A Real Choice on Medicare

We know it is not how most people want to spend their time, but Americans need to give a close reading to the Democrats’ and Republicans’ plans for Medicare reform. There are stark differences that will profoundly affect all of our lives — and clear political choices to come.
The Democratic approach is mostly imbedded in the broader health care reforms enacted last year. The Republicans’ approach — including a call to repeal reform and ultimately privatize Medicare — was fashioned by Representative Paul Ryan and adopted by the House.
Here are some of the most significant elements:
FOR BENEFICIARIES, OR THOSE WHO WILL SOON BE During last year’s Congressional campaign, Republican leaders claimed to be Medicare’s stalwart defenders — conveniently ignoring their historical animosity toward the program. Older voters overlooked that history and flocked to the party in large numbers. Now the Republicans have embraced many of reform’s changes for Medicare — without, of course, advertising their flip-flop.
One of the biggest differences, under both parties’ plans, would be a large reduction of unjustified subsidies to private Medicare Advantage plans that serve 11 million of Medicare’s 46 million enrollees. Last year, those plans were paid 9 percent more per enrollee, on average, for coverage comparable to what traditional Medicare would provide. By eliminating most of the subsidies, the Democrats hope to save $136 billion over 10 years. The Republicans plan to cut only $10 billion less.
The Republicans have also embraced health care reform’s necessary plan to slow the growth rate of payments to health care providers, which was expected to save hundreds of billions over the next decade.
House Republicans would make another deep cut — definitely not in the Democrats’ plan — that would hit many current and future Medicare users hard. The reform law provides subsidies to help close a gap in prescription drug coverage, known as the doughnut hole, that poses a hardship for millions of patients who need lots of medicine and often cannot afford to pay for it. The Republicans would repeal that subsidy.
Perhaps most significant, the two parties have very different approaches to what they would do with their savings. The Democrats would use the savings to extend coverage to tens of millions of uninsured Americans, a goal we heartily endorse. The Republicans say only that they would use the money in some way to bolster the solvency of Medicare. That is not good enough.
MEDICARE IN THE FUTURE The differences get even bigger over time. President Obama wants to retain Medicare as an entitlement in which the federal government pays for a defined set of medical services. The Ryan proposal would give those turning age 65 in 2022 “premium support” payments to help them buy private policies. There is little doubt that the Republican proposal would sharply reduce federal spending on Medicare by capping what the government would pay at very low levels. But it could cause great hardship by shifting a lot of the burden to beneficiaries. The Congressional Budget Office estimates that by 2022 new enrollees would have to pay at least $6,400 more out of pocket to buy coverage comparable to traditional Medicare.
Huge numbers of Medicare beneficiaries live on modest incomes and are already struggling to pay medical bills that Medicare does not fully cover. We should not force them into private health plans that would charge them a lot more or provide much skimpier benefits.
CONTROLLING REAL COSTS The country cannot wrestle the deficit under control unless a way is found to slow the rise in medical costs — and Medicare’s demands on the federal budget. President Obama is clearly dedicated to reforming the health care system. Mr. Ryan relies mainly on the idea that costs will come down because of competition among private plans and more judicious use of health care by patients who are forced to pay more. His proposal is too sketchy to determine whether he would repeal or retain most of the reform law’s quality-improvement efforts, consumer protections and pilot projects to reduce costs.
What is clear is that House Republicans are determined to repeal reform’s strongest cost-control measure: an independent board that would monitor whether Medicare is on track to meet spending targets and, if not, propose further reductions that Congress would have to accept or replace with comparable savings.
Republicans charge that this would allow “unelected bureaucrats” to “ration” health care, and members of both parties object to relinquishing any power over federal spending. But Congress has shown it is far too susceptible to lobbying by insurers, hospitals, patients and other special interest groups. It makes sense to let experts drawn from diverse backgrounds set a course for Congress based on the best available evidence of what might work.
We were skeptical when the Republicans suddenly claimed to be Medicare’s great defenders. We are even more skeptical now that we have read their plan. We are also certain that repealing reform — the Republicans’ No. 1 goal — would do enormous damage to all Americans and make it even harder to wrestle down health care costs, the best way to deal with the country’s long-term fiscal crisis.

NewYorkTimes

Unprotected Wi-Fi getting owners in trouble

Cases throughout the world show danger of pedophiles and online thieves taking advantage of unsecured wireless routers

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•  (AP Photo/David Duprey)
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(AP)  BUFFALO, N.Y. — Lying on his family room floor with assault weapons trained on him, shouts of "pedophile!" and "pornographer!" stinging like his fresh cuts and bruises, the Buffalo homeowner didn't need long to figure out the reason for the early morning wake-up call from a swarm of federal agents.

That new wireless router. He'd gotten fed up trying to set a password. Someone must have used his Internet connection, he thought.


