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Analysis, background reports and updates from the PBS NewsHour putting today's news in context.

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    Helicopters, speedboats and security forces surrounded a rural village in China Sunday that reportedly hosted a massive drug laboratory, seizing about three tons of methamphetamine and arresting 14 Communist Party officials.

    The village of Boshe consist of 14,000 people and rest north of the South China sea, according to local media.

    A senior anti-narcotic officer told state media that the village has supplied a third of the meth trade in China. But he did not specify exactly how much that was.

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    By 2060, nearly one in three U.S. residents will be Hispanic. That population is expected to more than double from the current 53 million to nearly 129 million. And as a group, Hispanics are projected to make up more than a fifth of the 65+ U.S. population by 2060.

    The non-Hispanic white population will peak in a decade at almost 200 million. But unlike other groups, it's projected to slowly decrease through 2060.

    And over the past decade or so, the number of nursing home beds has shrunk and the residents are becoming more Hispanic, black and Asian -- and less white, as the affluent elderly have opted for assisted living and other more desirable forms of care, according to Zhanlian Feng, assistant professor of community health in the Warren Alpert Medical School of Brown University.

    Yet Feng's research shows that Hispanics and other minorities who need nursing home care are much more likely to live in substandard facilities that are rife with staff issues, endemic with poor care and have a higher likelihood of closing. They're also more likely to live in urban areas not served by assisted living facilities.

    "[Nursing homes] are really the last resort," Feng said in a release. "Most elders would rather stay in their homes, or some place like home, but not a nursing home unless they have to."

    So as the Hispanic population doubles and they become a larger part of the elderly population, the ability to provide them with quality long-term care could become one of the nation's biggest challenges. We explore this more on Friday's NewsHour.

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    South Sudan rebels to meet with government negotiators

    Direct peace talks between the South Sudan government and South Sudanese rebels will take place on Sunday, according to Ethiopia's Foreign Ministry spokesperson, Dina Mufti.

    The negotiations are being held in Ethiopia and have experienced several delays.

    Freezing weather to hit Midwest

    Parts of the Midwest could experience some of the coldest temperatures in decades due to a 'polar vortex' expected to hit the region on Sunday.

    The low temperatures are expected to break records and continue through early next week.

    Iraq fighting continues

    The Iraqi army battled al Qaeda fighters in Ramadi on Saturday after shelling the western city of Fallujah overnight.

    At least eight people were killed and 30 were wounded in Fallujah, Reuters reports.

    The troops are attempting to regain control of Anbar province, which has been held by al Qaeda linked militants since Monday.

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    HONOLULU -- President Barack Obama returns to Washington this weekend eager to test whether a modest budget deal passed in the waning days of 2013 can spark bipartisan momentum on Capitol Hill. As he opens his sixth year in office, he also faces legacy-defining decisions on the future of government surveillance programs and the American-led war in Afghanistan.

    Looming over it all will be the November congressional elections, Obama's last chance to stock Capitol Hill with more Democratic lawmakers who could help him expand his presidential playing field.

    For Republicans, those contests are an opportunity to seize control of the Senate, which would render Obama a lame duck for his final two years in the White House.

    The wild card in 2014, for the White House and congressional Democrats facing re-election, will be the fate of the president's health care law. The website woes that tainted its launch have largely been resolved and enrollment has picked up. But the White House has been tight-lipped about who has enrolled, raising uncertainty about whether the insurance exchanges are on track to get the percentage of young and healthy people who are critical to keeping prices down.

    The health care questions aside, Obama spokesman Josh Earnest said the White House enters the new year buoyed by the "modest amount of legislative momentum" generated by the December budget deal.

    "We're hopeful Congress can build on it and make progress on other priorities where common ground exists," Earnest said.

    It won't take long to test that proposition, with debates on unemployment insurance, budget spending and the government's borrowing limit expected in quick succession in the opening weeks of the year.

    If all three can be resolved in drama-free fashion -- by Washington standards, of course -- the White House believes it could create a more favorable atmosphere for Obama to pursue second-term priorities such as an immigration overhaul and a higher minimum wage, though both would still face steep odds.

    The president is scheduled to arrive in Washington on Sunday morning after an overnight flight from his home state of Hawaii. He's spent two quiet weeks on the island of Oahu golfing and spending time with his family and childhood friends.

    Upon his return, Obama will step back quickly into the debate over expired unemployment benefits for 1.3 million Americans. Senate Majority Leader Harry Reid, D-Nev., has scheduled a vote Monday night on a bill that would reinstate the benefits for three months.

    Obama will try to make his case the following day, holding a White House event with some of those whose benefits expired at the end of December.

    "For decades, Republicans and Democrats put partisanship and ideology aside to offer some security for job-seekers, even when the unemployment rate was lower than it is today," Obama said in his weekly radio and Internet address. "Instead of punishing families who can least afford it, Republicans should make it their New Year's resolution to do the right thing and restore this vital economic security for their constituents right now."

    The issue with the greatest potential to upset the tepid truce forged in December's budget deal is the debt ceiling. As part of the agreement that ended the 16-day partial government shutdown in October, Congress suspended the $16 trillion-plus debt limit. Treasury Secretary Jacob Lew says bookkeeping maneuvers he can use to keep under that ceiling will last only until late February or early March.

    Obama once again has pledged that he won't negotiate on the matter. House Republicans will plot their strategy at a caucus retreat later this month.

    Aside from fiscal matters, the president also must make decisions on what changes he wants in the government's vast surveillance powers. He's expected to announce those changes before his Jan. 28 State of the Union address, though an exact date has not been set.

    A presidential commission presented Obama with more than 40 recommendations and the president signaled at a year-end news conference that he was open to many of the proposals. But he's facing pushback from his intelligence advisers, who argue that the widespread collection of telephone and Internet records is crucial to national security.

    The president also must make a decision on the future of the American force presence in Afghanistan. Afghan President Hamid Karzai is yet to sign a bilateral security agreement with the U.S. that the Obama administration says is crucial if American troops are to stay in the country after the war formally concludes at the end of 2014.

    The White House had hoped to have the agreement signed before Jan. 1, but indicated there was some flexibility on that timing. Officials say that without an agreement soon, the U.S. will be forced to start making plans to bring all of its troops home.

    "We are talking about weeks, not months, left on the clock," said Caitlin Hayden, Obama's National Security Council spokeswoman.

    Aides say January's packed agenda will keep the president in Washington for much of the lead up to his State of the Union address, though some brief domestic travel may occur.

    Associated Press Reporter Julie Pace wrote this report. Follow her on Twitter @jpaceDC.

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    JOSH ARONSON: Vianey Calixto lives in one of the poorest neighborhoods of Los Angeles and like many of her friends she was struggling in school.

    Vianey’s interest in learning music prompted her parents to enroll her in a music program in their neighborhood called the Harmony Project. In the three years since, much has changed in Vianey’s life.

    VIANEY CALIXTO:   Music is like a dialogue because we can play a certain thing  - let’s say the violin can play something back –it could be the same melody different notes and it’s like a conversation talking back and forth.

    JOSH ARONSON: Serving more than 2000 students with a budget of 2.5 million dollars, the mostly privately funded Harmony Project is filling a gap in low-income areas where schools have cut music education programs.  Students get at least 5 hours of music classes and rehearsals each week year round. For poor students it’s tuition free including their instrument.

    Fifty-nine-year-old Margaret Martin started the Harmony Project in 2001 after witnessing something on the streets of her hometown – Los Angeles.

    MARGARET MARTIN:  This party of badass LA gang members comes walking through a farmers’ market and stops to listen to a tiny kid playing Brahms on a tiny violin. They had shaved heads, tats, gang clothing, and attitude. After five or six minutes without saying a word to one another I watched those gang members pull out their own money and lay it gently in the child's case. Those gang members were teaching me that they would rather be doing what the child was doing than what they were doing but they never had the chance. 

    MARGARET MARTIN:  Harmony Project is a researched based replicable program and we commit to our students for their entire childhood.

    JOSH ARONSON: The programs are started purposely in tough inner city areas to serve children of poverty.

    MARGARET MARTIN:  We know that dropout rates are about 50 percent in the neighborhoods where we built Harmony Project Programs.

    More than 80 percent of poor black and Hispanic kids do not read at grade level. 

    JOSH ARONSON: It’s well documented that children whose mothers have little education, are rarely being read to and verbal interaction is minimal. Scientists believe that this not only puts them behind in school but those children rarely catch up because their brains are not be developing as rapidly as the brains of more stimulated kids.

    MARGARET MARTIN:  Early sustained music learning is actually the frame upon which education itself can be built for low-income kids.

    JOSH ARONSON: Margaret Martin was convinced of that because of the graduation rate of kids who have gone through her program. This year, she says, 93 percent of them finished high school in four years and went to college. But Martin acknowledges she does not have the formal training to prove that music helps kids grasp language better and become more proficient readers. So she enlisted the help of this woman. Her name is Dr. Nina Kraus. She is a neurobiologist at NorthwesternUniversity and for 25 years she has studied how the brain processes information – the neurobiology of auditory learning.

    JOSH ARONSON: What is the connection between sound and reading?         

    DR. NINA KRAUS: Well there's a connection with sound and reading in that when you're learning to read you need to connect the sounds of words that you've heard for many years with the symbol on the page. So you're making a sound to meaning connection.

    JOSH ARONSON:   No one has ever proven conclusively that music improves learning, and some studies have found no link at all. But, after being contacted by Martin, the Northwestern scientist designed tests to measure the impact music had on this group of low-income kids.

    Dr. Kraus started in 2011 with a group of 80 students from an LA gang zone. The students came from similar backgrounds and were all motivated to learn music at the Harmony Project. Half the kids were selected to start music study then and the other half, the control group, waited a year to begin. Dr. Kraus’s team took a mobile testing lab to LA at the beginning and then once a year for two years, to assess the change in the kids’ brain response in specific areas important for good reading and learning skills.

