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- 04/30/14--08:14: _Correcting 5 miscon...
- 04/30/14--08:17: _Botched execution r...
- 04/30/14--08:22: _After rash of storm...
- 04/30/14--08:25: _Join Library of Con...
- 04/30/14--09:23: _U.S. economic growt...
- 04/30/14--10:45: _Taco Bell takes the...
- 04/30/14--11:10: _Senate Republicans ...
- 04/30/14--11:55: _As Pacific acidifie...
- 04/30/14--12:45: _Who ended up paying...
- 04/30/14--15:33: _Is Obama’s foreign ...
- 04/30/14--15:46: _Telling the stories...
- 04/30/14--15:51: _More tolls may be c...
- 05/01/14--05:58: _Does the tea party ...
- 05/01/14--07:20: _White House denies ...
- 05/01/14--08:03: _Medicare wants to s...
- 05/01/14--08:27: _Charity database of...
- 05/01/14--08:33: _Russia now an adver...
- 05/01/14--09:10: _Dept. of Education ...
- 05/01/14--09:52: _Senate introduces b...
- 05/01/14--10:15: _Reports of military...
- Before Obamacare we had a free-market health-care system.
Government has been part of the business of medicine at least since the 1940s, when Washington began appropriating billions to build private and government hospitals. The drug industry and its customers owe much to federally funded research.
Of course Medicare for seniors and Medicaid for the poor, which both began in the 1960s, represent direct government transfers from some taxpayers to others. States have set rules for health insurance for decades.
If you’re insured through an employer that files an income-tax return your coverage is heavily subsidized by the feds. Tax deductions for private medical coverage cost the Treasury $250 billion a year.
Some would argue that private health insurance is own kind of subsidy. What the healthy pay in premiums finances care for the sick. Few patients except foreign potentates have paid their own medical bills for a long time.
- I fully paid for Medicare through taxes deducted from my salary.
Scholars at the Urban Institute have calculated that the typical Medicare beneficiary who retired in 2010 will cost the system more than twice as much in health costs than she and her employer paid in Medicare taxes.
It’s another subsidy. If Congress had designed Medicare to pay for itself rather than add to the budget deficit every year, payroll taxes would be far higher and your take-home pay would have been far lower.
- Premiums from my paycheck fund my company health plan.
Probably not entirely. Or even mostly.
For family coverage, which costs an average of $16,351 last year, the average worker paid only 29 percent of the premium. For single-person coverage, workers paid only 18 percent of the (lower) total cost.
Although premiums and out-of-pocket costs have been soaring for consumers, costs have been rising for employers, too — up by nearly 80 percent in a decade. Business spends more than half a trillion dollars annually on employee health care.
- Government and employers pay for almost all health care.
But give workers and consumers credit. In 2012 households still paid the largest single share of health costs, according to federal actuaries. Part was premiums paid through employers and directly to insurers. Part was out-of-pocket expense.
The household portion of the health-spending pie shrank from 37 percent in 1987 to 28 percent in 2012. But it’s still larger than the federal government’s 26 percent share or business’s 21 percent.
- The insurance company is always the bad guy.
Human resources pros like to trash-talk the company’s insurance plan when they tell employees the doctor network shrank, the deductible rose or certain procedures aren’t covered.
But more than half of all workers with health coverage are enrolled in “self-insured” plans where the employer pays medical bills directly. The insurance company only processes claims.
If your company has at least 500 workers it is probably self-insured
In such plans the employer is the insurance company. And it’s the employer calling the shots.
- 04/30/14--08:17: Botched execution renews debate over lethal injection procedure
- 04/30/14--08:22: After rash of storms, flooding hits Florida, Alabama
- 04/30/14--08:25: Join Library of Congress for discussion on poetry
- 04/30/14--09:23: U.S. economic growth stalls in first quarter of 2014
- 04/30/14--11:10: Senate Republicans block Democratic push to raise minimum wage
- 04/30/14--12:45: Who ended up paying attention to the Heartbleed bug?
- 04/30/14--15:33: Is Obama’s foreign policy doctrine working?
- 04/30/14--15:51: More tolls may be coming to an interstate near you
- 05/01/14--05:58: Does the tea party still have the juice?
- How might tea party vs. establishment storyline play out?
- May brings 13 primaries
- Laying out the calendar
- Your guide to this month’s races
A newly-released email has the White House on the defensive again over the administration’s role in shaping talking points for then-U.N. Ambassador Susan Rice following the attacks on U.S. diplomatic facilities in Benghazi, Libya, in September 2012. The email was obtained by the conservative group Judicial Watch through a Freedom of Information Act request. Conservative critics say the document offers further proof that the narrative provided by the administration after the attacks was politically motivated. The White House denies the email was specifically related to Benghazi.
By a vote of 54-42, the Senate failed to move forward on debate over increasing the minimum wage.
But the New York Times notes that even though two-thirds of Americans support an increase in the wage, according to the latest CBS-New York Times poll, it’s not at all clear that it’s a motivating issue.
Rep. Bennie Thompson, D-Miss., is standing by remarks in which he called Supreme Court Justice Clarence Thomas an “Uncle Tom,” Mitch McConnell a “racist,” and blamed opposition to President Obama on the president being black.
Speaking before a Senate Rules Committee hearing on “dark money,” retired Supreme Court Justice John Paul Stevens said Wednesday “money is not speech” and urged Congress to amend the Constitution to limit campaign spending.
Military sexual assault claims rose by 50 percent in 2013, which the Pentagon attributes to victims feeling more comfortable coming forward.
House Speaker John Boehner is having a “minor” back procedure.
Over candy bars and soda, about 10 House GOP members gathered in Sen. Ted Cruz’s office Tuesday night to discuss Speaker Boehner’s comments about immigration and leadership elections.
Politico reports that conservative opponents of immigration reform are coordinating efforts to make sure GOP leaders don’t move forward with an overhaul this year.
House Budget Committee Chair Paul Ryan met with the Congressional Black Caucus on Wednesday to discuss poverty reduction following his comments about a culture of poverty in inner cities. South Carolina Rep. James Clyburn reported that Ryan didn’t apologize for his remarks, “and nobody asked him to, either.”
Perhaps in an attempt to help Hillary Clinton’s potential 2016 run, former President Bill Clinton defended his economic legacy at Georgetown University Wednesday night.
Clinton leads former Florida Gov. Jeb Bush 49 percent to 41 percent among Florida voters in a Quinnipiac University poll released Thursday.
Examining Clinton’s relationship with the press in Politico Magazine, Glenn Thrush and Maggie Haberman hear from Clinton confidantes who say any ambivalence about running in 2016 stems from her discomfort with the media.
Senate Majority Leader Harry Reid cited the NBA’s lifetime ban of Donald Sterling to urge the NFL to force the Washington Redskins to change the team’s nickname.
- 05/01/14--07:20: White House denies email was explicitly about Benghazi attack
- 05/01/14--08:03: Medicare wants to stop paying twice for hospice patient drugs
- 05/01/14--08:27: Charity database offers wedding bliss of a different kind
- 05/01/14--08:33: Russia now an adversary, NATO official says
- 05/01/14--09:52: Senate introduces bipartisan bill to build Keystone oil pipeline
- 05/01/14--10:15: Reports of military sexual assault rose 50 percent, Pentagon finds
Eight million people have signed up for subsidized private health insurance under Affordable Care Act, President Obama said this month. Millions more obtained new coverage through the Medicaid program for the poor.
Full implementation of the health law, and its wider coverage, new taxes and shifting subsidies, has renewed discussions of winners and losers, makers and moochers.
Here’s a corrective to common misconceptions about who pays for health care.
This KHN story was produced in collaboration with USA Today. Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.
The post Correcting 5 misconceptions about who pays for health care in the U.S. appeared first on PBS NewsHour.
A botched execution of an Oklahoma inmate Tuesday night has renewed attention among opponents of the death penalty on the source of the drugs used to carry out the procedure.
Clayton Lockett, 38, writhed and appeared to struggle against restraints on the gurney as he was administered a drug combination that the state was using for the first time. As this was happening, an official lowered the blinds to the viewing area while Robert Patton, the state’s Department of Corrections director, halted the execution, about 20 minutes after the first drug was administered. Locket died of a heart attack shortly thereafter, according to reports.