"We know who you are! You downloaded thousands of images at 11:30 last night," the man's lawyer, Barry Covert, recounted the agents saying. They referred to a screen name, "Doldrum."

"No, I didn't," he insisted. "Somebody else could have but I didn't do anything like that."

"You're a creep ... just admit it," they said.


Law enforcement officials say the case is a cautionary tale. Their advice: Password-protect your wireless router.

Plenty of others would agree. The Sarasota, Fla. man, for example, who got a similar visit from the FBI last year after someone on a boat docked in a marina outside his building used a potato chip can as an antenna to boost his wireless signal and download an astounding 10 million images of child porn, or the North Syracuse, N.Y., man who in December 2009 opened his door to police who'd been following an electronic trail of illegal videos and images. The man's neighbor pleaded guilty April 12.


For two hours that March morning in Buffalo, agents tapped away at the homeowner's desktop computer, eventually taking it with them, along with his and his wife's iPads and iPhones.

Within three days, investigators determined the homeowner had been telling the truth: If someone was downloading child pornography through his wireless signal, it wasn't him. About a week later, agents arrested a 25-year-old neighbor and charged him with distribution of child pornography. The case is pending in federal court.


It's unknown how often unsecured routers have brought legal trouble for subscribers. Besides the criminal investigations, the Internet is full of anecdotal accounts of people who've had to fight accusations of illegally downloading music or movies.


Whether you're guilty or not, "you look like the suspect," said Orin Kerr, a professor at George Washington University Law School, who said that's just one of many reasons to secure home routers.

Experts say the more savvy hackers can go beyond just connecting to the Internet on the host's dime and monitor Internet activity and steal passwords or other sensitive information.


A study released in February provides a sense of how often computer users rely on the generosity — or technological shortcomings — of their neighbors to gain Internet access.

The poll conducted for the Wi-Fi Alliance, the industry group that promotes wireless technology standards, found that among 1,054 Americans age 18 and older, 32 percent acknowledged trying to access a Wi-Fi network that wasn't theirs. An estimated 201 million households worldwide use Wi-Fi networks, according to the alliance.


The same study, conducted by Wakefield Research, found that 40 percent said they would be more likely to trust someone with their house key than with their Wi-Fi network password.

For some, though, leaving their wireless router open to outside use is a philosophical decision, a way of returning the favor for the times they've hopped on to someone else's network to check e-mail or download directions while away from home .


"I think it's convenient and polite to have an open Wi-Fi network," said Rebecca Jeschke, whose home signal is accessible to anyone within range.

"Public Wi-Fi is for the common good and I'm happy to participate in that — and lots of people are," said Jeschke, a spokeswoman for the Electronic Frontier Foundation, a San Francisco-based nonprofit that takes on cyberspace civil liberties issues.


Experts say wireless routers come with encryption software, but setting it up means a trip to the manual.

The government's Computer Emergency Readiness Team recommends home users make their networks invisible to others by disabling the identifier broadcasting function that allows wireless access points to announce their presence. It also advises users to replace any default network names or passwords, since those are widely known, and to keep an eye on the manufacturer's website for security patches or updates.

People who keep an open wireless router won't necessarily know when someone else is piggybacking on the signal, which usually reaches 300-400 feet, though a slower connection may be a clue.


For the Buffalo homeowner, who didn't want to be identified, the tip-off wasn't nearly as subtle.

It was 6:20 a.m. March 7 when he and his wife were awakened by the sound of someone breaking down their rear door. He threw a robe on and walked to the top of the stairs, looking down to see seven armed people with jackets bearing the initials I-C-E, which he didn't immediately know stood for Immigration and Customs Enforcement.


"They are screaming at him, 'Get down! Get down on the ground!' He's saying, 'Who are you? Who are you?"' Covert said.

"One of the agents runs up and basically throws him down the stairs, and he's got the cuts and bruises to show for it," said Covert, who said the homeowner plans no lawsuit. When he was allowed to get up, agents escorted him and watched as he used the bathroom and dressed.


The homeowner later got an apology from U.S. Attorney William Hochul and Immigration and Customs Enforcement Special Agent in Charge Lev Kubiak.

But this wasn't a case of officers rushing into the wrong house. Court filings show exactly what led them there and why.


On Feb. 11, an investigator with the Department of Homeland Security, which oversees cybersecurity enforcement, signed in to a peer-to-peer file sharing program from his office. After connecting with someone by the name of "Doldrum," the agent browsed through his shared files for videos and images and found images and videos depicting children engaged in sexual acts.

The agent identified the IP address, or unique identification number, of the router, then got the service provider to identify the subscriber.