    Brain wave science
    More about the study of music and the human brain from The Music Instinct

    JOSH ARONSON:  What are some of the tests like that you actually do on these kids to measure these things?

    DR. NINA KRAUS:  We’re very interested in children's rhythmic skills. And so we ask them to tap along with a steady rhythm.

    So if you just present a beat like on a metronome and you ask a child to tap along with a beat, that ability is linked with reading ability.

    LAB TECHNICIAN: Ready set go.

    DR. NINA KRAUS:  We ask them to listen to words or parts of words…

    LAB TECHNICIAN: Imagine that you are at a party – there will be a woman talking and several other talkers in the background.

    DR. NINA KRAUS:  We ask them to listen sentences that are presented in noisy backgrounds and they have to repeat back as much of the sentence that they were able to hear…

    SPEAKER RECORDING AND THEN KID IN THE LAB REPEATS:  The pencil was cut to be sharp ….

    DR. NINA KRAUS:  And of course the background gets noisier and nosier and it gets harder and harder to hear the sounds.

    CHILD IN LAB:   A toad and a frog each had to tell a tale

    DR. NINA KRAUS:   People who had musical training are better at hearing speech in noise. And it's not that different from what you're asking your nervous system to do when you're listening for a teacher’s voice in a noisy classroom.

    And so we just simply know that if we ask people to repeat back sentences that are presented to them in background noise that if you have musical training, that you are better at repeating back the sentences accurately than if you did not have that musical training.

    JOSH ARONSON: I guess that’s especially true when a child is sitting in an orchestra and has to distinguish the sound he's making, and his section is making, from all the other sounds in the orchestra.

    DR. NINA KRAUS: Exactly.

    JOSH ARONSON: So the red is the group of kids who have had music experience and between year one and year two the perception in noise is a straight line up.

    And the black line represents the Control Group that started music in year two. Their comprehension of meaning in a noisy environment goes up only then, after they started music.

    DR. NINA KRAUS: And the kids who have now had 2 years of musical experience are continuing to make gains.

    Music education is an important investment in teaching a child all kinds of skills.

    JOSH ARONSON: Dr Kraus is still analyzing data. But she says preliminary findings suggest music may enhance the neurological development of kids in the Harmony program who had been behind in school.

    DR. NINA KRAUS:  You can document that kids who have had musical education now have nervous systems that respond more accurately and precisely to meaningful elements in language.

    VIANEY CALIXTO: In science I had very low grades and then once I started learning about music and being able to practice and concentrating, my science grades have gone higher and so have my other grade in other subjects. I would concentrate in my music and it was something to be focused on and not be bothered by anyone. I was using that on my homework and on any type of class work also. Science is now one of my best subjects.

    JOSH ARONSON: And you like it now?

    VIANEY CALIXTO: Yes I love it.

    JOSH ARONSON: What do you say to those who say …well these kids all listen to music? They are listening all the time. Why doesn’t that work?

    MARGARET MARTIN:  Nobody ever got fit watching spectator sports. Doing it transforms your nervous system. It makes you basically a better learner.

    JOSH ARONSON: Who‘s to say that arts education in general whether it’s dance or painting might be as beneficial as music in terms of developing learning skills for these kids?

    DR. NINA KRAUS:    There have been a number of studies. And the language abilities seem to be strengthened by the music instruction more than the art. And so these language-based skills seem to profit from music instruction.

    JOSH ARONSON: The Harmony Project has 17 sites in Los Angeles and one in Ventura. And there are 16 more in three other states.

    CONDUCTOR: Here we go. From the Allegro. Measure 37…

    JOSH ARONSON: What are the goals, where do you want to take this?

    MARGARET MARTIN:  Oh man, my dream is to build Harmony Project programs in inner cities throughout the country because our students are achieving their unique potential. They are blossoming.

     

     


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    HARI SREENIVASAN: This is actually how 41-year-old Bob Troia sometimes sleeps - with this gadget on his head.  So when he wakes up, he can see not only how long he slept … but also information so detailed he knows when - and how long - he was in rem sleep, light sleep, and deep sleep. 

    BOB TROIA: I tend to have a little point around 6am where my dog tends to bark at somebody. Then I’ll fall back asleep.

    HARI SREENIVASAN:  And this is just the start of Troia’s data-filled morning routine.

    Before he even gets out of bed, Troia uses an IPhone app to take his pulse.  He then weighs himself … takes his blood pressure … and his blood glucose level. 

    BOB TROIA: I have an elevated risk for type 2 diabetes.

    HARI SREENIVASAN:  Next: a finger-tapping exercise to test cognitive performance.

    And all throughout the day, a monitor on his chest and a band on his wrist collect data about his heart rate, sweat levels and skin temperature...so he can keep his stress levels in check.        

    BOB TROIA: So I can look down at my phone at any point in the day and see, kind of, how stressed am I.

    HARI SREENIVASAN:   All the data he collects is stored in a computer program, smartphone app or in a spreadsheet.  The point of all this tracking and monitoring?  Troia, the CEO of a marketing firm who lives in Brooklyn, says in addition to keeping diabetes at bay, he just wants to stay healthy.

    BOB TROIA: I think as you get older-- you know, once, I think, really, when I turned 40, for me was-- you start looking ahead.

    HARI SREENIVASAN:    So, I think by this sort of idea for me is doing what I can take to ensure that I have this sort of long, enjoyable life. 

    Troia's tracking and testing may seem extreme, but he's definitely not alone.  He’s part of a growing movement called “quantified self.”  People tracking and quantifying all kinds of personal data, often health-related. 

    Sixty percent of American adults track their weight, diet or exercise routine, and millions are now using technology to do it.  There are thousands of health and fitness smartphone apps and it’s estimated the wearable device industry could soon grow to more than a billion dollars – including these bands and bits that track everything from steps and calories to heart rate and sleep quality. 

    DAVID POGUE: It's about self- improvement, I think. 

    HARI SREENIVASAN: David Pogue is a technology columnist for the New York Times and host of NOVA ScienceNOW.  He says self-quantifiers range from the average person just trying to lose weight…. To the hard-core like Bob Troia. Pogue says these wearable devices can be powerful motivators.

    DAVID POGUE: I just that awareness that you're being watched and your activity level is being monitored leads you to get more activity.  You take more stairs; you get off a subway stop earlier because they reward you with little lights and graphs for doing well.

    HARI SREENIVASAN: Pogue says many devices also let you compare your data with other users.

    DAVID POGUE: So there's-- an almost competitive element to it.  It's fitness through shame.  

    HARI SREENIVASAN: Now what is it about that baseline sort of competition?  Like, it's an almost like an animal instinct.  Why do we respond to that?  

    DAVID POGUE:  I mean everybody behaves differently when they're on stage versus when they're off stage.  You want to be your best self.  You want to put your best foot forward.  And that's what sharing your data with a few other people does for you.

    HARI SREENIVASAN: Is this a grand narcissism of, you know, the internet age, or technology saying, "I'll just give you the tools to measure every nook and cranny of your life."

    DAVID POGUE: It's absolutely narcissism.  Or more healthfully, ego.  It's studying yourself as an interesting topic in ways that you couldn’t study yourself before, I mean, this is just giving you self-awareness into previously invisible aspects of your life.

    HARI SREENIVASAN:  Like something known as heart rate variability.

    DAVID POGUE: So in a stressful situation your pulse may inversely go up but your HRV goes down and over time like a higher HRV is just a general sense of your body being in that better natural state.

    HARI SREENIVASAN:  He knows what he means. Troia estimates he’s spent around $20,000 over the last few years on devices, programs and tests.  And it’s not just about health.  He’s also got a program that quantifies all the different ways he spends time on his computer, and quantifies which parts of the day he’s most productive. 

    HARI SREENIVASAN: So, you know, people are going listen to you and say, "this guy's extreme.  He's quantifying all this stuff.  Do you think you're extreme?

    BOB TROIA: No, not necessarily.  You know, I don't-- I think if you talk to a lot of my friends or family or coworkers-- it's not something that they even really can notice or tell that I'm doing.   

    HARI SREENIVASAN: There's actually a community for dedicated self-quantifiers like Bob Troia, across the U.S. and around the world, who gather often to share experiences and, of course, data.  At this recent gathering in New York City, which had a wait-list to get in, the main event was a show and tell.

    SPEAKER AT CONFERENCE: I ate a lot of butter here so there was a bump up

    HARI SREENIVASAN:  But these self-quantifiers aren’t just sharing information with each other.  Users are uploading massive quantities of personal data to the servers of companies that make these gadgets, programs and smartphone apps. 

    BOB TROIA: It’s a wireless scale so what it’s going to do is transmit my data to a server.

    HARI SREENIVASAN:   Bob Troia says there’s a lot of discussion in the quantified self community right now about who owns the data and what can be done with it.  But at the end of the day, Troia says he’s not too concerned.  After all, the risks are small compared to his goals – everything from preventing diabetes, to optimizing his time.

    BOB TROIA: Personally, like, my goal is to basically be-- an optimal human being in every aspect of my life.


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    HARI SREENIVASAN: And now to Iraq where a remarkable story is playing out in the cities of Ramadi and Fallujah, where American troops fought some of the most intense battles of the war a decade ago. Members of the Al Qaeda affiliated group known as the Islamic State of Iraq and Syria, or ISIS, reportedly have overrun both cities. The Washington Post's Liz Sly has been reporting the story from Beirut, Lebanon and joins us from there via Skype. So Liz, what happened yesterday? What's happening today?

    LIZ SLY: Well yesterday we saw the fighters of this Al Qaeda affiliated group, the Islamic State of Iraq and Syria, basically claim that they were in control of Fallujah. And it does look like there as much in control of that city as anyone else. They've raised their flag over their town and they told the citizens they're in control, and the Iraqi army is outside of town. Today we saw the Iraqi army shelling the town and seemingly some clashes on the outskirts in which they were trying to get back into the town, which as far as I can gather from the conversation I've had with people in Fallujah, they have not been able to re-enter as of now. 

