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	<title>Stories I’d like to see</title>
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	<description>Steven Brill</description>
	<lastBuildDate>Tue, 14 May 2013 11:41:36 +0000</lastBuildDate>
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		<title>The commencement speech market, Obamacare job bonanza, and recess appointment gridlock</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/05/14/the-commencement-speech-market-obamacare-job-bonanza-and-recess-appointment-gridlock/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/05/14/the-commencement-speech-market-obamacare-job-bonanza-and-recess-appointment-gridlock/#comments</comments>
		<pubDate>Tue, 14 May 2013 11:36:49 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[commencement speeches]]></category>
		<category><![CDATA[hillary clinton]]></category>
		<category><![CDATA[Obamacare]]></category>
		<category><![CDATA[recess appointments]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=832</guid>
		<description><![CDATA[It’s my guess that the most sought-after commencement speaker this season is former Secretary of State Hillary Clinton. ]]></description>
			<content:encoded><![CDATA[<p><span style="text-decoration: underline;"><strong>1.  The commencement speech market:</strong></span></p>
<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/05/hill.jpg"><img class="alignleft size-medium wp-image-833" style="margin-left: 5px; margin-right: 5px;" title="U.S. Secretary of State Hillary Clinton speaks at the commencement for Barnard College, in New York" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/05/hill-300x217.jpg" alt="" width="300" height="217" /></a>It’s my guess that the most sought-after commencement speaker this season is former Secretary of State Hillary Clinton. How many invites did she get, and how does that compare with other top names? And did she accept any? Is she getting paid? Especially now that Benghazi has come back into the news, has she set any ground rules related to the appearance, such as whether she will be available to the press before or after the talk?</p>
<p>Who else is a top drawer graduation speaker this year? And who, in terms of gravitas or lack thereof, is this year’s most unlikely pontificator?</p>
<p>What’s the market like generally this season? At a time when students face mounting tuition debt, have any schools, mindful that graduates are rarely rocked by any commencement speaker, made it a policy not to spend big bucks to put a star at the podium?</p>
<p><strong><span style="text-decoration: underline;">2. The Obamacare gravy train:</span></strong></p>
<p><strong></strong>According to this <a href="http://www.washingtonpost.com/national/health-science/ap-exclusive-lawmakers-granted-calif-health-exchange-unusual-secrecy-i">exclusive AP report</a> published last week, the state of California is going to spend “nearly $458 million on outside vendors by the end of 2014, covering lawyers, consultants, public relations advisers and other functions” to set up the state’s insurance exchange provided for by Obamacare. That suggests the birth of a new multi-billion dollar nationwide industry for people who can sell themselves as experts in building an electronic  consumer marketplace for health insurance, which until now has mostly been marketed to employers rather than individuals.</p>
<p>So, who’s leading the charge to cash in and how are they doing it?</p>
<p>The AP story suggests that there is one obstacle, as least in California, to finding out. AP reports that unlike in other states, where the books of the agencies overseeing the insurance exchanges are subject to open records laws, legislators in California inserted an usual provision in its law setting up the exchange support apparatus that allows that all the new spending to be kept secret. (How that happened would, itself, be a good story.) But the books are open in other states, and even in California a good reporter ought to be able to find out who’s getting in on the action and what strings they are pulling along the way.</p>
<p>A related story has to do with all the new federal jobs being created by Obamacare. Here’s <a href="http://capsules.kaiserhealthnews.org/index.php/2013/05/four-states-that-snubbed-health-law-gaining-jobs-from-it/">one snippet</a> from the health news service of the Kaiser Family Foundation that covers a piece of the story – the 9,000 people being hired just for the call centers being organized to answer consumer questions about the insurance exchanges being run by the federal government.</p>
<p><strong><span style="text-decoration: underline;">3. Looking in on court-ordered regulatory gridlock:</span></strong></p>
