Push for digital health records sparks debate
By Mimi Hall, USA TODAY
WASHINGTON — The blank wall behind the receptionists' desk stands as a symbol of efficiency in Peter Basch's bustling office. A dozen years ago, Basch and his fellow doctors went paperless and ditched the stacks of patients' charts that stood there.
An early entry into the world of electronic medical records, Basch is an enthusiastic supporter. "It allows our staff and physicians to be far more organized," he says. And that means "more focused on the patient."
President Obama wants doctors' offices and hospitals nationwide to follow suit, and the government has set a goal for every American to have an electronic health record by 2014.
Kathleen Sebelius, the White House nominee for Health and Human Services secretary, calls the move to computerization "one of the linchpins" of overhauling the nation's health care system. Obama casts it as a factor in the nation's economic recovery, saying going paperless would "save billions of dollars and thousands of jobs."
Naysayers suggest health information technology (IT), the overall move to computerization, is full of false promise. Digital records can lead to better care and fewer medical mistakes, they say, but the costly transformation could waste money if the doctors and hospitals buy systems that can't be connected to share information.
"We could head for a techno-Katrina," warns Sen. Barbara Mikulski, D-Md., referring to the government's failed efforts to respond to the 2005 hurricane. "I do not want to do that, where we do a dollar dump, and at the end of the day, we have a lot of microchips floating around."
Costs of an upgrade
Studies published in The New England Journal of Medicine show that less than 2% of hospitals use electronic records in all departments and that 17% of doctors have functioning digital systems.
The Obama administration says the government could save $12 billion over 10 years if doctors go digital because electronic systems help reduce duplication of tests, prevent medical errors and prompt doctors to prescribe less-expensive drugs. "We are confident that health IT will significantly bring down the cost of health care and benefit all Americans," says Nick Papas, a Health and Human Services spokesman.
In February, as part of the $800 billion economic stimulus package, Congress approved $19.5 billion to jump-start health care's digital revolution by providing incentives to doctors and hospitals that take Medicare and Medicaid patients — which 90% do. The federal government plans to set up regional centers, staffed by "geek squads," to help offices get their systems up and running, and those who don't take steps to go digital will face graduated penalties beginning in 2015.
Obama tapped Harvard Medical School professor David Blumenthal to oversee progress.
Questions about the effort are being raised by health care experts.
Avalere Health, a research company for government and industry, released a study last month showing that it will cost the average doctor or small medical practice about $124,000 to upgrade to computers over the period that the government incentives are offered, 2011-15. Those incentives, the study said, would add up to $44,000 per office at best.
Blumenthal co-wrote a study in March that raised similar concerns about the investments needed to buy and maintain the systems.
"There's not much reason to believe that this is going to save significant amounts of money," says Jonathan Oberlander, a University of North Carolina School of Medicine professor.
Push for protections
Basch's seven-doctor practice went digital when it was bought by MedStar Health, so the doctors didn't have to pay for the switch. The office then saved money by going from 3½ staffers per doctor to two. Each of the examining rooms has a large computer screen so doctors and patients can look at records together. If a new drug would interact badly with one the patient is already on, the system lets the doctor know.
As part of MedStar, the office is connected to 500-600 area doctors, several hospitals and labs.
Those kinds of connections raise concerns among privacy rights advocates. Strict new protections, including a ban on the sale of personal health information, were included in the stimulus bill. It's too early to tell how well they will be enforced.
Last week, Kaiser Permanente announced it had fired 15 hospital workers for snooping in the electronic health file of Nadya Suleman, the octuplets' mom.
Without proper protections, health IT could end up harming patients, says Ashley Katz of the group Patient Privacy Rights. If patients don't feel certain their records are protected from employers, creditors and marketers, they may not tell their doctors the truth about certain conditions or behaviors, she says. "The more data you have out there, the more good things you can do," Katz says. "But also, the more bad things."
Tuesday, April 07, 2009
Healthcare, in the U.S., Britain and Canada?
When it comes to healthcare, the U.S., Britain and Canada are hurting
Healthcare in all three countries has the same problem. They just feel it in different places.
By Ezra Klein
April 7, 2009
When asked by the New England Journal of Medicine to detail his healthcare vision during the campaign, John McCain concluded with a rousing denunciation of "new government bureaucracies that will translate into higher taxes, reduced provider payments and long waiting lines."
Long lines come up frequently in the American healthcare discussion, the symbol of all that is to be feared about a government-run system. And it's true that in Canada and Britain, the two countries most often cited in discussions of what nationalized healthcare might mean, some patients report having to wait months for some elective treatments. Sometimes.
But we've got waiting lines too -- along with 50 million uninsured and a system that costs more than twice as much per person as that of any other country. We've just managed to hide our lines through clever statistical gimmickry.
Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us!
Well, sort of. American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves. So although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of those who can't afford care simply won't get it.
When that very same survey also looked at cost problems among residents of different countries, 24% of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn't fill a prescription. And 22% said they didn't get a test or treatment. Those latter numbers are probably artificially small: If you can't afford to see a doctor, you never know that you can't afford the treatment she would recommend. In Britain and Canada, only about 6% of respondents reported that costs had limited their access to care.
Moreover, surveys conducted by the Organization for Economic Cooperation and Development have found that most countries don't have waiting lines or the uninsured. Not Germany or France or Japan or Sweden, all of which have more of a mix of public and private options. But Canada is next door, and Britain speaks our language, so we tend to spend a lot of time comparing our system with these systems and not a lot of time thinking through the full range of options.
In light of the "Health Affairs" data, smugness about our speedy access to care seems a bit peculiar. If someone can't afford care, we record their waiting time as zero. You don't wait for what you can't have. But a more accurate accounting would record that wait as infinite, or it would record when the patient eventually ends up in the emergency room because the original ailment went untreated. Research like this raises a simple question: Would you rather wait four months for a surgery or be unable to get it altogether?
Just last week, House Republicans expressed their preference for the latter. Their long-awaited budget document was admirably specific about changes to Medicare. They call for "a new Medicare program" in which enrollees are given a check "equal to 100% of the Medicare benefit," which they can then take to the private market to purchase their own care.
This proposal has a purpose beyond dismantling a popular government entitlement program. Currently, Medicare does not abide by a budget. It is not run like the Canadian or British healthcare systems. Instead, it pays whatever is deemed "reasonable and necessary." Because of that, costs are shooting through the roof: The Congressional Budget Office estimates that Medicare spending will more than triple by 2050.
The Republican plan gives Medicare a budget. Costs grow only as fast as the check grows. And because the check grows more slowly than health spending does, the program saves money. But this is, in effect, almost precisely the strategy of Britain and Canada: It is the government imposing an arbitrary budget on its healthcare spending.
The difference is that the British and Canadian governments try to apportion that health spending so that the whole population gets care. That can mean, alongside other cost-saving measures, longer waits for services. The Republican budget simply would give individuals a fixed check. That will mean that patients who exceed that sum and don't have money of their own go without needed care.
So Americans will continue to brag that no one waits, and Canadians and Britons will continue to brag that no one goes without. And somewhere, the French and the Germans and the Japanese and the Swiss and many others will wonder why we insist on choosing between such awful extremes.
Ezra Klein is an associate editor at the American Prospect.
Healthcare in all three countries has the same problem. They just feel it in different places.
By Ezra Klein
April 7, 2009
When asked by the New England Journal of Medicine to detail his healthcare vision during the campaign, John McCain concluded with a rousing denunciation of "new government bureaucracies that will translate into higher taxes, reduced provider payments and long waiting lines."
Long lines come up frequently in the American healthcare discussion, the symbol of all that is to be feared about a government-run system. And it's true that in Canada and Britain, the two countries most often cited in discussions of what nationalized healthcare might mean, some patients report having to wait months for some elective treatments. Sometimes.
But we've got waiting lines too -- along with 50 million uninsured and a system that costs more than twice as much per person as that of any other country. We've just managed to hide our lines through clever statistical gimmickry.
Britain and Canada control costs in a very specific fashion: The government sets a budget for how much will be spent on healthcare that year, and the system figures out how to spend that much and no more. One of the ways the British and Canadians save money is to punt elective surgeries to a lower priority level. A 2001 survey by the policy journal "Health Affairs" found that 38% of Britons and 27% of Canadians reported waiting four months or more for elective surgery. Among Americans, that number was only 5%. Score one of us!
Well, sort of. American healthcare controls costs in another way. Rather than deciding as a society how much will be spent in the coming year and then figuring out how best to spend it, we abdicate collective responsibility and let individuals fend for themselves. So although Britain and Canada have decided that no one will go without, even if some must occasionally wait, the U.S. has decided that most of those who can't afford care simply won't get it.
When that very same survey also looked at cost problems among residents of different countries, 24% of Americans reported that they did not get medical care because of cost. Twenty-six percent said they didn't fill a prescription. And 22% said they didn't get a test or treatment. Those latter numbers are probably artificially small: If you can't afford to see a doctor, you never know that you can't afford the treatment she would recommend. In Britain and Canada, only about 6% of respondents reported that costs had limited their access to care.
Moreover, surveys conducted by the Organization for Economic Cooperation and Development have found that most countries don't have waiting lines or the uninsured. Not Germany or France or Japan or Sweden, all of which have more of a mix of public and private options. But Canada is next door, and Britain speaks our language, so we tend to spend a lot of time comparing our system with these systems and not a lot of time thinking through the full range of options.
In light of the "Health Affairs" data, smugness about our speedy access to care seems a bit peculiar. If someone can't afford care, we record their waiting time as zero. You don't wait for what you can't have. But a more accurate accounting would record that wait as infinite, or it would record when the patient eventually ends up in the emergency room because the original ailment went untreated. Research like this raises a simple question: Would you rather wait four months for a surgery or be unable to get it altogether?
Just last week, House Republicans expressed their preference for the latter. Their long-awaited budget document was admirably specific about changes to Medicare. They call for "a new Medicare program" in which enrollees are given a check "equal to 100% of the Medicare benefit," which they can then take to the private market to purchase their own care.
This proposal has a purpose beyond dismantling a popular government entitlement program. Currently, Medicare does not abide by a budget. It is not run like the Canadian or British healthcare systems. Instead, it pays whatever is deemed "reasonable and necessary." Because of that, costs are shooting through the roof: The Congressional Budget Office estimates that Medicare spending will more than triple by 2050.
The Republican plan gives Medicare a budget. Costs grow only as fast as the check grows. And because the check grows more slowly than health spending does, the program saves money. But this is, in effect, almost precisely the strategy of Britain and Canada: It is the government imposing an arbitrary budget on its healthcare spending.
The difference is that the British and Canadian governments try to apportion that health spending so that the whole population gets care. That can mean, alongside other cost-saving measures, longer waits for services. The Republican budget simply would give individuals a fixed check. That will mean that patients who exceed that sum and don't have money of their own go without needed care.
So Americans will continue to brag that no one waits, and Canadians and Britons will continue to brag that no one goes without. And somewhere, the French and the Germans and the Japanese and the Swiss and many others will wonder why we insist on choosing between such awful extremes.
Ezra Klein is an associate editor at the American Prospect.
Sunday, April 05, 2009
Larger Than Life in London
A. A. GILL writes from LONDON
IT’S invariably the little things, the unconsidered, off the cuff, in passing, unrehearsed things that snag our attention, and seem to be telling of the bigger things. In the case of Barack Obama’s first visit to London and the Group of 20 conference to save the endangered habitat of bankers and real estate salesmen, it was the handshake with the bobby that seemed to be emblematic. In a forest of waving palms, this handshake meant more.
As the president stepped up to 10 Downing Street, he leant over, made eye contact, said something courteous, and shook the hand of the police officer standing guard. There’s always a police officer there; he is a tourist logo in his ridiculous helmet. He tells you that this is London, and the late 19th century. No one has ever shaken the hand of the policeman before, and like everyone else who has his palm touched by Barack Obama, he was visibly transported and briefly forgot himself. He offered the hand to Gordon Brown, the prime minister, who was scuttling behind.