    HARI SREENIVASAN: And so yesterday the Iraqi military and police just withdrew as soon as they saw ISIS was here?

    LIZ SLY: Basically, yes, this was the combination of some violent events over the previous several days in which the Iraqi army and security forces were forced to flee from this two towns, Fallujah and Ramadi. And they've had some successes getting back into Ramadi, but not in Fallujah.

    HARI SREENIVASAN: So how has the situation in Fallujah changed since the U.S. withdrew troops?

    LIZ SLY: Well the U.S. withdrew slowly over a period of time and they were handing power over the Iraqi security forces. But one of the bigger pictures that has gone on in that time, is the government Prime Minister Nouri al-Maliki has really not been particularly inclusive to the Sunni communities in the Sunni areas, and that has caused a lot of resentment to the central government. So what you're seeing is a continuation of the sectarian tensions that were stirred up by the U.S. invasion of Iraq. And a central failure of the central government to include these areas in the politics of the country in a way that might have calmed some of these tensions down. So there's a lot of different and complicated things going on.

    HARI SREENIVASAN: Has the situation in Syria next door made it easier for the Islamic movement of, what was it, the Islamic State of Iraq and Syria to try and establish a foothold in Ramadi and Fallujah?

    LIZ SLY: Well, absolutely because they have taken over provinces or territory in provinces bordering Iraq and that has given them freedom of movement, a place where they can arm and regroup and train people, and that has definitely made it much easier for them to assert themselves again in these Iraqi provinces from which the American troops had thought they had driven them out.

    HARI SREENIVASAN: Are we seeing a splintering of Iraq?

    LIZ SLY: Yes I think we're seeing a splintering of the whole region at the moment. The region is fragmenting along many, many different fault lines that were always there, but in the absence of strong central governments anywhere in the region, 
    extremists are asserting themselves in this area or that. Other groups are asserting themselves here and there. And yeah the whole region is fragmenting.

    HARI SREENIVASAN: And how does that effect the United States?

    LIZ SLY: The US troops put a lot, they put a lot of blood on the lines to defend the state of Iraq, a lot of money was spent. But the Obama administration has publicly declared a wish to not be involved in the Middle East as previous U.S. administrations were. And the results of that is obviously a lot of turmoil and upheaval because America was the biggest power in this region. 

    HARI SREENIVASAN: Liz Sly of the Washington Post joining us via Skype from Beirut. Thanks so much.

    LIZ SLY: Thank you.


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    On this edition, people living in the Midwest brace for dangerously low temperatures and freezing weather. Later, in our signature segment, can music education give inner-city children an academic head start?

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  • 01/05/14--05:00: What we're watching Sunday
  • Good morning. Here are some of the top stories we're watching today:

    Winter cold blast continues

    An Arctic blast moving into Midwest and Northeast with severe, record-breaking sub-zero cold forecast.

    NFL playoff game in Green Bay may be played in near record coldest conditions.

    Violence continues in Iraq

    Sporadic clashes continue in Fallujah, Ramadi. The military says it will take two to three days to dislodge al-Qaeda fighters (ISIL).

    Anbar commander says Sunni tribes are leading opposition against ISIL with army backing.

    The Guardian reports that Iraqi police confirm explosions across the Iraqi capital, including two car bombs that killed 10 and wounded 26 in the Shaab area.

    Secretary of State John Kerry says the US will support the Iraqi government, but will not send troops.

    Secretary of State's Mideast trip

    Secretary of State Kerry continues Mideast trip, meeting with leaders of Jordan, Saudi Arabia.

    Palestinians say Kerry is asking Palestinian President Abbas to recognize Israel as Jewish homeland.

    Election violence in Bangladesh

    Opposition activists burn more than 100 polling stations in boycott of today's national election; at least 13 killed.

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    JERUSALEM -- U.S. Secretary of State John Kerry said Sunday that the United States will support Iraq's fight against al-Qaida-linked militants who have overrun two cities, but won't send in American troops.

    BRENDAN SMIALOWSKI/AFP/Getty Images File photo. Credit: Brendan Smialowski/AFP/Getty Images

    Kerry said the militants are trying to destabilize the region and undermine a democratic process in Iraq, and that the U.S. is in contact with tribal leaders in Anbar province who are standing up to the terrorists.

    But, he said, "this is a fight that belongs to the Iraqis. That is exactly what the president and the world decided some time ago when we left Iraq, so we are not obviously contemplating returning. We are not contemplating putting boots on the ground. This is their fight. ... We will help them in their fight, but this fight, in the end, they will have to win and I am confident they can."

    Al-Qaida linked gunmen have largely taken over the cities of Fallujah and Ramadi in an uprising that has been a blow to the Shiite-led government of Iraqi Prime Minister Nouri al-Maliki. Bombings in the Iraqi capital, Baghdad, killed at least 20 people Sunday.

    Anbar, a vast desert area on the borders with Syria and Jordan, was the heartland of the Sunni insurgency that rose up against American troops and the Iraqi government after the 2003 U.S.-led invasion that toppled Saddam Hussein.

    In 2004, insurgents in Fallujah killed four American security contractors, hanging their burned bodies from a bridge. Ramadi and other cities have remained battlegrounds as sectarian bloodshed has mounted, with Shiite militias killing Sunnis.

    "We are very, very concerned about the efforts of al-Qaida and the Islamic State of Iraq in the Levant, which is affiliated with al-Qaida, who are trying to assert their authority not just in Iraq, but in Syria," Kerry said.

    "These are the most dangerous players in that region. Their barbarism against the civilians in Ramadi and Fallujah and against Iraqi security forces is on display for everyone in the world to see."

    Kerry made the comments as he left Jerusalem for talks with leaders in Jordan and Saudi Arabia about his Mideast peace-making efforts after three days of lengthy meetings with Palestinian President Mahmoud Abbas and Israeli Prime Minister Benjamin Netanyahu.

    Kerry said some progress was made in what he described as "very serious, very intensive conversations," but key hurdles are yet to be overcome.

    His talks with Jordan's King Abdullah II and Foreign Minister Nasser Judeh covered the peace process, Syria and Iraq.

    After his short stay in Amman, Kerry flew to Riyadh, Saudi Arabia, and then took a 30-minute helicopter ride to King Abdullah's desert palace.

    The Saudi leader developed an initiative in 2002 in which the Arab world offered comprehensive peace with Israel in exchange for a full pullout from all territories it captured in the 1967 Mideast war.

    The initiative, revolutionary when it was introduced, has been endorsed by the Arab League and, technically, remains in effect.

    "Saudi Arabia's initiative holds out the prospect that if the parties could arrive at a peaceful resolution, you could instantaneously have peace between the 22 Arab nations and 35 Muslim nations, all of whom have said they will recognize Israel if peace is achieved," Kerry said.

    "Imagine how that changes the dynamics of travel, of business, of education, of opportunity in this region, of stability. Imagine what peace could mean for trade and tourism, what it could mean for developing technology and talent, for job opportunities for the younger generation, for generations in all of these countries," Kerry said.

    Kerry, who arrived in the region Thursday, is trying to nudge Abbas and Netanyahu closer to a peace pact that would establish a Palestinian state alongside Israel.

    The talks have entered an intense phase aimed at getting the two sides to agree on a framework and provide guidance toward a final settlement. Reaching a deal on that framework is not expected on this trip, Kerry's 10th to the region for peace talks.

    On another issue roiling the Middle East, Kerry did not dismiss the idea that Iran could play a constructive role in finding a resolution to the civil war in Syria, even if Tehran is not a full participant in a conference on Syria this month in Switzerland.

    The U.S. has objected to Iran's participation because it hasn't publicly endorsed the principles from an earlier peace conference that called for a transitional government in Syria, and is backing militias, including the Iranian-allied Lebanese Hezbollah group that has aided the troops of Syrian President Bashar Assad.

    "If Iran doesn't support that, it's difficult to see how they are going to be a ministerial partner in the process," Kerry said.

    "Now could they contribute from the sidelines? Are there ways for them, conceivably, to weigh in? ... It may be that there are ways that that could happen," Kerry said.

    This report was written by Associated Press reporter Deb Riechmann.

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    WASHINGTON -- Congress returns to work Monday with election-year politics certain to shape an already limited agenda.

    Photo by Andrew Harrer/Bloomberg via Getty Images Photo credit: Andrew Harrer/Bloomberg via Getty Images

    Republicans intend to focus on every facet of President Barack Obama's health care law. They see a political boost in its problem-plagued rollout as the GOP looks to maintain its House majority and seize control of the Democratic-led Senate.

    First up in the House, according to Majority Leader Eric Cantor, R-Va., is legislation addressing the security of personal data, part of his party's effort "to protect the American people from the harmful effects of Obamacare."

    Republicans also promise closer scrutiny of the administration's tally of enrollment numbers in the program.

    Democrats will press to raise the federal minimum wage from $7.25 an hour and extend unemployment benefits, trying to cast the party as more concerned with the less fortunate and intent on dealing with income inequality. The issues resonate with liberals, the core Democratic voters crucial in low-turnout midterm elections.

    Rep. Steny Hoyer of Maryland, the No. 2 Democrat in the House, said an extension of federal benefits for an estimated 1.3 million Americans who saw their payments stopped on Dec. 28 is more than an economic issue.

    "It's about real people, people with families struggling to put food on the table, to make ends meet, including ... 200,000 military veterans who are among these folks who are losing their benefits," he told reporters Friday.

    Senate Majority Leader Harry Reid, D-Nev., has scheduled a vote Monday night on legislation by Sens. Jack Reed, D-R.I., and Dean Heller, R-Nev., to extend jobless benefits for three months.

