JUDY WOODRUFF: Good evening.

I'm Judy Woodruff.

On the "NewsHour" tonight: condolences and confrontation.

President Trump is met with protests while visiting El Paso and Dayton to console victims of the weekend's mass shootings.

Then: one-on-one with Democratic presidential candidate Tom Steyer to discuss guns, environmentalism and impeachment.

Plus: traveling for treatment.

Exploring the burgeoning industry of health tourism, as the high cost of health care in the U.S. has many patients looking abroad.

RAVI RAMAMURTI, Northeastern University: We need to shake up the health care industry in the U.S. You need a lot of people disrupting in little ways that add up to big change over a period of time.

JUDY WOODRUFF: All that and more on tonight's "PBS NewsHour."

(BREAK) JUDY WOODRUFF: Two cities united in their grief, but divided over condolences from the commander in chief.

Yamiche Alcindor reports on the latest from Dayton and El Paso.

YAMICHE ALCINDOR: Well before President Trump arrived, protesters in Dayton, Ohio, filled the streets.

Some denounced his rhetoric on race and immigration, and demanded action to prevent gun violence.

SHANDA, Dayton Resident: The tempers flare, but, at the end of the day, how can we not be out here?

And this is our city.

YAMICHE ALCINDOR: Others praised the president and welcomed his visit.

As he left the White House, President Trump said he hoped Congress could soon pass bipartisan gun legislation, though not a ban on assault weapons.

DONALD TRUMP, President of the United States: I don't want to put guns into the hands of mentally unstable people or people with rage or hate.

There's a great appetite -- and I mean a very strong appetite -- for background checks.

And I think we can bring up background checks like we'd never had before.

YAMICHE ALCINDOR: The president also insisted his comments have not fueled hate.

DONALD TRUMP: No, I don't think my rhetoric has at all.

I think my rhetoric is a very -- it brings people together.

YAMICHE ALCINDOR: Critics say he is part of the problem, because in between today's visits, he criticized Democrats and doubled down on his hard-line immigration stance.

President Trump first stopped in Dayton, where a gunman fired an automatic weapon outside a popular bar early Sunday, killing nine people.

The president and first lady went to a hospital where many people were treated.

There, they thanked first responders and medical staff.

They also met with some of the victims and their families.

Several hundred demonstrators gathered outside.

Later, President Trump traveled to the Texas border city of El Paso, where Saturday's racially motivated shooting at a Walmart claimed 22 lives.

MAN: Trump is responsible.

YAMICHE ALCINDOR: An El Paso Strong rally was held at the same time to counter the president's visit.

Many residents and Democratic lawmakers there, including El Paso native and presidential candidate Beto O'Rourke, had urged him to stay away.

O'Rourke attended a morning remembrance at a local high school.

BETO O'ROURKE (D), Presidential Candidate: What you are doing today here today, proudly and defiantly standing up against racism and hatred and terrorism, is the way forward for a United States of America that has never been more divided, more polarized than it is right now.

YAMICHE ALCINDOR: Meanwhile in Iowa, former vice president and Democratic presidential candidate Joe Biden sounded off.

He insisted President Trump bears some responsibility for inflaming tensions.

JOSEPH BIDEN (D), Presidential Candidate: Trump offers no moral leadership.

He seems to have no interest in unifying this nation.

No evidence that the presidency has awakened his conscience in the least.

Indeed, we have a president with a toxic tongue, who's publicly and unapologetically embraced the political strategy of hate, racism and division.

YAMICHE ALCINDOR: Other Democratic candidates also demanded urgent action on gun control.

New Jersey Senator Cory Booker spoke at an historically black church in Charleston, South Carolina, where, in 2015, nine people were killed in a racist attack.

SEN. CORY BOOKER (D-NJ), Presidential Candidate: There's no neutrality in this fight.

You are either an agent of justice or you are contributing to the problem.

Addressing this -- we must understand this - - addressing this is not an act of charity or philanthropy.

It is an issue of national security.

YAMICHE ALCINDOR: During a speech in Washington, Montana Governor Steve Bullock made a case for banning high-capacity magazines and assault weapons.

GOV.

STEVE BULLOCK (D-MT), Presidential Candidate: Let me say that, as a hunter, no real hunter needs a 30-round clip.

No real hunter needs a weapon of war.

No real hunter needs a bump stock.

YAMICHE ALCINDOR: For the "PBS NewsHour," I'm Yamiche Alcindor.

JUDY WOODRUFF: And now to our second lead story tonight.

The political turmoil in Puerto Rico took a new turn today when the island's Supreme Court overturned the swearing-in of Pedro Pierluisi as governor.

Outgoing Governor Ricardo Rossello, who was forced from office last week after public protests, had positioned Pierluisi to succeed him.

But the high court today found that process unconstitutional.

That cleared the way for Justice Secretary Wanda Vazquez to assume the post late this afternoon.

For the latest on all this, we turn to reporter Frances Robles of The New York Times.

Welcome back to the "NewsHour," Frances Robles.

So how did the Supreme Court arrive at this decision?

FRANCES ROBLES, The New York Times: It was a decision that was widely expected, because there was a contradiction between what Puerto Rican law says and what Puerto Rican Constitution says.

So he was never confirmed by the Senate, and the law seas that was OK, and the Constitution says it's not.

JUDY WOODRUFF: And so, Wanda Vazquez, after saying she wasn't interested in assuming this position, is now going to be stepping in?

FRANCES ROBLES: Yes, she was sworn in about an hour ago.

I don't know that she ever said she would turn down the job.

She just wanted to make clear that it wasn't her interest, she wasn't jockeying for the position.