<p>In January, a three judge panel of the U.S. Court of Appeals for the DC Circuit sharply curtailed President Obama’s ability to make so-called recess appointments, which allow a president to put his appointees in place when the senate refuses to  confirm them. The recess appointment gambit, regularly used by presidents of both parties, had allowed officials to take office if appointed by the President during a Senate recess and stay there until a new session of the Senate convened the following year.</p>
<p>In recent years senators in the party not occupying the White House had tried to block the tactic by not formally recessing and instead hold perfunctory, minutes-long sessions even on days when most of the Senate was out of town. But President Obama tried to trump that in 2011 by declaring that these pro-forma sessions were not real and, therefore, that he could make a recess appointment.</p>
<p>The appeals court ruled not only that President Obama’s tactic was an unconstitutional intrusion on Senate prerogatives but also that even during a real recess, the president could only appoint officials whose offices had become vacant during that same recess.</p>
<p>The decision, if not overturned on appeal, would invalidate the appointments of, among others, three sitting members of the five-member National Labor Relations Board (NLRB), who had been given recess appointments in 2011. The standing of the acting head of the new Consumer Financial Protection Board would also be in jeopardy.</p>
<p>That in turn could allow all of the decisions made by the NLRB since these appointees took office to be challenged, as could the regulations promulgated by the consumer protection board.</p>
<p>According to <a href="http://takingnote.blogs.nytimes.com/2013/02/05/recess-appointments-a-counterfactual/">this editorial</a> in the <em>New York Times</em>, citing the Congressional Research Service, “652 appointments by Presidents Reagan through Obama would have been blocked by those rules, because they came during breaks in Senate sessions or, even though they came during gaps between sessions, the actual vacancies did not occur in the gaps.”</p>
<p>The Obama administration announced two weeks ago that it would appeal the decision to the Supreme Court, but the high court is not likely to rule until some time next year.</p>
<p>So what kind of chaos is this causing at the affected agencies in the interim? Are the two agencies completely paralyzed? Are their rulings being challenged and held in abeyance? What other agencies are affected? What about the rulings of judges who might have decided cases while sitting on the bench through these recess appointments? This story is not exactly sexy but it’s likely causing havoc all over the executive and maybe even the judicial branches</p>
<p>The <em>Times</em> did report <a href="http://www.nytimes.com/2013/04/10/business/obama-nominates-3-for-labor-relations-board.html">early last month</a> that “more than 100 companies have asked the courts to rule that the labor relations board lacked a quorum — and thus had no authority to act against them.” I’d like to know what some of the most important of these cases involve, and what other challenges to other agencies, including the Consumer Financial Protection Bureau, have sprung up.</p>
<p>Put simply, who’s benefiting the most from this new DC monkey wrench, and who’s getting hurt?</p>
<p><em>Editor&#8217;s note: On several occasions (<a href="http://blogs.reuters.com/stories-id-like-to-see/2013/04/23/lawsuits-from-tragedy-ubiquitous-security-cameras-and-irs-torpor/">here</a>, <a href="http://blogs.reuters.com/stories-id-like-to-see/2012/07/30/romneys-tax-audit-aurora-and-risk-inside-the-irs/">here</a> and <a href="http://blogs.reuters.com/stories-id-like-to-see/2012/06/26/the-tax-man-who-could-change-the-2012-campaign/">here</a>) this column has advocated greater scrutiny of the IRS, and specifically how the agency treats tax-exempt 501 (c) (4) organizations that are closely aligned with political action committees. In the wake of reports last week about how Tea Party and other conservative organizations were apparently targeted by the IRS, some stories scrutinizing this aspect of the IRS have been published, including <a href="http://online.wsj.com/article/SB10001424127887324715704578478851998004528.html#articleTabs=article">this Wall Street Journal story</a>.</em></p>
<p><em>PHOTO: U.S. Secretary of State Hillary Clinton speaks at the commencement for Barnard College, in New York, May 18, 2009.  REUTERS/Chip East</em></p>