    However, Sen. Chuck Schumer, D-N.Y., said he is unsure Democrats can cobble together 60 votes needed to overcome a procedural hurdle.

    "If we don't get the 60, we will come back at this issue," he promised.

    President Barack Obama already has scheduled a White House event on Tuesday with some whose benefits expired at the end of December.

    "Instead of punishing families who can least afford it, Republicans should make it their New Year's resolution to do the right thing and restore this vital economic security for their constituents right now," Obama said Saturday in his weekly radio and Internet address.

    Republicans hinted they might go along with extending benefits if they win spending cuts from Reid elsewhere to pay for them.

    "If the senator comes up with any kind of a reasonable idea to offset the $26 billion, I think that he might find some people that are willing to talk to him," said Rep. Matt Salmon, R-Ariz.

    Schumer, one of his party's leaders, said Democrats would prefer to pass the proposal as is -- without a way to pay for it, as has been the case for previous extensions. But he told reporters Sunday he would listen to GOP suggestions.

    During a separate interview, Reid predicted widespread inaction would be the norm "unless the Republicans in Congress decide they should do something for the American people, I'm sorry to say."

    Such rancor ruled in the first session of the 113th Congress with few bills passed and sent to the president. The combination of divided government and the upcoming elections stand as an obstacle to major legislation in the second session, counting down to November when all 435 House seats and 35 Senate seats will be on the ballot.

    Still, Congress must deal with some significant unfinished business before delving deep into political votes and extended breaks for campaigning.

    The Senate was to vote Monday on Obama's nomination of Janet Yellen to become the head of the Federal Reserve. If confirmed, Yellen would become the first woman to fill the powerful post, replacing Ben Bernanke.

    Lawmakers face a Jan. 15 deadline to agree on a spending bill to keep the government running and avoid a partial shutdown that roiled Congress last fall. Passage of legislation in December scaling back the automatic, across-the-board cuts gave the House and Senate Appropriations Committees time to draft a massive, trillion-dollar-plus measure to run the government through September.

    A short-term measure is likely this month just to let the government continue operating.

    The GOP-controlled House and Democratic-led Senate spent a chunk of last year wrangling over renewing the nation's farm bill after passing competing versions of the five-year, roughly $500 billion measure. In dispute are crop subsidies and how deeply to cut the $80 billion-a-year food stamp program, with the House slashing $4 billion and the Senate $400 million annually.

    Several contentious issues loom in the near term.

    Twenty-six senators have signed on to a new Iran sanctions bill that Obama opposes while his administration negotiates with the Iranian government over its nuclear program. Proponents of the legislation are seeking to gain the support of further senators when Congress reconvenes, with the hope of a full Senate vote this month.

    Although the issue may not be an immediate legislative priority for returning lawmakers, it could become a major point of discussion as advocates and opponents of fresh penalties make their cases.

    Reid spared the administration a vote in December, but this month he may not be able to hold off proponents of tough sanctions.

    The majority leader did promise Sen. Kirsten Gillibrand, D-N.Y., a vote on her legislation to give victims of rape and sexual assault in the military an independent route outside the chain of command for prosecuting attackers. Her solution would take the decision from commanders and give it to seasoned military lawyers.

    The top echelon of the military, the Democratic chairman of the Senate Armed Services Committee and other Senate Democrats and Republicans oppose her plan. Reid backs it, as do several top Senate conservatives such as Ted Cruz, R-Texas, and Paul, but Gillibrand is still short of the 60-vote, filibuster-proof threshold.

    Unclear is whether the House will tackle major legislation to overhaul immigration laws. Advocates remain hopeful. But some House Republicans still resist any legislation, fearing it would lead to a final bill that includes a path to citizenship for the estimated 11 million immigrants living in the country illegally.

    Salmon and Reid spoke to CBS' "Face the Nation."

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    It's 5 p.m. EDT -- where are you getting your news? PBS NewsHour Weekend is streaming live on our UStream channel.

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    HARI SREENIVASAN: With all the talk the past many months about a possible military conflict between Israel and Iran, a new source of conflict might be emerging. The Wall Street Journal reported this week that the Islamic militant group, Hezbollah, is getting more advanced weaponry that could be far more precise in their attacks. Charles Levinson was one of the authors of The Peace and joins us now. So, there has been this arms race under the guys of the Syrian war that has been happening in the neighborhood. Who is getting what kind of weapons?

    CHARLES LEVINSON: Right. So, when Assad starts losing control in Syria in 2012, Iran and Syria want Hezbollah to lend its expertise to the fight. Hezbollah was reluctant because of its own domestic political considerations inside Lebanon. To sweeten the deal, Iran basically offered Hezbollah to upgrade its weapons arsenal from having tens of thousands – about a hundred thousand unguided, dumb bombs and rockets and missiles to having smart, guided missiles that can hit precise targets inside Israel. So, the weapons transfers that we are looking at so far are the SA-17. It is an anti-aircraft, sort of highly mobile, advanced anti-aircraft missile that would really threaten Israel’s dominance in the skies above Lebanon, especially its helicopters. You are talking about the Fato-110, which is very precise within a… I cannot remember the exact… but within a few dozen/few hundred meters let’s say. A surface-to-surface missile that can reach basically all of Israel, and the same thing called the surface-to-ship/anti-ship missile, which can basically take out any Israeli ship patrolling the Mediterranean off the coast of Lebanon.

    HARI SREENIVASAN: So, these are missiles that are now in Lebanon and in Syria where Hezbollah stores them?

    CHARLES LEVINSON: So, Hezbollah operates, obviously, in Lebanon, and also has a presence inside Syria, including warehouses and bases and whatnot. So, the way the transfers usually work is Syria transfers the weapons to Hezbollah inside Syria and then Hezbollah transfers them, you know, when it wants to inside Lebanon. There are conflicting reports about how successful they have been in getting them into Hezbollah’s hands and into Hezbollah’s hands inside Lebanon, but it appears that we have started to see at least some of these advanced weapons inside Hezbollah’s hands inside Lebanon.

    HARI SREENIVASAN: And Israel has been trying to stop these. In the past year they have actually had five air attacks into Syria, but without crossing into Syrian airspace. How do they do that?

    CHARLES LEVINSON: Right. So, once Israel starts getting wind of these transactions going on, starting in early 2013, Israel started launching airstrikes basically every time it was aware of one of these weapons transfers. Israel does not want to get tangled up in the Syrian conflict, so it was important to Israel to try and take out these weapons/ shipments without actually crossing into Syrian airspace, and so they deployed a rather remarkable tactic to do this. So, to take out these weapons in Syria without crossing into Syrian airspace, Israeli pilots have literally used this tactic called “lofting,” where they gun it – they gun their planes towards Syrian airspace and at the last minute they accelerate and go up, and on their heads up displays on their planes they literally have this basket icon that is the target and they have to sort of time the launch of their payloads, and this arch into Syria to hit these targets without ever going into Syrian airspace.

    HARI SREENIVASAN: Alright. Charles Levinson from The Wall Street Journal. Thanks so much.

    CHARLES LEVINSON: It is my pleasure. Thank you. 


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    WILLIAM BRANGHAM: Six years ago, a terrible family tragedy occurred here in rural British Columbia.  But over time, it became much more than that. This tragedy set in motion dramatic changes to the laws governing drinking and driving -- changes that supporters say have already saved dozens of lives. That tragedy involved a four year old girl. Her name was Alexa Middelaer.

    LAUREL MIDDELAER: Well, it was a beautiful May long weekend and my daughter, Alexa, loved this one particular horse and she really wanted to show her grandparents that horse.  I remember saying good bye to her, and then very shortly after that we heard all kinds of sirens. And at that moment I just-- I just knew.  I said, "It-- it's Alexa.  Something happened to Alexa." 

    WILLIAM BRANGHAM: A 56 year-old woman doing nearly twice the speed limit, lost control of her car and smashed into the exact spot where Alexa stood feeding the horse on the side of the road.  The woman - - who was later convicted and sent to prison -- admitted to police she’d had three glasses of wine before getting into her car.

    LAUREL MIDDELAER: When we knew, roadside, that our daughter was dead, I remember my husband just -- in the ambulance -- we both held each other and he said, "This will not break us.  This will define us.  There will be some good in this."

    WILLIAM BRANGHAM: After the accident, Alexa’s parents – Michael and Laurel – launched a campaign to try and change the culture around drinking and driving … and to deter people from doing it….  Their events became a regular feature on local news

    LAUREL MIDDELAER (from local news) We will honor our daughter and we will make the necessary changes that, number one…

    WILLIAM BRANGHAM: But they soon realized it would take more than that – they realized they’d have to change the drunk driving laws, which, like in the U.S., sets the legal blood alcohol limit at .08 percent.  After lobbying the government for nearly a year -- alongside groups like Mothers Against Drunk Driving – their efforts paid off.   In 2010, the Provincial Government not only stiffened penalties against driving at.08, but more importantly, it targeted drivers who fall below that level -- to .05 -- drivers who are not legally drunk.  The rationale?  Even a few drinks – as few as two for a woman, and three for a man -- can impair your driving ability

    The big change was that if you were now caught driving with a .05 blood alcohol level, the police were authorized – on the spot -- to fine you, suspend your drivers license, and immediately impound your car for at least three days.  They’d get you out of the vehicle, and a tow truck would haul it away. 

    In late 2010, police began enforcing the new laws, and police impound lots across British Columbia began filling up. The changes sparked an uproar.  Civil libertarians argued it gave the police too much power – and restaurant owners like  Mark Roberts said the new laws damaged the economy… he says his business dropped between 10 and 20 percent. 

    MARK ROBERTS: When the change of drinking-driving laws came out, we knew that was going to have a strong impact on our business.

    WILLIAM BRANGHAM: What did you think?  That customers would suddenly be afraid and that they wouldn't come to your door?