“It was a horrible thing to witness. This was totally botched,” said Lockett’s attorney, David Autry.
As foreign supplies have dwindled — in part because European manufacturers have been banned from exporting them to states that intend to use them in executions — traditional lethal injection drugs are being replaced with others manufactured in the U.S. But inmates and lawyers are questioning whether these new drugs will result in death without undue pain and suffering.
Lockett and another inmate, Charles Warner, who was scheduled to die after him, had sued the state for not disclosing the details of the drugs that would be used in their executions.
Missouri and Texas, like Oklahoma, have both refused to reveal their sources and both of those states have carried out executions with their new supplies, according to the Associated Press.
Oklahoma Gov. Mary Fallin ordered a 14-day stay of execution for Warner, who was scheduled to die two hours after Lockett. She also ordered a “full review of Oklahoma’s execution procedures to determine what happened and why during this evening’s execution.”
Lockett was convicted of shooting 19-year-old Stephanie Neiman and watching as two accomplices buried her alive in rural Kay County in 1999.
The post Botched execution renews debate over lethal injection procedure appeared first on PBS NewsHour.
The giant storm system that violently swept across Oklahoma, Mississippi and Arkansas last weekend has evolved into widespread flooding in the Florida Panhandle and Alabama Gulf Coast on Wednesday. The death toll from the storms has grown to 36 so far.
The National Weather Service said that as much as 22 inches of rain had fallen in Pensacola, Florida, as of Wednesday morning, with more rain to be expected throughout the day. Average annual rainfall for Pensacola is 65 inches, which means the city received one-third of that rainfall in one day.
Police and crews are struggling to respond to distress calls efficiently because of heavy flooding in the area. One woman died when she drove into high waters, and more people are stranded in cars and homes waiting for rescue. Officials said they received about 300 calls for evacuation and approximately 30,000 homes are without power.
This prolonged weather pattern is abnormal, according to forecasters, and the past few days marked the first time in 22 years with 10 or more tornado deaths for two straight days.
The post After rash of storms, flooding hits Florida, Alabama appeared first on PBS NewsHour.
How is the media helping to connect poetry with the public?
In celebration of National Poetry Month, PBS NewsHour’s Mike Melia will join the Library of Congress for a webcast discussion at 12 p.m. EDT Wednesday about that very question.
Over the past year, NewsHour has worked with the Library of Congress to better bridge the worlds of media and poetry. During the ongoing “Where Poetry Lives” series, NewsHour’s Jeffrey Brown and U.S. Poet Laureate Natasha Trethewey have explored programs across the country that are helping people through poetry — from seniors coping with dementia in Brooklyn, to incarcerated teens in Seattle.
Join Wednesday’s discussion, and tell us in the comments below how poetry has played a part in your life.
The U.S. economy grew by a disappointing 0.1 percent in the first three months of 2014, the slowest pace of expansion since late 2012.
Measuring the output of all good and services in the United States, the real gross domestic product is subject to seasonal fluctuations and subsequent revisions. Especially after a strong final quarter of 2013 and this winter’s icy temperatures and heavy snow, growth was expected to slow, but not as much as it did. Wall Street had anticipated a GDP of 1.2 percent.
The good news in Wednesday’s GDP report from the Bureau of Economic Analysis is that personal consumption spending rose by 3 percent. That increase was offset by a 7.6 percent drop in exports and a 5.5 percent drop in business spending on equipment.
Revised growth data for the first quarter will be released at the end of May, so Wednesday’s headline number could go up or down. But each quarter’s initial announcement attracts media attention, in large part, author Zachary Karabell told NewsHour economics correspondent Paul Solman, because it’s “the king of all statistics.” The GDP has come to represent the health of the U.S. and international economies, even if the growth it measures isn’t felt by average citizens, Karabell explained.
Solman also spoke with Steve Landefeld, director of the agency that calculates the GDP, about what factors into the metric and how it’s constantly evolving.
In a recent Making Sen$e segment, Paul explored alternative measurements of economic growth, including Maryland’s Genuine Progress Index, which considers environmental factors.
In other economic news Wednesday, private payrolls increased by 220,000 according to the monthly report from Automatic Data Processing. The ADP report precedes Friday’s unemployment data from the Bureau of Labor Statistics, but isn’t always a strong predictor of government data. Markets will be closely watching Wednesday’s policy announcement from the Federal Reserve’s Open Market Committee at 2 p.m. EDT. They are expected to reduce monthly bond purchases by another $10 billion.
The post U.S. economic growth stalls in first quarter of 2014 appeared first on PBS NewsHour.
Taco Bell was kind enough to tell us what’s in the other 12 percent of its beef: “they do have weird names, but they’re all safe and approved by the FDA,” says Taco Bell.
On its website, the popular food chain explains in a friendly voice what all is in the “other” ingredient. It breaks down each item for you, mostly because you probably have never heard of them — like torula yeast, lactic acid, maltodextrin, soy lecithin, etc.
These ingredients are completely safe and approved by the FDA, according to Taco Bell. So no need to worry, right? The company argues a lot of food items you buy at your local grocery store probably have these ingredients too.
Whether each explanation of the ingredient and what it does to human bodies is clear enough is another question. For example, when the site explains modified corn starch, which is among “the other 12 percent,” it says that it’s derived from corn. Then it goes onto explain what corn is — “a food staple in Mexican culture as well as many others.” They use it “as a thickener and to maintain moisture in our seasoned beef.”
Derek Lowe, a chemist and blogger with a Ph.D from Duke University, told ABC News that “there is nothing on this list I have a problem eating.”
The post Taco Bell takes the mystery out of the ‘other’ ingredients in its meat appeared first on PBS NewsHour.
WASHINGTON — Senate Republicans blocked an election-year Democratic bill on Wednesday that would boost the federal minimum wage, handing a defeat to President Barack Obama on a vote that is sure to reverberate in this year’s congressional elections.
The measure’s rejection, which was expected, came in the early months of a campaign season in which the slowly recovering economy — and its impact on families — is a marquee issue. It was also the latest setback for a stream of bills this year that Democrats have designed to cast themselves as the party of economic fairness.
The legislation by Sen. Tom Harkin, D-Iowa, would gradually raise the $7.25 hourly minimum to $10.10 over 30 months and then provide automatic annual increases to account for inflation. Democrats argue that if fully phased in by 2016, it would push a family of three above the federal poverty line – a level such earners have not surpassed since 1979.
“Millions of American workers will be watching how each senator votes today. To them, it’s a matter of survival,” Senate Majority Leader Harry Reid, D-Nev., said before the vote.
He pointedly added, “For Republicans, this vote will demonstrate whether they truly care about our economy.”
Republicans, solidly against the Democratic proposal, say it would be too expensive for employers and cost jobs. As ammunition, they cite a February study by the nonpartisan Congressional Budget Office that estimated the increase to $10.10 could eliminate about 500,000 jobs – but also envisioned higher income for 16.5 million low-earning people.
“Washington Democrats’ true focus these days seems to be making the far left happy, not helping the middle class,” said Senate Minority Leader Mitch McConnell, R-Ky.
“This is all about politics,” said No. 2 Senate GOP leader John Cornyn of Texas. “This is about trying to make this side of the aisle look bad and hard-hearted.”
The vote was 54-42 in favor of allowing debate on the measure to proceed, six votes short of the 60 that Democrats needed to prevail. Sen. Bob Corker, R-Tenn., was the only Republican to cross party lines and vote “yes.” Reid switched his vote to “no,” which gives him the right to call another vote on the measure. No other Democrats opposed the bill.
Sen. Susan Collins, R-Maine, who has been seeking a deal with other senators on a lower figure than $10.10, said Wednesday that she will continue that effort. Maine Sen. Angus King, an independent who usually sides with Democrats, said he too favors finding middle ground.
But Democratic leaders have shown no inclination to do that — a view shared by unions that favor an increase and business groups that oppose one.
“We’re not going to compromise on $10.10,” Reid told reporters after the vote.
In a clear sign of the political value Democrats believe the issue has, Democrats said they intend to force another vote on the increase closer to this year’s elections.
The White House issued a statement urging the bill’s passage and saying the administration wants legislation “to build real, lasting economic security for the middle class and create more opportunities for every hardworking American to get ahead.”
Supporters note that the minimum wage’s buying power has fallen. It reached its peak value in 1968, when it was $1.60 hourly but was worth $10.86 in today’s dollars.