It was ignored. He was left empty-handed. It isn’t that Mr. Brown snubbed the police officer; he just didn’t see him. To a British politician, a police officer is as invisible as the railings.
But the rest of us noticed. Because in this country that still feels the class system like a phantom limb, being overtly kind to servants is the very height of manners, the mark of true nobility. Being nice to the staff is second only to being nice to dogs as a pinnacle of civilization. Remember: a butler’s not just for Christmas. Apparently, the Obamas searched every cupboard and closet in Downing Street to personally thank all the servants for looking after them. That’s classlessly classy.
You often wonder what visiting dignitaries make of your country; American presidents must think that the whole world is in a constant state of riot. Wherever they go, CNN is full of angry banners, burning flags and tear gas. I went and joined the London riot. It was depressingly flabby, and half-hearted. Not so much a demonstration as a queue of arcane special pleading groups, ranging from anarchists for bicycles (who all waited politely at the traffic lights) and one-world vegans. Altogether, they looked like a collective of European street mimes.
A couple of broken windows and teeth, and that was it. The London police have discovered that the best way to neuter demonstrations is not to move everyone on, or disperse troublemakers, but hold them close, cordon them into a diminishing space for hours and hours, as a sort of arbitrary al fresco arrest. The crowd goes from righteous indignation to fury to despair, and ends up pleading. They’re all desperate to go. It’s crowd control by bladder control: effective but probably illegal.
The Obamas were likely also surprised at how black the old white colonial country is. Ethnic diversity is shamelessly and embarrassingly pushed to the front of every publicity shot. Michelle Obama went to a girls school where a gospel song was performed and where she made a surprisingly moving speech. All the world leaders’ wives are herded together in cultural outings of excruciatingly bland probity, but Mrs. Obama rose above it, and seemed to really inspire this group of young girls. It was noticed. The rest of the women grinned and clutched their handbags, apparently wondering when they could get away to Harrods.
The other thing that she rose above was Queen Elizabeth and Prince Philip: Honey, we shrunk the royal family. If ever we needed a totemic image of the merits of a republic over a monarchy, this was it.
Of all the G-20 wives, Carla Bruni, a k a Mrs. Nicolas Sarkozy, was noticeably absent. With her carefully demure wardrobe and the fluttered eyes of a reformed and legitimized mistress, she was too canny to let her herself be compared to those dumpy other halves. It left one dying to see what Jackie O.-type manipulation would go down when the Obamas crossed the Channel for the NATO summit meeting.
The French are never happy coming to London; this is an ancient and comforting enmity. President Nicolas Sarkozy of France plays nicely to our patronizing stereotypes. He is a small man, a Gallic in lifts who can’t hide the puffed-up, tip-toe insecurities of his shortness. Almost as if he wanted the world to think he has Napoleon syndrome, he postured and pouted and made arbitrary demands, and drew lines in the sand.
The truth is that the French have never really got over being dumped at the altar of the “special relationship.” It should have been them. It was after all, the French who gave you the Statue of Liberty and the keys to the Bastille and who think Jerry Lewis is funny. What did the English ever give you? Muffins and a burnt White House.
The Germans, too, might have imagined a tighter partnership. In terms of ancestry, America is a far more German country than an Anglo-Saxon one, and they have the biggest economy in Europe. Chancellor Angela Merkel of Germany and Mr. Sarkozy made a joint statement that they would categorically veto any further bailouts or attempts to spend our way out of debt, and then a mere 24 hours later they were beaming and shaking hands over an extra trillion-dollar binge.
The salutary fact is that when you look at the grinning group photograph, there is only one face you want to see. This conference was about saving the world, but more important for the participants, it was about saving their political lives. Mr. Obama is the only popular politician left in the world. He would win an election in any one of the G-20 countries, and his fellow world leaders will do anything to take home a touch of that reflected popularity.
We may be in the rare position of having an American president who has a deeper mandate among people who could never vote for him than with those who did. For the time being, he has only to offer his hand, and ask politely.
A. A. Gill is a contributing writer for Vanity Fair and The Sunday Times of London.
IT’S invariably the little things, the unconsidered, off the cuff, in passing, unrehearsed things that snag our attention, and seem to be telling of the bigger things. In the case of Barack Obama’s first visit to London and the Group of 20 conference to save the endangered habitat of bankers and real estate salesmen, it was the handshake with the bobby that seemed to be emblematic. In a forest of waving palms, this handshake meant more.
As the president stepped up to 10 Downing Street, he leant over, made eye contact, said something courteous, and shook the hand of the police officer standing guard. There’s always a police officer there; he is a tourist logo in his ridiculous helmet. He tells you that this is London, and the late 19th century. No one has ever shaken the hand of the policeman before, and like everyone else who has his palm touched by Barack Obama, he was visibly transported and briefly forgot himself. He offered the hand to Gordon Brown, the prime minister, who was scuttling behind.
It was ignored. He was left empty-handed. It isn’t that Mr. Brown snubbed the police officer; he just didn’t see him. To a British politician, a police officer is as invisible as the railings.
But the rest of us noticed. Because in this country that still feels the class system like a phantom limb, being overtly kind to servants is the very height of manners, the mark of true nobility. Being nice to the staff is second only to being nice to dogs as a pinnacle of civilization. Remember: a butler’s not just for Christmas. Apparently, the Obamas searched every cupboard and closet in Downing Street to personally thank all the servants for looking after them. That’s classlessly classy.
You often wonder what visiting dignitaries make of your country; American presidents must think that the whole world is in a constant state of riot. Wherever they go, CNN is full of angry banners, burning flags and tear gas. I went and joined the London riot. It was depressingly flabby, and half-hearted. Not so much a demonstration as a queue of arcane special pleading groups, ranging from anarchists for bicycles (who all waited politely at the traffic lights) and one-world vegans. Altogether, they looked like a collective of European street mimes.
A couple of broken windows and teeth, and that was it. The London police have discovered that the best way to neuter demonstrations is not to move everyone on, or disperse troublemakers, but hold them close, cordon them into a diminishing space for hours and hours, as a sort of arbitrary al fresco arrest. The crowd goes from righteous indignation to fury to despair, and ends up pleading. They’re all desperate to go. It’s crowd control by bladder control: effective but probably illegal.
The Obamas were likely also surprised at how black the old white colonial country is. Ethnic diversity is shamelessly and embarrassingly pushed to the front of every publicity shot. Michelle Obama went to a girls school where a gospel song was performed and where she made a surprisingly moving speech. All the world leaders’ wives are herded together in cultural outings of excruciatingly bland probity, but Mrs. Obama rose above it, and seemed to really inspire this group of young girls. It was noticed. The rest of the women grinned and clutched their handbags, apparently wondering when they could get away to Harrods.
The other thing that she rose above was Queen Elizabeth and Prince Philip: Honey, we shrunk the royal family. If ever we needed a totemic image of the merits of a republic over a monarchy, this was it.
Of all the G-20 wives, Carla Bruni, a k a Mrs. Nicolas Sarkozy, was noticeably absent. With her carefully demure wardrobe and the fluttered eyes of a reformed and legitimized mistress, she was too canny to let her herself be compared to those dumpy other halves. It left one dying to see what Jackie O.-type manipulation would go down when the Obamas crossed the Channel for the NATO summit meeting.
The French are never happy coming to London; this is an ancient and comforting enmity. President Nicolas Sarkozy of France plays nicely to our patronizing stereotypes. He is a small man, a Gallic in lifts who can’t hide the puffed-up, tip-toe insecurities of his shortness. Almost as if he wanted the world to think he has Napoleon syndrome, he postured and pouted and made arbitrary demands, and drew lines in the sand.
The truth is that the French have never really got over being dumped at the altar of the “special relationship.” It should have been them. It was after all, the French who gave you the Statue of Liberty and the keys to the Bastille and who think Jerry Lewis is funny. What did the English ever give you? Muffins and a burnt White House.
The Germans, too, might have imagined a tighter partnership. In terms of ancestry, America is a far more German country than an Anglo-Saxon one, and they have the biggest economy in Europe. Chancellor Angela Merkel of Germany and Mr. Sarkozy made a joint statement that they would categorically veto any further bailouts or attempts to spend our way out of debt, and then a mere 24 hours later they were beaming and shaking hands over an extra trillion-dollar binge.
The salutary fact is that when you look at the grinning group photograph, there is only one face you want to see. This conference was about saving the world, but more important for the participants, it was about saving their political lives. Mr. Obama is the only popular politician left in the world. He would win an election in any one of the G-20 countries, and his fellow world leaders will do anything to take home a touch of that reflected popularity.
We may be in the rare position of having an American president who has a deeper mandate among people who could never vote for him than with those who did. For the time being, he has only to offer his hand, and ask politely.
A. A. Gill is a contributing writer for Vanity Fair and The Sunday Times of London.
Saturday, April 04, 2009
NOT WATCHABLE!!!
NOT WATCHABLE!!!
The F-word News Channel (FNC) is just not watchable!
The few times I switch to see what they are up to.
They are most predicable in these slanted non news propaganda.
The few times I switch to FNC is Saturdays when they say they have NEWS reportage only and not the slanted crap of this wackout right wing ranters.
But there is no hope!
Saturday April 4 10:28 pct – I turned in for less than 30 seconds and
Heard the following:
(1) Finish of budget story (old news has been hashed over a lot – nothing newS)
in which they repeated GOP talking points about Obama’s budget predictions being to optimistic!
This from a bunch that double our national debt over the last 8 years!
(2) Teased a story of some people’s opposition to President Obama being invited to NOTRE DAME to speech at commencement!
This is in a weekend while the President is conducting a tour de force in Europe!!
P.S. I liked this week as DAVID LETTERMAN kicked the crap out of the crapper in chief BILL O’REALLY!! Check out UTube.
The F-word News Channel (FNC) is just not watchable!
The few times I switch to see what they are up to.
They are most predicable in these slanted non news propaganda.
The few times I switch to FNC is Saturdays when they say they have NEWS reportage only and not the slanted crap of this wackout right wing ranters.
But there is no hope!
Saturday April 4 10:28 pct – I turned in for less than 30 seconds and
Heard the following:
(1) Finish of budget story (old news has been hashed over a lot – nothing newS)
in which they repeated GOP talking points about Obama’s budget predictions being to optimistic!
This from a bunch that double our national debt over the last 8 years!
(2) Teased a story of some people’s opposition to President Obama being invited to NOTRE DAME to speech at commencement!
This is in a weekend while the President is conducting a tour de force in Europe!!
P.S. I liked this week as DAVID LETTERMAN kicked the crap out of the crapper in chief BILL O’REALLY!! Check out UTube.
Friday, April 03, 2009
Hopping on the misinformation band-Wagoner
Hopping on the misinformation band-Wagoner, GM-style
The media failed and they failed hard this week when it came to news that General Motors CEO Rick Wagoner had resigned at the request of the Obama administration. ABC's Diane Sawyer claimed of the resignation: "[S]omebody said it's like The Apprentice, White House-style." We're not sure who Sawyer's "somebody" actually is, though it is worth noting her comments were far from the worst on the subject. Take, for example, Fox News' Andrew Napolitano, who said that the resignation was "an absolute power grab, and it's the road to fascism" and that "this is Mussolini on the Potomac."
Worse still, many in the media falsely described Wagoner's resignation as unprecedented. A Washington Times editorial labeled Wagoner's departure from GM just that way -- as "unprecedented." At no point did the editorial mention that the government had required AIG, Fannie Mae, and Freddie Mac in September 2008 to replace their CEOs as a condition of receiving government funds during the Bush administration. Similarly, the Los Angeles Times and CNN's Lou Dobbs uncritically repeated Sen. John McCain's false claim that the government's Wagoner decision was "unprecedented." Despite the facts to the contrary, MSNBC's Chris Matthews called McCain's assessment "very correct," while Fox News' Steve Doocy actually claimed "the last president who fired a CEO was Putin" and conservative leader Rush Limbaugh said the White House had sought Wagoner's resignation as "payback for the unions."
