Monday, November 16, 2009

BLOOD SUCKERS part #2 Questions About Cholesterol Drug’s Benefit

Study Raises Questions About Cholesterol Drug’s Benefit NYTimes NATASHA SINGER

ORLANDO, Fla. — For patients taking a statin to control high cholesterol, adding an old standby drug, niacin, was superior in reducing buildup in the carotid artery to adding Zetia, a newer drug that reduces bad cholesterol, according to a new study.

The results of the study, published in The New England Journal of Medicine, were presented here Sunday night at an annual meeting of the American Heart Association.

The study has been a polarizing topic here and has also attracted the attention of a powerful senator who has been investigating the conduct of two drug makers, Merck and Schering-Plough, in relation to their sales and marketing of Zetia and a combination cholesterol drug, Vytorin, which includes Zetia. The drug makers merged this month.

The small study, with only 208 patients, has attracted outsize attention because the researchers did a head-to-head comparison of niacin and Zetia, which has been heavily marketed.

The Food and Drug Administration approved Zetia in 2002 to lower bad cholesterol, a risk factor for heart disease. But the drug has not yet proved to have a longer-term clinical benefit in reducing heart attacks and deaths. Merck, the maker of the drug, is conducting a clinical trial on that issue involving up to 18,000 patients. Statins like Lipitor have proved in studies to significantly lower the risk of heart attack.

Some cardiologists here hailed the study as an indication that the popularity of Zetia and Vytorin, which had combined sales last year of about $4.6 billion, has far outstripped their evidence of a concrete benefit on heart health. Other doctors here dismissed the study because it did not directly measure the drugs’ effects on reducing heart attacks.

Nevertheless, this study has the potential to make big waves in the use of cholesterol drugs.

“It will certainly strengthen the idea that, after you give a statin, the weight of the evidence is that, as a second agent, you should give niacin,” said Dr. Roger S. Blumenthal, a professor of medicine at the Johns Hopkins University Medical School. “That is the implication of the study.”

But Dr. Peter S. Kim, the president of Merck Research Laboratories, said Sunday in an interview that the study was limited because it did not compare the groups of patients taking a statin and a second drug to a placebo group. Furthermore, he said, a drug’s ability to improve artery-wall thickness has not been proved to automatically correlate with a reduction in heart attacks.

Zetia, he said, lowers bad cholesterol and lowering bad cholesterol is a known good.

The study results “should be compared to the overwhelming body of evidence that lowering LDL cholesterol is an important thing to do to improve cardiovascular health,” Dr. Kim said.

The study randomly assigned patients who were taking a statin and who had heart disease or a risk of heart disease to additionally take either Zetia or Niaspan.

Statins are a class of drug which lowers LDL, known as bad cholesterol because it can cause arterial thickening and lead to heart problems. The drugs work by inhibiting the production of cholesterol in the liver.

Zetia, which inhibits the absorption of cholesterol in the intestines, lowers bad cholesterol.

Niaspan is a prescription extended-release form of niacin, not the over-the-counter vitamin. Niacin increases HDL, known as “good cholesterol.” Niaspan is made by Abbott Laboratories, which financed the study.

Over the course of the 14-month study, the bad cholesterol of the patients on Zetia decreased by 19.2 percent, but the patients’ arterial wall thickness stayed the same, the study said. In the niacin group, good cholesterol increased by 18.4 percent and the carotid wall thickness decreased.

By itself, the study does not have major significance, said Dr. James H. Stein, a professor at the University of Wisconsin medical school. But taken in the context of more than 30 years of research on and use of niacin, he said, the study adds to the weight of evidence that it can a great benefit to patients with heart disease, he said. “Compare that to Zetia where there is not a shred of evidence that it does anything good for blood vessels or heart disease,” Dr. Stein said.

On Friday, Senator Charles E. Grassley, Republican of Iowa, wrote to the Department of Health and Human Services, asking its director, Kathleen Sebelius, what action she intended to take in light of the study results. Mr. Grassley sits on the Senate Finance Committee which has jurisdiction over Medicare and its drug spending. In 2006 and 2007, the drug makers made more than $300 million through Medicare Part D in sales of Vytorin, a drug that combines Zetia and a statin, Mr. Grassley wrote.

In response to a query from a reporter, a Merck spokesman said the small trial did not change the company’s belief in the demonstrated ability of Zetia and Vytorin to reduce bad cholesterol.

DRUG Makers are BLOOD SUCKERS!

Drug Makers Raise Prices in Face of Health Care Reform


Even as drug makers promise to support Washington’s health care overhaul by shaving $8 billion a year off the nation’s drug costs after the legislation takes effect, the industry has been raising its prices at the fastest rate in years.

In the last year, the industry has raised the wholesale prices of brand-name prescription drugs by about 9 percent, according to industry analysts. That will add more than $10 billion to the nation’s drug bill, which is on track to exceed $300 billion this year. By at least one analysis, it is the highest annual rate of inflation for drug prices since 1992.

The drug trend is distinctly at odds with the direction of the Consumer Price Index, which has fallen by 1.3 percent in the last year.

Drug makers say they have valid business reasons for the price increases. Critics say the industry is trying to establish a higher price base before Congress passes legislation that tries to curb drug spending in coming years.

“When we have major legislation anticipated, we see a run-up in price increases,” says Stephen W. Schondelmeyer, a professor of pharmaceutical economics at the University of Minnesota. He has analyzed drug pricing for AARP, the advocacy group for seniors that supports the House health care legislation that the drug industry opposes.

A Harvard health economist, Joseph P. Newhouse, said he found a similar pattern of unusual price increases after Congress added drug benefits to Medicare a few years ago, giving tens of millions of older Americans federally subsidized drug insurance. Just as the program was taking effect in 2006, the drug industry raised prices by the widest margin in a half-dozen years.

“They try to maximize their profits,” Mr. Newhouse said.

But drug companies say they are having to raise prices to maintain the profits necessary to invest in research and development of new drugs as the patents on many of their most popular drugs are set to expire over the next few years.

“Price adjustments for our products have no connection to health care reform,” said Ron Rogers, a spokesman for Merck, which raised its prices about 8.9 percent in the last year, according to a stock analyst’s report.