    MARK ROBERTS: We thought that there was a lot of unknowns about what that meant.  How many drinks could people have?  There was very little information about how that was going to be enforced, how it was going to impact what people could drink. We were creating non-alcoholic drinks to make up for the lost sales.  It was a lot of fear, a lot of unknowns, and some real changes in people’s behavior.

    WILLIAM BRANGHAM: And the impact was immediate.  During the first year the new law was in effect, the number of drunk driving deaths in British Columbia plunged. Critics argued that first year was just a fluke.  But the second year?  The number declined again.  A 55% reduction in deaths in just two years.

    The message, it seemed, had started getting through to drivers

    TIM STOCKWELL: So it was quite well-publicized.  And for deterrence to work it's as much about knowing and expecting there being a consequence than it actually be likely.  People's perception that they were likely to be caught was probably way higher than it actually was.

    WILLIAM BRANGHAM: And that’s key?

    TIM STOCKWELL: That is key.  It’s very important….

    WILLIAM BRANGHAM: Tim Stockwell is an expert on alcohol policy at the University of Victoria. He told us he can’t think of a single reform that’s had this big an impact, this quickly.  He and his colleagues recently published a peer-reviewed study of the effectiveness of the new laws.

    TIM STOCKWELL: These laws epitomize a perfect deterrence theory in action.  And it is very important to understand that you don't need draconian, severe penalties. They have to be severe enough.  It's more important that they are certain, and that they are swift.  So on the spot, losing your car for three days, a week, that's severe enough.

    WILLIAM BRANGHAM: The new laws have faced some setbacks: the police had problems with some of their breathalyzers, the government had to ammend the laws when courts ruled that drivers deserved a better appeals process.  And last fall a judge ruled in favor of a driver who appealed his 2012 driving suspension.  Critics say that ruling that could force a rewriting of the laws.  For now, the heart of the new laws though remain intact.

    WILLIAM BRANGHAM: What about the argument that there have been so many lives saved by these new rules that yes, it may have taken a hit out of your business, but that to save a bunch of people's lives that that's an OK price to pay?

    MARK ROBERTS:  Yeah.  Well, it's hard to argue that.  I'm certainly not going to sit here and say well, we should allow people to drink whatever, and whatever the consequences are, that's the way it is going to be.  I certainly wouldn't advocate that.

    WILLIAM BRANGHAM: Why do you think this has been so effective?

    LAUREL MIDDELAER: I think because the consequence is firm.  I think that people respond when there's a harsher consequence.  And I think, too, because it's aligned to a larger goal.  Just like secondhand smoke, we have no tolerance for that anymore, just like when seatbelts came in, there was that fundamental shift.  My goal has always been that there will be a fundamental shift that it's not OK to drink and drive.  Drinking is fine.  Absolutely -- drink whatever you like and enjoy and partake, but just don't mix it with driving.

     

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    HARI SREENIVASAN: Michael Bloomberg left office a few days ago after serving twelve years as the mayor of New York City and people are already trying to assess his legacy. Some pointed to the city’s plunging crime rate, others to its soaring real estate prices, and income inequality. Still, others to the mayor’s health initiatives. When I spoke with Reporter Katherine Bagley, of Inside Climate News, she said it was something else altogether. I began by asking her why she considers the mayor’s efforts to address climate change to be so significant.

    KATHERINE BAGLEY: So, he has been working for the past six years on sustainability and climate change initiatives, and it is something that gets very little attention in the public and by the media, and yet what he has done is both a physical transformation of the city, And also something that a lot of people do not see; things like reducing emissions and reducing harmful pollutants in the air – things that have public health dangers.

    HARI SREENIVASAN: Right. So, we see the bike lanes all over town. We see perhaps some of the impacts on transportation infrastructure, but what are some of these longer term projects? What is that legacy going to be like?

    KATHERINE BAGLEY: So, you know, a lot of what they have done is taking the thousands of buildings that are in New York City and really switching their heating fuel source from these really heavily-polluting fuels to cleaner energy sources. That is kind of one of the big projects that a lot of people do not see, and so far 5,200 buildings have been involved, and there are thousands more that have to comply as well. A lot of the longer term initiatives came in after Hurricane Sandy hit, because they had been working for five years on mitigation, reducing emissions, increasing green spaces throughout the city – things like that, and then Sandy hit and there was kind of a wakeup call just about how vulnerable the city was. They had known about how vulnerable it was, but it made it more apparent to the public. There was more of a push to build these bigger projects. So, over the next few decades you are going to see New York transformed with sea walls and doom systems, and kind of these massive transformation projects going all over the 520 miles of New York City’s coastline.

    HARI SREENIVASAN: Let’s talk about some of those infrastructure issues, building insurance changes, the park system change. Even the way we think about energy is changing in this city.

    KATHERINE BAGLEY: Yes, it is. It has been a gradual transformation and it was not one that came easily. I mean, the administration really had to fight for a lot of these things to get done, and, what has been remarkable is that they never gave up. They started their plan “YC” as they called it. In 2007 is when they officially launched it, and then you had the recession hit a year later and you had a lot of people that said, “Whoa, let’s back off. Let’s stop doing all of these massive projects and…” – You know the city went from having no deficit to having a four billion dollar deficit in a year, and yet the Bloomberg Administration just pushed forward. This was very much led by the mayor saying, “No, we said we were going to do this. We are going to do this.”

    HARI SREENIVASAN: Does he plan to continue doing this after his mayorship?

    KATHERINE BAGLEY: Yes, we had an interview with him in September and he said that he very much wants to stay involved in climate change. He is involved in – it is called C40. It is an international coalition of mayors from countries across the globe. What they are trying to do is take action on climate change in ways that federal governments are not. He plans to stay very involved with that. He is currently the leader of that. He is also launching a program to kind of look at the actual cost of climate change in the US over the next few years, and what is going to happen. So, he is very much involved, but I am not sure how much he is going to stay involved in New York City.

    HARI SREENIVASAN: Alright. The eBook is called Hidden Legacy: Climate Change and The Future of New York City, written by Katherine Bagley and Maria Gallucci. Thanks so much for joining us.

    KATHERINE BAGLEY: Thank you for having me.


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    WASHINGTON -- Terry McAuliffe's successful campaign for governor in Virginia might provide a playbook for fellow Democrats in 2014 -- and a warning for Republicans.

    Outside money makes a difference.

    Money Sign Nominally independent committees, political action groups, environmentalists and unions poured almost $14 million into McAuliffe's campaign. He went on to raise and spend almost $33 million to defeat Republican Ken Cuccinelli.

    But money that didn't go through McAuliffe's campaign helped him just as much.

    In the final month before the November election, allies aired an additional $3 million in television ads to help McAuliffe maintain his lead, according to the nonpartisan Virginia Public Access Project, which tracks political money.

    What's up for grabs in 2014? Try 435 seats in the House, one-third of the 100-member Senate and 36 governor's offices.

    Outside spending will play a pivotal, if not deciding, role.

    This year's elections will be the first when both parties fully embrace outside groups and their potential to accept unlimited contributions from supporters.

    The usual players such as the National Republican Senatorial Campaign and the Democratic National Committee are expected to keep helping candidates. But other major groups on the outside also are now poised to influence the races.

    REPUBLICANS:

    American Crossroads and Crossroads GPS. The partner organizations take their cues from strategists Karl Rove and Carl Forti, as well as former Republican National Committee heads Haley Barbour, Ed Gillespie and Mike Duncan. Considered the heaviest hitter among Republican outside groups, the two spent $176 million in 2012, mostly criticizing Democrats. Only donors for American Crossroads, a super political action committee, are disclosed.

    Americans for Prosperity. The chief outlet for libertarian billionaire brothers Charles and David Koch. The group helped the nascent tea party rise in 2010 and has spent heavily in support of libertarian-minded Republicans. Tax filings in Colorado from 2013 showed the group spent $122 million during 2012 but came up short in its bid to defeat President Barack Obama. Because of the way it is structured, it does not have to disclose its donors.

    Heritage Foundation. The longtime think tank on Capitol Hill has stepped up its political machinery since former Sen. Jim DeMint, R-S.C., took over. The group's political arm, Heritage Action, played an outsized role in October's government shutdown, warning lawmakers who supported a compromise that there would be consequences. The 2014 elections will be the first ones with DeMint calling the shots.

    U.S. Chamber of Commerce. The biggest business coalition with deep pockets for Republicans. In 2012, the group spent almost $36 million to help GOP candidates and causes. The establishment-minded group has taken sides during some Republican primaries, coming to the aid of more mainstream candidates. It does not disclose its donors.

    America Rising. A research shop that is run by GOP operatives, including Mitt Romney's campaign manager, Matt Rhoades, and RNC aides Joe Pounder and Tim Miller. The group and its affiliated consulting firm send staffers to track Democratic candidates with the goal of capturing their gaffes. The researchers also dig into Democrats' histories. America Rising then shares information with fellow conservatives.

    FreedomWorks. Another Koch-backed operation, this one focused on mobilizing rank-and-file conservatives to support conservative Republicans running for office. The group trains grassroots activists to fight for lower taxes and less government and threatens Republicans if they break from party orthodoxy. It took its name from a group started by former House Republican Majority Leader Dick Armey of Texas, who is no longer part of the organization.

    Club for Growth. A take-no-prisoners enforcer for candidates who pledge to lower taxes. The well-funded group spent $17 million to help candidates, and punish defectors, in 2012 and has sketched out a strategy to go after incumbent Republicans who stray from the group's line. Its current leader is former Indiana Rep. Chris Chocola, who took over when Pat Toomey was elected to the Senate.

    Senate Conservatives Fund. Like Heritage and FreedomWorks, a thorn in the side of compromise-minded Republicans. The Senate Conservatives Fund is backing challengers to Senate Minority Leader Mitch McConnell of Kentucky, as well as Sens. Pat Roberts of Kansas and Thad Cochran of Mississippi. The group, founded by DeMint, has run ads against Republican Sens. Jeff Flake of Arizona, Lindsey Graham of South Carolina, Johnny Isakson of Georgia and Richard Burr of North Carolina.