Media Matters has been taking the "Limbaugh Challenge" for years
Just a few short weeks after Media Matters for America launched The Limbaugh Wire, a special website dedicated to providing hour-by-hour coverage of and commentary on Limbaugh's radio program, the Los Angeles Times printed an op-ed by Andrew Klavan, a contributing editor of the conservative Manhattan Institute's quarterly magazine, City Journal, in which Klavan claimed: "I listen to Limbaugh every chance I get, and I have never heard the man utter a single racist, hateful or stupid word." Klavan then issued to "liberals" what he referred to as "the Limbaugh Challenge," writing: "Listen to the show. Not for five minutes but for several hours: an hour a day for several days. Consider what he has to say -- the real policy material under the jokes and teasing bluster. Do what your intellectual keepers do not want you to do and keep an open mind." Of course, Media Matters has been listening to the entire Rush Limbaugh Show everyday for years and has documented hundreds of examples of Limbaugh spewing outrageous commentary and basic misstatements of fact. Don't have the time (or the patience) to take "the Limbaugh Challenge" yourself? You can always sign up to receive The Limbaugh Wire by email each weekday.
Media fail to reconcile facts in coverage of president's budget
Throughout Obama's presidency (and even before it started), media figures have tried to pin the blame for the current economic situation on Obama by disappearing the Bush administration's role in their reporting of economic issues and repeatedly referencing the "Obama recession" and the "Obama bear market." Nonetheless, a recent Washington Post/ABC News poll indicates that, as ABCNews.com reported: "Part of Obama's advantage in dealing with the economy is that, while blame and anger are in great supply, he escapes both. Eight in 10 Americans blame the situation on banks and other financial institutions for taking on too much risk; as many blame large business corporations for poor management decisions. Seventy-two percent blame consumers for taking on too much debt; 70 percent blame the Bush administration for lack of needed regulation. Just 26 percent, though, blame the Obama administration." Media Matters released a compelling online video this week contrasting the punditry of media figures with the recent poll -- be sure to check it out.
Additionally, numerous media outlets advanced the false notion that it would be unprecedented for congressional Democrats to use the budget reconciliation process to pass major policy initiatives, or failed to challenge conservatives making such claims. On Fox News' Special Report with Bret Baier, correspondent Molly Henneberg falsely claimed that "[r]econciliation was last used in 2001 by Republicans to pass the first Bush tax cuts." After Media Matters and others pointed out that Republicans used reconciliation to pass several of President Bush's major initiatives after 2001, Baier apologized for Henneberg's "error" three days later. The Washington Post also allowed "moderate" Sen. Arlen Specter (R-PA) to criticize the use of the reconciliation process without noting his votes to use it to pass Bush's tax cuts. The Hill ignored the GOP's use of the reconciliation process in forwarding Republicans' complaints that it "was never intended to ram through major legislation."
Because so many media figures and outlets promoted a number of falsehoods about the president's budget plan, Media Matters released a debunking of three major myths repeated in coverage of the proposal, including the false suggestion that Obama's proposal would increase taxes on a large percentage of small businesses and the previously mentioned falsehood about reconciliation. The debunking also noted that media outlets have engaged in a pattern of criticizing Obama for addressing health care in the budget or elsewhere given the size of the current and projected U.S. federal debt without addressing the president's response that health-care reform is essential to the long-term economic and fiscal health of the country.
Important questions: What will they give? What will she wear?
As the president and first lady arrived in Europe for the G-20 economic summit and a meeting with NATO, many in the media were transfixed by trivial matters. Rather than report on the important issues being discussed at the meetings of world leaders, many seemed to be asking the questions: What did they give the queen? What is Michelle wearing?
While Fox News' Sean Hannity declared he was "not so concerned in what gifts wealthy people are giving each other," he nevertheless repeatedly used his show to complain about the iPod the Obamas gave to the queen. Not to be outdone, his Fox colleague Bill O'Reilly claimed giving an iPod to royalty "would have gotten you beheaded in Henry VIII's time."
If you thought controversy over the gift was ridiculous, coverage of the first lady's attire was even worse. On NBC's Today, co-host Meredith Vieira said the "big question" concerning Michelle Obama's visit with the queen is, "will she bare her arms?" The big question? Days later, Vieira joked about a potential "cat fight" and "mud wrestling" between Mrs. Obama and France's Carla Bruni. Not to be outdone in the women's attire department, MSNBC's Chris Matthews gushed over the "summit" between Obama and Bruni, asking weather they'll be "dressed to beat the other." Hannity, doing his best to gin up yet another conspiracy, claimed it was Michelle Obama's "hope" to "get all these great designer clothes and that everyone will report on it and call [her], you know, Jackie Kennedy."
The Fox Nation launches amid more apologies from ... Fox News
This week, Fox News launched The Fox Nation, which, according to the website, was "created for people who believe in the United States of America and its ideals, as expressed in the Constitution, the Declaration of Independence, and the Emancipation Proclamation." The website goes on to describe itself as a place "for those committed to the core principles of tolerance, open debate, civil discourse -- and fair and balanced coverage of the news."
If it sounds too good to be true, that is because it is.
In an entry to FoxNews.com's Fox Forum, Americans for Tax Reform president Grover Norquist wrote that the website "takes no position on issues -- although unlike so many other Web portals, FOX Nation does begin with the presumption that America is a special and unique place, a blessed land to be treasured and defended." As Media Matters noted, however, The Fox Nation recently labeled Rep. Barney Frank (D-MA) and Sen. Chris Dodd (D-CT) a "[d]angerous duo," linking to an Agence France-Presse article that simply reported that Dodd and Frank "promised President Barack Obama on Monday they would work with the White House to enact a sweeping overhaul of US financial regulatory structures by year's end." Nothing in the AFP article in any way characterized Dodd or Frank as "[d]angerous."
Fair and balanced? Hardly.
Indeed, in the same Fox Forum entry, Norquist undermined his own claim that The Fox Nation "takes no position on issues," writing: "That's right, conservatives, libertarians, and other believers in limited government have found a new home -- at FOX Nation."
News of the website came as Fox News offered its third apology in recent weeks for getting a story relating to the Obama administration plain wrong.
Additionally, Media Matters detailed how, during an interview this week between Happening Now co-host Jon Scott and Rep. Paul Ryan (R-WI), Fox News aired "FOXfact[s]" purporting to describe facts about the House Republican budget, when, in fact, all seven of the on-screen "FOXfact[s]" were nearly identical to portions of an op-ed Ryan published in that day's Wall Street Journal. For example, using nearly identical language, Fox News and Ryan's op-ed both characterized President Obama's cap-and-trade proposal as a "scheme." Ryan wrote, "We do these things by rejecting the president's cap-and-trade scheme"; the "FOXfact" stated that the "GOP budget rejects the president's cap-and-trade scheme."
Don't forget, Media Matters previously noted that Scott passed off a GOP press release as Fox News' own research, even reproducing a typo contained in the Republican press release.
CNN's Kurtz has the Kudlow-down on CNBC
Last weekend on CNN's Reliable Sources, host Howard Kurtz discussed CNBC host Larry Kudlow's decision not to run for U.S. Senate in Connecticut. Kudlow announced his decision after Media Matters issued an open letter to CNBC President Mark Hoffman expressing concern over Kudlow's use of airtime to further his potential candidacy. Kurtz cited Media Matters, noting "Larry Kudlow, the CNBC host, was considering a run for the Senate from Connecticut. But with his network being pressed by the liberal advocacy group Media Matters to say whether he was a pundit or a pol, Kudlow made his decision. ... Kudlow also canceled plans this week to speak at a Republican Party fundraiser in Washington, which is a good thing, since he wouldn't be very credible on CNBC if he were openly shilling for one party."
Ann Coulter: April's Fool
Right-wing pundit Ann Coulter, who often accuses progressives of lacking a sense of humor, fell for a fake April Fools' Day article by Car and Driver magazine this week. The phony article claimed that Obama had ordered GM and Chrysler to cease their participation in NASCAR because it is an "unnecessary expenditure." Falling hook, line, and sinker for the joke, Coulter wrote in her April 1 column, "If Obama can tell GM and Chrysler that their participation in NASCAR is an 'unnecessary expenditure,' isn't having public schools force students to follow Muslim rituals, recite Islamic prayers and plan 'jihads' also an 'unnecessary expenditure'?" Car and Driver later clarified that the story was an April Fools' Day joke, and then removed the story from its website. As USA Today reported, "Car and Driver later pulled the fake story (which estimated savings of $250 million between the manufacturers) and apologized for 'going too far' while noting the magazine 'has a proud tradition of irreverent editorial and we amplify that each year with our April Fool's Day joke.' "
The media failed and they failed hard this week when it came to news that General Motors CEO Rick Wagoner had resigned at the request of the Obama administration. ABC's Diane Sawyer claimed of the resignation: "[S]omebody said it's like The Apprentice, White House-style." We're not sure who Sawyer's "somebody" actually is, though it is worth noting her comments were far from the worst on the subject. Take, for example, Fox News' Andrew Napolitano, who said that the resignation was "an absolute power grab, and it's the road to fascism" and that "this is Mussolini on the Potomac."
Worse still, many in the media falsely described Wagoner's resignation as unprecedented. A Washington Times editorial labeled Wagoner's departure from GM just that way -- as "unprecedented." At no point did the editorial mention that the government had required AIG, Fannie Mae, and Freddie Mac in September 2008 to replace their CEOs as a condition of receiving government funds during the Bush administration. Similarly, the Los Angeles Times and CNN's Lou Dobbs uncritically repeated Sen. John McCain's false claim that the government's Wagoner decision was "unprecedented." Despite the facts to the contrary, MSNBC's Chris Matthews called McCain's assessment "very correct," while Fox News' Steve Doocy actually claimed "the last president who fired a CEO was Putin" and conservative leader Rush Limbaugh said the White House had sought Wagoner's resignation as "payback for the unions."
Media Matters has been taking the "Limbaugh Challenge" for years
Just a few short weeks after Media Matters for America launched The Limbaugh Wire, a special website dedicated to providing hour-by-hour coverage of and commentary on Limbaugh's radio program, the Los Angeles Times printed an op-ed by Andrew Klavan, a contributing editor of the conservative Manhattan Institute's quarterly magazine, City Journal, in which Klavan claimed: "I listen to Limbaugh every chance I get, and I have never heard the man utter a single racist, hateful or stupid word." Klavan then issued to "liberals" what he referred to as "the Limbaugh Challenge," writing: "Listen to the show. Not for five minutes but for several hours: an hour a day for several days. Consider what he has to say -- the real policy material under the jokes and teasing bluster. Do what your intellectual keepers do not want you to do and keep an open mind." Of course, Media Matters has been listening to the entire Rush Limbaugh Show everyday for years and has documented hundreds of examples of Limbaugh spewing outrageous commentary and basic misstatements of fact. Don't have the time (or the patience) to take "the Limbaugh Challenge" yourself? You can always sign up to receive The Limbaugh Wire by email each weekday.
Media fail to reconcile facts in coverage of president's budget
Throughout Obama's presidency (and even before it started), media figures have tried to pin the blame for the current economic situation on Obama by disappearing the Bush administration's role in their reporting of economic issues and repeatedly referencing the "Obama recession" and the "Obama bear market." Nonetheless, a recent Washington Post/ABC News poll indicates that, as ABCNews.com reported: "Part of Obama's advantage in dealing with the economy is that, while blame and anger are in great supply, he escapes both. Eight in 10 Americans blame the situation on banks and other financial institutions for taking on too much risk; as many blame large business corporations for poor management decisions. Seventy-two percent blame consumers for taking on too much debt; 70 percent blame the Bush administration for lack of needed regulation. Just 26 percent, though, blame the Obama administration." Media Matters released a compelling online video this week contrasting the punditry of media figures with the recent poll -- be sure to check it out.