The legislation is opposed by business groups including the National Council of Chain Restaurants and the International Franchise Association. The National Restaurant Association has hundreds of members at the Capitol this week lobbying lawmakers on several issues, including opposition to a higher minimum wage.
Also opposed were conservative organizations including Heritage Action and Americans for Prosperity, which is backed by Charles and David Koch. The billionaire brothers are spending millions this year to unseat congressional Democrats, and Senate Majority Leader Harry Reid, D-Nev., and his allies are casting them as unfettered villains.
Other Democratic bills that have splattered against GOP roadblocks this year would restore expired benefits for the long-term unemployed and pressure employers to pay men and women equally. Democrats plan future votes on bills easing the costs of college and child care.
Opposition from Republicans running the House makes it unlikely that chamber would debate minimum wage legislation this year.
According to the federal Bureau of Labor Statistics, about two-thirds of the 3.3 million people who earned $7.25 an hour or less last year worked in service jobs, mostly food preparation and serving.
More than 6 in 10 of those making $7.25 or under were women, and about half were under age 25. Democrats hope their support for a minimum wage boost will draw voters from both groups – who usually lean Democratic – to the polls in November, when Senate control will be at stake. The GOP’s hold on the House is not in doubt.
Harkin’s bill would also gradually increase the minimum wage for tipped workers like waiters to 70 percent of the minimum for most other workers. It is currently $2.13 hourly, which can be paid as long as their hourly earnings with tips total at least $7.25.
The minimum wage was first enacted in 1938 and set at 25 cents.
Congress has passed nine laws slowly increasing it, including one each decade since the 1980s. The minimum has been $7.25 since 2009.
The post Senate Republicans block Democratic push to raise minimum wage appeared first on PBS NewsHour.
Scientists have known for some time that shells of the tiniest sea life have been dissolving due to an increasingly polluted ocean. Pteropods, ocean-dwelling snails roughly the size of a thumbnail, have been dubbed by some the “canary in the coal mine” for oceanic climate change. Off America’s West Coast, the snails are losing their shells at faster rates than previously thought, according to a new study published Wednesday.
“We did not expect to see pteropods being affected to this extent in our coastal region for several decades,” said William Peterson, an oceanographer at NOAA’s Northwest Fisheries Science Center and one of the paper’s co-authors.
The pteropods — meaning “winged foot” and sometimes called sea butterflies — are tiny, transparent marine snails. They use their foot to swim freely in the water, rather than to slug along the ground like their non-swimming cousins. They’re also food for other fish, such as mackerel and herring.
As fossil fuels are burned to create energy, the resulting carbon dioxide is released into the atmosphere, part of which settles into the world’s oceans. As the ocean waters become more C02-enriched, the ocean’s acidity increases, a process known as ocean acidification. At a certain threshold, the acidity can and does dissolve the snail’s shells.
And as the ocean acidifies, the sea butterfly’s habitat becomes more endangered. Sea butterflies, oysters, clams, mussels and corals cannot survive without their shell to protect them. Scientists surveying the U.S.’ west coast found that more than 50 percent of pteropods sampled from central California up through northern Washington had “severely dissolved shells.” Since the pre-industrial era, the percent of pteropods with dissolving shells has doubled. That’s expected to triple by 2050, when coastal waters are estimated to become 70 percent more corrosive than in the pre-industrial era.
Ocean life with skeletons or shells made of calcium carbonate have been found to be especially vulnerable to acidification — mostly small organisms that make up the base of the ocean food chain, as well as corals and mussels.
“We do know that organisms like oyster larvae and pteropods are affected by water enriched with carbon dioxide,” co-author Richard Feely said, noting that more research needs to be done. “The impacts on other species, such as other shellfish and larval or juvenile fish that have economic significance, are not yet fully understood.”
Watch more of the NewsHour’s reporting on climate change :
The post As Pacific acidifies, ‘sea butterflies’ are quickly losing their shells appeared first on PBS NewsHour.
When security researchers discovered a serious flaw — named “Heartbleed” — in the encryption technology that was supposed to protect users’ information, no one knew how the bug would affect online users.
Of the 1,501 American adults that Pew Research Center surveyed, only 39 percent of those took action to secure their online accounts, after finding out about the Heartbleed bug.
Twenty-nine percent believed their information was put at risk, but only six percent thought any of their information was actually stolen.
There is no way yet to know if users’ information has been compromised. Even if a user secured their account in April, the account could have been hacked at any time in the past two years. So for two years, users’ data could have been stolen. If money from your bank account has disappeared, the evidence is clear. But if a cyberthief stole something like your Social Security number, you might not know, unless already a victim of identity theft.
Chances are though, if nothing happened to you in the past two years while the flaw went undetected, you’re (hopefully) safe.
The post Who ended up paying attention to the Heartbleed bug? appeared first on PBS NewsHour.
GWEN IFILL: The Obama administration has been fielding questions this week about its handling of foreign policy matters. Tonight, we look at some of those questions, and the issues they raise.From Syria to Israel, to Ukraine and Russia, to last week’s four-nation Asia trip, foreign policy has returned to center stage for President Obama. But setbacks have claimed as much attention as success. The president returned home yesterday with a new military agreement with the Philippines.
But a broader Pacific trade deal was left undone. Meanwhile, Russian President Vladimir Putin threatened Ukraine’s borders, and Israel’s Benjamin Netanyahu abandoned peace talks with the Palestinians.
In Washington, critics like Republican Senator John McCain have challenged the president’s leadership and taken Secretary of State John Kerry to task.
SEN. JOHN MCCAIN, R, Ariz.: My hero, Teddy Roosevelt, used to say talk softly, but carry a big stick. What you’re doing is talking strongly, and carrying a very small stick, in fact, a twig.
The people of Ukraine should know, why won’t we give them some defensive weapons when they are facing the — and another invasion, not the first, but another invasion of their country? It is just beyond logic.
GWEN IFILL: Kerry responded that diplomacy should always be the avenue of first resort.
JOHN KERRY, Secretary of State: But your friend Teddy Roosevelt also said that the credit belongs to the people who are in the arena who are trying to get things done, and we’re trying to get something done. Sure, we may fail. And you want to dump it on me, I may fail. I don’t care. It’s worth doing. It’s worth the effort.
GWEN IFILL: In Syria, President Bashar al-Assad is now seeking reelection, ignoring repeated U.S. calls for him to step down.
More than 150,000 are now dead in that civil war, and peace talks in Geneva fizzled earlier this year. On Monday, while traveling in Manila, the president offered a pointed response to critics who say he has been too slow to act forcefully.
PRESIDENT BARACK OBAMA: My job as commander in chief is to deploy military force as a last resort, and to deploy it wisely. And, frankly, most of the foreign policy commentators that have questioned our policies would go headlong into a bunch of military adventures that the American people have no interest in participating in and wouldn’t advance our core security interests.
GWEN IFILL: The administration has been able to score some victories, including the destruction of much of Syria’s chemical weapons arsenal. And last November, Iran agreed to a six-month deal to freeze parts of its nuclear program. Negotiations for a longer-term agreement are continuing.
So, we dive right into the debate about the successes and the setbacks with Nicholas Burns, a career Foreign Service officer and former ambassador to NATO. He’s now at Harvard University’s Kennedy School. Retired Army Colonel Andrew Bacevich, professor of international relations and history at Boston University, his latest book is “Breach of Trust: How Americans Failed Their Soldiers and Their Country. And Trudy Rubin is the “Worldview” columnist at The Philadelphia Inquirer.
Familiar faces, all. Thank you for joining us again.
Andrew Bacevich, I want to start with you up there in Boston. What is your sense about how well or how well it has not gone, the Obama foreign policy doctrine?
COL. ANDREW J. BACEVICH (RET.), Boston University: Well, when we elected President Obama, I think the expectations were that he was going to score an A. Remember, he is the guy that, upon being inaugurated, received the Nobel Peace Prize. And he doesn’t deserve an A.
He probably deserves about a C. But it’s all relative. And I would take a C over the F that his predecessor scored.
GWEN IFILL: Trudy Rubin?
TRUDY RUBIN, The Philadelphia Inquirer: I would also say, although it’s very hard to rate a president, I would say C, or passing, because I think there have been some real failures and a lack of connecting the dots, and focus on a preconceived notion that we were entering into a world where we could build a rule-based global system, and somehow ignoring the fact that there were big players out there who still played hard politics and were interested in using hard power, not soft power.