    DEMOCRATS:

    American Bridge. The research-focused operation was a model for the GOP-friendly America Rising. When Republicans flub, there's a good chance that someone from American Bridge is there to capture it and pass it along to reporters, Democratic campaigns and the Internet. The group, founded by former Bill Clinton critic-turned-liberal patron David Brock, has started an effort to defend Democrats' potential 2016 candidates and to document prospective Republican rivals' challenges.

    Priorities USA. Begun as a way for Democrats to counter the super PAC-savvy GOP in 2012's presidential campaign and now shifting its focus to 2016. It spent $65 million to defeat Romney, aided by supporters such as movie mogul Jeffrey Katzenberg, director Steven Spielberg and comedian Bill Maher. The group, founded by former Obama White House aides, is in talks with former colleagues to consider becoming a de facto super PAC-in-waiting for Hillary Rodham Clinton, who may run for president in 2016.

    Independence USA. Ex-New York Mayor Michael Bloomberg's political group is dedicated to defeating candidates who don't support a crackdown on illegal weapons or back education improvements. Bloomberg spent $2.2 million in Virginia's governor's race alone to help McAuliffe defeat Cuccinelli. That's a preview of the clout that Bloomberg could wield now that he's just left office.

    Planned Parenthood. A reliably Democratic group that helps candidates who support abortion rights and dogs those who don't. The group is powerful because it can introduce abortion rights into a race, forcing both candidates to make clear their positions, and often putting anti-abortion Republicans on the defensive. Led by Cecile Richards, a former top aide to House Democratic leader Nancy Pelosi of California, the group has proved potent in using paid advertising and grass-roots organizing to fight politicians who would restrict abortion rights.

    EMILY's List. Powerhouse organization that aims to help female pro-abortion rights candidates raise cash at all levels of government. It combines advertising, grass-roots organizing and voter data to help its chosen candidates compete. The group has been an early advocate for a female president, with its Madam President effort widely seen as an effort to prepare the way for a Hillary Clinton to run again for president.

    NextGen Climate Action. The project of Tom Steyer, a San Francisco billionaire investor who spent $2.4 million in television ads against Cuccinell. In all, NextGen spent almost $8 million in the Virginia race, including online ads, websites and mail to voters. Steyer has signaled he will continue to spend heavily to help candidates who pledge to work to curb climate change and has shown he will go beyond green topics if he needs to. In Virginia, his PAC ran an ad criticizing Cuccinelli's position on abortion rights.

    House Majority PAC and Senate Majority PAC. Taken together, they represent one of the Democrats' best shots at controlling both chambers. Run separately from the Democratic Congressional Campaign Committee and the Democratic Senatorial Campaign Committee, they can accept unlimited contributions from people or companies looking to help Democrats. Already, Senate Majority has aired ads to help endangered Democratic Sens. Kay Hagan of North Carolina and Mary Landrieu of Louisiana.

    By Philip Elliott, Associated Press

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    By Larry Kotlikoff

    Elderly Couple For many widow(er)s, there's no advantage to delaying the collection of survivor benefits from a deceased spouse who collected retirement benefits early. Photo by Purestock via Getty Images.

    Larry Kotlikoff's Social Security original 34 "secrets", his additional secrets, his Social Security "mistakes" and his Social Security gotchas have prompted so many of you to write in that we now feature "Ask Larry" every Monday. We are determined to continue it until the queries stop or we run through the particular problems of all 78 million Baby Boomers, whichever comes first. Kotlikoff's state-of-the-art retirement software is available here, for free, in its "basic" version.

    Here is the question that I posed to myself this week.

    Question: Dear Larry, is it true that for many widows whose husbands took their benefits early, there may be no advantage at some point several years before reaching full retirement age to waiting to collect their widow's benefits?

    Answer: Dear Larry, I wouldn't have expected such a brilliant question from you. From Paul, absolutely. But from you? Well, let's just say you've surprised me.

    In fact, you are 100 percent right. One of Social Security's most complicated features involves the calculation of widow(er)'s benefits for widow(er)s whose deceased spouse took his or her retirement benefits early before dying.

    But let me first discuss the opposite case of the decedent not taking benefits early, and let me do so via the example of Natalie and Tommy, who got married a ways back. If Tommy doesn't take his retirement benefit before full retirement age, and dies before making it to full retirement, Natalie will receive, as a survivor benefit, Tommy's full retirement benefit reduced to the degree that Natalie takes her widow benefit early (before full retirement age). She can start her widow's benefit as early as age 60. In this case, she'll receive 71.5 percent of Tommy's full retirement benefit as a survivor's benefit.

    MORE FROM LARRY KOTLIKOFF: Is Social Security Contributing to the Deficit?

    If Tommy takes his retirement benefit after reaching full retirement age (but before he dies), Natalie's survivor benefit, before any reduction for taking it early, will equal the retirement benefit Tommy was receiving when he died. This will include any delayed retirement credits he received for suspending the collection of his retirement benefit after reaching full retirement age. Note, therefore, that Natalie's survivor benefit will equal the retirement benefit Tommy was actually receiving and not the full retirement benefit to which he could have been eligible.

    If Tommy dies after reaching full retirement age, but before taking his retirement benefit, Natalie's survivor benefit, again, before any reduction for taking it early, will equal the actual retirement benefit to which Tommy would have been eligible had he applied for it the day he died.

    Now, Larry, let me get to your terrific question. You're referring to the case in which Tommy takes his retirement benefit before full retirement age and subsequently drops dead. In this case, Natalie's survivor benefit, inclusive of any reduction for taking it early, is given by this simple formula, which I explain in full below:

    Natalie's Widows Benefit = Min (reduction factor times PIA, max (RIB times DRC, .825 times PIA))

    I'll explain this formula as well as I can. But if I'm unclear, do call your representative and ask him or her to explain it. Congress put or is keeping in place this formula, so they surely understand it.

    "Min" stands for minimum. Min (x, y) equals the minimum value of x and y. If x is less than y, Min (x, y) equals x. Otherwise, it equals y. "Max" stands for maximum. Max (x, y) equals the larger of x and y.

    The PIA is Tommy's Primary Insurance Amount, otherwise known as his full retirement benefit, calculated whether or not he survived to full retirement. The reduction factor stands for the reduction Natalie would face from taking her benefits early if reduction x PIA is, in fact, the minimum value of the two values in the Min function.

    RIB, or the Retirement Insurance Benefit, is the actual retirement benefit Tommy received when he first started collecting retirement benefits. DRC stands for any additional delayed retirement credits he would have received had he suspended his benefits after attaining full retirement age.

    Finally, .825 PIA stands for 82.5 percent times Tommy's full retirement benefit.

    Now that this is crystal clear, let's consider an example to show you why you are right. Suppose Tommy takes his retirement benefit at 62, so that his retirement benefit (his RIB) is 75 percent of his full retirement benefit. (The 75 percent reflects Tommy's early retirement benefit reduction factor.)

    Now assume that Tommy croaks at 65 just when Natalie reaches age 60. If Natalie takes her widow's benefit at 60, Tommy's RIB will equal .75 x PIA. So Natalie's widow's benefit will equal Min (.715 times PIA, max (.75 times PIA, .825 times PIA)). This all ends up equaling just .715 times PIA. So Natalie gets a widow's benefit equal to 71.5 percent of Tommy's full retirement benefit.

    But, and here, thank God, is the punchline. What if Natalie waits until age 62 1/2 to collect her survivor benefit?

    In this case, Natalie's benefit will equal Min (.834 times PIA, max (.75 PIA, .825 times PIA), which equals .825 times PIA. And, if Natalie takes her survivor benefit at any age after age 62 1/2, her survivor benefit will remain at 82.5 percent of her PIA. Hence, Natalie has no incentive after age 62 1/2 to delay taking her survivor benefit. It will never be any larger!

    Note that if Tommy hadn't taken retirement benefits early, Natalie would gain something each month through age 66 by waiting to collect her survivor benefit. But because he did take his benefits early, and, in this example, at age 62, Natalie will just lose money by waiting beyond age 62 1/2 to collect her survivor benefit.

    Now Larry, you are probably wondering how the story might change if Natalie had her own earnings history and can collect retirement benefits on her own. Well, the calculation of her survivor benefit doesn't change. It's still based on the gory formula I presented that only Paul can love because he thinks politics is messy in a democracy and that formulas like this are somehow a sign of a healthy democracy as opposed to a sign of pure insanity.

    But let me not vent about this jaw dropper. Rather, I'll simply state that if Natalie's own retirement benefit exceeds her survivor benefit, she will likely do best to take her retirement benefit starting at age 70 when it's as large as possible and, thus, take her survivor benefit from 62 1/2 through age 70. If Natalie's own retirement benefit will never exceed her survivor benefit, she would do well to take her retirement benefit starting at 62 and then at 62 1/2 switch over to her survivor benefit.

    Read more about the best age to take spousal or survivor benefits in this previous column.

    My best, Larry

    Charles Coons -- Coxsackie, N.Y.: I will be turning 66 in June 2014. Someone told me that I can sign up early even before I reach 66, as long as I don't make over a certain amount before I turn 66. Is that true?

    Larry Kotlikoff: Yes, but your retirement benefit will be permanently reduced if you take it between 62 and 66.

    Deborah Checkwood -- Oceanside: If I am receiving my own benefit and my spouse dies, can I switch over to survivor benefits? My spouse's benefit was substantially higher.

    Larry Kotlikoff: Yes, but see my explanation of survivor benefits above in the question I posed to myself this week.

    Jan -- Johnston, Iowa: I have been unemployed for several years and I don't want those years to be figured into my benefit calculations. Can you tell me how that is done?