Investigators could have taken an extra step before going inside the house and used a laptop or other device outside the home to see whether there was an unsecured signal. That alone wouldn't have exonerated the homeowner, but it would have raised the possibility that someone else was responsible for the downloads.

After a search of his devices proved the homeowner's innocence, investigators went back to the peer-to-peer software and looked at logs that showed what other IP addresses Doldrum had connected from. Two were associated with the State University of New York at Buffalo and accessed using a secure token that UB said was assigned to a student living in an apartment adjacent to the homeowner. Agents arrested John Luchetti March 17. He has pleaded not guilty to distribution of child pornography.


Luchetti is not charged with using his neighbor's Wi-Fi without permission. Whether it was illegal is up for debate.

"The question," said Kerr, "is whether it's unauthorized access and so you have to say, 'Is an open wireless point implicitly authorizing users or not?'

"We don't know," Kerr said. "The law prohibits unauthorized access and it's just not clear what's authorized with an open unsecured wireless."


In Germany, the country's top criminal court ruled last year that Internet users must secure their wireless connections to prevent others from illegally downloading data. The court said Internet users could be fined up to $126 if a third party takes advantage of their unprotected line, though it stopped short of holding the users responsible for illegal content downloaded by the third party.


The ruling came after a musician sued an Internet user whose wireless connection was used to download a song, which was then offered on an online file sharing network. The user was on vacation when the song was downloaded.

Resistance to Gas Drilling Rises on Unlikely Soil

Stuart Palley for The Texas Tribune

In Fort Worth, opposition to natural gas drilling and hydraulic fracturing, or fracking, has emerged.

By KATE GALBRAITH

FORT WORTH — Texans pride themselves on being the heart of the nation’s oil and gas business. But even here, public concern about natural gas drilling is growing.

Expanded coverage of Texas is produced by The Texas Tribune, a nonprofit news organization. To join the conversation about this article, go to texastribune.org.

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Stuart Palley for The Texas Tribune

Opposition has also grown in Southlake.

On Wednesday, several dozen protesters marched through downtown Fort Worth, waving signs and chanting anti-drilling slogans that reflected concern over air and water pollution.
The anxiety centers on a recently expanded drilling method called hydraulic fracturing, or fracking, which is now used in more than half of new gas wells drilled in Texas. This practice — which involves blasting water, sand and chemicals far underground to break up rock and extract gas — is common in the Barnett Shale, a major shale-gas field around Fort Worth.
“It’s our health that’s at stake,” said Dana Schultes, who lives in south Fort Worth and worries about the impact of the drilling on her young daughter.
The protest, organized by the group Rising Tide North Texas, is the latest sign of a backlash against drilling in Texas. Yard signs saying “Get the Frack Out of Here” and “Protect Our Kids/No Drilling” have appeared in some yards in Southlake, a Dallas suburb. A few communities have declared a temporary moratorium on drilling permits, and Dallas set up a task force last week to examine drilling regulations within its city limits.
Analysts say the discontent appears to be partly inspired by highly publicized concerns in Pennsylvania, a state unaccustomed to drilling and where fracking has recently increased. The federal government is also raising concerns: the Environmental Protection Agency is beginning a study about the method’s effect on groundwater, and a report for Congressional Democrats released last week detailed the quantity of chemicals that gas companies are putting into the ground.
Lease payments by gas companies have also dropped significantly in Texas since natural gas prices hit highs in 2008, said Mike Slattery, the director of the Institute for Environmental Studies at Texas Christian University — even as gas production rises in the state.
Gas companies say fracking is safe, but some acknowledge that changes are needed.
“For the most part, I would view these as self-inflicted wounds,” said Matt Pitzarella, a spokesman for Range Resources, a drilling company, speaking about the industry generally.
Gas companies, Mr. Pitzarella said, have existed under the radar for a long time but now need to be more responsive to public concerns.
The Fort Worth protesters ended up at Range Resources’ offices. The company was singled out, an organizer said, partly because it is one of the drillers with headquarters in the city.
Range Resources is also the subject of a battle between the E.P.A. and the Texas Railroad Commission, which regulates oil and gas operations in the state. In December the E.P.A. accused the company of contaminating two water wells in Parker County, west of Fort Worth. The driller denied the accusations, and the Railroad Commission investigated and cleared it. But the E.P.A. case is continuing.
City governments are getting more involved, too. Fort Worth, which has just under 2,000 gas wells within its city limits, expects to complete a study this summer of drilling’s impact on air quality. Dallas, on the edge of the Barnett Shale, has no wells so far, but gas companies are keen to drill — hence the establishment of the task force, which may deliver recommendations to the City Council this fall.
Gas drillers are also facing extra scrutiny in Austin, where lawmakers are considering whether to reduce a tax break for “high cost” natural gas drilling, like hydraulic fracturing. The break cuts the amount of severance tax paid by many gas companies.