So, there’s been a couple of redeeming areas, but basically the preconceptions, I think, has led him really astray.
GWEN IFILL: Nick Burns, that sounds naiveté on the president’s part?
NICHOLAS BURNS, Harvard University: I think the president and we, as the American people, are facing multiple challenges on every continent.
And I think his record is mixed because it’s hard to take a snapshot on any one day and say he is winning and losing in foreign policy. These are long-run problems. Where he’s done very well is on Iran, where for the first time in 34 years, we have got the Iranians at the negotiating table, mainly through very tough-minded sanctions that he and George W. Bush put in place.
I think on this recent trip of Asia, he showed the big conceptual breakthrough of the first term of his administration, that more of our interests, strategic, military, economic, political interests, will be in Asia than in any other part of the world. He has given it real time. This new agreement with the Philippines is going to reinforce our military strength.
He is spending more time with Xi Jinping. That’s his most important relationship, given China’s power. Now, there are a lot of problems with the Chinese. But you want the American president and Chinese president to be talking.
I think, Gwen, that the attack on the president, the rhetorical attack, this week, has been he isn’t leading with a great degree of self-confidence in, say, Ukraine on the Russia problem or in Syria with the Assad problem.
GWEN IFILL: Well, let’s start with those bookends, Andrew Bacevich, Syria on end getting up to the brink and then not intervening, or Putin in Russia and Crimea and allowing — or at least that’s what his critics say — allowing Putin to claim Crimea without much of a fight.
How would you describe what happened in between those two poles?
COL. ANDREW J. BACEVICH: Well, I think on Syria, there’s no question that the president misspoke, to put it kindly, when he drew his red line that the Assad regime subsequently crossed.
Then the president looked around as he was about to go to war in Syria and realized that nobody was with him. Certainly, the American people were not with him. So to make a threat and then to not make good on that threat was a great mistake.
That said, ultimately, the decision not to intervene militarily in Syria was the correct decision. This is a massive humanitarian problem. I think you can make an argument that we generally in the West are not doing enough to alleviate the suffering caused by that civil war. But to meddle in the civil war without knowing which side really ought to win in terms of advancing our own interests would be a mistake.
And I think the Ukraine issue needs to be placed in a larger context. And then the larger context is the aftermath of the Cold War. When the Cold War ended, there were any number of countries that in a sense were up for grabs, Central Europe, the Baltic republics, the Balkans, and virtually all of these countries have since been incorporated into the West, into the E.U., into NATO.
That’s to say that we have scarfed up about 95 percent of the marbles that were still in play. And in that sense, it’s hardly surprising that Putin, who is a thug, is taking this moment to poke us back because he has been the loser for the past two decades.
GWEN IFILL: Trudy Rubin, what about the president’s role in both of those cases. Andrew Bacevich says he didn’t do it well, but he ultimately did the right thing in Syria. Did that happen in — first of all, do you agree? And then did that happen in Ukraine?
TRUDY RUBIN: No, I think he did the wrong thing in Syria.
And I don’t think it was ever an issue of going to war in Syria. I think what the president did is overlook the fact that moving towards diplomacy and saying there’s no military solution doesn’t mean that you sometimes have to take tough steps in order to convince some of the players, in this case, Assad and Vladimir Putin, that they had no choice but to go to diplomacy.
In fact, John Kerry was much more outspoken about this when he was chairman of Senate Foreign Relations. And he said back then in 2012 quite bluntly that, in order to get Assad to the table — and he could have said in order to get Putin to accept this — you would have to work hard at organizing the opposition, and you might have to give lethal arms.
Having covered this from the beginning, there were forces who could have been trusted, who could have been vetted. And in order to get Assad to the table, especially as this thing develops with all the casualties, you had to take a lead role in organizing and making sure that weapons went to the right people.
Instead, by basically hanging back, the president has in effect allowed a situation to develop where there’s a new Afghanistan on the Mediterranean. And there’s a real terrorist threat all through Eastern Syria and Western Iraq that could have been confronted early on.
GWEN IFILL: Well, Nick Burns, to what degree did the White House or the administration prioritize incorrectly? For instance, a lot of energy on Secretary Kerry’s part was expended trying to get the Israelis and Palestinians back to the peace table? Was that the wrong choice?
NICHOLAS BURNS: I’m not sure it’s the right construct, because we are the only global power.
We have important American interests everywhere in the world, and so we have got to be able to have a national security team — and I think we do — that can be active on China and Japan, that can be active with the Israelis and Palestinians. I respect what Secretary Kerry tried to do.
But it’s now clear that the Israelis and Palestinians are not ready for a negotiation. So, he is going to have to pivot to the China-Japan relationship and reduce conflict there. And I think their big challenge will be Putin now, because a lot of people are watching all over the world.
I have been in Sao Paulo and Hong Kong in the last six weeks, and people saying, if the president didn’t show decisiveness on Syria, is he going to make Putin respect him and draw lines that Putin will respect in Europe? And I think it’s that credibility problem that the president has time to address it. He has two-and-a-half years left.
Presidents in their second term sometimes turn to foreign policy because the Constitution gives them great latitude, and he needs that grasp that opportunity for leadership here.
GWEN IFILL: Here is the dilemma I want to pose to all three of you.
We have seen two new big national polls come out this week, in which the American people basically said, it’s OK, I don’t really feel like we should be intervening, we should have that muscular a role anymore in foreign policy.
And yet — and yet, at the same time, if the president does that, they say he is not leading, that he’s a little weak, that he’s behind the curve. Where is the sweet spot, the middle ground there, Andrew Bacevich?
COL. ANDREW J. BACEVICH: Well, your lead-in quoted the president as saying that force is a last resort, should be a last resort, right, correctly.
And I think that marks the distance that we have traveled since the early years of the George W. Bush administration, which treated force as the first resort and produced catastrophic consequences.
So, the president I think is correctly interpreting the views of the American people, and the American people, in this case, are not stupid.
GWEN IFILL: Let me ask Trudy Rubin, and ask you to keep it tight.
TRUDY RUBIN: I think we’re not talking about going to war.
I think that even if the president puts an emphasis on diplomacy, it has to be backed up by something. Putin respects strength. And so I think there should have been more targeted sanctions earlier and more now. He is likely to disrupt elections in May, and if there’s not a message, clear message sent. I don’t think it’s a question of looking at the polls and saying no war, no more war.
It’s a question of looking at American needs and looking how you can back up diplomacy with a real strong policy where you show interest and take leadership.
GWEN IFILL: Nick Burns?
NICHOLAS BURNS: It’s not surprising the American people after two bitter wars and a big recession want to rebuild the country at home. But the reality is that our economic and our political security future depend on being that world leader.
And that’s the job of the president, to really defy these polls and to explain to the American people from the bully pulpit what we have invested overseas and why we need to continue to be the world leader and fight the isolationist trends in the Democratic Party on the left and in the Republican Party, certainly Tea Party, on the right.
GWEN IFILL: Nick Burns, Trudy Rubin, Andrew Bacevich, thank you all.
NICHOLAS BURNS: Thank you.
JUDY WOODRUFF: Finally, tonight, a conversation about love and marriage and the law.
Jeffrey Brown has that.
JEFFREY BROWN: In 2008, California voters passed Proposition 8, a ban on same-sex marriage, the latest turn in a long-running battle over the issue largely waged state by state.
It led to a high-profile five-year pursuit of a federal lawsuit to overthrow Prop 8 that ended in a major decision by the Supreme Court.
The story is told in the new book “Forcing the Spring: Inside the Fight for Marriage Equality” by author Jo Becker, the Pulitzer Prize-winning investigative reporter for The New York Times and, I have to add, long ago a young staff person here at the NewsHour.
So, welcome back.
JO BECKER, The New York Times: Thanks for having me.
JEFFREY BROWN: Now, to go back to where this started for you, you clearly saw a big story developing in 2008. You managed to embed yourself with part of that effort. Tell us how it started.
JO BECKER: I wrote a story for The New York Times about Ted Olson, this guy that liberals love to hate, because he won Bush v. Gore for Bush, how he had come to embrace this cause.