This year’s increases mean the average annual cost for a brand-name prescription drug that is taken daily would be more than $2,000 — $200 higher than last year, Professor Schondelmeyer said.

And this means that the cost of many popular drugs has risen even faster. Merck, for example, now sells daily 10-milligram pills of Singulair, the blockbuster asthma drug, at a wholesale price of $1,330 a year — $147 more than last year. Singulair is now selling at retail, on drugstore.com, for nearly $1,478 a year.

The drug companies “can charge what they want — it’s not fair,” Eric White, the 42-year-old owner of a small jewelry store in Queens, said as he left a pharmacy recently.

Despite having drug insurance, Mr. White says he now pays $110 a month out of pocket for two brand-name allergy medicines, even as he has cut prices in his jewelry store by at least 40 percent to keep customers coming through the door.

He shook his head. “What can I do?” he said. “I need my medicines.”

The drug industry has actively opposed some of the cost-cutting provisions in the House legislation, which passed Nov. 7 and aims to cut drug spending by about $14 billion a year over a decade.

But the drug makers have been proudly citing the agreement they reached with the White House and the Senate Finance Committee chairman to trim $8 billion a year — $80 billion over 10 years — from the nation’s drug bill by giving rebates to older Americans and the government. That provision is likely to be part of the legislation that will reach the Senate floor in coming weeks.

But this year’s price increases would effectively cancel out the savings from at least the first year of the Senate Finance agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal.

“It makes it much easier for the drug companies to pony up the $80 billion because they’ll be making more money,” said Steven D. Findlay, senior health care analyst with the advocacy group Consumers Union.

Name-brand prices have risen even as prices of widely used generic drugs have fallen by about 9 percent in the last year, Professor Schondelmeyer said. But name brands account for 78 percent of total prescription drug spending in this country. And as long as a name-brand drug still has patent protection it faces no price competition from generics.

Ken Johnson, senior vice president of the industry association — the Pharmaceutical Research and Manufacturers of America — criticized the analysis Professor Schondelmeyer had conducted for AARP, saying it was politically motivated.

“In AARP’s skewed view of the world, medicines are always looked at as a cost and never seen as a savings — even though medicines often reduce unnecessary hospitalization, help avoid costly medical procedures and increase productivity through better prevention and management of chronic diseases,” he said.

But Professor Schondelmeyer’s analysis — which found prices for the name-brand drugs most widely used by the Medicare population rising by 9.3 percent in the last year, the fastest rate since 1992 — is in line with the findings of a leading Wall Street analyst, too. The report was released on Monday.

Catherine J. Arnold, a drug industry analyst at Credit Suisse, said her latest study of the nation’s eight biggest pharmaceutical companies showed markedly similar results: list prices rising an average of 8.7 percent in the 12 months ending Sept. 30 — the highest rate of growth since at least 2004.

As does Professor Schondelmeyer, Ms. Arnold based her price calculations on reported wholesale prices and a formula that puts more emphasis on each company’s best-selling drugs.

Ms. Arnold said the prospect of cost containment under health care reform, as well as the tougher business environment, entered into the decisions of manufacturers to raise prices this year.

The industry stands to gain about 30 million customers with drug insurance from the legislation pending in Congress. But the industry also faces the prospect of tougher negotiations from both public and private buyers as the government tries to squeeze savings out of the health system.

“If you’re going to take price increases,” Ms. Arnold said, “here and now might be the place to do that, because the next year and the year after that might be tough.”

Mr. Johnson did not dispute the Credit Suisse study or deny Ms. Arnold’s finding that American drug makers have raised prices at the fastest rate in five years.

He said both studies were incomplete by failing to include rebates that drug makers give distributors. But Ms. Arnold, Professor Schondelmeyer and a 2007 Congressional study of Medicare said the rebates often accrue to the middlemen, not consumers, and higher manufacturer prices lead to higher retail prices.

And the drug industry’s own major consulting firm, IMS Health, has also reported a significant run-up in prices. Back in April, IMS predicted that United States drug sales might actually decline this year.

Billy Tauzin, president of the industry’s trade association, highlighted the gloomy prediction in a June 1 letter to President Obama shortly before striking the deal to cut drug costs by $80 billion. In negotiating the deal, the drug makers argued that they could not afford to give up more than that.

But in October, IMS made an unusual change in the middle of its forecasting cycle, saying it now believed United States sales would grow at least 4.5 percent in 2009 — or $21 billion more than expected six months earlier.

A major reason, IMS said, was higher-than-expected price increases for drugs in the United States.

For Some Smokers, Even Home Is Off Limits

NYTimes C. J. HUGHES

The movement to ban smoking in New York City has grown so quickly that no place seems immune — certainly not restaurants or bars, and public beaches and parks may not be far behind. Now the efforts are rapidly expanding into the living room.

More landlords are moving to prohibit smoking in their apartment buildings, telling prospective tenants they can be evicted if they light up in them.

This month, the Related Companies will ban smoking at some of its downtown apartment buildings because of health concerns about secondhand smoke, according to company officials.

Smokers who already live in any of these buildings will not be affected, according to Jeff Brodsky, a president of Related, which is a national developer with 17 buildings in Manhattan.

But any new renters must promise not to smoke at home, even if they continue to elsewhere.

Kenbar Management, a local developer, is going a step further. When its new project, 1510 Lexington Avenue, opens in December, smoking will be banned in all 298 units, in addition to private and shared terraces.

And the typical smoker’s refuge — directly outside the building — is also off limits; tenants must agree not to smoke on any of the sidewalks that wrap around the building, which takes up most of a block in East Harlem, according to Kinne Yon, a Kenbar principal.

The trend has predictably divided smokers and nonsmokers in New York.

“I think it’s absolutely absurd,” said Bryan Marx, 53, a cabinetmaker who has lived at Tribeca Park, a Related building on Chambers Street, since 1999. He smokes hand-rolled cigarettes in his apartment, but said that he cut back on a cigar habit a few years ago to appease a neighbor.

“How about a little tolerance?” Mr. Marx added. “Smokers have become the whipping boys for everything that’s unhealthy about living in New York City.”