And it is actually widely expected that she will not stay in the job.

Everyone is kind of expecting her to make a bunch of Cabinet nominations and then resign herself, so that the succession continues.

JUDY WOODRUFF: Why do people believe she's not interested and won't stay?

FRANCES ROBLES: You know, this is the "Game of Thrones" without the dragons and the homicides.

And so what it is, is a bunch of people in backrooms jockeying of who's going to be in power.

And, so, the person who has a lot of power in Puerto Rico now is the head of the Senate, and he and she are archenemies.

And so it's kind of just understood that he will not allow for her to stay in that position long and there have been deals made as to how this is going to play out.

JUDY WOODRUFF: So what does that mean, Frances Robles?

Who steps in if she doesn't stay long and someone has to replace her?

FRANCES ROBLES: Well, it depends on whose rumor you believe.

But the prevailing rumor, which has been actually published in the local media, is that the Puerto Rican Congresswoman Jenniffer Gonzalez is very much expected to be named secretary of state.

If she is named and then confirmed by the House and the Senate, which is the part that Mr. Pierluisi didn't do, then, if Ms. Vazquez resigns, then Ms. Gonzalez will become the governor of Puerto Rico.

JUDY WOODRUFF: And, in fact, she was a guest on the "NewsHour" just the other day.

So she would be acceptable to the people of Puerto Rico, it's believed?

FRANCES ROBLES: I think she is.

She doesn't have the baggage that a lot of people have.

Even Ms. Vazquez, she was suspended from office a few months ago.

Mr. Pierluisi has a got of connections in his family, and so that they were very much seen as products of the establishment, of the establishment taking advantage of this popular uprising to put in more of their own.

And although Ms. Gonzalez is a member of that party, she's pretty well respected.

She's actually a pretty popular political figure on the island.

JUDY WOODRUFF: And in just a few seconds, how are the people in Puerto Rico dealing with the turmoil at the top?

FRANCES ROBLES: Everybody is just kind of waiting to see who's going to be next to see whether they have to unleash those protests again.

You saw that a bit when Mr. Pierluisi took office, and now there's kind of a calm, a tense calm.

JUDY WOODRUFF: Frances Robles of The New York Times, we thank you.

FRANCES ROBLES: Thanks for having me, Judy.

JUDY WOODRUFF: And in the day's other news: U.S. Immigration and Customs Enforcement arrested 680 undocumented workers, mostly Latinos, at food plants in Mississippi.

They were the largest such raids in at least 10 years and involved 600 government agents.

The operation targeted processing plants in half-a-dozen towns outside Jackson.

ICE officials said it was planned months ago.

In Afghanistan, 14 people were killed and nearly 150 wounded when a powerful car bomb exploded in Kabul.

The blast leveled buildings near a police station and shattered windows in houses and shops for blocks around.

The wounded, most of them civilians, were rushed to hospitals.

The Taliban claimed responsibility, even as it continues peace talks with U.S. diplomats.

Pakistan is expelling the ambassador from India and suspending cross-border trade in an escalating dispute over contested Kashmir.

That's after India stripped its part of Kashmir of political autonomy.

Today, hundreds returned to the streets in the Pakistani-controlled part of Kashmir, condemning New Delhi's decision.

MAN (through translator): This is a heinous conspiracy, and we strongly condemn it.

It has been our demand since the beginning that Kashmir should become autonomous.

We are protesting for this, and, God willing, we will continue to protest for this.

JUDY WOODRUFF: India's Hindu nationalist government is pressing for Muslim-majority Kashmir to be fully integrated with the rest of the country.

The United States and Turkey may be close to setting up a so-called safe zone in Northeastern Syria.

Negotiators said today that they have agreed to form a joint operations center.

That could head off a Turkish military invasion to clear the region of Syrian Kurdish forces.

The Kurds are aligned with the U.S., but Turkey regards them as terrorists.

In Northwestern Syria, government forces have recaptured two villages in a renewed offensive on the last major rebel stronghold.

The assault on Idlib province began in late April, but the Syrian military called a brief cease-fire over the weekend.

In three months, airstrikes and shelling have displaced 400,000 people and killed more than 2,000 others.

Back in this country, Democrats in the U.S. House of Representatives moved today to make former White House counsel Don McGahn answer questions.

In a federal lawsuit, the House Judiciary Committee demanded that McGahn obey a subpoena.

It also rejected White House claims that he has legal immunity against testifying.

And on Wall Street, stocks plunged initially today amid new fears about the U.S.-China trade war, then battled their way back.

By the end of the day, the trading day, the Dow Jones industrial average lost 22 points to close at 26007.

It had been down nearly 600 at one point.

The Nasdaq rose 29 points, and the S&P 500 added two.

Still to come on the "NewsHour": leaders from both El Paso and Dayton react to the president's visit; Democratic presidential candidate Tom Steyer on his top priorities; the high cost of health care has many Americans seeking medical care abroad; and much more.

Two views now from leaders in the two cities where the president visited today.

William Brangham has those.

WILLIAM BRANGHAM: President Trump's first stop today was in Dayton, Ohio, where a gunman killed nine people and wounded 26 others early Sunday morning.

Ahead of his visit, Mayor Nan Whaley said she felt it is her duty to welcome the president, and that she hoped he was coming to add value to our community.

Mayor Nan Whaley joins me now.

Mayor, thank you very much for being here.

And, again, on behalf of all of us, our condolences to you and what your town has been going through.

Before we talk about the president's visit, I'm just curious how Dayton is doing now.

NAN WHALEY (D), Mayor of Dayton, Ohio: Well, I think we're a little tired here in Dayton.