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		<title>The compensation racket, Al Jazeera&#8217;s plans, and Boston health costs</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/05/07/the-compensation-racket-al-jazeeras-plans-and-boston-health-costs/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/05/07/the-compensation-racket-al-jazeeras-plans-and-boston-health-costs/#comments</comments>
		<pubDate>Tue, 07 May 2013 11:17:25 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[al jazeera]]></category>
		<category><![CDATA[boston bombing]]></category>
		<category><![CDATA[compensation consultants]]></category>
		<category><![CDATA[health care costs]]></category>
		<category><![CDATA[warren buffett]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=826</guid>
		<description><![CDATA[Warren Buffett had this to say about compensation consultants. ]]></description>
			<content:encoded><![CDATA[<p>1.     <strong><span style="text-decoration: underline;">Looking at ‘Ratchet, Ratchet and Bingo’</span></strong>:</p>
<p>In his <a href="http://www.berkshirehathaway.com/letters/2005ltr.pdf">2006 annual report to shareholders</a> , Warren Buffett had this to say about compensation consultants:</p>
<blockquote><p>Too often, executive compensation in the U.S. is ridiculously out of line with performance. That won’t change, moreover, because the deck is stacked against investors when it comes to the CEO’s pay. The upshot is that a mediocre-or-worse CEO – aided by his handpicked VP of human relations and a consultant from the ever-accommodating firm of Ratchet, Ratchet and Bingo – all too often receives gobs of money from an ill-designed compensation arrangement.</p></blockquote>
<p>Buffett went on to explain how these consultants simply make outsized pay in any industry the norm by ratcheting up the average, so that all executives in a given “peer group” have to get what everyone else gets:</p>
<blockquote><p>Additionally, the committee is told about new perks that other managers are receiving. In this manner, outlandish “goodies” are showered upon CEOs simply because of a corporate version of the argument we all used when children: “But, Mom, all the other kids have one.” When comp committees follow this “logic,” yesterday’s most egregious excess becomes today’s baseline.<em></em></p></blockquote>
<p>During his talk a year ago at the Berkshire Hathaway annual shareholders meeting, when Buffett called these compensation consultants prostitutes, his vice chairman Charles Munger objected.  “Prostitution would be a step up for them,” Munger said.</p>
<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/05/buffett.jpg"><img class="alignleft size-medium wp-image-830" style="margin-left: 5px; margin-right: 5px;" title="Berkshire Hathaway CEO Warren Buffett rests after a table tennis game in Omaha" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/05/buffett-300x209.jpg" alt="" width="300" height="209" /></a>I came across this ratchet phenomenon when I reported <a href="http://www.time.com/time/magazine/article/0,9171,2136864,00.html">my story about soaring health care costs</a> in the March 4<sup>th</sup> issue of Time. I asked an executive at the Memorial Sloan Kettering Cancer Center how it was that executives at hospitals like his make so much more than people in similar positions at other large non-profit organizations. As an example I used the fact that Sloan Kettering’s chief fundraiser makes $1,483,000, compared to $392,000 for the chief fundraiser at Harvard. His answer was disarmingly, if alarmingly, candid: “All of us hospitals have the same compensation consultants, so I guess it’s a self-fulfilling prophecy.” By which he meant that if the same consultants are setting salaries across the hospital industry, then they will define the average in the peer group, and, of course, they can keep defining it up.</p>
<p>In honor of Buffett having just concluded his latest shareholder love-fest in Omaha last weekend, Reuters, Bloomberg, or the <em>Wall Street Journal</em> ought to do a major project on compensation consultants. Who dominates the setting of executive pay in which industries? How do they do their work? On what basis do they get paid? How do they deal with conflicts? Does any firm puncture the stereotype of Buffett’s Ratchet, Ratchet and Bingo?</p>
<p>In fact, the best story would be one that finds a compensation consultant who is well known for advising board compensation committees that their executives are making too much money. Who knows? Maybe there’s someone carving out that specialty working for activist shareholders. Or maybe there’s someone now working at a laundromat or car wash who tried that approach.</p>
<p><strong><span style="text-decoration: underline;">2. The coming of Al Jazeera America:</span></strong></p>