Across the country, the movement to ban smoking in residential buildings is gaining traction. The Department of Housing and Urban Development has strongly encouraged public housing agencies to ban smoking in some or all of their units.

So far, about 50 public housing agencies have now forbidden smoking, according to Betsy Feigin Befus, a lawyer with the National Multi Housing Council, a landlord trade group that has tracked the efforts.

Other cities, through legislation or by initiatives of developers, have taken similar steps. In California, for example, all apartments and condos in Richmond, near San Francisco, must outlaw cigarette smoking, according to an ordinance passed in July. Across the bay in Belmont, a ban on smoking in apartments took effect in January after a 14-month grace period, with $100 fines possible for offenders.

While there is no question about the dangers of secondhand smoke, there is debate about whether the amount of smoke that may be transmitted from one apartment to another is harmful. A recent study by New York City’s health department found that about 57 percent of nonsmokers had been exposed to substantial levels of cigarette smoke, raising suspicions among experts that apartment dwellers might be susceptible to secondhand smoke from their neighbors.

New York City has been at the forefront of efforts to ban smoking in bars and restaurants, and the city’s health commissioner, Dr. Thomas A. Farley, said in September that he supported a ban on smoking at city beaches and parks. But the city, he said, has no plan to push for a smoking ban in public housing developments.

The city did help Related research the health effects of smoke in apartment buildings, Dr. Farley said, adding, “Our focus would be on individuals having their homes smoke-free.”

Pan Am Equities, a real estate management company, may have been one of the first in New York to introduce a smoking ban to an apartment building. About 18 months ago, the company asked new renters to promise not to smoke; the ban did not affect existing tenants, according to David Iwanier, a company vice president.

All of Pan Am’s rentals — which include 270 Park Avenue South, 145 West 67th Street and 60 West 23rd Street — are affected, though Mr. Iwanier would not discuss the reasons for the ban.

“It was just something we decided to do,” he said. And in terms of lease renewals, he added, “we’ve not had any negative feedback.”

Mr. Brodsky, of Related, said that existing tenants would be reassured that they would not be evicted or pressured to leave. He would not specify which of the developer’s buildings are in line for the ban, saying only that they are among the six in or near Battery Park City and Chelsea. Those include Tribeca Park; the Caledonia, which abuts the High Line park; and Tribeca Green in Battery Park City, which bills itself as “New York’s most environmental rental.”

“I think it’s a bloody good thing,” said Dale Smith, 41, a Broadway producer who formerly worked in the health care industry. A resident of Tribeca Green for nearly three years, Mr. Smith, who does not smoke, said he had complained to his landlord about secondhand smoke in his apartment.

“A policy that is in place because something has proven to be hazardous in eating establishments should be effective in the home,” he said.

Experts say there is no known law in the United States that prohibits landlords from banning smoking in their buildings, and many trial judges have sided with the nonsmoker. In New York, for example, a 2006 decision found that tenants had the right to break a lease because the landlord failed to safeguard an apartment from secondhand smoke.

Co-ops and condominiums have been somewhat slower to embrace such bans, according to real estate lawyers.

In interviews with several lawyers who represent real estate concerns, only one, Stuart Saft, knew of any buildings that had instituted a smoking ban. He said that of the 100 or so co-op buildings he represents on the Upper East and West Sides of Manhattan, only two have banned smoking outright in the last few years.

A poll commissioned by the NYC Coalition for a Smoke Free City suggested that a residential smoking ban might not hurt rentals or sales. The survey of 1,000 New Yorkers, which was administered by Zogby International in July, found that 58 percent would pay more to live in smoke-free housing; 68 percent might not live in a smoking building in the first place.

Yet some real estate brokers question the wisdom of instituting a smoking ban during a housing downturn, with vacancy rates climbing.

That 950,000 New Yorkers — or 16 percent of the population — call themselves smokers, according to the city’s health department, is not insignificant, said Daniel Baum, chief executive at the Developers Group/The Real Estate Group of New York, a brokerage that focuses on rentals.

“I think in general it’s probably not an ideal time to try to limit potential tenants,” Mr. Baum said. “Every occupied apartment counts.”

And Audrey Silk, the founder of Citizens Lobbying Against Smoker Harassment, a nine-year-old advocacy group, said the trend was troubling from a civil liberties perspective.

“If we’re talking about annoying odors, where do you draw the line?” she said. “What about cooking odors, from fish or curry?”

Yet some smokers seemed resigned to their fate. Brian Mossotti, 28, a day trader, moved into the Pan Am-run building on 23rd Street 14 months ago, after the developer’s ban had taken effect. After receiving three warnings from management about fumes in the hallway, including a stern letter in September, Mr. Mossotti finally agreed to take his two-a-day cigarette habit to the sidewalk, he said.

“You can’t smoke in bars because of the whole secondhand smoke thing, so it doesn’t surprise me,” he said. “But it is irritating.”

Friday, November 13, 2009

Palin's book goes rogue on some facts

FACT CHECK: Palin's book goes rogue on some facts
By CALVIN WOODWARD Associated Press

Sarah Palin's new book reprises familiar claims from the 2008 presidential campaign that haven't become any truer over time.

Ignoring substantial parts of her record if not the facts, she depicts herself as a frugal traveler on the taxpayer's dime, a reformer without ties to powerful interests and a politician roguishly indifferent to high ambition.

Palin goes adrift, at times, on more contemporary issues, too. She criticizes President Barack Obama for pushing through a bailout package that actually was achieved by his Republican predecessor George W. Bush — a package she seemed to support at the time.

A look at some of her statements in "Going Rogue," obtained by The Associated Press in advance of its release Tuesday:

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PALIN: Says she made frugality a point when traveling on state business as Alaska governor, asking "only" for reasonably priced rooms and not "often" going for the "high-end, robe-and-slippers" hotels.

THE FACTS: Although travel records indicate she usually opted for less-pricey hotels while governor, Palin and daughter Bristol stayed five days and four nights at the $707.29-per-night Essex House luxury hotel (robes and slippers come standard) overlooking New York City's Central Park for a five-hour women's leadership conference in October 2007. With air fare, the cost to Alaska was well over $3,000. Event organizers said Palin asked if she could bring her daughter. The governor billed her state more than $20,000 for her children's travel, including to events where they had not been invited, and in some cases later amended expense reports to specify that they had been on official business.