You know, we have gotten an awful lot of press coverage.

And most of the reporters around town have talked about how great and gracious day Daytonians have been.

But we're in the process of really getting to really undergo some serious grieving.

The visitations and funerals will be starting in the next few days.

And we're just trying to keep our community together.

WILLIAM BRANGHAM: And we saw that you visited some victims of this massacre with the president today.

How did that visit go?

NAN WHALEY: Oh, the president was very well-received by the victims and the first responders.

We saw the guys that were so heroic on the streets, on Fifth Street, that Saturday night, they were super grateful to see the president of the United States, and lots of pictures all around for those folks.

WILLIAM BRANGHAM: You had said in advance of the president's visit that you had hoped - - you had said that his rhetoric has been painful for many in our community, meaning your community.

NAN WHALEY: Sure.

WILLIAM BRANGHAM: What did you mean specifically by that?

NAN WHALEY: Well, I will just say that, when the president announced he was coming Tuesday, you could just feel a tension in the community that we really hadn't experienced before that.

And I think that is not anything he said specifically today or yesterday.

It's just three years of this hyperpartisan way that he works, and that's painful for some people in the community.

I am glad the president went, when he decided to come, that he decided to go and focus really on the victims and the first responders.

I appreciate that he didn't go to the Oregon District.

And, actually, the Oregon District was pretty tense today during his visit, with both pro-Trump and anti-Trump people walking the streets.

And so that's what I mean, when his rhetoric is just so hot.

WILLIAM BRANGHAM: Did his visit today and in your conversations with him, did you communicate those concerns to him?

Did he assuage any of your concerns about his rhetoric and how he has governed?

NAN WHALEY: Look, my focus has actually been on just getting something done around gun control.

And so my conversation with the president wasn't anything to do with his rhetoric, but everything about getting something done when it comes to commonsense gun legislation, and really trying to see if there was a way forward to be truly bipartisan.

And, frankly, that's just something we haven't seen for a very long time in Washington, D.C. WILLIAM BRANGHAM: I mean, as you know, the people who watch how gun legislation has risen and fallen in Washington, D.C., especially after the Sandy Hook massacre, where all those children were killed... NAN WHALEY: Right.

WILLIAM BRANGHAM: ... and people said, if nothing can happen after that event, what makes you think something is different now?

NAN WHALEY: Well, you know, I'm a person of hope.

And I know that Dayton was the 250th mass shooting in the country this year.

And so we are getting to the place where every single community has experienced some sort of gun violence that could have been preventable.

When so many people experience it, I think more and more Americans make it a higher priority.

And I think we're seeing that, as you look at polls, where the majority of Americans are for an assault weapons ban; 90 percent of Ohioans are for universal background checks.

Those are enormous numbers.

And, really, the NRA and their money can only hold us out for so long.

WILLIAM BRANGHAM: From your conversations with the president today, did you get a sense he would push that?

Because our understanding is that the Senate majority leader, Mitch McConnell, has said he won't bring any bills to the Senate floor that he doesn't think the president will support.

Did you try to persuade the president today that this is something he has to get behind?

NAN WHALEY: Absolutely.

Senator Brown and I towards the end said: "Hey, why don't you consider an assault weapons ban?"

The president pointed out that President Obama let the assault weapons ban lapse.

And I said to the president: "Hey, maybe this is something that you could get done that President Obama couldn't get done.

That would be something spectacular," pointing out that Senator DeWine had even voted for the assault weapon ban.

The president pivoted and said he was going to do something terrific for our first responders who he had just met.

And Senator Brown eloquently said: "The best thing you could do for our first responders is get these guns off the street, so they don't have to fight them anymore."

WILLIAM BRANGHAM: One of my colleagues, Yamiche, was in your town a few days ago.

And she spoke to some of your constituents.

NAN WHALEY: Yes.

Yes.

WILLIAM BRANGHAM: And she spoke with one young man who said his fear was that, once the cameras go, once the attention dies down, that all of this talk of reform and change and do something will disappear with it.

I know you said that you're a hopeful person, but where does that hope come from?

NAN WHALEY: Well, we are seeing some marginal difference around gun control.

I talked to Mayor Bloomberg a few days ago, who is the godfather of this work for mayors.

He said, we're making some progress.

Indiana has a red flag law.

The governor here is going to introduce a red flag law.

It's a Republican governor.

We're starting to see change.

Is it as fast as I would like?

Absolutely not.

But I think, after you go through one of these mass shootings, it changes the community, and it changes your perspective around commonsense gun legislation, too.

And let me be clear.

Doing something is not about video games.

This whole farce around video games being the reason why we suddenly have mass shootings is a fool's errand.

One example is, the most aggressive video games in the world are actually in Japan, and last I have seen, they don't have the mass shooting problem that we do have here in America.

WILLIAM BRANGHAM: Mayor Nan Whaley, good luck with your community and with all the grieving that I know you guys are all -- have in front of you.

Thank you very much for being here.

NAN WHALEY: Thank you.

WILLIAM BRANGHAM: And now, for the view from the second city the president visited today, we return to El Paso, where I'm joined by Iliana Holguin.

She's the chairwoman of the Democratic Party in El Paso County and is also an immigration attorney.

Ms. Holguin, thank you very much for being here.

Before we get to the president's visit and all of the protests and the concern over that, I wonder if you could just talk to us a little bit about how the Latino community in El Paso is doing.

ILIANA HOLGUIN, Chair, El Paso County Democratic Party: Well, as you can imagine, everyone is still, I think, in a little bit of shock and disbelief.