And I was hooked. It was such an interesting group of characters. You had Rob Reiner, the movie director. You had Chad Griffin, a young kind of political operative, and the pairing up of these kind of super lawyers, Ted Olson and David Boies, who was his of course adversary in Bush v. Gore.
And mostly the plaintiffs, these four people who were willing to kind of put themselves out there, I wanted to know what does it feel like to kind of be kind of the face of in a major civil rights case?
JEFFREY BROWN: And the strategy which is part of much of what you write, the strategy they pursued was controversial even within the gay rights movement, right? Tell us how they decided to go for the federal lawsuit.
JO BECKER: At the time, there was a real feeling that the Supreme Court wasn’t ready, the country wasn’t ready.
And what all of the activities were pursuing instead this 10, 10, 10 strategy to have 30 states essentially with some form of marriage recognition before you went the federal route. This group thought it is time to do something different.
JEFFREY BROWN: The danger of course was that it could all backfire.
JO BECKER: It could be — it was a very — it was a gamble. It really was.
And a lot of the activists who had been working for years on this issue were extremely upset by it. There was a scene I describe in the book where they are called to the Reiners’ home in Brentwood, several of the lawyers who have been working on this case, on these issues, and they’re clueing them in: Hey, we’re thinking about doing this.
And it was like this cacophony of criticism, because not that they didn’t share the goal — they did share the goal, of course. But they were worried that they would take it all the way to the Supreme Court and they would lose. And that would just deal a terrible setback for the movement. That’s the fear.
JEFFREY BROWN: People waited to see what would happen with Barack Obama on this issue. And you describe that famous moment when it was Joe Biden who sort of forced his hand.
JO BECKER: Joe Biden, two weeks before he sort of made his famous gaffe, went on “Meet the Press,” and got out ahead of the president on this, he had been at the home of a gay couple, and outside playing with their kids.
And he had been asked this question in the privacy of this home, like, how do you feel about this issue? And a staffer told, it was like his hard drive got erased, being in that house, playing with those kids. He had been answering the question the same way, but suddenly he said something different.
And two weeks later, he told me that question and that episode was ringing sort of fresh in his mind. And he was — but — and he was asked on “Meet the Press,” and this time, he gave the same answer, but it was on national television.
JEFFREY BROWN: And did the president then feel, is it correct he felt forced to do something?
JO BECKER: Yes, he was — it forced the president’s hand.
It’s interesting. The president, everybody said, many of his aides said, urged him to take Biden to the woodshed. And he wouldn’t do it. And, in fact, the first lady, I report in this book, felt it was a blessing in disguise. She said to him that morning, you don’t have to dance around this issue anymore. You can go out and tell it — speak from your heart, tell what you really feel.
She said to him that morning at breakfast, enjoy this day. You are free.
JEFFREY BROWN: Tell me about the reporting of a book like this. Here, you had incredible access for a long time to the plaintiff’s side.
JO BECKER: Yes.
So, basically, the only stipulation was that I did not — I wouldn’t write about this until after there was a resolution to the case, for obvious reasons. But I was in the war room, in the political war rooms where they plotted the kind of how to speak to the American public about — there was a huge public education campaign that went along with this.
I was there in those rooms, in the rooms while lawyers sort of talked over strategy, and with the plaintiffs in their homes. Every time they drove to court, I was in the van with them. And I try to tell their stories.
JEFFREY BROWN: Now, you are getting great reviews. You are also getting some real criticism and pushback from people especially in the gay community who think that you, by focusing so much on this case and this — these years, you exaggerate the contributions of some of the protagonists, you sort of ignore the past history that led up to it.
JO BECKER: You know, I am getting some criticism in some quarters.
Look, this book was never meant to be a history of the gay rights movement. That — wonderful books have been done on that. It wasn’t even meant to be a history of the marriage equality movement. It was — we didn’t sell it that way. We didn’t bill it that way.
This is a — The New York Times, as well as The Washington Post, has given this great reviews, as have others. And what they say is, it’s a stunningly intimate portrait. I tried to take you inside, let you feel what it’s like to be the judge who himself is gay and listening to this evidence, what it’s like to be the plaintiffs getting threatening phone calls.
But ultimately what I really wanted to tell is what it’s like to feel like you want something, as Kris Perry testified, you want something that everybody else has and you — and be told, no, you can’t have it. That’s a story actually that was so moving, that the guy who fought them all the way to the Supreme Court, the lawyer on the other side, Charles Cooper, said after watching them over these four-and-half years, when he finally saw them get married on television, he told me that he couldn’t help but rejoice from their happiness.
I mean, wow, what a story. I think it’s a great story. I hope people will read it.
JEFFREY BROWN: OK. The book is “Forcing the Spring.”
Jo Becker, thanks so much.
JO BECKER: Thanks for having me.
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With highways funds running out of fuel, the White House is willing to consider new tolls on interstate highways to pay the bills and repair the roads.
The proposal is part of a larger four-year, $302 billion transportation bill that the Obama administration has sent to Congress.
If enacted, the proposal would reverse a ban on tolls for pre-existing interstate highways, a ban first enacted under the Eisenhower administration in 1956. The Department of Transportation already has a pilot program that allows states to exact tolls on new interstate highway systems.
“We want to open the aperture, if you will, to allow more states to choose to make broader use of tolling, to have that option available,” Transportation Secretary Anthony Foxx told the Washington Post.
The tolls could be used to shore up an impending shortfall in the Highway Trust Fund, which DOT analysts predict will run out of money sometime in fiscal year 2014. Most of the revenue for this fund comes from an 18.4-cent tax on gasoline.
Miles Morin, spokesman for the Alliance for Toll-Free Interstates, told The New York Times that tolls are an “inefficient mechanism” to collect revenue because as much as 20 percent of the revenue has to be used to manage the toll operations.
“Those paying the toll may not even see that road improved because the president’s plan would allow toll revenue to go to other projects in the state,” Morin said.
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Today in the Morning Line:
Let the elections begin! The midterm election primary season kicks off in earnest Tuesday with elections in North Carolina, Ohio and Indiana. Get this: There are 13 states with primaries in May. It’s always nice when instead of just talking about races, you get results. The overarching question for May: does the tea party still have the juice? In races this month in places like Kentucky and Georgia, “establishment” candidates appear poised to beat conservative challenges. But in North Carolina, Texas and Idaho, the tea party is once again threatening. The GOP appears to have learned the lessons of 2010, when many Republicans argue tea party challengers cost them control of the Senate. To that point, Democrats concede Republican establishment candidates will probably prevail in many of May’s races, but only because, they say, the GOP has co-opted the tea party. “It’s clear the tea party and the extreme right wing have overtaken the GOP establishment,” Justin Barasky, press secretary for the Democratic Senatorial Campaign Committee, told Morning Line. “That’s why so many establishment candidates will be nominees — even though they’re no different than Ken Buck, Sharron Angle, etc.” Colorado’s Buck and Nevada’s Angle are two of the candidates blamed for GOP’s 2010 inability to make bigger gains in the Senate.
The long road to November: Democrats also believe (maybe hope?) candidates like Republican Senate leader Mitch McConnell in Kentucky, North Carolina state House Speaker Thom Tillis and whoever gets through the Georgia primary will be bruised, having had to use resources to beat back primary opponents. But Republicans would argue, it’s still six months out from the general election and those candidates will have plenty of time to replenish resources and mend fences with the base. One race to watch down the road that could be a game-changer is Mississippi. Public and private polls show incumbent Sen. Thad Cochran up by a lot against state Sen. Chris McDaniel, a tea party challenger, but establishment Republicans are taking nothing for granted. They are doing everything they can to beat him, because they worry his past remarks would not only put Mississippi on the table for Democrats, but also become potentially damaging for other Republicans across the country, who would need to answer if they support McDaniel.