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PALIN: Boasts that she ran her campaign for governor on small donations, mostly from first-time givers, and turned back large checks from big donors if her campaign perceived a conflict of interest.

THE FACTS: Of the roughly $1.3 million she raised for her primary and general election campaigns for governor, more than half came from people and political action committees giving at least $500, according to an AP analysis of her campaign finance reports. The maximum that individual donors could give was $1,000; $2,000 for a PAC.

Of the rest, about $76,000 came from Republican Party committees.

She accepted $1,000 each from a state senator and his wife in the weeks after the two Republican lawmakers' offices were raided by the FBI as part of an investigation into a powerful Alaska oilfield services company. After AP reported those donations during the presidential campaign, she said she would give a comparative sum to charity after the general election in 2010, a date set by state election laws.

PALIN: Rails against taxpayer-financed bailouts, which she attributes to Obama. She recounts telling daughter Bristol that to succeed in business, "you'll have to be brave enough to fail."

THE FACTS: Palin is blurring the lines between Obama's stimulus plan — a $787 billion package of tax cuts, state aid, social programs and government contracts — and the federal bailout that Republican presidential candidate John McCain voted for and President George W. Bush signed.

Palin's views on bailouts appeared to evolve as McCain's vice presidential running mate. In September 2008, she said "taxpayers cannot be looked to as the bailout, as the solution, to the problems on Wall Street." A week later, she said "ultimately what the bailout does is help those who are concerned about the health care reform that is needed to help shore up our economy."

During the vice presidential debate in October, Palin praised McCain for being "instrumental in bringing folks together" to pass the $700 billion bailout. After that, she said "it is a time of crisis and government did have to step in."

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PALIN: Says Ronald Reagan faced an even worse recession than the one that appears to be ending now, and "showed us how to get out of one. If you want real job growth, cut capital gains taxes and slay the death tax once and for all."

THE FACTS: The estate tax, which some call the death tax, was not repealed under Reagan and capital gains taxes are lower now than when Reagan was president.

Economists overwhelmingly say the current recession is far worse. The recession Reagan faced lasted for 16 months; this one is in its 23rd month. The recession of the early 1980s did not have a financial meltdown. Unemployment peaked at 10.8 percent, worse than the October 2009 high of 10.2 percent, but the jobless rate is still expected to climb.

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PALIN: She says her team overseeing the development of a natural gas pipeline set up an open, competitive bidding process that allowed any company to compete for the right to build a 1,715-mile pipeline to bring natural gas from Alaska to the Lower 48.

THE FACTS: Palin characterized the pipeline deal the same way before an AP investigation found her team crafted terms that favored only a few independent pipeline companies and ultimately benefited a company with ties to her administration, TransCanada Corp. Despite promises and legal guidance not to talk directly with potential bidders during the process, Palin had meetings or phone calls with nearly every major candidate, including TransCanada.

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PALIN: Criticizes an aide to her predecessor, Gov. Frank Murkowski, for a conflict of interest because the aide represented the state in negotiations over a gas pipeline and then left to work as a handsomely paid lobbyist for ExxonMobil. Palin asserts her administration ended all such arrangements, shoving a wedge in the revolving door between special interests and the state capital.

THE FACTS: Palin ignores her own "revolving door" issue in office; the leader of her own pipeline team was a former lobbyist for a subsidiary of TransCanada, the company that ended up winning the rights to build the pipeline.

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PALIN: Writes about a city councilman in Wasilla, Alaska, who owned a garbage truck company and tried to push through an ordinance requiring residents of new subdivisions to pay for trash removal instead of taking it to the dump for free — this to illustrate conflicts of interest she stood against as a public servant.

THE FACTS: As Wasilla mayor, Palin pressed for a special zoning exception so she could sell her family's $327,000 house, then did not keep a promise to remove a potential fire hazard on the property.

She asked the city council to loosen rules for snow machine races when she and her husband owned a snow machine store, and cast a tie-breaking vote to exempt taxes on aircraft when her father-in-law owned one. But she stepped away from the table in 1997 when the council considered a grant for the Iron Dog snow machine race in which her husband competes.

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PALIN: Says Obama has admitted that the climate change policy he seeks will cause people's electricity bills to "skyrocket."

THE FACTS: She correctly quotes a comment attributed to Obama in January 2008, when he told San Francisco Chronicle editors that under his cap-and-trade climate proposal, "electricity rates would necessarily skyrocket" as utilities are forced to retrofit coal burning power plants to reduce carbon dioxide emissions.

Obama has argued since then that climate legislation can blunt the cost to consumers. Democratic legislation now before Congress calls for a variety of measures aimed at mitigating consumer costs. Several studies predict average household costs probably would be $100 to $145 a year.

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PALIN: Welcomes last year's Supreme Court decision deciding punitive damages for victims of the nation's largest oil spill tragedy, the Exxon Valdez disaster, stating it had taken 20 years to achieve victory. As governor, she says, she'd had the state argue in favor of the victims, and she says the court's ruling went "in favor of the people." Finally, she writes, Alaskans could recover some of their losses.

THE FACTS: That response is at odds with her reaction at the time to the ruling, which resolved the long-running case by reducing punitive damages for victims to $500 million from $2.5 billion. Environmentalists and plaintiffs' lawyers decried the ruling as a slap at the victims and Palin herself said she was "extremely disappointed." She said the justices had gutted a jury decision favoring higher damage awards, the Anchorage Daily News reported. "It's tragic that so many Alaska fishermen and their families have had their lives put on hold waiting for this decision," she said, noting many had died "while waiting for justice."

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PALIN: Describing her resistance to federal stimulus money, Palin describes Alaska as a practical, libertarian haven of independent Americans who don't want "help" from government busybodies.

THE FACTS: Alaska is also one of the states most dependent on federal subsidies, receiving much more assistance from Washington than it pays in federal taxes. A study for the nonpartisan Tax Foundation found that in 2005, the state received $1.84 for every dollar it sent to Washington.

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PALIN: Says she tried to talk about national security and energy independence in her interview with Vogue magazine but the interviewer wanted her to pivot from hydropower to high fashion.