No one could ever believe that anything this horrific can happen in their community.

El Paso has always been a very warm, welcoming, friendly community.

And we have always prided ourselves on that.

So to have someone drive 10, 11 hours specifically to carry out an act of hate has just been absolutely shocking and unbelievable to all of us.

But one thing that we all know is that El Paso is extremely resilient, and we know that we're going to get through this together.

WILLIAM BRANGHAM: When I was there a couple of days ago, I heard a lot of what you are saying, a lot of fear and anguish and sadness.

Several people mentioned to me that, all of a sudden, they think about their daily lives in a different way.

They think about going to the store differently or dropping their kids at day care differently.

Are you hearing the same thing from people?

ILIANA HOLGUIN: Yes, I am.

People are very afraid.

We know that one of the motivations of this person coming to our community was specifically because of his hatred of Latinos.

And we're 85 percent Latino.

So, we know that our community was targeted specifically because of who we are, because of our identity.

And knowing that is certainly making people afraid that we might see something like this happen again, another white supremacist decides to come to our community to cause harm to us.

So, yes, I have also been hearing that, that people are afraid to do things that normally no one would ever think to be afraid of, to go out in public in open spaces.

And, certainly, that's not a way that any community should have to live.

WILLIAM BRANGHAM: I know that you wrote a letter to the president in advance of his visit, saying, please don't come.

Can you explain why you didn't want him to visit?

ILIANA HOLGUIN: Yes.

You know, El Pasoans right now, we're still trying to figure out how to heal.

We're still grieving.

We're going to be facing having 22 funerals here in the next few days.

And many of us really hold the president responsible in a lot of ways for this increase in, you know, the demonization of immigrant communities.

And a lot of the same rhetoric the president uses on a daily basis in his Twitter account, in his rallies, you heard some of the same phrases being used by this person in that essay that he posted just minutes before he opened fire here in El Paso.

So, really, we feel that the president has to acknowledge that his language has played a role in what happened.

His words have consequences.

And here in El Paso, we learned that on Saturday, that his words have very, very severe consequences that can change a community.

And so we didn't want him to come while we were in this process of grieving and healing, and until he acknowledges that he has to change the way he talks about immigrants and immigrant communities and people of color.

He has to recognize that his language is what's doing us harm, and Saturday was just a manifestation of that.

WILLIAM BRANGHAM: I mean, the president today was asked that specific question: Do you think your rhetoric is contributing to this?

And he said: No, no, no, my words have not contributed this.

And many of his supporters would argue no one but the shooter -- nobody forced the gun into that man's hands.

Nobody forced him to drive 600 miles down and commit this violence.

But you really do believe that the president sets the table that causes this kind of thing to happen?

ILIANA HOLGUIN: Yes.

And that's true.

We're not saying that the president somehow is the one that told this person to do this horrific thing.

But the president's language definitely contributes to just the divisiveness, the demonization.

The way he talks about communities like ours, it -- he stokes that hatred and that anger that we know that white supremacists already feel towards a community like ours.

So he may not have directly played a role in putting the gun into the shooter's hands, but he certainly encourages people with white supremacist views.

He certainly condones it.

We saw the same thing happen with Charlottesville, where he tried to somehow, yes, condemn white supremacists on one hand, but, at the same time, say that not everyone's that bad.

He seems to -- can't just come out and denounce white supremacy.

And that is what we need him to do, because if he sounds like he's condoning it, if the president of the United States sounds like he's condoning it, then, of course, we're going to see physical manifestations of that, like what happened here in El Paso.

WILLIAM BRANGHAM: All right, Iliana Holguin from El Paso, thank you very much for being here.

ILIANA HOLGUIN: Thank you very much.

JUDY WOODRUFF: And we stay in El Paso, where the president is still visiting with victims and with survivors.

Our Dan Bush is there.

And he joins me now.

So, Dan, you have been there all day.

You have been talking to people.

Tell us what people are saying about the president's visit, how they're doing.

How are they doing today?

DANIEL BUSH: Well, it's a deeply divided city, Judy, as we just heard from the previous guests.

There's a lot of anger here in the El Paso community directed at President Trump.

And in what is still a conservative state, it was hard to find Republicans in downtown El Paso today who were willing to say, yes, we want President Trump here, we want to hear what he has to say.

But I did speak with one person who gave a different perspective and said he was a Trump supporter, he didn't always agree with what the president has to say, he did want him here.

And the man also said that he was open to some gun control measures because of what happened here in El Paso.

So while it is a divided city, people are trying to find some common ground, in some areas at least.

JUDY WOODRUFF: So, Dan, we didn't know ahead of time what the president was going to be doing or very much about it, what he was going to be doing in El Paso.

What do we know now about his plans while he's there?

DANIEL BUSH: So, President Trump arrived here a little while ago.

He was greeted at the airport by the Texas governor, Greg Abbott, the state's two U.S. senators, and some others.

The president didn't speak to reporters.

He looked very solemn as he got into a motorcade with the first lady and headed into the city.

We know he went to University Hospital, Judy, where he met with victims and some of their families and first responders as well.

We did see, in the air, en route to Texas, President Trump spar with Democratic officials there over the way they portrayed his visit.

So we're waiting to see what will come out of this, but already, as we're seeing, divisions are very high.

And I did have a chance to speak with Senator Cruz briefly as President Trump left for the hospital.

And I asked Senator Cruz what he wanted the president to say.

And he said: Listen, this is a moment of unity.

But Ted Cruz also said both sides need to tamp the rhetoric down.

So, we will see if that happens.

JUDY WOODRUFF: All right, Dan Bush reporting for us again today from El Paso, thank you, Dan.

