technical direction from Matt Reed and Andre Peralta. Our theme music is by Mike Moschetto, Max Liebman, and me, Chris Bentley. Our digital producers are Allison Hagen and Grace Griffin. And Here and Now's executive producer is Alan Price. Thanks for listening. We'll be back with you tomorrow.