THE FACTS are somewhat in dispute. Vogue contributing editor Rebecca Johnson said Palin did not go on about hydropower. "She just kept talking about drilling for oil."

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PALIN: "Was it ambition? I didn't think so. Ambition drives; purpose beckons." Throughout the book, Palin cites altruistic reasons for running for office, and for leaving early as Alaska governor.

THE FACTS: Few politicians own up to wanting high office for the power and prestige of it, and in this respect, Palin fits the conventional mold. But "Going Rogue" has all the characteristics of a pre-campaign manifesto, the requisite autobiography of the future candidate.

Wednesday, November 11, 2009

GOP blizzard of untrue statements

Health scare tactics
A GOP blizzard of untrue statements By Ruth Marcus

I'm hoping, for your sake, that you didn't spend your Saturday night as I did: watching the House debate health-care reform on C-SPAN.

Pathetic, I know. The outcome wasn't in doubt, and the arguments were as familiar as an old pair of slippers. Moral imperative! Government takeover! Long-overdue protections! Crippling mandates!

I'm not a huge fan of the House measure, but I was glad to see it straggle across the finish line, if only to keep the process going. And, by the end of the long debate, I was cheering for it even more because of the appalling amount of misinformation being peddled by its opponents.

I don't mean the usual hyperbole about "a children-bankrupting, health-care-rationing, freedom-crushing, $1 trillion government takeover of our health-care system," as Texas Republican Jeb Hensarling put it. Or the tired canards about taxpayer-funded abortion or insurance subsidies for illegal immigrants.

Or the extraneous claims about alleged Democratic excesses, as in this from Georgia Republican Jack Kingston: "Let's remember the Pelosi plan for jobs: an $800 billion stimulus plan that caused unemployment to go from 8.5 percent to over 10 percent."

Caused? We can debate whether the stimulus was effective, although the best evidence is that it prevented things from being even worse. No rational person believes the stimulus "caused" unemployment to rise.

I mean the flood of sheer factual misstatements about the health-care bill.

The falsehood-peddling began at the top, with Minority Leader John Boehner:

"If you're a Medicare Advantage enrollee . . . the Congressional Budget Office says that 80 percent of them are going to lose their Medicare Advantage."

Not true. The CBO hasn't said anything of the sort. Boehner's office acknowledges that he misspoke: He meant to cite a study from the Medicare actuary estimating that projected enrollment would be down by 64 percent -- if the cuts took effect. Choosing not to enroll in Medicare Advantage is different from "losing" it.

But Boehner wasn't alone.

Kentucky Republican Brett Guthrie: "The bill raises taxes for just about everyone."

Not true. The bill imposes a surtax on the top 0.3 percent of households, individuals making more than $500,000 a year and couples making more than $1 million.

Georgia Republican Tom Price: "This bill, on Page 733, empowers the Washington bureaucracy to deny lifesaving patient care if it costs too much."

Not true. The bill sets up a Center for Comparative Effectiveness Research "in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically."

Are Republicans against figuring out what works? There's nothing in there about cost, and certainly nothing about denying "lifesaving patient care."

Price, again: "This bill, on Page 94, will make it illegal for any American to obtain health care not approved by Washington."

Not true. The vast majority of Americans get their insurance through their employers. The bill envisions setting minimum federal standards for such insurance, in part to determine who is eligible to buy coverage through the newly created insurance exchanges. This is hardly tantamount to making it "illegal" to obtain "health care" without Washington's approval.

Michigan Republican Dave Camp: "Americans could face five years in jail if they don't comply with the bill's demands to buy approved health insurance."

Not true. The bill requires people to obtain insurance or, with some hardship exceptions, pay a fine. No one is being jailed for being uninsured. People who intentionally evade paying the fine could, in theory, be prosecuted -- just like others who cheat on their taxes.

California Republican Buck McKeon: "I offered two amendments to try to improve this bill -- one to require members of Congress to enroll in the public option like we're going to require all of you to do."

Not true. No one is required to enroll in the public option. In fact, most people won't even be eligible to enroll in the public option or other plans available through the exchanges.

Florida Republican Ginny Brown-Waite: "The president's own economic advisers have said that this bill will kill 5.5 million jobs."

Not true. Christina Romer, chair of the Council of Economic Advisers, has estimated that the bill would increase economic growth and add jobs. Republicans misuse Romer's previous economic research on the impact of tax increases to produce the phony 5.5 million number.

You have to wonder: Are the Republican arguments against the bill so weak that they have to resort to these misrepresentations and distortions?

Sunday, November 08, 2009

NICHOLAS D. KRISTOF Chemicals in Our Food, and Bodies

source: NYTimes

Your body is probably home to a chemical called bisphenol A, or BPA. It’s a synthetic estrogen that United States factories now use in everything from plastics to epoxies — to the tune of six pounds per American per year. That’s a lot of estrogen.

More than 92 percent of Americans have BPA in their urine, and scientists have linked it — though not conclusively — to everything from breast cancer to obesity, from attention deficit disorder to genital abnormalities in boys and girls alike.

Now it turns out it’s in our food.

Consumer Reports magazine tested an array of brand-name canned foods for a report in its December issue and found BPA in almost all of them. The magazine says that relatively high levels turned up, for example, in Progresso vegetable soup, Campbell’s condensed chicken noodle soup, and Del Monte Blue Lake cut green beans.

The magazine also says it found BPA in the canned liquid version of Similac Advance infant formula (but not in the powdered version) and in canned Nestlé Juicy Juice (but not in the juice boxes). The BPA in the food probably came from an interior coating used in many cans.

Should we be alarmed?

The chemical industry doesn’t think so. Steven Hentges of the American Chemistry Council dismissed the testing, noting that Americans absorb quantities of BPA at levels that government regulators have found to be safe. Mr. Hentges also pointed to a new study indicating that BPA exposure did not cause abnormalities in the reproductive health of rats.

But more than 200 other studies have shown links between low doses of BPA and adverse health effects, according to the Breast Cancer Fund, which is trying to ban the chemical from food and beverage containers.

“The vast majority of independent scientists — those not working for industry — are concerned about early-life low-dose exposures to BPA,” said Janet Gray, a Vassar College professor who is science adviser to the Breast Cancer Fund.