Here’s the May primary calendar followed by a look at the state of play of “establishment” vs. tea party in some key states and some of the other key races to watch:
May 6: Indiana, North Carolina, Ohio
May 13: Nebraska, West Virginia
May 20: Arkansas, Georgia, Idaho, Kentucky, North Dakota, Oregon, Pennsylvania
May 27: Texas runoff
North Carolina: The big story to watch Tuesday is whether Tillis surpasses the 40 percent threshold to move onto the general election — or if he gets dragged into a runoff by Greg Bannon, a doctor and tea party challenger backed by Rand Paul, or Mark Harris, an evangelical pastor. Polls have shown Tillis close to or surpassing the mark. Republicans think momentum is on Tillis’ side. They sure hope so, anyway, because a runoff would mean Tillis having to spend another two months not focusing on vulnerable Democrat Kay Hagan. A runoff would take place July 15. How much do Democrats want Tillis to get stuck in a runoff? Listen to this ad that implies Tillis thinks the health care law is a “great idea” — and it’s paid for by Hagan. … And in the House, 10-term Rep. Walter Jones is facing a serious challenge from Taylor Griffin, a former Bush aide and GOP consultant. Jones took a hard turn against the Iraq war, has voted against Republican budgets and aligned with some Ron Paul groups. None of it won the praise of the GOP-led House leadership. … Also, can former American Idol star Clay Aiken make it through a Democratic primary in a potentially competitive seat.
Nebraska: Tea Party groups, Sens. Ted Cruz, R-Texas, and Mike Lee, R-Utah, and Sarah Palin have all thrown their support behind Ben Sasse, president of Midland University. The state establishment candidate is state Treasurer Shane Osborn. They are locked in a tight race, the results of which will likely determine the next U.S. senator from the Cornhusker State.
Georgia: Polls have shown former Dollar General and Reebok CEO David Perdue, Rep. Jack Kingston and former Georgia Secretary of State Karen Handel ahead. Republicans would prefer any of those three to Reps. Phil Gingrey and Paul Broun, who are seen as less disciplined and weaker against Democrat Michelle Nunn, daughter of former Sen. Sam Nunn.
Idaho: GOP Rep. Mike Simpson is the establishment pick and is trying to fend off a challenge from lawyer Bryan Smith, who has the backing of the Club for Growth. The Chamber of Commerce has gone in for Simpson and so has Mitt Romney, who appears in an ad for the eight-term congressman. Romney holds particular sway in Idaho, because 23 percent of the state is Mormon, the second-highest percentage in the country behind Utah.
Kentucky: McConnell appears to have a solid lead over tea party challenger Matt Bevin. But he faces the challenge of bringing those conservatives home to stave off a strong challenge from Democrat Alison Lundergan Grimes.
Oregon: Everyone’s watching to see if pro-abortion rights Republican Monica Wehby, a physician who has run one of the most powerful biographical ads of this campaign, gets through the Senate primary against state Rep. Jason Conger. Republicans believe she’d have an outside chance of giving incumbent Democrat Jeff Merkley a real race.
Pennsylvania: Republican Gov. Tom Corbett is among the most, if not THE most, vulnerable incumbents in the country. But Democrats haven’t sorted out who will take him on. Businessman/kitchen-cabinet-maker Tom Wolf, who served as Gov. Ed Rendell’s Secretary of Revenue, is well ahead in the polls, having leapfrogged Rep. Allyson Schwartz with big ad spending. He’s poured in $10 million of his own money into the campaign. Democrats debated Wednesday and have another debate Thursday and will surely be aiming for Wolf, who has never run for office before.
Texas: The big tea party vs. establishment fight here is in the lieutenant governor’s race. And before you dismiss a down-ballot race like this one, consider that Republicans are concerned that if the tea party candidate, state Sen. Dan Patrick, upends David Dewhurst — and he is favored to do just that — then Democrat Leticia Van de Putte, a Latina state senator, could have a real chance. If she does pull it off, she would be the first Democrat elected statewide in this now-majority-minority state in 20 years. And if that happens, forget Wendy Davis, the current Democratic nominee for governor, Van de Putte would likely be the real rising star with a jump off to run for governor down the line. … Republican incumbent congressman Ralph Hall, the oldest member of Congress at 91, is in a fight for his political career, facing a challenge from former U.S. Attorney John Ratcliffe, 48. Hall’s age has become a subtle, but primary issue. Both are vying for the tea party vote.
Daily Presidential Trivia: On this day in 2003, President George W. Bush declared that major hostilities were over in Iraq, during his famous “Mission Accomplished” speech. Exactly 8 years later, an American president made another notable announcement; what was it?
Be the first to Tweet us the correct answer using #PoliticsTrivia, and you’ll get a Morning Line shout-out. No one guessed Yesterday’s trivia correctly. The answer was: Washington received 100 percent of the vote and ran more or less unopposed except for the 11 men vying for the number two seat as Vice President.
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WASHINGTON — The White House on Wednesday denied that a staff member’s email three days after the deadly attack on the U.S. mission at Benghazi, Libya, was actually about the attack. Critics have branded the electronic missive as evidence that the Obama administration sought to deceive the public about the true circumstances surrounding the deaths of four Americans during the final months of the 2012 presidential campaign.
“It was explicitly not about Benghazi,” press secretary Jay Carney told journalists during his daily briefing at the White House. “It was about the overall situation in the region, the Muslim world, where you saw protests outside of embassy facilities across the region, including in Cairo, Sana’a, Khartoum and Tunis.”
Sen. Lindsey Graham, R-S.C., has called the email a “smoking gun” that “shows political operatives in the White House working to create a political narrative at odds with the facts.”
The U.S. ambassador to Libya, Chris Stevens, and three other Americans died in the attack on Sept. 11, 2012. Republicans contend that President Barack Obama, eager to claim in an election year that al-Qaida and terrorists in general were on the run, misled Americans by linking the Benghazi attack to protests over an anti-Islamic video when he knew otherwise.
The intelligence community compiled its own talking points for members of Congress that suggested the Benghazi attack stemmed from protests in Cairo and elsewhere over the anti-Islamic video rather than an assault by extremists. The U.S. ambassador to the United Nations, Susan Rice, used those talking points during her appearances on Sunday news shows following the attack. However, the CIA’s former deputy director, Mike Morrell, later said he had deleted from the talking points the references to terrorism warnings to avoid showing up the State Department, not for political reasons.
Administration officials later corrected their description of the attack, and Obama himself referred to “act of terror” in several speeches in the two days following the attack yet also referred to the video at times in other remarks. On Sept. 20, Carney said it was “self-evident” that it had been a terrorist attack, but Obama didn’t use the term “act of terrorism” for some time.
The email from Ben Rhodes, then the deputy national security adviser for strategic communications at the White House, was dated Sept. 14, the Friday before Rice appeared on the Sunday news programs. The watchdog group Judicial Watch obtained the email and 40 others through a Freedom of Information request and posted them Tuesday on its website.
The email’s subject line reads, “Prep call with Susan: Saturday at 4:00 p.m. EST.” Among the list of goals was “to underscore that these protests are rooted in an Internet video, and not a broader policy failure.” The email goes on to list a half-dozen points of discussion, including Obama’s actions “since we began to see protests in response to this Internet video” and administration response to security concerns around the world, relations with governments in the region, the U.S. condemnation of the anti-Islamic video and efforts to have other world leaders speak out against violence.
“This document, as I said, was explicitly not about Benghazi, but about the general dynamic in the Arab – or in the Muslim world at the time,” Carney said Wednesday. “So I would also point out that the document itself states explicitly that Ambassador Rice is not on the Sunday shows to talk politics. This was part of our effort to explain our views both as a matter of policy and as a matter of what was happening on the ground with regards to the protests that were underway around the region.”
Asked why the Rhodes email was only now being released, Carney said the email was not about the attack and thus was not included in the thousands of pages of material about the attack that had been turned over to investigators.
In an interview Tuesday with the website Newmax, Graham said: “Their goal was not to tell the truth about what actually happened. … They did not want to provide the best information available. Instead, we were provided the most beneficial political story for President Obama.”
Sen. Jim Inhofe, R-Okla., told Newsmax: “This was a cover-up, and these e-mails only continue to confirm my belief.”
In a statement Wednesday, House Speaker John Boehner, R-Ohio, accused the White House of being evasive and not cooperating with House efforts to investigate the attack and the U.S. response.
“Four Americans lost their lives in Benghazi, and this White House has gone to extraordinary lengths to mislead, obstruct and obscure what actually took place,” Boehner said. “I am appalled to learn that the administration concealed relevant documents after the House subpoenaed all emails related to the misleading talking points. When four Americans die at the hands of terrorists, the families of the victims – and the American people – deserve the full, unvarnished truth and nothing less. Instead, this White House been callously dismissive of our efforts to get answers.”
The post White House denies email was explicitly about Benghazi attack appeared first on PBS NewsHour.