    Larry Kotlikoff: Social Security looks at all your past covered earnings in each year since you were 16. It indexes to the economy's average real wage growth all the past covered earnings up through age 60. It effectively lists these annual indexed amounts together with the actual (non-indexed) covered earnings after age 60. Then it takes the 35 highest of these annual values and divides by 35 times 12 to produce what it calls your Average Indexed Monthly Earnings (AIME). This quantity is then fed into a progressive Primary Insurance Amount (PIA) formula to determine your full retirement benefit were you to take your retirement benefit at full retirement age.

    If you have, say, 38 years in which you worked in covered employment and five years in which you were unemployed, those five years won't enter into your highest 35 years, so they won't impact your benefits.

    But if you have fewer than 35 years in which you worked and contributed to Social Security, your years of unemployment will work to reduce your PIA because your highest 35 years of covered earnings will includes years with zero covered earnings.

    If, for example, you have only 20 years of covered earnings and were unemployed in all other years, the AIME will be calculated by taking the sum of all your covered earnings in those 20 years and still dividing by 35 times 12, not 20 times 12. The fact that the divisor remains 35 times 12 means those years of unemployment that left you with fewer than 35 years of covered employment will, in fact, come back to bite you because they will lower your average AIME and, therefore, your PIA.

    Phillip McArthur -- Alexander, Maine: I am 66 and working as of now. Can I get disability Social Security if I am not able to work?

    Larry Kotlikoff: No, Phillip, you can't receive disability benefits after reaching full retirement age. Indeed, as I've written in a column discussing disability insurance benefits, those who are on disability automatically have their disability benefit converted to a full retirement benefit when they reach full retirement age, which is now 66.

    This entry is cross-posted on the Rundown -- NewsHour's blog of news and insight. Follow @paulsolman


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    Spots

    And so once again Father Time and said to Mother Nature, "Mother, put a few more of those brown spots on him, please," and so she did, dutifully and without malice she place them here and there among the others she had left before as gentle reminders, though if you've ever looked in the mirror and noticed several there weren't there the night before ... I lose my train of thought, it was on Herrengracht the cobblestones were irregular for pedestrian feet such as mine so I kept looking down when I most wanted to look straight ahead and around. "The Earth is a cobblestone," said Father Time to Mother Nature, but she made no reply for she did not like fancy allusions to her cousin Mother Earth. The kitchen became edgy for a moment and then it passed, the edginess, that is along with the moment: both were moved along to the area of Past Experiences and form there shunted into The Forgotten.

    But I remember it was my birthday and my mother is large with me and her mind is full of ironing like music you can't stop hearing in your head, the music of ironing, and so me, first a spot, then a boy with a dog named Spot, and now a man on whom more spots are arriving in the night, when Mother Nature makes her rounds and Father Time keeps the watch.

    Before Ron Padgett read "Spots" during a phone call with Art Beat in December, he called it "another geezer poem."

    "That poem is about becoming an old person and getting liver spots on you. You don't write those poems when you're 19. It doesn't seem like a very interesting subject."

    Padgett recently published his collected poems, works he has written from the age of 19 all the way to his more recent compositions from the last decade. More than 50 years of poems that span a lifetime and, as indicated by "Spots," the changing interests that come with getting older.

    Padgett wrote the poem in a way that he wouldn't have if he were in another mood, he said. "I put it into this kind of fairy tale-like setting. I have these characters, Father Time and Mother Nature."

    "Spots" is almost an autobiographical poem, both in terms of his life and in terms of his experience composing it.

    Starting at the beginning when Padgett reads, "if / you've ever looked in the mirror / and noticed several there weren't there / the night before ... I lose / my train of thought, it was on Herrengracht / the cobblestones were irregular"

    "Right in the middle, I actually did lose my train of thought writing this and I decided to put that in ... I kind of followed what was happening at the moment of composition, even if it meant an interruption to the poem."

    And so, Padgett lands on a large street in Amsterdam, when Father Time makes a pronouncement and brings him back to his original thought.

    That's when we learn some Padgett family history.

    "When my mother was nine months pregnant and she got the internal signal that she was ready to have me, she was in fact ironing and she was listening to the radio ... Every weekday there was a live 15 min program that was MC-ed and run by great country and western legend, Bob Wills, ... That became part of the family lore, when my mother realized she was going to have me, she was at that moment ironing and listening to Bob Wills on the radio."

    Padgett did also have a dog named Spot as a child.

    "I didn't think all this stuff up. It just happened. I wrote this poem; I didn't change hardly a word from the first draft of this."

    For Padgett, that happens more often when he writes short poems, because, for him, they are easier to write.

    "Every once in a while ... you can get lucky and come out with something fully formed like Athena springing from Zeus's head as a full-blown goddess she was perfect, she just -- boom -- she just popped out. And sometimes poems will do that, they just roll right out and you think well that came out okay and you look at it later and you go, 'By golly it did come out okay, there is not a word I want to add or subtract from this.'"

    Curating the poems for his "Collected Poems" was not as easy. "It's fairly rare when living poets have their collected poems published. It's the kind of thing that most poets would die for. It's such an honor."

    But once Padgett got his a first copy of the book, which he says looked exactly how he wanted it too, he didn't feel quite as he expected. In fact, he says he found it depressing.

    "I looked down on it and I thought, it's a little cube of paper, and I thought I've spent my whole life and little chunk of my soul, let's call it, working on this project and it comes out to be a little cube of paper that I can hold in one hand. I thought maybe I could have done something a little more productive or helpful to the world."

    Padgett's wife wouldn't let those feelings last long. He describes her as his best and most perceptive critic of his work and he attributed snapping out of his depression to her.

    "Now I feel good about it. I'm glad I did and I'm glad I got through that little depressed phase and I'm looking forward to writing new things."

    "Spot" is reprinted by permission from Collected Poems (Coffee House Press, 2013). Copyright © 2013 by Ron Padgett.

    Coffee House Press

    Photo by John Sarsgard/Coffee House Press

    Ron Padgett is an American poet, essayist, fiction writer, translator and member of the New York School. The son of a bootlegger, growing up in Tulsa, Okla., Padgett began writing at 13. Since then he attended Columbia University in New York City while also traveling around North America, Eastern Europe and Asia. He is the recipient of the Guggenheim Fellowship from the America Academy of Arts and Letters, the Shelley Memorial Award from the National Endowment for the Arts and was a 2012 Pulitzer Prize finalist in poetry. His latest book "Collected Poems" is a compilation of his works from 1960-2004 including 11 previous publications and dozens of uncollected poems.


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    As more research turns to the prevention of Alzheimer's disease, many nutritionists say the first steps to better brain health can start in the kitchen. Photo by Carsten Koall/Getty Images

    A dash of coconut oil, two sardines, five berries and plenty of kale; blend thoroughly and drink up. You're halfway to preventing the onset of Alzheimer's, right?

    Well, not quite. A few bona fide brain experts would endorse that kind of drink as fool-proof prevention. But all the "brain food" buzz in recent years isn't totally off-base, either, according to Paul D. Nussbaum, senior brain health advisor to the Alzheimer's Foundation of America.

    "I try to stay away from the word 'prevention' and the word 'cure,' but we do have the ability to promote the health of our brains and the opportunity to build brain resilience," said Nussbaum, who is also president of the Brain Health Center in Wexford, Pa.

    To help understand why food can help, Nussbaum advises patients to hold up an arm and picture it as a nerve track in your brain, with information passing quickly up and down the track. Now imagine that your shirt sleeve is insulation -- or "good fat" that helps pad the nerve track and facilitate the speedy transmission of electrical signals.

    If it doesn't have proper insulation, these signals will slow down, Nussbaum said. "So we have to build that up by eating proper fats like walnuts, green leafy vegetables and fish. These foods can help the brain cells be more permeable and help facilitate rapid and efficient information processing," he said.

    So while nutrition alone may not be your ticket to dementia-free old age, it's an essential part of building up a natural defense. "It doesn't prevent a condition like Alzheimer's, but it can delay its onset," Nussbaum said.

    On Monday's PBS NewsHour broadcast, Jeffrey Brown examines a revival in research aimed at preventing Alzheimer's -- a trend that comes on the heels of decades of frustratingly slow drug trials to treat the disease. Researchers hope this new emphasis on prevention could be a "tipping point" for the debilitating disease. Tune in for the full report.

    In the meantime, Nussbaum and Rita M. Singer, a registered dietitian with the Brain Health Center, offer 10 tips for eating and drinking your way to a better brain.

    10 Brain Health Boosting Tips, According to the Brain Health Center

    1. Eat breakfast daily

    Start each day with a balanced breakfast. People who eat breakfast weigh less -- important since obesity is a risk factor for Alzheimer's disease. Missing out on breakfast means missing out on the opportunity to maximize nutrition for the entire day. Think smoothies, eggs or egg whites, oatmeal with fruit and nuts and other foods that provide a variety of nutrients.

    2. Increase intake of omega-3 fats and DHA

    A growing body of evidence links the benefits of DHA, a fatty acid found in cold water fish, with brain health. Boost DHA intake by eating salmon, sardines, tuna and mackerel. Vegetarian sources of these nutrients are blue algae or seaweed, also known as spirulina.

    3. Reach for the coconut

    Coconut oil contains high levels of medium-chain triglycerides, or MCT, which have been shown to improve glucose metabolism in the brain. It also is ideal for cooking because it is stable at high temperatures. And, coconut water is great for hydration, after a workout or anytime.

    4. Taste the rainbow

    Choose colorful, nutrient-rich fruits and vegetables, such as kale, carrots, berries, broccoli and apples, that contain high levels of antioxidants and phytonutrients that can help decrease inflammation as well as oxidative damage associated with neurodegeneration -- or the breakdown of nerve tissue.

    5. Bulk up on berries

    In addition to eating a colorful diet, focus on including more berries. The protective effect of berries against inflammation is well-documented. Research shows that high intakes of blueberries and strawberries can improve behavior and cognitive function.