Additionally, numerous media outlets advanced the false notion that it would be unprecedented for congressional Democrats to use the budget reconciliation process to pass major policy initiatives, or failed to challenge conservatives making such claims. On Fox News' Special Report with Bret Baier, correspondent Molly Henneberg falsely claimed that "[r]econciliation was last used in 2001 by Republicans to pass the first Bush tax cuts." After Media Matters and others pointed out that Republicans used reconciliation to pass several of President Bush's major initiatives after 2001, Baier apologized for Henneberg's "error" three days later. The Washington Post also allowed "moderate" Sen. Arlen Specter (R-PA) to criticize the use of the reconciliation process without noting his votes to use it to pass Bush's tax cuts. The Hill ignored the GOP's use of the reconciliation process in forwarding Republicans' complaints that it "was never intended to ram through major legislation."
Because so many media figures and outlets promoted a number of falsehoods about the president's budget plan, Media Matters released a debunking of three major myths repeated in coverage of the proposal, including the false suggestion that Obama's proposal would increase taxes on a large percentage of small businesses and the previously mentioned falsehood about reconciliation. The debunking also noted that media outlets have engaged in a pattern of criticizing Obama for addressing health care in the budget or elsewhere given the size of the current and projected U.S. federal debt without addressing the president's response that health-care reform is essential to the long-term economic and fiscal health of the country.
Important questions: What will they give? What will she wear?
As the president and first lady arrived in Europe for the G-20 economic summit and a meeting with NATO, many in the media were transfixed by trivial matters. Rather than report on the important issues being discussed at the meetings of world leaders, many seemed to be asking the questions: What did they give the queen? What is Michelle wearing?
While Fox News' Sean Hannity declared he was "not so concerned in what gifts wealthy people are giving each other," he nevertheless repeatedly used his show to complain about the iPod the Obamas gave to the queen. Not to be outdone, his Fox colleague Bill O'Reilly claimed giving an iPod to royalty "would have gotten you beheaded in Henry VIII's time."
If you thought controversy over the gift was ridiculous, coverage of the first lady's attire was even worse. On NBC's Today, co-host Meredith Vieira said the "big question" concerning Michelle Obama's visit with the queen is, "will she bare her arms?" The big question? Days later, Vieira joked about a potential "cat fight" and "mud wrestling" between Mrs. Obama and France's Carla Bruni. Not to be outdone in the women's attire department, MSNBC's Chris Matthews gushed over the "summit" between Obama and Bruni, asking weather they'll be "dressed to beat the other." Hannity, doing his best to gin up yet another conspiracy, claimed it was Michelle Obama's "hope" to "get all these great designer clothes and that everyone will report on it and call [her], you know, Jackie Kennedy."
The Fox Nation launches amid more apologies from ... Fox News
This week, Fox News launched The Fox Nation, which, according to the website, was "created for people who believe in the United States of America and its ideals, as expressed in the Constitution, the Declaration of Independence, and the Emancipation Proclamation." The website goes on to describe itself as a place "for those committed to the core principles of tolerance, open debate, civil discourse -- and fair and balanced coverage of the news."
If it sounds too good to be true, that is because it is.
In an entry to FoxNews.com's Fox Forum, Americans for Tax Reform president Grover Norquist wrote that the website "takes no position on issues -- although unlike so many other Web portals, FOX Nation does begin with the presumption that America is a special and unique place, a blessed land to be treasured and defended." As Media Matters noted, however, The Fox Nation recently labeled Rep. Barney Frank (D-MA) and Sen. Chris Dodd (D-CT) a "[d]angerous duo," linking to an Agence France-Presse article that simply reported that Dodd and Frank "promised President Barack Obama on Monday they would work with the White House to enact a sweeping overhaul of US financial regulatory structures by year's end." Nothing in the AFP article in any way characterized Dodd or Frank as "[d]angerous."
Fair and balanced? Hardly.
Indeed, in the same Fox Forum entry, Norquist undermined his own claim that The Fox Nation "takes no position on issues," writing: "That's right, conservatives, libertarians, and other believers in limited government have found a new home -- at FOX Nation."
News of the website came as Fox News offered its third apology in recent weeks for getting a story relating to the Obama administration plain wrong.
Additionally, Media Matters detailed how, during an interview this week between Happening Now co-host Jon Scott and Rep. Paul Ryan (R-WI), Fox News aired "FOXfact[s]" purporting to describe facts about the House Republican budget, when, in fact, all seven of the on-screen "FOXfact[s]" were nearly identical to portions of an op-ed Ryan published in that day's Wall Street Journal. For example, using nearly identical language, Fox News and Ryan's op-ed both characterized President Obama's cap-and-trade proposal as a "scheme." Ryan wrote, "We do these things by rejecting the president's cap-and-trade scheme"; the "FOXfact" stated that the "GOP budget rejects the president's cap-and-trade scheme."
Don't forget, Media Matters previously noted that Scott passed off a GOP press release as Fox News' own research, even reproducing a typo contained in the Republican press release.
CNN's Kurtz has the Kudlow-down on CNBC
Last weekend on CNN's Reliable Sources, host Howard Kurtz discussed CNBC host Larry Kudlow's decision not to run for U.S. Senate in Connecticut. Kudlow announced his decision after Media Matters issued an open letter to CNBC President Mark Hoffman expressing concern over Kudlow's use of airtime to further his potential candidacy. Kurtz cited Media Matters, noting "Larry Kudlow, the CNBC host, was considering a run for the Senate from Connecticut. But with his network being pressed by the liberal advocacy group Media Matters to say whether he was a pundit or a pol, Kudlow made his decision. ... Kudlow also canceled plans this week to speak at a Republican Party fundraiser in Washington, which is a good thing, since he wouldn't be very credible on CNBC if he were openly shilling for one party."
Ann Coulter: April's Fool
Right-wing pundit Ann Coulter, who often accuses progressives of lacking a sense of humor, fell for a fake April Fools' Day article by Car and Driver magazine this week. The phony article claimed that Obama had ordered GM and Chrysler to cease their participation in NASCAR because it is an "unnecessary expenditure." Falling hook, line, and sinker for the joke, Coulter wrote in her April 1 column, "If Obama can tell GM and Chrysler that their participation in NASCAR is an 'unnecessary expenditure,' isn't having public schools force students to follow Muslim rituals, recite Islamic prayers and plan 'jihads' also an 'unnecessary expenditure'?" Car and Driver later clarified that the story was an April Fools' Day joke, and then removed the story from its website. As USA Today reported, "Car and Driver later pulled the fake story (which estimated savings of $250 million between the manufacturers) and apologized for 'going too far' while noting the magazine 'has a proud tradition of irreverent editorial and we amplify that each year with our April Fool's Day joke.' "
BAN THE BREAST PUMP
Ban the Breast Pump
At another time, in another place, they would have been burned at the stake as witches.
In coming weeks, as the news of their heresy spreads, they will undoubtedly roast in the hellfire of mommy-blog vituperation.
“That was my least favorite thing I ever did in my whole life,” Washington writer Hanna Rosin says in a podcast conversation with three pals that accompanies her sure-to-be-controversial new feature, “The Case Against Breast Feeding,” on The Atlantic’s Web site.
She’s talking about pumping breast milk – the grotesque ritual carried out behind closed office doors nationwide by beleaguered working mothers who are fully “committed” (as the lactation consultants put it) to the goal of long-term, exclusive breast-feeding.
“The way your nipples can get stretched,” the others chime in. “… the nipple gets sucked into the plastic thing” … “and it hurts by the way” … “and you measure your success every day by now many ounces you produce.”
Rosin does an excellent imitation of a breast pump machine as the room erupts into laughter. “Who could blame [your husband] for never wanting to sleep with you again?”
“It’s the moment that kind of brings together all the awfulness of being a modern mother,” she says.
Hallelujah, I all but shouted at the computer, desperate to join in the conversation with these newfound sure-to-be best friends.
And then I flinched. And then I ducked, as though I expected the long arm of All That Is Decent to reach out from behind the screen to strike me.
Now, let me just be clear: I am no enemy of breast-feeding. I nursed both my daughters and would not take back that experience for all the world. But I did not breast-feed them exclusively. I had a mother who breast-fed in the mid-’60s despite the disgust of friends and family, and who insisted that my happiness depended on giving them one bottle of formula a day. I was in France, where their doctor started adding fruits and vegetables to their diet at about three or four months. And where it was easy, after a few miserable weeks, to give up on pumping milk, if only because it made me feel like a cow.
Is it at long last possible – on this side of the Atlantic – to suggest that we’ve maybe taken “breast is best” a bit too far? That a mother’s need for some semblance of physical dignity is perhaps a right worth respecting? That supplementing with formula – if it makes for greater happiness (and emotional availability) in the baby’s most important caretaker – isn’t necessarily an act of gross irresponsibility?
Maybe. Maybe we’re even at a point where it’s permissible to insist that the needs of a mother and the needs of her baby, rather than being opposed are, in fact, linked, and that the best way to meet both is to scale down the demands now put on mothers and beef up support for them.
Rosin’s article, based upon a review of the relevant medical literature and some physician interviews, makes the case that the health claims about breast milk have been greatly overstated. There’s contradictory evidence, she writes, on the virtues of breast milk in combating allergies, leukemia, high cholesterol and diabetes. There is evidence that breast-feeding can help prevent diarrhea, and some indications that breast-feeding might hike up a baby’s I.Q. – by a more or less meaningless couple of points. But the cause of this intelligence boost is unclear. Are breast-fed babies very slightly smarter because they’ve been fed breast milk, or because they’ve been snuggled more closely, been cooed over more exclusively, or otherwise enjoyed any other hard-to-identify-or-isolate variables that simply can’t be controlled in the kinds of studies that currently exist and compare breast-fed and bottle-fed babies?
There’s no way to know. After all, you can’t carry out randomized, controlled trials of baby-feeding. You can’t assemble a group of mothers of equivalent levels of education, income and physical and mental health, control for every possible variation in their emotional availability and parenting style, and then instruct half of them to breast-feed their children, while ordering the other half to bottle-feed for the sake of science. Which means, Rosin writes, that there really is no good science on breast-feeding.
I am sure that the American Academy of Pediatrics – which currently recommends six months of exclusive breast feeding and some breast feeding for at least a year – will soon speak up to refute Rosin’s conclusions, and that the Dr. William Sears-inspired attachment parenting crowd will soon assail her in the blogosphere. Whether her science is or is not on track, I cannot judge. But her argument raises questions that I believe are worth asking.
Why have we made such a fetish of breast milk when there’s no evidence to prove whether, as Rosin puts it in the Atlantic video, “what’s key about breast feeding is the milk or the act of breast-feeding”?
Why, as a society, have we privileged the magic elixir of maternal milk over actual maternal contact, denying the vast, vast majority of mothers the kind of extended maternity leave that would make them physically present for their babies?
Why do we keep sticking our heads in the sand, putting all the burdens of our half-changed society on women – their “choices,” their “priorities,” their bodies – instead of figuring out reasonable ways to make our new family lives work?
Why do we, as women, accept all the guilt and pressure about breast-feeding that comes our way instead of standing up for what we need in order, in the broadest possible sense, to nourish and sustain ourselves and our families?
“There’s this funny thing going on where women have worked for a long time. Almost 50 years. There’s been a tremendous change. Children still have to be raised. The equation doesn’t add up and everyone pretends it’s not happening,” Rosin says near the end of the video interview. “So I feel like when that step happens, there’ll sort of be a degree of ownership, that O.K., we have to make all these things happen at once. And formula will enter into that conversation.”