Now we continue our series of conversations with 2020 presidential candidates.

Joining me, billionaire activist and philanthropist Tom Steyer.

Tom Steyer, welcome to the "NewsHour."

TOM STEYER (D), Presidential Candidate: Judy, thank you so much for having me.

JUDY WOODRUFF: So, let's talk about your decision to get in.

In January, you said: I'm not running for president.

But then, last month, you said: I'm going to run.

But, by this point, there were, what, two dozen other Democrats running.

TOM STEYER: Yes.

JUDY WOODRUFF: Why should people vote for you?

TOM STEYER: Well, my basic thesis on what's going on in the United States is that we have a broken government in Washington, D.C., that corporate cash has bought the democracy, and that the only solution is to push power back to the people, to retake the democracy on behalf of, of, by and for the people.

And for the last 10 years, I have been organizing coalitions of ordinary American citizens to take on that unchecked corporate power, and we have been winning.

JUDY WOODRUFF: Well, let's talk about one of the issues that is motivating many Americans today.

And that is in the aftermath of these terrible shootings in Ohio and Texas.

You have a number of other Democratic candidates for presidents this week condemning President Trump's rhetoric, condemning white supremacist ideology.

They're also talking about gun control.

What would your priority be to stop these kinds of incidents as president, if you're elected president?

TOM STEYER: Well, as you point out, Judy, there are two things coming together here.

There is the failure to check gun violence in the United States, and there is the racist rhetoric that the president has employed to create an atmosphere that empowers people to take on these acts.

So, let's start with the first one, the failure to check gun violence in the United States.

These are -- the El Paso and Dayton are 250th and 251st mass shootings this year in the United States we have had.

Don't forget Parkland.

Don't forget Sandy Hook.

This has been decades of unchecked violence, gun violence, in the country.

And why is that?

It's because the gun manufacturers, through the NRA, control the Republican control the Republican Party, and commonsense gun legislation that over 90 percent of American citizens support can't get into law because of that corporate control of the Senate.

JUDY WOODRUFF: And you're saying you would go after those corporations.

But let me point out that it was under Democratic President Obama legislation even on background checks could not get passed.

So now you have other Democrats running for president who are talking about tougher measures, gun licensing, gun buyback programs.

Do you have a worry that Democrats, in advocating these kinds of things, could go so far to the left that there could be some kind of blowback?

TOM STEYER: No.

Over 90 percent of Americans want mandatory background checks on every gun purchase.

There is no question here that the will of the American people is being frustrated, and is being frustrated by gun manufacturers through the NRA.

And this is just one example.

JUDY WOODRUFF: And you're saying... TOM STEYER: I think it does in this case.

To be fair, look, I have been going after this idea of corporate control of our government.

That is the motivating idea behind my campaign.

But let me say, I am the person who almost two years ago said, impeach this president.

JUDY WOODRUFF: Right.

TOM STEYER: He is deeply corrupt.

And he has more than met the criteria.

And he needs to go.

JUDY WOODRUFF: And that, in fact, is what many people will recognize you for.

You are running -- have been running millions of dollars in ads on television and elsewhere arguing for the impeachment of President Trump.

A few months ago, you said this is something that had to happen this year, it couldn't happen in 2020.

But here we are.

It's almost the fall.

Even the Democratic congressional leadership is not in favor of an impeachment process.

Where is this going?

TOM STEYER: Look, Judy, the funny thing is, more than half the congressional Democrats have come out publicly for impeachment.

I have pushed to get as many televised hearings in front of the American people, because what we were really trying to do with impeachment is let the American people decide.

Have televised hearings.

Let -- all our research said, if the American people get the facts, they say, I didn't know that, he's a liar and a crook, and, if I did that, I would go to jail.

JUDY WOODRUFF: But yes or no, you think it can happen this year?

TOM STEYER: I think time is extremely short, Judy.

JUDY WOODRUFF: 2019.

TOM STEYER: We're still pushing for it.

We will never walk away from the fact that the right thing is to impeach and remove this president.

But time is extremely short, because the only way to get this done is to bring in the American people.

And that means televised hearings, like the one in Watergate, that convinced the American people that Richard Nixon was a crook who had to go.

JUDY WOODRUFF: Climate change, this has been a passion of yours.

You have worked on this issue for years.

You have spent hundreds of millions of dollars advocating there.

There are some environmental activists out there who are saying, Tom Steyer would be much better off continuing to focus on climate change, rather than turning his focus to running for president.

What do you say to them and to those who point to your report managing a hedge fund, where you invested in things like coal mines around the world that were carbon emitters, ultimately, and companies that, frankly, invested in these private prisons, where -- detention facilities for migrants on the border?

TOM STEYER: So, let me answer -- let me first answer the investment question, and then I will talk about what I'm doing now in terms of climate change.

Look, we invested in everything, every part of the American economy, including fossil fuels.

And I decided over 10 years ago, oh my gosh, I realized there is this impact on the climate that's going to be dreadful and we need -- I need to divest myself from it.

I quit my business.

I took the giving pledge to give my money to good causes, and I started organizing coalitions to fight to prevent climate change right then.

That's exactly what I have been asking other Americans to do.

We all grew up in a fossil fuel-based economy, including you.

We have all filled up at the pump.

That is where we came from.

We need to go to a different place.

And that's what I have been pushing for, for more than 10 years ago, successfully beating oil companies.

In terms of the private prisons, we made an investment.

I thought about it.

I decided, that is not the right thing to do.

It was a mistake.

And I sold it 15 years before any of this political stuff came, because I said, that's not a place where somebody should be making money, including us.