<p><a href="http://www.chicagobusiness.com/article/20130429/NEWS06/130429756/now-hiring-in-chicago-al-jazeera">This story from <em>Crain</em>’<em>s Chicago Business</em></a> reports that “Al Jazeera America, a new U.S.-based extension of the media organization funded by the Qatar government,” is hiring 800 American journalists, including eight reporters and producers for a Chicago bureau, plus ten other bureaus in cities like Seattle and Dallas, a 120-person Washington office, and a major New York home base. Having spent $500 million to buy Al Gore’s Current TV – which was a business failure but still managed to get placement in tens of millions of cable and satellite TV homes – Qatar is obviously planning to make a serious splash.</p>
<p>So, it’s about time Al Jazeera America got some serious treatment from the press (beyond the stories of Al Gore cashing in with oil money). First, are those numbers – especially the claimed plan to hire 800 journalists – real?  That’s almost as many journalists as the <em>New York Times</em> employs around the world.</p>
<p>And who’s really going to decide what they report? Is this likely to be a serious addition to the TV news line-up that will provide welcome, honest competition for cable news channels that are increasingly more about talk and punditry than reporting? Or, are the suspicions of those who see something more sinister in a government, especially a Middle East oil power, financing such a large and well-distributed news channel justified?</p>
<p><strong><span style="text-decoration: underline;">3. Crime victims and medical bills:</span></strong></p>
<p>In the wake of the Boston Marathon terrorist attack, we’ve seen lots of comforting stories about how Boston area hospitals are forgiving the bills of the injured victims, many of whom are reported to have faced tens or even hundreds of thousands of dollars in bills as they recover from having had limbs amputated. Insurance companies have also been reported to be waiving co-payments or deductibles for the victims, while charities have been organized and richly funded to cover other recovery needs.</p>
<p>It’s a pet peeve of mine that the reports of the amount of the bills &#8212; and, therefore, the hospitals’ claimed charity &#8212; don’t take into account that the hospitals are using their wildly inflated list prices (called “chargemaster” prices), not the amounts they usually get paid, let alone their actual costs. Hospitals routinely tout their charity using these inflated amounts, rather than the cost of the care. Still, it’s great that the victims have been relieved of this burden.</p>
<p>However, I’ll bet that some time during the day or week of the Marathon bombing someone in Boston without adequate insurance was seriously injured by a mugger or drunk driver and is now stuck with the kinds of bills the bombing victims would have faced.</p>
<p>If, as is highly likely, he or she did lack adequate insurance, these victims of more common crimes might now be getting dunned for those inflated chargemaster bills. Indeed, I know from writing about healthcare billing that thousands of crime victims across the country regularly face this double jeopardy assault on their bodies and then on their wallets.</p>
<p>There are varieties of crime victims’ compensation funds across the country, but the degree to which there are publicized and their effectiveness varies dramatically. I’d like to see an ambitious reporter find a poorly-insured mugging or drunk driving victim injured in Boston the week of the bombing and use the difference in aid extended to him or her as a departure point to explore all of that. (It may turn out that Massachusetts has an effective compensation regime for all victims, but if that were the case why all the hoopla over the aid extended to those injured in the Marathon bombing?)</p>
<p>The rationale for aiding terrorism victims more readily than other crime victims is that we want to show the terrorists that as a community we will unite to mitigate the damage they do. Even if one accepts that argument, questions remain about disparate treatment. The 9/11 victims got a government victims compensation fund. The Oklahoma City bombing victims and the Boston victims had to rely on private aid. How come? Why not have a statute that defines the kind of terrorism attack that merits federal compensation? Have any public officials proposed a law like that? If not, why not? And if it has been proposed, why hasn’t it passed?</p>
<p><em>PHOTO: Berkshire Hathaway CEO Warren Buffett rests after a table tennis game in Omaha May 5, 2013 the day after company&#8217;s annual meeting. REUTERS/Rick Wilking </em></p>
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		<title>Lawsuits from tragedy, ubiquitous security cameras, and IRS torpor</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/04/23/lawsuits-from-tragedy-ubiquitous-security-cameras-and-irs-torpor/</link>