And she adds, “I’m hoping pump companies will just disappear.”
So am I. In fact, I hope that some day, not too long in the future, books on women’s history will feature photos of breast pumps to illustrate what it was like back in the day when mothers were consistently given the shaft. Future generations of female college students will gaze upon the pumps, aghast.
“Did you actually use one of those?” they’ll ask their mothers, in horror.
And the moms, with a shudder, will proudly say no.
At another time, in another place, they would have been burned at the stake as witches.
In coming weeks, as the news of their heresy spreads, they will undoubtedly roast in the hellfire of mommy-blog vituperation.
“That was my least favorite thing I ever did in my whole life,” Washington writer Hanna Rosin says in a podcast conversation with three pals that accompanies her sure-to-be-controversial new feature, “The Case Against Breast Feeding,” on The Atlantic’s Web site.
She’s talking about pumping breast milk – the grotesque ritual carried out behind closed office doors nationwide by beleaguered working mothers who are fully “committed” (as the lactation consultants put it) to the goal of long-term, exclusive breast-feeding.
“The way your nipples can get stretched,” the others chime in. “… the nipple gets sucked into the plastic thing” … “and it hurts by the way” … “and you measure your success every day by now many ounces you produce.”
Rosin does an excellent imitation of a breast pump machine as the room erupts into laughter. “Who could blame [your husband] for never wanting to sleep with you again?”
“It’s the moment that kind of brings together all the awfulness of being a modern mother,” she says.
Hallelujah, I all but shouted at the computer, desperate to join in the conversation with these newfound sure-to-be best friends.
And then I flinched. And then I ducked, as though I expected the long arm of All That Is Decent to reach out from behind the screen to strike me.
Now, let me just be clear: I am no enemy of breast-feeding. I nursed both my daughters and would not take back that experience for all the world. But I did not breast-feed them exclusively. I had a mother who breast-fed in the mid-’60s despite the disgust of friends and family, and who insisted that my happiness depended on giving them one bottle of formula a day. I was in France, where their doctor started adding fruits and vegetables to their diet at about three or four months. And where it was easy, after a few miserable weeks, to give up on pumping milk, if only because it made me feel like a cow.
Is it at long last possible – on this side of the Atlantic – to suggest that we’ve maybe taken “breast is best” a bit too far? That a mother’s need for some semblance of physical dignity is perhaps a right worth respecting? That supplementing with formula – if it makes for greater happiness (and emotional availability) in the baby’s most important caretaker – isn’t necessarily an act of gross irresponsibility?
Maybe. Maybe we’re even at a point where it’s permissible to insist that the needs of a mother and the needs of her baby, rather than being opposed are, in fact, linked, and that the best way to meet both is to scale down the demands now put on mothers and beef up support for them.
Rosin’s article, based upon a review of the relevant medical literature and some physician interviews, makes the case that the health claims about breast milk have been greatly overstated. There’s contradictory evidence, she writes, on the virtues of breast milk in combating allergies, leukemia, high cholesterol and diabetes. There is evidence that breast-feeding can help prevent diarrhea, and some indications that breast-feeding might hike up a baby’s I.Q. – by a more or less meaningless couple of points. But the cause of this intelligence boost is unclear. Are breast-fed babies very slightly smarter because they’ve been fed breast milk, or because they’ve been snuggled more closely, been cooed over more exclusively, or otherwise enjoyed any other hard-to-identify-or-isolate variables that simply can’t be controlled in the kinds of studies that currently exist and compare breast-fed and bottle-fed babies?
There’s no way to know. After all, you can’t carry out randomized, controlled trials of baby-feeding. You can’t assemble a group of mothers of equivalent levels of education, income and physical and mental health, control for every possible variation in their emotional availability and parenting style, and then instruct half of them to breast-feed their children, while ordering the other half to bottle-feed for the sake of science. Which means, Rosin writes, that there really is no good science on breast-feeding.
I am sure that the American Academy of Pediatrics – which currently recommends six months of exclusive breast feeding and some breast feeding for at least a year – will soon speak up to refute Rosin’s conclusions, and that the Dr. William Sears-inspired attachment parenting crowd will soon assail her in the blogosphere. Whether her science is or is not on track, I cannot judge. But her argument raises questions that I believe are worth asking.
Why have we made such a fetish of breast milk when there’s no evidence to prove whether, as Rosin puts it in the Atlantic video, “what’s key about breast feeding is the milk or the act of breast-feeding”?
Why, as a society, have we privileged the magic elixir of maternal milk over actual maternal contact, denying the vast, vast majority of mothers the kind of extended maternity leave that would make them physically present for their babies?
Why do we keep sticking our heads in the sand, putting all the burdens of our half-changed society on women – their “choices,” their “priorities,” their bodies – instead of figuring out reasonable ways to make our new family lives work?
Why do we, as women, accept all the guilt and pressure about breast-feeding that comes our way instead of standing up for what we need in order, in the broadest possible sense, to nourish and sustain ourselves and our families?
“There’s this funny thing going on where women have worked for a long time. Almost 50 years. There’s been a tremendous change. Children still have to be raised. The equation doesn’t add up and everyone pretends it’s not happening,” Rosin says near the end of the video interview. “So I feel like when that step happens, there’ll sort of be a degree of ownership, that O.K., we have to make all these things happen at once. And formula will enter into that conversation.”
And she adds, “I’m hoping pump companies will just disappear.”
So am I. In fact, I hope that some day, not too long in the future, books on women’s history will feature photos of breast pumps to illustrate what it was like back in the day when mothers were consistently given the shaft. Future generations of female college students will gaze upon the pumps, aghast.
“Did you actually use one of those?” they’ll ask their mothers, in horror.
And the moms, with a shudder, will proudly say no.
Wednesday, April 01, 2009
Health Critic Brings a Past and a Wallet
JIM RUTENBERG
WASHINGTON — Richard L. Scott is unusual in these tough economic times: a rich, conservative investor willing to spend freely on a political cause.
Mr. Scott is starring in his own rotation of advertisements against the broad outlines of President Obama’s health care plans. (“Imagine waking up one day and all your medical decisions are made by a central, national board,” he warns in a radio spot.) He has dispatched camera crews to other countries to document the perils of socialized medicine.
He visited with lawmakers on Capitol Hill this week, and his new group, Conservatives for Patients’ Rights, has hired a leading conservative public relations firm, CRC, well known for its work with Swift Boat Veterans for Truth, the group that attacked Senator John Kerry, Democrat of Massachusetts, during his presidential campaign.
Mr. Scott’s emergence this spring as the most visible conservative opponent to Mr. Obama’s not-fully-defined health care effort has former friends and foes alike doing double takes, given Mr. Scott’s history.
Once lauded for building Columbia/HCA into the largest health care company in the world, Mr. Scott was ousted by his own board of directors in 1997 amid the nation’s biggest health care fraud scandal. The company’s guilty plea and payment of $1.7 billion to settle charges including the overbilling of state and federal health programs was taken as a repudiation of Mr. Scott’s relentless bottom-line approach.
“He hopes people don’t Google his name,” said John E. Hartwig, a former deputy inspector general at the Department of Health and Human Services, one of various state and federal agencies that investigated Columbia/HCA when Mr. Scott was its chief executive.
Liberal groups planning to defend the administration’s health care plan, whatever form it takes, are seizing on Mr. Scott’s background through Web videos, fact sheets, blog postings and unflattering additions to his Wikipedia entry, which until recently did not mention his ouster from Columbia.
“He’s a great symbol from our point of view,” said Richard J. Kirsch, the national campaign manager for Health Care for America Now. “We cannot have a better first person to attack health care reform than someone who ran a company that ripped off the government of hundreds of millions of dollars.”
Conservative health care activists, while glad to have a potential ally willing to spend $5 million out of his own pocket, are not fully embracing Mr. Scott, noting that he is entering a changed landscape in which some Republicans and industry groups that opposed President Bill Clinton’s health care proposals now view some form of change as necessary and inevitable.
“At the end of the day, they may come up with something we like,” said John C. Goodman, a leading conservative health care policy expert. “We shouldn’t just assume that this is something horrible — if this is something horrible, we will be against it.”
“There is no Obama plan that’s been made public yet, so what’s the point of running ads?” Mr. Goodman added. “I don’t see that you gain anything except attention for Rick Scott.”
Some former allies are more hostile toward Mr. Scott, painting him as counterproductive to their efforts for compromise.
“I just don’t understand why he would be a messenger people would listen to,” said Charles N. Kahn III, who was a senior executive with the insurance industry group that ran the “Harry & Louise” advertisements credited with helping to kill the Clinton plan 15 years ago but who is working for a deal now. “I don’t think people are waiting to hear from him.”
Mr. Kahn, a Republican, is now the head of the Federation of American Hospitals, a private-hospitals group.
Mr. Scott is showing more support from some Republicans in Congress, though. Representative Michael C. Burgess, Republican of Texas and a member of the House health subcommittee, said in an interview that he had invited Mr. Scott to meet with him on Tuesday because he liked what Mr. Scott had been saying.
Mr. Scott declined several interview requests. His public relations firm, after initially offering to make him available for a discussion, later declined to answer questions about him, citing an exclusive arrangement with another publication.
In recent years, Mr. Scott, 56, has settled into a comfortable life in Naples, Fla., where he has built an investment portfolio that includes a chain of urgent-care clinics, some located in Wal-Mart stores, which Mr. Scott promotes as inexpensive alternatives to emergency rooms, especially for the uninsured.
Mr. Scott has said his sole policy interest is to see to it that whatever overhaul Mr. Obama and Congress consider does not move the country toward a socialized system and away from what he calls his four pillars of reform: “choice, competition, accountability and personal responsibility.”
“After spending over two decades in the health care provider industry, I’ve seen these principles work firsthand,” Mr. Scott said in a recent statement in which he also criticized Mr. Obama for seeking a $634 billion reserve fund for unspecified changes to the health care system.
Mr. Scott’s supporters say that he has been unfairly attacked over the years for challenging the longstanding orthodoxy of the nonprofit health care establishment.
“He has a much more businesslike approach to health care than anybody I’ve ever seen, and it is much more bottom-line-driven,” said Joshua Nemzoff, a hospital consultant based in New Hope, Pa., who has represented nonprofit hospitals in several deals with Mr. Scott. “He’s aggressive, and sometimes that rubs people the wrong way.”
Mr. Scott, a former Navy radar operator, built what would become Columbia/HCA from two hospitals in Texas into the largest health care chain in the world over just a few years. He seemed to relish publicly lambasting the nonprofit hospitals against which he competed and which he described as “non-taxpaying hospitals” impervious to real-world business concerns.
His approach earned him plenty of enmity, but also high praise. In 1996, Time magazine named him one of the “25 most influential Americans” for “transforming how American hospitals do business,” with an operation that “consolidates operations and imposes cost controls.”
Though Mr. Scott was not directly implicated in the fraud scandal — with whistle-blower suits filed against some hospitals before his acquisition of them — critics said his drive for profits had created incentive for fraud.
“The practices did pre-exist Rick Scott,’ said Stephen Meagher, a lawyer who represented some of the ex-employees whose complaints prompted the initial investigation. “They were aggravated by the pressure he put on HCA employees.”
In an interview this week with The Washington Independent, Mr. Scott said of the charges against his former company, “If you go back and look at the hospital industry, and the whole health care industry since the mid-1990s, it was constantly going through investigations.” He added, “Great institutions, like ours, paid fines.”
One defender of Mr. Scott, Mr. Burgess, the Texas lawmaker and a former HCA doctor, said of the investigation, “A lot of us just looked at it as somebody in Washington playing politics.”