It was a mistake to ever buy it.

And we sold it.

And we -- that was 15 or 17 years ago.

But let me answer this last question, Judy, which was, what am I -- why is this a way to attack climate change?

If you have seen the climate proposal that I put out about two weeks ago, it is the most aggressive climate proposal by far in this campaign.

It talks about declaring a state of emergency the first day of my presidency.

It talks about basically being animated by environmental justice, going to most affected communities, and getting their ideas of leadership to make sure the program works for them.

And it talks about trying to lead an international coalition on day one, not the idea of signing back up for Paris.

Of course we'd sign up -- back up for Paris.

That is far from enough.

If you look at the numbers in climate -- and I would challenge these climate activists to talk about how they're going to make an impact -- if you look at the numbers on climate, it is an emergency.

The president should deal with it that way, because we're talking about the health and safety of every American.

And we can't do it unless the global community comes along with us, unless we lead it, and unless we have made the commitment to get our house in order.

JUDY WOODRUFF: Tom Steyer, running for the Democratic nomination, thank you very much.

TOM STEYER: Judy, thank you so much for having me.

JUDY WOODRUFF: Stay with us.

Coming up on the "NewsHour": filmmaker Ron Howard reflects on his long career on both sides of the camera; and El Paso pays tribute to the youngest victim of this weekend's mass shooting.

As health care costs continue to rise, especially in the U.S., one hospital chain in India has continued to bring costs down.

It's now brought some of its ideas very close to America's shores and is courting American patients.

Special correspondent Fred de Sam Lazaro reports.

It's part of his series Agents for Change and this week's Leading Edge segment, focusing on science and medicine.

DR. SAVITR SASTRI, Health City Cayman Islands: What we have here is basically a two-centimeter port that we use.

FRED DE SAM LAZARO: With cutting edge imaging, robotics and other technology, surgeons like Savitr Sastri perform the most advanced procedures offered anywhere in the Western Hemisphere, in this case a slipped disk fixed with very little actual cutting.

DR. SAVITR SASTRI: It's minimally invasive, less tissue damage.

FRED DE SAM LAZARO: But this hospital is not in the U.S. or Canada.

It's in the British Caribbean territory of Grand Cayman.

And Dr. Sastri and the entire medical staff are from India, employees of that country's largest hospital chain.

Called Health City Cayman Islands it is a new frontier for the for-profit chain founded 19 years ago by Dr. Devi Prasad Shetty, an entrepreneur obsessed with efficient health care delivery and technology.

Even here, on a brief visit to the Caymans, he was never far from home base.

DR. DEVI PRASAD SHETTY, Founder, Narayana Health: First thing I do is to do the rounds in my hospital in Bangalore.

FRED DE SAM LAZARO: From Cayman?

DR. DEVI PRASAD SHETTY: From Cayman.

FRED DE SAM LAZARO: With a new phone app being developed by his company and Microsoft, he says he keeps tabs on patients, easily call up a record, or check a new X-ray, for instance.

DR. DEVI PRASAD SHETTY: The X-ray technician touches a button in the ICU of Bangalore hospital.

In less than a second, like I say, it appears in my phone.

FRED DE SAM LAZARO: Working from his sprawling Bangalore headquarters, Shetty has become a world-renowned and prolific cardiac surgeon.

DR. DEVI PRASAD SHETTY: Hole in the heart.

FRED DE SAM LAZARO: Doing two to three procedures a day and, as he told us in 2015, at very low cost.

DR. DEVI PRASAD SHETTY: This patient would have paid us about $2,500 to about $3,000, but in the U.S., an operation of this nature would cost, I guess, more, anything from $70,000, $100,000.

FRED DE SAM LAZARO: Since then, Dr. Shetty has sought to prove he can transfer his low-cost model to more expensive First World settings, beginning with the Cayman Islands.

DR. DEVI PRASAD SHETTY: Cayman Islands is a very unique place.

It's a First World country, ideally located close to U.S., as well as in part of the Caribbean.

FRED DE SAM LAZARO: Health City opened in 2014 and is joint commission accredited, meaning it meets the highest global standards of care.

Yet its costs are 50 to 65 percent lower than the U.S.

Among its competitive advantages, the ability to buy in bulk.

DR. DEVI PRASAD SHETTY: When we implant one of the largest number of heart valves in the world, obviously, you pay for it less than others.

FRED DE SAM LAZARO: They also pay a lot less for drugs.

How much cheaper is it to bring your drugs from India than it would be in a market in this region?

DR. BINOY CHATTUPARAMBIL, Clinical Director, Health City Cayman Islands: It would be around 50, 60 percent.

FRED DE SAM LAZARO: So, you pay about half?

DR. BINOY CHATTUPARAMBIL: Yes.

FRED DE SAM LAZARO: Dr. Binoy Chattuparambil is clinical director of the newly built hospital.

DR. BINOY CHATTUPARAMBIL: You can see the lab.

FRED DE SAM LAZARO: He took us on a tour of the new facility, designed, he says, with both physicians and architects at the drawing board.

Unlike most hospitals that buy oxygen from commercial sources, this one makes its own, one of several small steps that promise savings.

Another huge cost savings, patient bills are simplified, with a fixed bundled price that is disclosed when a patient is first seen.

In the hallway, Dr. Chattuparambil, who is also chief of cardiovascular surgery, ran into a patient's grateful family.

LEONIE EBANKS, Spouse: And all the arteries that were clogged, they're all cleared?

DR. BINOY CHATTUPARAMBIL: All clear.

FRED DE SAM LAZARO: Leonie Ebanks' husband, Eddie, had suffered a heart attack.