Published journal articles have found that BPA given to pregnant rats or mice can cause malformed genitals in their offspring, as well as reduced sperm count among males. For example, a European journal found that male mice exposed to BPA were less likely to make females pregnant, and the Journal of Occupational Health found that male rats administered BPA had less sperm production and lower testicular weight.

This year, the journal Environmental Health Perspectives found that pregnant mice exposed to BPA had babies with abnormalities in the cervix, uterus and vagina. Reproductive Toxicology found that even low-level exposure to BPA led to the mouse equivalent of early puberty for females. And an array of animal studies link prenatal BPA exposure to breast cancer and prostate cancer.

While most of the studies are on animals, the Journal of the American Medical Association reported last year that humans with higher levels of BPA in their blood have “an increased prevalence of cardiovascular disease, diabetes and liver-enzyme abnormalities.” Another published study found that women with higher levels of BPA in their blood had more miscarriages.

Scholars have noted some increasing reports of boys born with malformed genitals, girls who begin puberty at age 6 or 8 or even earlier, breast cancer in women and men alike, and declining sperm counts among men. The Endocrine Society, an association of endocrinologists, warned this year that these kinds of abnormalities may be a consequence of the rise of endocrine-disrupting chemicals, and it specifically called on regulators to re-evaluate BPA.

Last year, Canada became the first country to conclude that BPA can be hazardous to humans, and Massachusetts issued a public health advisory in August warning against any exposure to BPA by pregnant or breast-feeding women or by children under the age of 2.

The Food and Drug Administration, which in the past has relied largely on industry studies — and has generally been asleep at the wheel — is studying the issue again. Bills are also pending in Congress to ban BPA from food and beverage containers.

“When you have 92 percent of the American population exposed to a chemical, this is not one where you want to be wrong,” said Dr. Ted Schettler of the Science and Environmental Health Network. “Are we going to quibble over individual rodent studies, or are we going to act?”

While the evidence isn’t conclusive, it justifies precautions. In my family, we’re cutting down on the use of those plastic containers that contain BPA to store or microwave food, and I’m drinking water out of a metal bottle now. In my reporting around the world, I’ve come to terms with the threats from warlords, bandits and tarantulas. But endocrine disrupting chemicals — they give me the willies.

I invite you to comment on this column on my blog, On the Ground. Please also join me on Facebook, watch my YouTube videos and follow me on Twitter.

Monday, November 02, 2009

Tuesday, October 27, 2009

Pelosi claim CIA lied validated

Pelosi claim CIA lied validated by House Intelligence Committee
By Jared Allen - TheHill 10/27/09

Democrats on the Intelligence Committee have concluded that the CIA did not fully inform Congress about the use of enhanced interrogation techniques during a September 2002 briefing.

The new report seemingly validates House Speaker Nancy Pelosi’s (D-Calif.) claim earlier this year that she was lied to about the program.

Reps. Jan Schakowsky and Anna Eshoo – the chairwomen of a pair of subcommittees investigating the legitimacy of briefings given to Congress by intelligence officials – have identified at least five instances going back to at least 2001 in which the C.I.A. withheld information from or lied to Congress, the two Democrats said on Tuesday.

At least one the C.I.A.’s obfuscations was already known. A 2008 C.I.A. Inspector Generals report determined that the agency withheld information from Congress relating to the shooting down of a plane carrying missionaries over Peru in 2001.

But Schakowsky said their ongoing investigation found that the practice of incomplete briefings or outright lying was part of a “large disease” of misinforming even the chairmen of the select intelligence committees.

On June 24 of this year current C.I.A. Director Leon Panetta first alerted the House Intelligence Committee about a top-secret program to assassinate top al Qaeda operatives, and it was long suspected that the agency had been ordered by Vice President Cheney to keep Congress in the dark.

Schakowsky and Eshoo identified “Director Panetta’s June 24 notification” as one of the five instances linked to a complete communication breakdown between the intelligence community and Congress.

In addition, the C.I.A. withheld information or lied about the 2005 destruction of videotapes recording the interrogation of al Qaeda operatives by intelligence officials, and the agency had also done so during a September 2002 briefing of the so-called “Gang of Eight” in Congress on the enhanced interrogation of terrorism suspects, Schakowsky and Eshoo said.

Sunday, October 25, 2009

Money Talks to Have Before Marriage

NewYorkTIMES By RON LIEBER

Divorce tends to be emotionally gut-wrenching for the people who go through it (not to mention those around them). But most couples don’t realize that divorce can also be among the most ruinous financial moves anyone can make.

Sure, you could bet big and lose on a single stock or money manager. Or your small business could go bankrupt, taking your life savings with it. But divorce and the costs that often come with it — from legal bills to the sudden need for an additional residence — affect far more people.

The risk that any marriage will end in divorce is about 45 percent, according to David Popenoe, a professor of sociology emeritus at Rutgers University. The chances fall to about 40 percent for first marriages and decline further for college-educated couples, people from intact families and couples who share the same religion.

Given the various financial complications, I’ve long wanted to devote a series of columns to divorce and money. This week, I’ll start with a topic that could save some marriages if more people made it a priority. It’s crucial to air and resolve financial disagreements beforehand.

“It’s almost impossible to be hooked up to somebody who has the same balance of spender and saver as you, or expansiveness versus conservativeness or financial circumstances,” says Gregory A. Kuhlman, a New York City psychologist who runs marriage success training programs with his wife, Patricia Schell Kuhlman.

He adds that the mix gets even more volatile with second marriages, when couples may have children, ingrained financial habits and savings or other assets that necessitate the discussion of a prenuptial agreement. “Success in marriage is only partly attributable to compatibility. It’s about how you manage those differences and whether you have a style for doing so that is successful.”

What follows is a list of four financial issues that ought to be near the top of the discussion list before getting married. Please add to the list in the comments of the online version of this article.

ANCESTRY When Lisa J. B. Peterson started her Boston-based financial planning firm, Lantern Financial, she knew she wanted to focus her practice on young professionals. She quickly realized that many of them could use premarital financial counseling and built a program called Harmoney around their needs.