New Medicare guidance taking effect today aims to stop the federal government from paying millions of dollars to hospice organizations and drug insurance plans for the same prescriptions for seniors. But the changes may make it more difficult for dying patients to get some medications, senior advocates and hospice providers say.
The new measures direct insurers not to pay for any prescriptions for hospice patients until they receive confirmation that the drugs are not covered instead by the hospice provider.
Requiring additional authorization for these prescriptions will “prevent duplicate payments for drugs covered under the hospice benefit,” Medicare officials told hospice providers and insurers in a conference call three weeks ago.
Medicines for Medicare patients receiving hospice care generally are paid in two ways. Drugs related to palliative and comfort care are supposed to be covered under the fixed-rate federal payments to the hospice. Drugs for diabetes, heart disease or other chronic conditions still used by these patients but not directly related to their terminal illness are covered by Medicare Part D prescription drug plans, which are heavily subsidized by Medicare, with beneficiaries picking up roughly 25 percent of the bill.
Medicare officials said in the conference call the new measures are a response to a 2012 investigation that found Part D prescription drug plans paid more than $33 million in 2009 that should have probably been covered by the hospice benefit. That was for analgesic, anti-nausea, laxative and antianxiety drugs, as well as prescription drugs used to treat pulmonary problems and amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. Beneficiaries paid nearly $4 million in copayments, the report by the Department of Health and Human Services’ inspector general found.
Although the drugs are primarily used for palliative care and were prescribed to beneficiaries during the time they also received hospice care, drug plans did not know if those drugs should have been paid for instead by hospice groups, according to the report.
About 1.1 million Medicare beneficiaries received hospice care in 2009 and 437,121 filled prescriptions through their Medicare drug plan, according to the report.
Instead of leaving it to insurers and hospice providers to identify the drugs they are responsible for, the new rule sets up a process that requires Part D plans to reject initially any prescription from a hospice patient. The patient or doctor, with the hospice provider’s agreement, must explain to the insurer why the drug is not related to end-of-life care. The insurer may deny coverage for a number of reasons, including if the doctor or hospice did not explain sufficiently why the drug was unrelated to the terminal illness, Medicare officials told hospice organizations and insurers.
Several insurers that sell popular Medicare drug policies did not respond to requests for comment. But Clare Krusing, a spokeswoman for America’s Health Insurance Plans, an industry trade association, said, “Part D sponsors will continue to work with hospice providers to make sure patients understand the coordination of benefits under Part D and hospice when electing hospice care.”
In their announcement of the new process, Medicare officials conceded that in the past the government’s guidance “was ambiguous and there were no objective criteria for Part D sponsors to apply in making Part D versus [hospice] coverage and payment determinations.”
The new payment process, proposed in March and already in use in some areas, is causing some hospice patients or their families to leave their pharmacies empty handed.
“We had a couple of patients who went in to get their cardiac medications and were denied,” said Susan Strauss, a registered nurse and chief compliance officer at Hope Health Inc., in Hyannis, Mass., which provides hospice care for 300 patients.
“Denying people cardiac meds — or the medication they need to breathe easier — that they have had for 30 years and are unrelated to their hospice diagnosis is causing them more pain, more anxiety and puts them at greater risk for more emergency room visits and hospitalizations,” said Strauss.
If the Part D plan refuses to cover a prescription, hospice patients or their authorized representatives will need their doctor’s help in requesting an expedited appeal from Medicare to improve their chances of success, said Terry Berthelot, a senior attorney at the Center for Medicare Advocacy, which offers more details on its website. If the doctor says the patient’s health is in immediate jeopardy, a decision is supposed to be made within 24 hours. If that fails, patients can work their way through Medicare’s appeals process, she said.
Medicare officials declined to comment about the measures but are expected to provide more details when they announce next year’s hospice payment rates, probably in the coming days.
Kaiser Health News, KHN, is a nonprofit news service covering health policy issues at the federal and state level, with stories appearing in media outlets nationwide. It is an editorially independent program of the Henry J. Kaiser Family Foundation. This KHN story was produced in collaboration with The Washington Post.
The post Medicare wants to stop paying twice for hospice patient drugs appeared first on PBS NewsHour.
When wedding season rolls around each year, it’s always a scramble to get the happy couple just the right gift.
Kendall Webb fondly remembers the Hummel porcelain figurine she received. “You’re supposed to put it on your shelf,” she laughs. “There are all these jokes about wedding gifts that you never want — certain blenders and things like that.”If you ask Miss Manners, “Registries are never proper. … It is simply never polite to ask someone to buy you a present.” But there are still many well-meaning souls who want to get something and would appreciate some guidance.
That’s where Webb comes in. She is the founder and executive director of JustGive.org, a San Francisco-based website where couples can register to have their guests donate to a charity instead of buying them that unwanted blender or toaster.
Other websites provide the same service, but JustGive.org is also a database of more than 1 million charities that people can search — based on their interests — to send a donation. Corporations can use it to create “gift card” donations to distribute at conferences or to employees at bonus time.
Webb came up with the idea in the 1990s while working for a website that sold drugstore items, such as toothpaste and cold cream. It was a time of booming online startups with plenty of funding from venture capitalists and workers eager to develop their web skills.
But she noticed, even with the abundance of new websites, an absence of nonprofit companies using the Internet for philanthropic purposes. The few companies Webb encountered that were delving into the philanthropic sector were doing so as a way to make money, she said.
“So that was when I decided to quit my job and bring the Internet to the philanthropic sector as a nonprofit,” said Webb.
She decided to set up a nonprofit “donor-advised fund” website, to help connect donors to charities, but was told her website would have to be a for-profit since the technology then was so expensive. “But I said I’ll just pool all of the people and companies who are on the for-profit side and are successful, and get them involved.”
She and her team built a board of directors and advisers out of people from flourishing Internet companies, acquiring their expertise and start-up funding. JustGive.org “became kind of the philanthropic child of the successes of the for-profit Internet world,” she said.
At the time the website launched in October 2000, there were about 680,000 nonprofits. That number has nearly tripled to 1.8 million today, said Webb.
To help donors select charities in that ever-growing list, JustGive.org allows users to search by 19 categories, including animals, environment, children and the homeless, or by their zip code if they’d like to give locally.
People can click on the charity name to find out about its mission, projects, board of directors, size and budget, to get a sense of how much of an impact their donation could make.
With so many charities going into and out of existence, JustGive.org updates its list with data from the IRS, which assigns each charity an identification number, and from GuideStar, which edits the IRS information to create its own library of all nonprofits.
On average, people give to six to eight charities per year, said Webb. (See more charitable giving statistics from the National Philanthropic Trust.) So users of JustGive.org can sign up to give a one-time or monthly donation to as many charities as they would like, and at the end of the year can print out a receipt of all of their donations for tax purposes. “It’s kind of an Amazon equivalent of charitable giving, where you would have a giving history,” and can repeat it year after year with a few clicks on the website, she said.
The cost of donating on JustGive.org is 4.5 percent of the amount of the donation, which includes a 3 percent charge levied by the credit card company and 1.5 percent that goes toward JustGive.org’s overhead. The website also charges corporations licensing fees for its services.
People can purchase “gift cards” on the website for a small fee to provide a donation in someone else’s name. Corporations, such as American Express, Microsoft and Discover, have started buying the gift cards in bulk, with their own company’s logo, to give to their customers and employees, said Webb.
JustGive.org started another product, the wedding registries, in 2006 in response to popular demand. Many couples getting married these days are either older or onto their second marriages, Webb said, and they already have set up their kitchens. Even couples getting married at a younger age are sometimes not interested in the fancy silverware or china place settings of yore. The donation registry pleases all parties.
On Webb’s wish list is the ability to expand the database to include international organizations. However, only a handful of countries have similar standards for monitoring charities as the United States, making it difficult to endorse them, she said. “It’s a huge challenge that no one’s figured out.”
She also would like to assess which nonprofits are the most efficient and effective, like people can do with stocks. “We’ve toyed with it, but other organizations have tried to do it and failed, so we’re watching on the sidelines.” Instead, people can enter feedback on the website about the charities, such as their experiences as volunteers, which donors can use to make their decisions.