His surgery included a double bypass, a tube grafted to replace a rupturing aorta and repairing two leaking heart valves.

DR. BINOY CHATTUPARAMBIL: Quite a complex operation.

FRED DE SAM LAZARO: How many hours did it take you to do that?

DR. BINOY CHATTUPARAMBIL: It took almost eight hours.

FRED DE SAM LAZARO: And in the U.S. would easily cost a half-a-million dollars, he says.

Here, the final bill was $110,000.

Where would you normally have gone for that kind of surgery?

EDDIE EBANKS, Patient: Miami.

FRED DE SAM LAZARO: Miami might have been a tough ride.

EDDIE EBANKS: Yes, could have been.

Thank God.

FRED DE SAM LAZARO: But with 104 beds, it's clear the Health City project had plans to reach well beyond local patients.

Grand Cayman is just a 90-minute flight away from the United States, a tropical paradise whose economy depends heavily on tourism.

And that's a big reason why the government here gave the Indian hospital chain tax breaks and other incentives to locate a facility here.

American tourists would come now not just for the beach, but for their health care.

So far, that hasn't happened.

RAVI RAMAMURTI, Northeastern University: American patients still assume that health care provided outside the U.S. is not as good at that you can get in the U.S. FRED DE SAM LAZARO: Northeastern University business Professor Ravi Ramamurti recently co-authored a book called "Reverse Innovation in Health Care" that studied the Cayman hospital.

American tourists are everywhere, he says, just not the ones the hospital was looking for, older Americans who need cardiac surgery or knee or hip replacement, for instance.

RAVI RAMAMURTI: A lot of people in that generation who need this kind of care probably don't even have a passport.

So the idea of going to a strange place to get an important medical procedure is something I think people want to avoid, if they can avoid it at all.

FRED DE SAM LAZARO: For his part, Dr. Shetty says, even at its current 40 percent occupancy, the hospital has staying power, treating Caribbean, Central American, and even a few Canadian patients.

MAN: You're doing extremely well.

FRED DE SAM LAZARO: You're profitable now here?

DR. DEVI PRASAD SHETTY: We have been profitable for quite some time, yes.

(LAUGHTER) FRED DE SAM LAZARO: Eventually, he says, Americans will come.

He predicts their insurers will begin to offer an offshore alternative with free travel and no co-pays.

Professor Ramamurti doesn't see a competitive threat, but says American providers could benefit from studying the Indian-Caribbean upstart.

RAVI RAMAMURTI: We need to shake up the health care industry in the U.S.

I don't think it's going to happen by the arrival of an Amazon or an Uber that single-handedly turns an industry upside down.

You need a lot of people you need a lot of people disrupting in little ways that add up to big change over a period of time.

FRED DE SAM LAZARO: Change that he says is urgently needed to slow cost increases in an industry that now accounts for 18 percent of the U.S. gross national product.

For the "PBS NewsHour," this is Fred de Sam Lazaro in Grand Cayman.

JUDY WOODRUFF: Fred's reporting I in partnership with the Under-Told Stories Project at University of St. Thomas in Minnesota.

Initially famous for his acting on TV, Ron Howard has grown up on screen right before our eyes.

Now he is one of Hollywood's leading directors and producers.

Earlier this summer, Jeffrey Brown reported on Howard's latest film, "Pavarotti."

Tonight, a profile of the director, as part of our arts and culture series, Canvas.

JEFFREY BROWN: The grand stairway at the Metropolitan Opera in New York, perhaps not the place you would expect to meet Ron Howard.

This isn't your world.

RON HOWARD, Filmmaker: No, not my world at all.

JEFFREY BROWN: So, you didn't stop with Pavarotti thinking... RON HOWARD: No.

But I knew more about opera than I knew about Formula One before I did the movie "Rush," or certainly going to the moon before "Apollo 13."

JEFFREY BROWN: Howard, now 65, has just made a documentary on the life of opera great Luciano Pavarotti.

And the Met, it turned out, was just the place to talk about his long, varied and hugely successful in show business.

It began early, with both parents working in Hollywood, as a child actor, most famously as Opie in "The Andy Griffith Show" in the 1960s, and Richie on "Happy Days" in the 70s.

RON HOWARD: We got it all figured out, see?

We're not going to be ourselves.

We're going to be adult businessman.

(LAUGHTER) JEFFREY BROWN: A decade later, and his transition to directing was in full swing with hit comedies such as "Splash," "Cocoon" and "Parenthood," leading to dramas, including "Apollo 13" in 1995, and "A Beautiful Mind," which won him an Oscar for best director in 2001.

When you look back now, does it make sense?

RON HOWARD: It makes complete sense.

JEFFREY BROWN: It does?

RON HOWARD: Complete sense, because I really wanted it.

It wasn't somebody else's idea.

It was my idea.

JEFFREY BROWN: And you just knew that from... RON HOWARD: Well, it evolved.

You know what I mean?

So many of the directors on "The Andy Griffith Show" had been actors.

And so they might just drop here and there, "Hey, I bet you want to be a director someday."

My father directed a lot of theater, no film.

I watched him.

I watched him rehearsing.

I could see what that process was.

And just like a ballplayer might one day want to manage or a basketball player might want to coach, I was drawn to the total process.

JEFFREY BROWN: Yes.

What is the key to directing for you?

RON HOWARD: Partly, directing for me is trying to create that environment, not just for the actors, but also for all the key department heads in the production.

And then it's really a matter of interpretation, understanding that story, beginning to understand on a kind of both macro and micro level what the elements are going to be.