Others say the scandal took place so long ago they can hardly remember it. “I remembered reading a newspaper article about it all,” said Merrill Matthews Jr., director of the Council for Affordable Health Insurance, a group that formed to fight the Clinton proposals and expects to fight Mr. Obama’s. Mr. Matthews said he would not shun Mr. Scott. “He’s bringing a lot of money to the table,” he said.
WASHINGTON — Richard L. Scott is unusual in these tough economic times: a rich, conservative investor willing to spend freely on a political cause.
Mr. Scott is starring in his own rotation of advertisements against the broad outlines of President Obama’s health care plans. (“Imagine waking up one day and all your medical decisions are made by a central, national board,” he warns in a radio spot.) He has dispatched camera crews to other countries to document the perils of socialized medicine.
He visited with lawmakers on Capitol Hill this week, and his new group, Conservatives for Patients’ Rights, has hired a leading conservative public relations firm, CRC, well known for its work with Swift Boat Veterans for Truth, the group that attacked Senator John Kerry, Democrat of Massachusetts, during his presidential campaign.
Mr. Scott’s emergence this spring as the most visible conservative opponent to Mr. Obama’s not-fully-defined health care effort has former friends and foes alike doing double takes, given Mr. Scott’s history.
Once lauded for building Columbia/HCA into the largest health care company in the world, Mr. Scott was ousted by his own board of directors in 1997 amid the nation’s biggest health care fraud scandal. The company’s guilty plea and payment of $1.7 billion to settle charges including the overbilling of state and federal health programs was taken as a repudiation of Mr. Scott’s relentless bottom-line approach.
“He hopes people don’t Google his name,” said John E. Hartwig, a former deputy inspector general at the Department of Health and Human Services, one of various state and federal agencies that investigated Columbia/HCA when Mr. Scott was its chief executive.
Liberal groups planning to defend the administration’s health care plan, whatever form it takes, are seizing on Mr. Scott’s background through Web videos, fact sheets, blog postings and unflattering additions to his Wikipedia entry, which until recently did not mention his ouster from Columbia.
“He’s a great symbol from our point of view,” said Richard J. Kirsch, the national campaign manager for Health Care for America Now. “We cannot have a better first person to attack health care reform than someone who ran a company that ripped off the government of hundreds of millions of dollars.”
Conservative health care activists, while glad to have a potential ally willing to spend $5 million out of his own pocket, are not fully embracing Mr. Scott, noting that he is entering a changed landscape in which some Republicans and industry groups that opposed President Bill Clinton’s health care proposals now view some form of change as necessary and inevitable.
“At the end of the day, they may come up with something we like,” said John C. Goodman, a leading conservative health care policy expert. “We shouldn’t just assume that this is something horrible — if this is something horrible, we will be against it.”
“There is no Obama plan that’s been made public yet, so what’s the point of running ads?” Mr. Goodman added. “I don’t see that you gain anything except attention for Rick Scott.”
Some former allies are more hostile toward Mr. Scott, painting him as counterproductive to their efforts for compromise.
“I just don’t understand why he would be a messenger people would listen to,” said Charles N. Kahn III, who was a senior executive with the insurance industry group that ran the “Harry & Louise” advertisements credited with helping to kill the Clinton plan 15 years ago but who is working for a deal now. “I don’t think people are waiting to hear from him.”
Mr. Kahn, a Republican, is now the head of the Federation of American Hospitals, a private-hospitals group.
Mr. Scott is showing more support from some Republicans in Congress, though. Representative Michael C. Burgess, Republican of Texas and a member of the House health subcommittee, said in an interview that he had invited Mr. Scott to meet with him on Tuesday because he liked what Mr. Scott had been saying.
Mr. Scott declined several interview requests. His public relations firm, after initially offering to make him available for a discussion, later declined to answer questions about him, citing an exclusive arrangement with another publication.
In recent years, Mr. Scott, 56, has settled into a comfortable life in Naples, Fla., where he has built an investment portfolio that includes a chain of urgent-care clinics, some located in Wal-Mart stores, which Mr. Scott promotes as inexpensive alternatives to emergency rooms, especially for the uninsured.
Mr. Scott has said his sole policy interest is to see to it that whatever overhaul Mr. Obama and Congress consider does not move the country toward a socialized system and away from what he calls his four pillars of reform: “choice, competition, accountability and personal responsibility.”
“After spending over two decades in the health care provider industry, I’ve seen these principles work firsthand,” Mr. Scott said in a recent statement in which he also criticized Mr. Obama for seeking a $634 billion reserve fund for unspecified changes to the health care system.
Mr. Scott’s supporters say that he has been unfairly attacked over the years for challenging the longstanding orthodoxy of the nonprofit health care establishment.
“He has a much more businesslike approach to health care than anybody I’ve ever seen, and it is much more bottom-line-driven,” said Joshua Nemzoff, a hospital consultant based in New Hope, Pa., who has represented nonprofit hospitals in several deals with Mr. Scott. “He’s aggressive, and sometimes that rubs people the wrong way.”
Mr. Scott, a former Navy radar operator, built what would become Columbia/HCA from two hospitals in Texas into the largest health care chain in the world over just a few years. He seemed to relish publicly lambasting the nonprofit hospitals against which he competed and which he described as “non-taxpaying hospitals” impervious to real-world business concerns.
His approach earned him plenty of enmity, but also high praise. In 1996, Time magazine named him one of the “25 most influential Americans” for “transforming how American hospitals do business,” with an operation that “consolidates operations and imposes cost controls.”
Though Mr. Scott was not directly implicated in the fraud scandal — with whistle-blower suits filed against some hospitals before his acquisition of them — critics said his drive for profits had created incentive for fraud.
“The practices did pre-exist Rick Scott,’ said Stephen Meagher, a lawyer who represented some of the ex-employees whose complaints prompted the initial investigation. “They were aggravated by the pressure he put on HCA employees.”
In an interview this week with The Washington Independent, Mr. Scott said of the charges against his former company, “If you go back and look at the hospital industry, and the whole health care industry since the mid-1990s, it was constantly going through investigations.” He added, “Great institutions, like ours, paid fines.”
One defender of Mr. Scott, Mr. Burgess, the Texas lawmaker and a former HCA doctor, said of the investigation, “A lot of us just looked at it as somebody in Washington playing politics.”
Others say the scandal took place so long ago they can hardly remember it. “I remembered reading a newspaper article about it all,” said Merrill Matthews Jr., director of the Council for Affordable Health Insurance, a group that formed to fight the Clinton proposals and expects to fight Mr. Obama’s. Mr. Matthews said he would not shun Mr. Scott. “He’s bringing a lot of money to the table,” he said.
CSI is it real or so much bull....?
Report questions science, reliability of crime lab evidence
The National Academy of Sciences says many courtroom claims about fingerprints, bite marks and other evidence lack scientific verification. It finds forensics inconsistent and in disarray nationwide.
By Jason Felch and Maura Dolan
February 19, 2009
Sweeping claims made in courtrooms about fingerprints, ballistics, bite marks and other forensic evidence often have little or no basis in science, according to a landmark report released Wednesday by the nation's leading science body.
The National Academy of Sciences report called for a wholesale overhaul of the crime lab system, which has become increasingly crucial to American jurisprudence.
Many experts said the report could have a broad impact on crime labs and the courts, ushering in changes at least as significant as those generated by the advent of DNA evidence two decades ago. But the substantial reforms would require years of planning and major federal funding.
In the meantime, the findings are expected to unleash a flood of new legal challenges by defense attorneys.
"This is a major turning point in the history of forensic science in America," said Barry Scheck, co-founder of the Innocence Project, an organization dedicated to exonerating the wrongfully convicted. He said the findings would immediately lead to court challenges.
"If this report does not result in real change, when will it ever happen?" Scheck asked.
The Los Angeles County Public Defender's office plans to use the National Academy report to file challenges on the admissibility of fingerprint evidence and is reviewing cases in which fingerprints played a primary role in convictions, officials said.
Separately, the Los Angeles Police Department has been reviewing 1,000 fingerprint cases after discovering that two people were wrongfully accused because of faulty fingerprint analyses.
The academy, the preeminent science advisor to the federal government, found a system in disarray: labs that are underfunded and beholden to law enforcement and that lack independent oversight and consistent standards.
The report concludes that the deficiencies pose "a continuing and serious threat to the quality and credibility of forensic science practice," imperiling efforts to protect society from criminals and shield innocent people from convictions.
With the notable exception of DNA evidence, the report says that many forensic methods have never been shown to consistently and reliably connect crime scene evidence to specific people or sources.
"The simple reality is that the interpretation of forensic evidence is not always based on scientific studies to determine its validity," the report says.
For example, frequent claims that fingerprint analysis had a zero error rate are "not scientifically plausible," the report said. The scientific basis for bite mark evidence is called "insufficient to conclude that bite mark comparisons can result in a conclusive match."
Recent cases of CSI gone awry have underscored the report's urgency. In the cases of the 232 people exonerated by DNA evidence, more than half involved faulty or invalidated forensic science, according to the Innocence Project.
Margaret Berger, a professor at Brooklyn Law School and a member of the panel, explained: "We're not saying all these disciplines are useless. We're saying there is a lot of work that needs to be done."
Said U.S. Court of Appeals Judge Harry Edwards, co-chairman of the panel: "There are a lot of people who are concerned, and they should be concerned. Forensic science is the handmaiden of the legal system. . . . If you claim to be science, you ought to put yourself to the test."
Although the panel's recommendations are not binding, they are expected to be influential. Among the recommendations:
* Create a new federal agency, the National Institute of Forensic Science, to fund scientific research and disseminate basic standards.
* Make crime labs independent of law enforcement. Most crime labs are run by police agencies, which can lead to bias, a growing body of research shows.
* Require that expert witnesses and forensic analysts be certified by the new agency, and that labs be accredited.
* Fund research into the scientific basis for claims routinely made in court, as well as studies of the accuracy and reliability of forensic techniques.
Those recommendations have been cautiously embraced by leading associations of forensic scientists, which in 2005 helped convince Congress that the study was necessary.
"You can't continue to do business in 2009 the way you did in 1915," said Joseph Polski of the International Assn. for Identification, whose members include examiners of fingerprints, documents, footwear and tire tracks. "We knew there would be things in there we'd like and things we didn't like."
Many forensic scientists were hesitant to criticize the report for fear of seeming resistant to testing and scrutiny. But there were some delicate complaints.
"It's not the science of forensic science that is in need of repair, I think; it's how the results are interpreted in the courtroom," said Dean Gialamis, head of the American Society of Crime Lab Directors, who was quick to add that his group welcomed the recommendations.
The report was hailed by many defense attorneys, scientists and law professors, who for years have been raising scientific and legal challenges.
"The courts were highly skeptical of experts and resistant to hearing their arguments," said Simon A. Cole, a professor of criminology at UC Irvine who has often testified for defense teams about the limitations of fingerprint evidence. "I feel like I'm Alice coming out of the rabbit hole and back into a world of sanity and reason."
The report had harsh words for the FBI Laboratory and the National Institute of Justice, the research arm of the Justice Department, which have shown little enthusiasm for exploring the shortcomings of forensic science.
"Neither agency has recognized, let alone articulated, a need for change," the report states, adding that they could be subject to pro-prosecution biases.
Atty. Gen. Eric H. Holder Jr. signaled in comments to reporters shortly before the report was released that he would take its concerns seriously: "I think we need to devote a lot of attention and a lot of resources to that problem."
Prosectors on the front lines, however, were more skeptical. "I know the defense is probably starting bonfires, but this should not in any way shake up anyone's confidence in forensics," said Paula Wulff, manager and senior attorney of the DNA Forensic Program of the National District Attorneys Assn.
She called the recommendations a "Cadillac of aspirations," and expressed doubt that they would be followed given the poor state of the economy.
All sides, however, agreed that the report signals an aggressive reentry of scientists into issues that for decades have fallen to lawyers, judges and juries to resolve.