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		<pubDate>Tue, 23 Apr 2013 10:28:55 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[boston bombing]]></category>
		<category><![CDATA[irs]]></category>
		<category><![CDATA[lawsuits]]></category>
		<category><![CDATA[security cameras]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=818</guid>
		<description><![CDATA[A judge has opened the door to expensive litigation brought by people who had tragically bad luck against a corporate defendant whose pockets are deep but for whom finding fault would be, to put it mildly, quite a stretch.]]></description>
			<content:encoded><![CDATA[<p><strong>1. </strong><strong><span style="text-decoration: underline;">Does awful luck always have to mean a lawsuit?</span></strong></p>
<p><strong></strong>As <a href="http://newsandinsight.thomsonreuters.com/Legal/News/2013/04_-_April/Placing_blame_for_Aurora_mass_shooting__Is_movie_theater_responsible_/">Alison Frankel reported</a> in her Thomson Reuters litigation column, last week a federal judge in Colorado refused to dismiss a suit brought by victims of the movie massacre in Aurora, Colorado against Cinemark, the theater chain that owned the Aurora venue.</p>
<p>The judge, as Frankel reports, wrote in his decision that “his first reaction to suits against Cinemark was, ‘How could a theater be expected to prevent something like this.’” But he went on to rule, according to Frankel, that:</p>
<blockquote><p>[V]ictims should be allowed to probe exactly what Cinemark knew about past criminal activities at the Aurora theater (which had been the site of occasional gang-related violence), what it should have known about the risk of shootings, and what informed its decisions about safety and security for moviegoers. Holmes [the alleged shooter], after all, apparently made more than one trip from the theater to his car, where he had stored weapons and ammunition, and each time returned to the theater via a door he had propped open. &#8220;This took an extended period of time, but he was not monitored, deterred or contacted by theater personnel,&#8221; the judge said. [Judge] Jackson also noted that the theater didn&#8217;t bring in security guards for the midnight Batman premiere, even though it often hired security on the weekends.</p></blockquote>
<p>To be sure, the judge noted that this was a close call and that he might end up giving the theater owner summary judgment after he reviews pre-trial discovery. Nonetheless, he has opened the door to expensive litigation brought by people who had tragically bad luck against a corporate defendant whose pockets are deep but for whom finding fault would be, to put it mildly, quite a stretch.</p>
<p>Not only does the green light for this case deserve coverage far beyond Frankel’s column, it also suggests lots of related, broader stories:</p>
<p>Will theater owners stop hiring guards occasionally for fear of being held responsible when they don’t?</p>
<p>What will decisions like this do to insurance rates at public venues?</p>
<p>And let’s see a list of all the suits brought (along with their status) against all defendants in this and similar recent tragedies, such as Sandy Hook, Tucson, and now, I guess, the Boston Marathon.</p>
<p>Finally, with all of this in mind, let’s start seeing some probing stories about the litigation that’s probably already brewing as a result of another tragedy last week where the culprit really may be a corporate actor rather then some shallow-pocketed (and, in some cases, dead) mad men: the explosion last week at that fertilizer plant in West, Texas that killed 14 people, left many more missing or severely maimed, and devastated much of the town.</p>
<p>Have plaintiffs’ lawyers already descended <em>en masse</em> on West while the dust is still clearing, as usually happens? Who’s signing up the most clients, and how?</p>
<p>And which corporations responsible for the plant and its safety are their likely targets?</p>
<p><strong><span style="text-decoration: underline;">2. Ubiquitous security cameras:</span></strong></p>
<p><strong></strong><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/security.jpg"><img class="alignleft size-medium wp-image-823" style="margin-left: 5px; margin-right: 5px;" title="Investigators look for evidence near security cameras on the Lord and Taylor department store building at the scene of the Boston Marathon bombings in Boston" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/security-300x221.jpg" alt="" width="300" height="221" /></a>With ubiquitous security cameras (including one positioned outside a department store) having been the key to nailing the alleged Boston Marathon bombers, deploying these remote spy tools is likely to accelerate. As <a href="http://www.dnainfo.com/chicago/20130417/near-west-side/rahm-defends-security-cameras-cites-boston-bomb-investigation">this story</a> reports, even as the FBI and police were just starting to close in on the brothers Tsarnaev, Mayor Rahm Emanuel of Chicago “lauded the use of such cameras in Chicago” and promised to keep buying more.</p>