Putting together a film, television show, documentary, it's sort of like a mosaic.

It's built in tiny little pieces, unlike, you know, a live performance, which is, you know, this is it, there's no going back.

JEFFREY BROWN: And how much control or how loose is it?

RON HOWARD: It depends on the moment.

JEFFREY BROWN: Yes?

RON HOWARD: It depends on the moment.

Sometimes, you want to be as relaxed and loose and carefree as you possibly, possibly can be.

And, other times, you need to get everybody's focus JEFFREY BROWN: Many stories have followed for Howard, as both director and producer.

Imagine Entertainment, the production company started by Howard and his friend Brian Grazer, is a film and TV powerhouse, including hits such as "Arrested Development."

Several new projects are in production, including a documentary on the Paradise Fire that devastated parts of Northern California last year.

For Howard, documentaries are an exciting new way of storytelling.

RON HOWARD: Frankly I have always loved documentaries.

And I was a little shy, maybe fearful of sticking my toe in those waters.

JEFFREY BROWN: You were fearful because what?

RON HOWARD: It's a different discipline.

JEFFREY BROWN: Yes.

RON HOWARD: And if I'm going to do it and put my name on it, I wanted to believe I could put my best foot forward.

And the good news to me was that I can.

I can actually use much more of my storytelling experience and sensibility in the doc world than I even expected that I could.

JEFFREY BROWN: One new scripted work is a dramatized version of "Hillbilly Elegy," the memoir by J.D.

Vance about growing up in Appalachia, focusing attention on the white underclass that helped elect Donald Trump.

RON HOWARD: I think this is particularly interesting at this time, where there's a tendency to sort of dig in with what's familiar, what you relate to the best and so forth.

And so if entertainment can shed light on sort of what it is that we have in common, I think that's useful.

If it could shed light on a corner of society that people might have some questions about or are curious about in an interesting, engrossing, emotional way, then that's a form of entertainment.

JEFFREY BROWN: The film is being shot in Georgia.

And after the state recently passed a restrictive new abortion law, Howard's company joined others from Hollywood in speaking out against it.

WOMAN: Just this week, a new Amazon show, as well as a Lionsgate movie starring Kristen Wiig, canceled shoots set to start in Georgia.

JEFFREY BROWN: For now, though, shooting will continue.

RON HOWARD: We didn't want to bail out on all those people whose livelihoods depend on us being there.

But we did want to be counted, that, as a part of the media industry, if it passed, we would be disinclined to work in Georgia.

JEFFREY BROWN: At 65, Ron Howard continues to exhibit a youthful exuberance.

For many Americans, he knows he is forever Opie.

In reflecting on his latest documentary subject, Luciano Pavarotti, Howard focused on the tenor's drive and willingness to take risks.

You come across as an easygoing person.

That was your actor persona as well.

But there's clearly some drive or ambition?

Or is there a killer instinct in there that... RON HOWARD: Well, only a respect for the medium.

I mean, I think the -- Pavarotti was -- he was charming.

People loved working with him.

They really wanted to work with him.

I hope people feel that way about working with me.

I bring a lot of joy and excitement to the set with me, because that's the way I feel.

JEFFREY BROWN: You're 65.

You have been at this a long time, right?

RON HOWARD: Sixty-one of those years.

JEFFREY BROWN: Sixty-one of 65.

(LAUGHTER) JEFFREY BROWN: But you seem to be busier than ever.

RON HOWARD: As a storyteller, it's almost like this buffet.

It's incredibly energizing to me.

JEFFREY BROWN: All right, Ron Howard, thank you very much.

RON HOWARD: Pleasure.

Thanks.

JUDY WOODRUFF: Finally tonight, we want to offer a different look at the wrenching, emotional toll these mass shootings can take.

William Brangham is back with that.

WILLIAM BRANGHAM: Judy, Monday night in El Paso, we went to the very first memorial for one of the victims of Saturday's massacre.

His name is Javier Amir Rodriguez.

The teenager and his uncle were shopping at the Walmart when the attacker entered the store.

They were both shot.

His uncle survived.

At Javier's memorial, held at the football stadium at Horizon High School outside of El Paso, friends and teachers remembered Javier as a happy-go-lucky boy, a great soccer player, and a good friend.

The memorial took a particularly emotional turn when the local school superintendent, Dr. Juan Martinez, spoke.

Here's a brief, edited excerpt of what he had to say: DR. JUAN MARTINEZ, Clint Independent School District Superintendent: Tonight, even though we are angry and mourn the death of a friend, our student, our son, we refuse to accept darkness as our closest friend.

Darkness came from outside of our city and took Javier away from us.

But Javier will remain in our hearts, as a symbol of goodness and love, respect and kindness for one another.

And that, darkness can never take away from us.

Javier didn't deserve to be taken away from his family.

Javier didn't deserve to be taken away from his friends.

Javier did not deserve to be taken away from his school.

And Javier did not deserve to be taken away from all of us.

And I want to make it very clear, we do not deserve this.

Javier did not deserve this.

We are people of light.

We are people of hope.

And we hope, truly and sincerely and with all my heart, that this will never, ever again repeat again anywhere in any school in this country.

No, not our children.

Stop taking them away from us.

No, not one more.

Please, not one more.

We may have differences, but there's other ways, there are other ways to address it, not with violence, not with hate, not our children.

Please, don't.

Not one more.

JUDY WOODRUFF: Javier Amir Rodriguez was 15 years old.

And that is the "NewsHour" for tonight.

I'm Judy Woodruff.

Join us online and again here tomorrow evening.

For all of us at the "PBS NewsHour," thank you, and we'll see you soon.