One of the first things she asks clients about is what she refers to as their financial ancestry. “It’s looking back at your own personal past,” she says. “How did your parents deal with money, how does that impact how you deal with it, and how might that impact the couple’s relationship?”

Because so many of our money behaviors are learned, she asks couples to share their earliest money memories — whether their father hid money from their mother or how either parent fretted over the funds available. This can be a particularly intense discussion for people whose parents were divorced, and the stories are sometimes accompanied by tears. “Money is so emotional, and people forget that,” Ms. Peterson says. “You think that it’s just numbers.”

CREDIT While it’s about the least romantic subject imaginable, your credit history holds a chunk of your permanent financial record. It follows naturally from the ancestry conversation, and Lantern Financial pulls credit reports and scores for its clients.

Molly Milinazzo and Scott Donovan, an engaged couple who live in the Dorchester section of Boston and are both 24 years old, were relieved to discover that their scores were within about 15 points of one another when they went through the Harmoney program in May. “A lot of people end up surprised, and it’s best to keep those kinds of surprises at bay,” Ms. Milinazzo says.

Full disclosure on the credit front is useful for two reasons. First, a credit report is, in part, a catalog of past mistakes and overall habits — loan payments you missed or department store credit cards you didn’t really need. That in itself is a good starting point for a discussion about what you’ve learned (or still need to learn) about handling money.

There’s an immediate practical side to this, too. If there are errors or low credit scores that a couple can improve, there may still be time to make the fixes so that the couple can get the best rates on a loan for their first home a year or two later.

CONTROL Figuring out who will pay the bills each month may not seem to be an important conversation or assignment. But it gets tricky when both people want to take it on. “People understand that in a relationship, money is control,” says Jeff Kostis, a financial planner in Vernon Hills, Ill., who walks engaged couples and newlyweds through a checklist of questions. “If you’re not paying the bills, you don’t know where the money is going, and you feel like ‘He doesn’t want me to go out with my friends’ or ‘She doesn’t want me to play in the fantasy football pool.’ ”

For two people who have both been on their own for a while and don’t want to give up doing the monthly financial chores their own way, Mr. Kostis suggests, at a minimum, regular household meetings complete with Quicken or other spreadsheets so that the person writing the checks can keep the other one up to speed. With more stubborn couples, he might suggest handing the controls back and forth at the beginning of each year.

Mr. Kuhlman, who explains the counseling approach he and his wife take with clients at stayhitched.com, says it shouldn’t be surprising that control issues come up constantly when talking about money. “It’s concrete, you can see it,” he says. “It’s not ephemeral or less measurable, like affection.”

A few things that he suggests couples discuss early on: If one person is making most or all of the money, does that person get to make most or all of the financial decisions? If you’re the car aficionado or have researched all of the local school options for the children, do you get to make the decisions about those things? “These are the kinds of things that don’t come out when you’re dating,” he says.

AFFLUENCE Here’s another question that tends not to come up during courtship: Just how rich do we want to be one day? Mr. Kuhlman refers to this more politely as the “desired level of affluence.” “Are our career paths going to be something that pulls us together? Or, more often, are they things that will tend to pull us apart, where we’ll really have to be proactive to make sure it’s under control?” he says.

Mr. Kostis might put it a bit more bluntly, say to a spouse of an aspiring investment banker or corporate lawyer: Are you O.K. with acting essentially as a single parent, with your partner working 80 hours a week until the age of 80? “Not that there is a right or wrong answer,” he says. “It’s just about understanding, going into the marriage, what that would really mean.”

He adds that people in the financial advice business often joke that they spend half their time talking about money and the other half acting as marriage counselor. “But it’s the same communication style,” he says. “You’re giving people permission to be honest without having someone jump down their throat for giving the answer that they really want to give.”

What did your divorce cost you? Write to rlieber@nytimes.com.

Saturday, October 24, 2009

Media Matters: Fox News isn't news

Media Matters: Fox News isn't news -- this is news?

It is perhaps not unsurprising but still disappointing that several in the mainstream media rallied around Fox News this week following the White House's well-warranted castigation of the network as an "arm" of the Republican Party. The most prominent defense of "one of our sister organizations" came from ABC News' Jake Tapper, who was baffled as to why the White House would declare Fox News "not a news organization." On Tuesday, he had the following exchange with White House Press Secretary Robert Gibbs:

Tapper: It's escaped none of our notice that the White House has decided in the last few weeks to declare one of our sister organizations "not a news organization" and to tell the rest of us not to treat them like a news organization. Can you explain why it's appropriate for the White House to decide that a news organization is not one --

(Crosstalk)

Gibbs: Jake, we render, we render an opinion based on some of their coverage and the fairness that, the fairness of that coverage.

Tapper: But that's a pretty sweeping declaration that they are "not a news organization." How are they any different from, say --

Gibbs: ABC --

Tapper: ABC. MSNBC. Univision. I mean how are they any different?

Gibbs: You and I should watch sometime around 9 o'clock tonight. Or 5 o'clock this afternoon.

Tapper: I'm not talking about their opinion programming or issues you have with certain reports. I'm talking about saying thousands of individuals who work for a media organization, do not work for a "news organization" -- why is that appropriate for the White House to say?

Gibbs: That's our opinion.

Of course, Tapper was lauded by Fox News and other conservatives. (Which is not the first time.) Glenn Beck called Tapper a "watchdog of freedom," while Sean Hannity praised Tapper's ability to "recognize the great quality of Fox News." Bill O'Reilly said Tapper did "pretty good" and "really challenged" Gibbs, and the Fox & Friends gang called him a "great reporter" for his defense of Fox. Lou Dobbs called it an "extraordinary exchange."

But Tapper's real mistake was suggesting that the White House's criticism of Fox News amounted only to criticism of their "opinion programming or issues ... with certain reports." Tapper's remarks echoed Fox News senior vice president Michael Clemente's comments from last week: "It's astounding the White House cannot distinguish between news and opinion programming."