<p>So, it’s time for a slew of stories about this surging security technology. Who are the big winners in the business? What are the economics? What are the quality differences in the products being sold?</p>
<p>Have any courts impeded the deployment of video recording devices, challenging what seems to be the logical argument that if you can be seen in a public place you have no legal expectation of privacy?</p>
<p>Which cameras also record audio? And doesn’t the possibility of overhearing conversations raise privacy issues beyond those having to do with people in public just being seen?</p>
<p>Have any private parties tried to subpoena video (or audio) recordings from cameras deployed by other private parties or even the police? For example, if a hotel has security cameras in the lobby or at the entrance, has anyone involved in a contentious divorce tried to use the recordings for evidence?</p>
<p>Finally, there’s the phenomenon of facial recognition technology – the process by which video recordings are frozen and the faces of those shown are digitized and then compared with data bases of other digitized photos. It started as a relatively primitive technology, with only near-perfect, straight-on camera shots being able to be matched with each other. And the databases were pretty much limited to mug shots and passport photos. Have things now advanced far enough so that the kinds of street-camera images recorded of the Tsarnaev brothers can produce quick matches? And have other photos, such as drivers’ licenses now been loaded into the databases?</p>
<p><strong><span style="text-decoration: underline;">3. Holding the IRS accountable:</span></strong></p>
<p><strong></strong>Karl Rove’s Crossroads GPS, the conservative political action fund, and others like it continue to be allowed to keep the names of their donors secret because they claims status as a 501 C (4) tax exempt entity under Internal Revenue Service rules that are supposed to be for the benefit of “social welfare” organizations. This designation allows them to evade Federal Election Commission rules requiring that the names of political donors be made public.</p>
<p>Rove’s questionable application to the IRS has been pending for almost three years, and under IRS rules he is free to collect his secret money and spend it on candidates unless and until the IRS rules that he can’t.</p>
<p>Meantime, a growing number of non-profit online local news organizations – formed to take up the slack in vital news coverage caused by staff cutbacks at financially-pressed traditional newspapers – can’t get non-profit, tax exempt status because the IRS is apparently still operating under a guideline it wrote in 1967, under which organizations can’t qualify if they cover the kind of news that commercial newspapers cover.</p>
<p>The sixties were the days, of course, when commercial newspapers were thriving and actually covering a lot of news; there would seem to be a good argument that the news business – and the need for non-profit journalism – has changed 46 years later.  But whatever the merits, for me the more striking story here is that no one seems to be holding the IRS accountable for its actions in these cases, or for its inaction in cases like those in which political slush funds like Rove’s or Organizing For America, the 501 C (4) organized by supporters of President Obama, remain under wraps.</p>
<p>This <a href="http://www.knightfoundation.org/blogs/knightblog/2013/4/8/hope-irs-will-reconsider-outdated-media-rules/">otherwise comprehensive post</a> on the blog of the John S. and James L. Knight Foundation, a leading funder of online news non-profits, illustrates perfectly how the IRS seems to be regarded as an inscrutable, unaccountable building rather than a group of public servants who work for us. The blog post deftly summarizes the argument for the absurdity of the IRS’s position that the new non-profit news organizations don’t qualify for tax exemptions but never tells us the names of the people making these decisions or what their side of the story is. In fact, it seems from other material I have read about the issue, that, as with the controversy over the secret slush funds, the IRS has never been asked to tell us its side.</p>