The National Academy of Sciences says many courtroom claims about fingerprints, bite marks and other evidence lack scientific verification. It finds forensics inconsistent and in disarray nationwide.
By Jason Felch and Maura Dolan
February 19, 2009
Sweeping claims made in courtrooms about fingerprints, ballistics, bite marks and other forensic evidence often have little or no basis in science, according to a landmark report released Wednesday by the nation's leading science body.
The National Academy of Sciences report called for a wholesale overhaul of the crime lab system, which has become increasingly crucial to American jurisprudence.
Many experts said the report could have a broad impact on crime labs and the courts, ushering in changes at least as significant as those generated by the advent of DNA evidence two decades ago. But the substantial reforms would require years of planning and major federal funding.
In the meantime, the findings are expected to unleash a flood of new legal challenges by defense attorneys.
"This is a major turning point in the history of forensic science in America," said Barry Scheck, co-founder of the Innocence Project, an organization dedicated to exonerating the wrongfully convicted. He said the findings would immediately lead to court challenges.
"If this report does not result in real change, when will it ever happen?" Scheck asked.
The Los Angeles County Public Defender's office plans to use the National Academy report to file challenges on the admissibility of fingerprint evidence and is reviewing cases in which fingerprints played a primary role in convictions, officials said.
Separately, the Los Angeles Police Department has been reviewing 1,000 fingerprint cases after discovering that two people were wrongfully accused because of faulty fingerprint analyses.
The academy, the preeminent science advisor to the federal government, found a system in disarray: labs that are underfunded and beholden to law enforcement and that lack independent oversight and consistent standards.
The report concludes that the deficiencies pose "a continuing and serious threat to the quality and credibility of forensic science practice," imperiling efforts to protect society from criminals and shield innocent people from convictions.
With the notable exception of DNA evidence, the report says that many forensic methods have never been shown to consistently and reliably connect crime scene evidence to specific people or sources.
"The simple reality is that the interpretation of forensic evidence is not always based on scientific studies to determine its validity," the report says.
For example, frequent claims that fingerprint analysis had a zero error rate are "not scientifically plausible," the report said. The scientific basis for bite mark evidence is called "insufficient to conclude that bite mark comparisons can result in a conclusive match."
Recent cases of CSI gone awry have underscored the report's urgency. In the cases of the 232 people exonerated by DNA evidence, more than half involved faulty or invalidated forensic science, according to the Innocence Project.
Margaret Berger, a professor at Brooklyn Law School and a member of the panel, explained: "We're not saying all these disciplines are useless. We're saying there is a lot of work that needs to be done."
Said U.S. Court of Appeals Judge Harry Edwards, co-chairman of the panel: "There are a lot of people who are concerned, and they should be concerned. Forensic science is the handmaiden of the legal system. . . . If you claim to be science, you ought to put yourself to the test."
Although the panel's recommendations are not binding, they are expected to be influential. Among the recommendations:
* Create a new federal agency, the National Institute of Forensic Science, to fund scientific research and disseminate basic standards.
* Make crime labs independent of law enforcement. Most crime labs are run by police agencies, which can lead to bias, a growing body of research shows.
* Require that expert witnesses and forensic analysts be certified by the new agency, and that labs be accredited.
* Fund research into the scientific basis for claims routinely made in court, as well as studies of the accuracy and reliability of forensic techniques.
Those recommendations have been cautiously embraced by leading associations of forensic scientists, which in 2005 helped convince Congress that the study was necessary.
"You can't continue to do business in 2009 the way you did in 1915," said Joseph Polski of the International Assn. for Identification, whose members include examiners of fingerprints, documents, footwear and tire tracks. "We knew there would be things in there we'd like and things we didn't like."
Many forensic scientists were hesitant to criticize the report for fear of seeming resistant to testing and scrutiny. But there were some delicate complaints.
"It's not the science of forensic science that is in need of repair, I think; it's how the results are interpreted in the courtroom," said Dean Gialamis, head of the American Society of Crime Lab Directors, who was quick to add that his group welcomed the recommendations.
The report was hailed by many defense attorneys, scientists and law professors, who for years have been raising scientific and legal challenges.
"The courts were highly skeptical of experts and resistant to hearing their arguments," said Simon A. Cole, a professor of criminology at UC Irvine who has often testified for defense teams about the limitations of fingerprint evidence. "I feel like I'm Alice coming out of the rabbit hole and back into a world of sanity and reason."
The report had harsh words for the FBI Laboratory and the National Institute of Justice, the research arm of the Justice Department, which have shown little enthusiasm for exploring the shortcomings of forensic science.
"Neither agency has recognized, let alone articulated, a need for change," the report states, adding that they could be subject to pro-prosecution biases.
Atty. Gen. Eric H. Holder Jr. signaled in comments to reporters shortly before the report was released that he would take its concerns seriously: "I think we need to devote a lot of attention and a lot of resources to that problem."
Prosectors on the front lines, however, were more skeptical. "I know the defense is probably starting bonfires, but this should not in any way shake up anyone's confidence in forensics," said Paula Wulff, manager and senior attorney of the DNA Forensic Program of the National District Attorneys Assn.
She called the recommendations a "Cadillac of aspirations," and expressed doubt that they would be followed given the poor state of the economy.
All sides, however, agreed that the report signals an aggressive reentry of scientists into issues that for decades have fallen to lawyers, judges and juries to resolve.
Iraqi Militants Show a New Boldness in Cities
ALISSA J. RUBIN
BAGHDAD — As the American military prepares to withdraw from Iraqi cities, Iraqi and American security officials say that jihadi and Baath militants are rejoining the fight in areas that are largely quiet now, regrouping as a smaller but still lethal insurgency.
There is much debate as to whether any new insurgency, at a time of relative calm in most of Iraq, could ever produce the same levels of violence as existed at the height of the fighting here. A recent series of attacks, however, like bubbles that indicate fish beneath still water, suggest the potential danger, all the more perilous now because the American troops who helped to pacify Iraq are leaving.
Several well-planned bombings, one on a street recently reopened because it was thought to be safe, have killed 123 people, most of them in and around Baghdad. Three were suicide bombings, signatures of Al Qaeda in Mesopotamia, a homegrown Sunni extremist group with some foreign leadership.
Assassination attempts on members of the Awakening movement, some of them former insurgents who switched sides for pay, are rising, as are fears that some of the members are joining Islamic extremists or other insurgent groups. On Saturday an important Awakening leader was arrested on charges, among others, of being a member of the military wing of the outlawed Baath Party, formerly led by Saddam Hussein.
Detainees, some innocent, but many of them former insurgents long held in American military custody, are being set free every day, potentially increasing the insurgency’s numbers. The American-Iraqi security agreement requires the release of all detainees in American custody unless there is sufficient evidence to bring charges in an Iraqi court.
At least one former detainee has already blown himself up in a suicide attack.
Most of the latest attacks, at a time when overall violence is at its lowest level since the beginning of the war in 2003, have singled out Iraqis, but one development affects the Americans. A new weapon has appeared in Iraq: Russian-made RKG-3 grenades, which weigh just five pounds and, attached to parachutes, can be lobbed by a teenager but can penetrate the American military’s latest heavily armored vehicle, the MRAP. The grenades cost as little as $10, according to American military officials, who would not say how often they have killed soldiers.
To some experts, this amounts to ugly, but unavoidable, background noise, the deadly but no longer destabilizing face of violence in Iraq. In this view, there will be attacks, but no longer ones likely to topple Iraq’s government. Military officers, who spoke on the condition of anonymity because they were not authorized to talk to the news media, say they have reduced the number of jihadi militants to under 2,000, from about 3,800.
“In most places there isn’t an insurgency in Iraq anymore,” said an American military intelligence officer in Washington, who was not authorized to be quoted by name. “What we have now is a terrorism problem, and there is going to be a terrorism problem in Iraq for a long time.”
Other officials, Iraqi and American, are more worried. They observe jihadi and other insurgent groups activating networks of sleeper cells, which are already striking government and civilian targets. Insurgent groups linked to the rule of Mr. Hussein are also reviving.
Among the most powerful now is Nashqabandi, which is believed to have ties to a former Hussein deputy, Izzat Ibrahim al-Douri. The organization, which gets money from Iraqi exiles in Syria, formed an alliance with religious Sunni extremists, according to American and Iraqi military intelligence.
“Al Qaeda and the hard-core Saddamists are the main threats to the national security of Iraq,” said Mowaffak al-Rubaie, Iraq’s national security adviser.
“Nashqabandi is the cradle; they are providing logistical support for Al Qaeda,” he said. “What we are seeing is the resurgence of the hard-core Saddamists, but using Al Qaeda in Iraq as a front and as suicide bombers.”
American military officials believe they have checked the insurgency, but liken it to a spring. “It can come up quickly as soon as it is released, but the longer you keep it down the less it rebounds,” said Col. James Phelps, an insurgency expert attached to the multinational force in Iraq. “Some Al Qaeda in Iraq leadership did go to ground,” he said.
In interviews with 14 leaders of the Awakening movement, which has been credited with helping to reduce violence, all said they believed that the jihadi presence in their areas had increased, as American troops began to close combat outposts or hand them over to the Iraqi Army, a first step toward withdrawing entirely. The Awakening leaders reported signs of trouble: assassination attempts, homemade bombs placed near their homes or under their cars, leaflets urging them not to work with the Iraqi government.
“We notice when there is a bomb buried on a back road where there has not been one before,” said Sheik Awad al-Harbousi, whose Awakening group works in Taji, north of Baghdad, much of it empty country traversed by rugged dirt roads. One of his fighters was killed three weeks ago and two were wounded.
Undermining the stability of the last few months is rising friction between the Awakening Councils and the Iraqi Army and the police, much of it with a sectarian edge. The tensions turned violent in Baghdad on Saturday, when members of the Awakening Council in the Fadhil neighborhood of Baghdad had a shootout with a combined American and Iraqi force.
The Awakening Councils are largely Sunni, while the security forces are dominated by Shiites. Many Awakening members are angry because promises of jobs in the Shiite-dominated government have not been kept.
In Dhuluiya, in eastern Salahuddin Province, deep in the Tigris River Valley, Mullah Nadhim al-Jubori, a onetime insurgent linked to Islamic extremists who became an Awakening leader, worries that the situation is fraying.
He ticked off seven troubling events over the last month, including the abduction of four of his men. Two were executed and two were released after a ransom was paid.
“The ransom was picked up in Baghdad,” he said. “That tells me there is good coordination and organization among Al Qaeda members.”
A few of his followers have changed sides. During the last four months, 12 Awakening members were arrested as double agents, accused of killing Awakening leaders, Mr. Nadhim said.
Farther east, in Diyala Province, the situation is worse. The insurgency has never been fully eradicated there, according to the American and Iraqi military. The province’s geography favors those who know its dry high hills, empty patches of desert and thick groves of date palms.
While the province is far more secure than in 2006 and 2007, when the provincial capital, Baquba, was known locally as “the city of death,” attacks are now increasing. Forty-three people were killed in Diyala in March, up from 29 in February and 6 in January, according to the Diyala Operations Command.
Ali Al-Tamimi, the chief of the Provincial Council’s security committee, predicted an increase in violence both in Baghdad and in Baquba because the security commanders had not acted on warnings about the growing activities of armed groups within an hour of Baghdad.
“We have told them that Al Qaeda is still present in some neighborhoods and villages,” he said. “They have not done enough to stop them.”
Suadad al-Salhy and Mohamed Hussein contributed reporting from Baghdad, and an Iraqi employee of The New York Times from Diyala Province.
BAGHDAD — As the American military prepares to withdraw from Iraqi cities, Iraqi and American security officials say that jihadi and Baath militants are rejoining the fight in areas that are largely quiet now, regrouping as a smaller but still lethal insurgency.