Another of Webb’s goals is to entice companies that issue reward points, such as airlines, hotels and retail outlets, to give the reward recipients the option of redeeming their points for charity. Under this concept, customers or employees would be able to go to the company’s website and click on a button that would link them to a page operated by JustGive.org to donate their points as cash to a charity.
“It’s a whole new channel of fundraising for nonprofits, which they’re always looking for,” she said. “And it’s good for the donors, because they don’t look at their points as a bank account line item but as a perk that they can use for good.”
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WASHINGTON — NATO’s second-ranking official says Moscow’s annexation of the Crimean Peninsula and its destabilizing actions in eastern Ukraine have compelled the U.S.-led alliance to start treating Russia as more of an enemy than a partner.
This marks a turning point in decades of effort by NATO to draw Moscow closer, says Alexander Vershbow, the deputy secretary-general of the alliance. He made the remarks to a group of reporters.
Vershbow said the alliance is considering new measures aimed at deterring Russia from any aggression against NATO member countries along its border, such as the Baltic states that were once part of the Soviet Union.
Ukraine’s acting president Oleksandr Turchynov says the country’s security forces are “helpless” to stop unrest in two eastern regions bordering Russia. Video by Associated Press
Vershbow said that among possible moves by NATO are deployment of more substantial numbers of allied combat forces to Eastern Europe, either permanently or on a rotational basis.
WASHINGTON — The Education Department on Thursday took the unprecedented step of releasing the names of the 55 colleges and universities currently facing a Title IX investigation over their handling of sexual abuse complaints.
The release came two days after a White House task force promised greater government transparency on sexual assault in higher education. Going forward, the department said, it will keep an updated list of schools facing such an investigation and make it available upon request.
The schools range from big public universities like Ohio State University, the University of Michigan in Ann Arbor and Arizona State University to private schools like Knox College in Illinois, Swarthmore College in Pennsylvania and Catholic University of America in the District of Columbia. Ivy League schools like Harvard, Princeton and Dartmouth are also on the list.
The agency previously would confirm such an investigation when asked, but students and others were often unaware of them.
“We hope this increased transparency will spur community dialogue about this important issue,” Catherine E. Lhamon, the department’s assistant secretary for civil rights, said in a statement.
Lhamon said a school’s appearance on the list does not mean that it has violated the law but that an investigation is ongoing.
Title IX prohibits gender discrimination at schools that receive federal funds. It is the same law that guarantees girls equal access to sports, but it also regulates institutions’ handling of sexual violence and increasingly is being used by victims who say their schools failed to protect them.
Citing research, the White House has said that 1 in 5 female students is assaulted. President Barack Obama appointed a task force comprised of his Cabinet members to review the issue after hearing complaints about the poor treatment of campus rape victims and the hidden nature of such crimes.
The task force announced the creation of a website, notalone.gov, offering resources for victims and information about past enforcement actions on campuses. The task force also made a wide range of recommendations to schools, such as identifying confidential victims’ advocates and conducting surveys to better gauge the frequency of sexual assault on their campuses.
The department publicized guidance on Title IX’s sexual assault provisions in 2011, and complaints by students have since increased. Complaints, however, don’t always lead to an investigation.
The department can withhold federal funding from a school that doesn’t comply with the law, but it so far has not used that power and instead has negotiated voluntary resolutions for violators.
Sens. Kirsten Gillibrand, D-N.Y., and Claire McCaskill, D-Mo., have said non-compliance under the law is “far too common.” They say a lack of federal resources is partly to blame for that, and they’ve sought more money to ensure timely and proper investigations.
Another law that campus sexual assault cases fall under is the Clery Act, which requires colleges and universities to report crime statistics on or near their campuses. It also requires schools to develop prevention policies and ensure victims their basic rights. Investigations under this law are not included in the list that was released.
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WASHINGTON — Senate supporters of the long-delayed Keystone XL pipeline have introduced legislation authorizing its immediate construction and say they expect the measure will come to a vote in the coming days.
The legislation was introduced by Democratic Sen. Mary Landrieu of Louisiana and Republican Sen. John Hoeven of North Dakota.
— Senator Landrieu (@SenLandrieu) May 1, 2014
The legislation is the latest response in Congress to the Obama administration’s recent announcement that it was delaying a decision on the pipeline indefinitely, citing a Nebraska court case relating to the project.
The House has voted previously to approve construction of the pipeline, which would carry oil from Canada to the United States, where it eventually would reach Gulf Coast states.
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But officials are still unhappy with the low number of male victims who reported sexual assault, and they say there will be a greater emphasis in the months ahead on getting men to come forward and seek help. Final data obtained by The Associated Press show that about 14 percent of the reports filed last year involved male victims.
Defense officials said Wednesday that encouraging more men to report sexual assaults is a difficult challenge because male victims often worry that it will make people think they are weak and trigger questions about their sexual orientation. In most cases, however, sexual orientation has nothing to do with the assault and it’s more an issue of power or abuse.
“There is still a misperception that this is a women’s issue and women’s crime,” said Nate Galbreath, the senior executive adviser for the Pentagon’s sexual assault prevention office. “It’s disheartening that we have such a differential between the genders and how they are choosing to report.”
The Pentagon planned to release its report Thursday. Defense Secretary Chuck Hagel was expected to call on the military services to step up efforts to encourage troops to intervene in assault situations and work with military bases and local communities to better train bar workers and promote more responsible alcohol sales. According to officials, alcohol was a factor in as many as two-thirds of the cases.
Under the military’s definition, a sexual assault can be anything from unwanted sexual contact, such as inappropriate touching or grabbing, to sodomy and rape.
While the number of reported assaults shot up sharply in 2013, defense officials said that based on survey data and other information, they believe the increase was largely due to victims feeling more comfortable coming forward. Overall, there were 5,061 reports of sexual abuse filed in the fiscal year that ended Sept. 30, compared with 3,374 in 2012, for a 50 percent gain. About 10 percent of the 2013 reports involved incidents that occurred before the victim got into the military, up from just 4 percent in 2012.
“There is no indication that this increase in reporting constitutes an increase in crime,” said Maj. Gen. Jeffrey Snow, director of the Pentagon’s Sexual Assault Prevention and Response Office. “We assess that this unprecedented increase is consistent with a growing confidence in the response systems.”
Over the past two years, the military services have increased awareness of the problem and treatment programs to instill more confidence in the system and get victims to come forward. Phone numbers and contact information for sexual assault prevention officers are plastered across military bases, including inside the doors of bathroom stalls. And top military officers have traveled to bases around the world speaking out on the issue.
Officials said prosecutions also have increased. Galbreath said the military was able to take some action against 73 percent of the accused perpetrators who were subject to the military justice system. In 2012 it was 66 percent. Some cases involve perpetrators who are not in the military so are not subject to commander’s actions or military courts.
Sexual assault has been a front-burner issue for the military, Congress and the Obama administration over the past year, triggering Capitol Hill hearings and persistent questions about how effectively the military was preventing and prosecuting assaults and how well it was treating the victims. Fueling the outrage has been a number of high-profile assault cases and arrests, including incidents involving senior commanders, sexual assault prevention officers and a number of military trainers.
At the same time, the military has long struggled to get victims to report sexual assault in a stern military culture that emphasizes rank, loyalty and toughness. Too often, victims have complained they were afraid to report assaults to ranking officers for fear of retribution, or said that their initial complaints were rebuffed or ignored. A 2012 anonymous survey found that about 26,000 service members said they were the victim of some type of unwanted sexual contact or assault.
A key finding in that survey was that, in sheer numbers, more men than women said they had been assaulted. About 6.8 percent of women surveyed said they were assaulted and 1.2 percent of the men. But there are vastly more men in the military; by the raw numbers, a bit more than 12,000 women said they were assaulted, compared with nearly 14,000 men.
The military, Galbreath said, needs to get the message out that this is not just a women’s problem.
“It’s not the damsel in distress; it’s your fellow service member that might need you to step in,” he said, adding that troops need to treat it like any other need for aid, just like on the battlefield.
As a result, Hagel was expected to order the military services to improve reporting by male victims and encourage them to seek assistance. In addition, he was to press for a renewed emphasis on prevention and the need to take some of the programs various services have been conducting and use them across the military.
Those include programs that urge troops to intervene when they see a buddy in trouble or being harassed. And there now may be a move to work with bars and stores that sell alcohol around the bases to educate their employees, offer menus when they serve drinks and review hours of liquor sales.
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