    6. Pack a punch with probiotics

    Hippocrates once said, "All diseases start in the gut." More and more research is showing the connection between stomach/intestinal health and whole body health. In a recent study, scientists found that a probiotic regimen for 30 days in humans reduced symptoms of anxiety, depression and anger. Probiotics are "good bacteria" that help with digestive health. Probiotic-rich foods include yogurt, kefir, sauerkraut, kombucha and kimchi.

    7. Chart a course for the Mediterranean

    Studies have shown that a Mediterranean diet -- long touted for its perceived heart health benefits -- also may benefit brain health as well. This eating plan emphasizes consumption of monounsaturated fats, such as olive oil, as well as vegetables, fruit, whole grains, legumes (beans), nuts and fish.

    8. Enjoy that cup of coffee

    Studies link moderate caffeine consumption to possible decrease in neurodegeneration associated with Alzheimer's disease.

    9. Be a "B"-liever

    People with mild cognitive impairment who took a high-dose regimen of B12, B6 and folic acid experienced significantly reduced atrophy in the areas of the brain most seriously affected by Alzheimer's disease. In addition, volunteers who took the B vitamins performed better on cognitive tests.

    10. Say "Cheers!"

    To protect brain health, alcohol should be consumed in moderation, but there is good news for those who like to imbibe occasionally. Studies indicate that resveratrol, a natural chemical found in red wine, and EGCG, a compound found in green tea, may obstruct the adherence of amyloid clumps -- a hallmark of Alzheimer's disease -- to nerve cells.

    Bonus Tip: Drink This Smoothie

    Berry Breakfast Smoothie

    1 cup frozen or fresh mixed berries 6 ounces fat free Greek yogurt 1 cup coconut water 2 teaspoon spirulina powder or ground flaxseed 1 banana 1/2 cup kale or spinach

    Add ingredients to a blender and blend.

    This makes two glasses, each containing 160 calories and 11 grams of protein.

    Related Content

    Don't Worry, Be Happy and 8 Other Ways to Reduce Your Risk of Alzheimer's

    Food writer Paula Wolfert reflects on cooking to cope with Alzheimer's

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    A new essay in the journal Health Affairs proposes that tackling tort reform on the federal level could convince doctors to agree to bigger changes in the U.S. health care system. Photo illustration by DNY59.

    It's a scenario most people have considered at least once. Patient A is hoisted onto Dr. B's operating table. Knife slips and causes massive injury -- and unlimited pain and suffering -- to Mr. A.

    Should the resulting monetary compensation be unlimited, as well? Or should monetary damages be capped to help doctors feel more comfortable in high-stakes situations, leading to better patient outcomes and possibly helping to keep America's ever-rising health care costs in check?

    The debate's been raging for decades, and while it's shown no signs of letting up in recent years, some say the current atmosphere of change in the health care system makes the time ripe for compromise.

    But the stakes are high. In 2013, an article in the Journal of Patient Safety estimated that between 210,000 to 400,000 people die every year in the U.S. from hospital medical errors. In turn, a 2011 study in the New England Journal of Medicine found that roughly 1 in 14 U.S. doctors faces a malpractice suit every year.

    Malpractice reform, often known as medical tort reform, has been tackled in a number of states, including California and Texas. But attempts at passing similar regulations on the federal level have failed since the 1970s.

    Typically, injured individuals and the lawyers who represent them argue against tort reform, saying it will prevent patients from being protected against negligent physicians. Doctors, on the other hand, usually push for reform, saying it will protect patients from having to pay the high costs of malpractice insurance and perhaps even increase accessibility to some health care services. With the divisiveness of the issue presenting an emotional and political challenge, the federal government has largely refrained from addressing it.

    An essay published Monday in the journal Health Affairs argues that it might be time for the government to step in. More specifically, lead author Dr. William Sage proposes that doctors and the federal government should strike a deal: Tort reform is implemented at the federal level to appease physicians, and in return, physicians will be more willing to adapt to larger changes in the health care system.

    For example, physicians might have to accept a more accelerated movement away from fee-for-service -- the current system where physicians charge for each service performed -- to a more collaborative model that bundles services and brings down costs, Sage said.

    Such a deal, Sage believes, would not only benefit patients, but will ultimately pave the way for better and more affordable health care.

    "We think that patients benefit more than anyone if health care is quicker, cheaper, and more reliable," he said. "The bottom line fact is: We need affordable, basic health care in this country. And as care becomes more sophisticated, we need to deliver it more collaboratively."

    PBS NewsHour spoke with Sage last week to learn more about his proposal and what it could mean for the future of the U.S. health care system.

    PBS NEWSHOUR: Dr. Sage, thanks for joining us. Medical malpractice can certainly be a sensitive subject for doctors and patients alike. But why has malpractice policy been such a sore spot in the health care system?

    SAGE: Many doctors take the notion of a malpractice suit very, very personally. They're very nervous, not just about the reality but even about the prospect of being sued. And if doctors are worried about lawsuits, there could be more defensive medicine -- or worse, they might not tell patients something bad has happened to them because they're afraid of the consequences.

    NEWSHOUR: All of this has been a concern for many years. But are are any changes coming on this front with the Affordable Care Act?

    SAGE: Many in the policy community realize that American health care is overpriced, wasteful, often not safe -- and if we don't do something about it, we're all going to go broke. And we now have the Affordable Care Act and this moment of health reform that's working to fix this issue. But the ACA doesn't really include tort reform at all. It's a topic that the political process punted on for a variety of reasons. The ACA has prompted discussion about health insurance mandates and universal coverage, which is important. But at a core level, all the people in health policy, across the political spectrum, agree that we have to be better at how we deliver health care -- and that's where physicians come in. If physicians are not on board or are nervous, we're not going to be able to make these changes.

    NEWSHOUR: In your paper, you say it's time for physicians and the federal government to "make a deal" when it comes to malpractice. What deal are you proposing?

    SAGE: Medical malpractice policy has almost always been at the state level. And here's the ACA coming in at the federal level, trying to make improvements in health insurance and health care delivery. But we think that the federal process is getting hung up on a lot of the health care delivery changes. One of the hangups is that doctors worry about liability consequences of changing what they're doing; another is that they don't really see anything in it for them.

    So the deal comes between the medical profession and the federal government, and says that the federal government could offer something that it has never offered before: federal tort reform. In exchange, they'd get much better cooperation on the part of physicians with things related to health care delivery -- including the payment for health care services.

    NEWSHOUR: Break it down a little more for us. What would it specifically change about malpractice policy, and who's benefiting?

    SAGE: We're advocating for the federal government to adopt the type of tort reform that California enacted in 1975, and that Texas did a version of in 2003. These reforms included caps on how much doctors can be sued for non-economic damages -- meaning damages available for pain and suffering, rather than for medical expenses or lost wages. So that side of the deal is pretty straightforward.

    Most importantly, these reforms are familiar and desirable to physicians. We and many other malpractice scholars have always preferred other, more complex reforms to non-economic damage caps, but we recognize that giving physicians what they want is more likely to make them receptive to offering something meaningful in return.

    On the other side of it, there are a few more variables. For example, physicians might have to accept a much more accelerated movement away from fee-for-service payment, to a more collaborative model that bundles doctor or hospital services. Another thing doctors might have to do is provide much clearer information about what things in health care cost. And finally, physicians would have to address another emotional issue: the scope of permitted practice for people who aren't physicians. But the bottom line fact is, we need affordable, basic health care in this country. And as care becomes more sophisticated, we need to deliver it more collaboratively.

    NEWSHOUR: You say that similar reforms have already been enacted in California and Texas. Have they altered the health care landscapes there in any way?

    SAGE: The California reform has been in place for almost 40 years, the Texas reform for only 10 years. Both reforms have reduced litigation and stabilized liability insurance premiums paid by physicians. Neither state's reforms have had substantial impacts on health care spending, physician supply or patient safety.

    NEWSHOUR: So it seems like this deal could really benefit both doctors and the federal government. But what about patients? Couldn't putting a cap on how much doctors can be sued for end up hurting them?

    SAGE: We think that patients benefit more than anyone if health care is quicker, cheaper, and more reliable. We've studied the malpractice system for a long time, and we think it achieves some rough justice at a very great expense. At the margins, it sometimes might make health care safer -- but health care is still too dangerous, too disorganized, and too expensive. I personally have never felt that caps on damages had a major effect on patients one way or the other. Patients are safer if there are communication-and-resolution programs in place to identify, communicate and treat injuries promptly. We think that's a much better system. We don't think caps on damages impairs that at all; if anything, caps on damages may make it easier to bring those systems into existence.

    You can certainly find individuals or groups of patients who have been disadvantaged after being harmed by an avoidable error because damages were capped. We're not saying that a cap on damages hurts nobody -- they hurt the people that otherwise would seek damages. We just think that in the bigger picture, particularly given how much doctors value the perception of fewer lawsuits, that patients would be much better off to give doctors tort reform. We are also not just saying, "cap damages" -- we are saying cap damages in exchange for something else that would really help patients.

    NEWSHOUR: With so many changes that would have to take place in order for a malpractice policy trade-off to be successful, is implementing a deal like this feasible?

    SAGE: This is a toxic political environment, and I think we're all disheartened by that. Not just around health care, but around all sorts of things that the public cares about. Insofar as anything is hard politically, this would be hard, too. But if you're not depressed about the possibility for constructive change, I don't think this is particularly difficult. I actually think that if people can recognize that one can get cooperation and leadership from physicians as a group by offering them this deal, then it could happen.

    As a country, if we keep sticking our heads in the sand about the need to improve health care delivery so that it can be quicker, cheaper, and more reliable, it's not going to serve us well in the long run. Anything we can do now to be talking about improving the delivery of health care is a good thing.

    NEWSHOUR: Dr. Sage, thank you for joining us.

    SAGE: Thank you very much.

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