Putting aside the suggestion that the relentless and vicious assaults on Barack Obama and the administration by Beck, Hannity, and O'Reilly alone shouldn't have any bearing on how the White House treats the network, Tapper is ignoring that those shows set the agenda for the rest of the network. And of course, Tapper is ignoring that the attacks of Fox's triumvirate dictate his own network's -- and the rest of the media's -- agenda as well. Is there any doubt that Glenn Beck's war on ACORN -- he's reportedly mentioned ACORN 1,224 times (versus 50 mentions of Al Qaeda) since his Fox News show started -- is the primary reason his network and other media are still talking about the organization? Beck and his fellow Fox News personalities have repeatedly called for Obama administration officials to be fired, asked viewers to dig up information on administration officials, and fearmongered about Obama, his advisers, and his policies. How can that not affect Fox's "news" coverage of those same officials?

Fox's "news" staff regularly conflates commentary and news reporting. The network's "news" reporting is full of smears, falsehoods, deceptive editing, and GOP talking points. Just Thursday morning, the Fox & Friends crew parroted a House Republican press release and repeated its claim that the stimulus impact is "6 million jobs shy of what the administration promised us" since the administration stated "that 3.5 million jobs would be created. And, in fact, the United States has lost 2.7 million since the stimulus plan." However, the administration estimated 3.5 millions jobs created or saved by 2011. It's so much easier to read GOP talking points than actually do journalism!

The problems with Fox News aren't confined to "certain reports." Nor are they confined to Fox's "opinion programming."

Fox has organized and promoted campaigns against the administration. Fox has allowed its personalities to use the network to raise money for conservative PACs -- money that is used for more attacks on the administration.

And Fox News' actual "news" is anything but.

As Media Matters President Eric Burns pointed out this week, "Fox News is the story."

Beck's little red book of smears
On the walls of the Forbidden City, looming over Beijing's Tiananmen Square, there is a giant portrait of Mao Zedong. Mao's specter similarly looms over Glenn Beck's show.

Beck has figured out that Chairman Mao is the best vehicle for him to attack progressives as "communists." After all, communism is still kicking in China -- well, not really, but just enough for Beck to launch McCarthyism 2.0: Great Wall Edition.

And as was the case with Joseph McCarthy's crusade, no connection is too tenuous, no comment too innocuous. Beck's favorite target du jour is White House communications director Anita Dunn -- no doubt because she was the first to call out Fox News for its "war against Barack Obama and the White House."

Beck managed to dig up a speech Dunn gave to graduating students earlier this year in which Dunn called Mao one of her "favorite political philosophers" (she also mentioned Mother Teresa) and related this anecdote:

In 1947, when Mao Zedong was being challenged within his own party on his plan to basically take China over, Chiang Kai-shek and the Nationalist Chinese held the cities, they had the army, they had the air force, they had everything on their side. And people said, "How can you win? How can you do this? How can you do this against all of the odds against you?" And Mao Zedong said, you know, "You fight your war, and I'll fight mine." And think about that for a second.

And to think that she was allowed to encourage students to follow their own paths and not do what they are told! Wait a minute, isn't that pretty much the message Beck preaches every day?

Well, no matter. It doesn't matter what she said -- it's that she quoted Chairman Mao! Gasp! You know, like John McCain did -- repeatedly. And Newt Gingrich did. And numerous other conservatives did.

Dunn's reference to Mao even made its way to a straight news story on Monday's Special Report (take note, Jake Tapper).

On Monday, Beck ranted that, because of the overlap in the message of volunteerism from President Obama's "Corporation for National and Community Service and a call for more service and volunteerism" on network television from the Entertainment Industry Foundation, "[i]t's almost like we're living in Mao's China right now" and noted that NBC executive Mitch Metcalf is an "EIF board member," exclaiming, "[M]y God, it can't be." But, predictably, Beck's wild conspiracy theory overlooks that Fox Broadcasting Co. -- which airs Fox News programming and, like Fox News, is owned by News Corp. -- is also participating in EIF's volunteer initiative and has a vice president who sit on EIF's board of directors with Metcalf. Further, News Corp. chairman and CEO Rupert Murdoch sits on EIF's "honorary board of governors."

On Tuesday, Beck moved on to attacking "manufacturing czar" Ron Bloom because he once employed Mao's quote that power stems from the barrel of a gun -- a quote so threatening it can be found on a junior-high boy's Rage Against the Machine T-shirt.

Beck has taken Dunn's and Bloom's employment of these quotes to ridiculous levels, claiming Mao is "the man that [Dunn] turns to most" and that Bloom is the latest in "long line of White House officials who seem to just love Chairman Mao."

(Sean Hannity and Lou Dobbs followed Beck's lead again, attacking both Dunn and Bloom over the quotes.)

And of course, it should be noted that Beck's (Chinese) communist witch hunt goes all the way to the top.

In one of his countless bizarre rants in front of a chalkboard last week, Beck started with the premise, "If the president of the United States, Barack Obama, said to you, 'You know who I really love? Chairman Mao.' " With a premise that absurd, you can only guess where it headed. He then proceeded to explain how people like Van Jones, Valerie Jarrett, and John Podesta were somehow used to "keep separating" Obama from Mao so people wouldn't see the direct connection between the two (the "six degrees of Obama"). You know, because President Obama loves Chairman Mao.

This from a guy who wrote that McCarthy made the "cries" of communism and socialism a "joke."

Other notable quotes this week:
"The Obama administration going to issue a new medical marijuana policy today, which I'm frankly thankful for folks, because we're going to need to be stoned to live for the next three and a half years." -- Rush Limbaugh on Monday. Limbaugh cleverly dubbed the proposal "Don't Ask, Don't Smell."
"[W]hy doesn't President Obama have his children vaccinated in front of us on TV?" -- Deirdre Imus on Wednesday's Hannity expressing concerns about the safety of the H1N1 vaccine.
"Jerome Corsi, a terrific author, an amazing, amazing book, an important book." -- Lou Dobbs on his radio show Wednesday following an interview with birther and widely discredited smear merchant Corsi.
"What was interesting to me is, just from my perspective having been in a White House, there is a network, MSNBC, that I could have said that about the evening anchors, or some people in the morning or -- I could have taken that tack, but I thought it was not the right thing to do, and I think it's mostly because it's really unproductive, it feels un-American, and it's not inspiring." -- former White House press secretary and Fox News contributor Dana Perino, ignoring her own role in advancing Bush administration attacks on NBC.