There is much debate as to whether any new insurgency, at a time of relative calm in most of Iraq, could ever produce the same levels of violence as existed at the height of the fighting here. A recent series of attacks, however, like bubbles that indicate fish beneath still water, suggest the potential danger, all the more perilous now because the American troops who helped to pacify Iraq are leaving.
Several well-planned bombings, one on a street recently reopened because it was thought to be safe, have killed 123 people, most of them in and around Baghdad. Three were suicide bombings, signatures of Al Qaeda in Mesopotamia, a homegrown Sunni extremist group with some foreign leadership.
Assassination attempts on members of the Awakening movement, some of them former insurgents who switched sides for pay, are rising, as are fears that some of the members are joining Islamic extremists or other insurgent groups. On Saturday an important Awakening leader was arrested on charges, among others, of being a member of the military wing of the outlawed Baath Party, formerly led by Saddam Hussein.
Detainees, some innocent, but many of them former insurgents long held in American military custody, are being set free every day, potentially increasing the insurgency’s numbers. The American-Iraqi security agreement requires the release of all detainees in American custody unless there is sufficient evidence to bring charges in an Iraqi court.
At least one former detainee has already blown himself up in a suicide attack.
Most of the latest attacks, at a time when overall violence is at its lowest level since the beginning of the war in 2003, have singled out Iraqis, but one development affects the Americans. A new weapon has appeared in Iraq: Russian-made RKG-3 grenades, which weigh just five pounds and, attached to parachutes, can be lobbed by a teenager but can penetrate the American military’s latest heavily armored vehicle, the MRAP. The grenades cost as little as $10, according to American military officials, who would not say how often they have killed soldiers.
To some experts, this amounts to ugly, but unavoidable, background noise, the deadly but no longer destabilizing face of violence in Iraq. In this view, there will be attacks, but no longer ones likely to topple Iraq’s government. Military officers, who spoke on the condition of anonymity because they were not authorized to talk to the news media, say they have reduced the number of jihadi militants to under 2,000, from about 3,800.
“In most places there isn’t an insurgency in Iraq anymore,” said an American military intelligence officer in Washington, who was not authorized to be quoted by name. “What we have now is a terrorism problem, and there is going to be a terrorism problem in Iraq for a long time.”
Other officials, Iraqi and American, are more worried. They observe jihadi and other insurgent groups activating networks of sleeper cells, which are already striking government and civilian targets. Insurgent groups linked to the rule of Mr. Hussein are also reviving.
Among the most powerful now is Nashqabandi, which is believed to have ties to a former Hussein deputy, Izzat Ibrahim al-Douri. The organization, which gets money from Iraqi exiles in Syria, formed an alliance with religious Sunni extremists, according to American and Iraqi military intelligence.
“Al Qaeda and the hard-core Saddamists are the main threats to the national security of Iraq,” said Mowaffak al-Rubaie, Iraq’s national security adviser.
“Nashqabandi is the cradle; they are providing logistical support for Al Qaeda,” he said. “What we are seeing is the resurgence of the hard-core Saddamists, but using Al Qaeda in Iraq as a front and as suicide bombers.”
American military officials believe they have checked the insurgency, but liken it to a spring. “It can come up quickly as soon as it is released, but the longer you keep it down the less it rebounds,” said Col. James Phelps, an insurgency expert attached to the multinational force in Iraq. “Some Al Qaeda in Iraq leadership did go to ground,” he said.
In interviews with 14 leaders of the Awakening movement, which has been credited with helping to reduce violence, all said they believed that the jihadi presence in their areas had increased, as American troops began to close combat outposts or hand them over to the Iraqi Army, a first step toward withdrawing entirely. The Awakening leaders reported signs of trouble: assassination attempts, homemade bombs placed near their homes or under their cars, leaflets urging them not to work with the Iraqi government.
“We notice when there is a bomb buried on a back road where there has not been one before,” said Sheik Awad al-Harbousi, whose Awakening group works in Taji, north of Baghdad, much of it empty country traversed by rugged dirt roads. One of his fighters was killed three weeks ago and two were wounded.
Undermining the stability of the last few months is rising friction between the Awakening Councils and the Iraqi Army and the police, much of it with a sectarian edge. The tensions turned violent in Baghdad on Saturday, when members of the Awakening Council in the Fadhil neighborhood of Baghdad had a shootout with a combined American and Iraqi force.
The Awakening Councils are largely Sunni, while the security forces are dominated by Shiites. Many Awakening members are angry because promises of jobs in the Shiite-dominated government have not been kept.
In Dhuluiya, in eastern Salahuddin Province, deep in the Tigris River Valley, Mullah Nadhim al-Jubori, a onetime insurgent linked to Islamic extremists who became an Awakening leader, worries that the situation is fraying.
He ticked off seven troubling events over the last month, including the abduction of four of his men. Two were executed and two were released after a ransom was paid.
“The ransom was picked up in Baghdad,” he said. “That tells me there is good coordination and organization among Al Qaeda members.”
A few of his followers have changed sides. During the last four months, 12 Awakening members were arrested as double agents, accused of killing Awakening leaders, Mr. Nadhim said.
Farther east, in Diyala Province, the situation is worse. The insurgency has never been fully eradicated there, according to the American and Iraqi military. The province’s geography favors those who know its dry high hills, empty patches of desert and thick groves of date palms.
While the province is far more secure than in 2006 and 2007, when the provincial capital, Baquba, was known locally as “the city of death,” attacks are now increasing. Forty-three people were killed in Diyala in March, up from 29 in February and 6 in January, according to the Diyala Operations Command.
Ali Al-Tamimi, the chief of the Provincial Council’s security committee, predicted an increase in violence both in Baghdad and in Baquba because the security commanders had not acted on warnings about the growing activities of armed groups within an hour of Baghdad.
“We have told them that Al Qaeda is still present in some neighborhoods and villages,” he said. “They have not done enough to stop them.”
Suadad al-Salhy and Mohamed Hussein contributed reporting from Baghdad, and an Iraqi employee of The New York Times from Diyala Province.
Tuesday, March 31, 2009
Supreme Court Upholds Tobacco Award
Supreme Court Upholds Tobacco Award
Robert Barnes
Washington Post Staff Writer
March 31, 2009
The Supreme Court today dealt a blow to Philip Morris, saying it would not decide the cigarette maker's challenge of a punitive damages award brought by the widow of a longtime smoker that now is worth nearly $150 million.
The court's decision, announced in a one-sentence order, was a surprising and anticlimactic ending to a case that has bounded back and forth through the judicial system for nearly a decade. When an Oregon jury awarded Mayola Williams nearly $80 million following the death of her husband, Jesse, it was the largest award of its kind.
Even though the justices have strongly implied that the award was too large and twice sent the case back west, the Oregon Supreme Court found reasons to leave it as it was. After the Oregon justices declined to change the decision for a second time, attorneys for Philip Morris petitioned the high court to "vindicate" its authority.
Instead, the court today said it should not have accepted the case for a third time, and in the language of the court, dismissed the case as "improvidently granted."
Because the case was argued in early December and the court issued its decision only today, it suggests the justices had trouble coming together on how to solve the legal issues raised.
When it last considered the case, the court ruled 5 to 4 that the Oregon court had applied the wrong constitutional standard in reviewing the award. It strongly suggested the figure was too high and told the state court to make sure the jury had not awarded such heavy punitive damages -- which are aimed at discouraging companies from reprehensible behavior -- because of harm the cigarette maker might have done to others, rather than to Williams.
Instead, the Oregon justices rejected Philip Morris's challenge on the grounds of state law, saying the company's proposed jury instructions nearly 10 years prior had been insufficient. The Oregon court said it did not need to get to the question of the court's constitutional standards in order to uphold the award.
At oral arguments, Philip Morris lawyer Stephen M. Shapiro told the justices that the case had returned "because the Oregon court failed to follow this court's directions."
But the justices said that maybe the Oregon court had a point, after all.
Justice Stephen G. Breyer, who wrote the court's 2007 decision in the case, said he thought at first that Oregon was giving the court the "runaround." But after studying the case more closely, he said, "I'm not sure that I think that now."
Chief Justice John G. Roberts Jr. had suggested during the arguments that the court use the case to finally decide the question of whether there should be a cap on punitive damages.
The justices had declined to accept that issue when they took Philip Morris's petition, and doing so would likely have required additional briefing and more arguments.
It would have greatly raised the stakes of the case, and settled a question that big business and trial lawyers have battled over for years. The issue of whether large punitive damages awards are unconstitutional is one that has split the court in a way different from its ideological divide.
Because of interest that the company must pay, it is unclear exactly what the award is currently worth, but it was set at $143 million last June. Under Oregon law, it is to be split between the state and Mayola Williams.
Murray Garnick, a senior vice president at Altria, which owns Philip Morris, said while the company "had hoped for a different outcome," the court's decision today does not end a dispute over whether damages must be paid to Oregon. Philip Morris is seeking a ruling from an Oregon court to keep the state from collecting punitive damages in this case.
Robert Barnes
Washington Post Staff Writer
March 31, 2009
The Supreme Court today dealt a blow to Philip Morris, saying it would not decide the cigarette maker's challenge of a punitive damages award brought by the widow of a longtime smoker that now is worth nearly $150 million.
The court's decision, announced in a one-sentence order, was a surprising and anticlimactic ending to a case that has bounded back and forth through the judicial system for nearly a decade. When an Oregon jury awarded Mayola Williams nearly $80 million following the death of her husband, Jesse, it was the largest award of its kind.
Even though the justices have strongly implied that the award was too large and twice sent the case back west, the Oregon Supreme Court found reasons to leave it as it was. After the Oregon justices declined to change the decision for a second time, attorneys for Philip Morris petitioned the high court to "vindicate" its authority.
Instead, the court today said it should not have accepted the case for a third time, and in the language of the court, dismissed the case as "improvidently granted."
Because the case was argued in early December and the court issued its decision only today, it suggests the justices had trouble coming together on how to solve the legal issues raised.
When it last considered the case, the court ruled 5 to 4 that the Oregon court had applied the wrong constitutional standard in reviewing the award. It strongly suggested the figure was too high and told the state court to make sure the jury had not awarded such heavy punitive damages -- which are aimed at discouraging companies from reprehensible behavior -- because of harm the cigarette maker might have done to others, rather than to Williams.
Instead, the Oregon justices rejected Philip Morris's challenge on the grounds of state law, saying the company's proposed jury instructions nearly 10 years prior had been insufficient. The Oregon court said it did not need to get to the question of the court's constitutional standards in order to uphold the award.
At oral arguments, Philip Morris lawyer Stephen M. Shapiro told the justices that the case had returned "because the Oregon court failed to follow this court's directions."
But the justices said that maybe the Oregon court had a point, after all.
Justice Stephen G. Breyer, who wrote the court's 2007 decision in the case, said he thought at first that Oregon was giving the court the "runaround." But after studying the case more closely, he said, "I'm not sure that I think that now."
Chief Justice John G. Roberts Jr. had suggested during the arguments that the court use the case to finally decide the question of whether there should be a cap on punitive damages.
The justices had declined to accept that issue when they took Philip Morris's petition, and doing so would likely have required additional briefing and more arguments.
It would have greatly raised the stakes of the case, and settled a question that big business and trial lawyers have battled over for years. The issue of whether large punitive damages awards are unconstitutional is one that has split the court in a way different from its ideological divide.
Because of interest that the company must pay, it is unclear exactly what the award is currently worth, but it was set at $143 million last June. Under Oregon law, it is to be split between the state and Mayola Williams.
Murray Garnick, a senior vice president at Altria, which owns Philip Morris, said while the company "had hoped for a different outcome," the court's decision today does not end a dispute over whether damages must be paid to Oregon. Philip Morris is seeking a ruling from an Oregon court to keep the state from collecting punitive damages in this case.
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