<p>Why haven’t Treasury Secretary Jack Lew, his predecessor Timothy Geithner, or their IRS Commissioner, Douglas Shulman, been asked to explain their decisions or their inaction? Ditto, the issue <a href="http://blogs.reuters.com/stories-id-like-to-see/2013/03/26/obamacare-and-hospital-costs-sourcing-leno-stories-and-firing-civil-servants/">I wrote about last month</a>  – the IRS’s failure, now more than three years running, to promulgate regulations to implement Obamacare’s important new restrictions on the ability of hospitals to hound and sue poor patients who can’t pay inflated bills.</p>
<p>Memo to Washington reporters: The IRS is not a court, where decisions made, or decisions delayed, aren’t supposed to be questioned by pesky reporters. It’s a division of the executive branch. It’s your job to pester the people behind the curtain.</p>
<p><em>PHOTO: Investigators look for evidence near security cameras on the Lord and Taylor department store building at the scene of the Boston Marathon bombings in Boston, Massachusetts April 18, 2013.  REUTERS/Brian Snyder</em></p>
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		<title>A New York Times home run, piggyback journalism, and hospital TV ads</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/04/16/a-new-york-times-home-run-piggyback-journalism-and-hospital-tv-ads/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/04/16/a-new-york-times-home-run-piggyback-journalism-and-hospital-tv-ads/#comments</comments>
		<pubDate>Tue, 16 Apr 2013 10:55:50 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[bronx]]></category>
		<category><![CDATA[health care]]></category>
		<category><![CDATA[hospitals]]></category>
		<category><![CDATA[justice system]]></category>
		<category><![CDATA[new york times]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=810</guid>
		<description><![CDATA[This item comes under the category of stories I loved seeing.]]></description>
			<content:encoded><![CDATA[<p>1.   <strong><span style="text-decoration: underline;">The <em>Times</em> hits a home run in the Bronx:</span></strong></p>
<p><strong></strong><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/gavel.jpg"><img class="alignleft size-medium wp-image-811" style="margin-left: 5px; margin-right: 5px;" title="The judge's gavel is seen in court room 422 of the New York Supreme Court" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/gavel-300x210.jpg" alt="" width="300" height="210" /></a>This item comes under the category of stories I loved seeing. On Sunday the <em>New York Times</em> did <a href="http://www.nytimes.com/2013/04/14/nyregion/justice-denied-bronx-court-system-mired-in-delays.html?hp&amp;_r=0">a front pager</a> (continued on two full pages inside) by veteran reporter William Glaberson on the collapse of the criminal courts in the Bronx that was about as close to perfection in execution and impact as journalism can get.</p>
<p>Glaberson’s chronicle of epic incompetence and sheer laziness among the judges, prosecutors and just about everyone else mixed mountains of impressive data (endless delays, startlingly low conviction rates) with the kind of personal stories that give the data indelible meaning: A murder defendant who was held in jail for nearly four years before being acquitted recounts how court officers, lawyers and prosecutors would be “laughing and giggling” while they scheduled postponement after postponement, ignoring him so completely that he “felt almost invisible inside the courtroom.” There’s a running narrative, artfully sprinkled in italics throughout the piece, of the agony of the family of a murdered bodega proprietor that is forced to wait five years for the accused killer to come to trial, only to have to face a new trial later this year because stale evidence and the witnesses’ foggy memories resulted in a hung jury.</p>
<p>When a reporter uncovers almost unbelievable data about a system failing, he’s doing a terrific job. When he then ties it this way to real people, he creates a reading experience that is unforgettable. Imagine igniting water cooler conversation about the Bronx criminal justice system rather than Kim Kardashian’s pregnancy. Glaberson did that.</p>
<p>Everything about the piece shows the <em>Times</em> running on all cylinders. The front page photo – of crowds of frustrated witnesses, family members, and prospective jurors waiting to go through under-manned security checkpoints at the entrance to the courthouse – is emblematic of what goes on inside. The chart on the jump page that uses Glaberson’s stopwatch record of how long court was actually in session versus how much time was lost to the judge or lawyers being late or taking breaks or going to lunch or leaving early was a home run, too. The sub-headlines – “Routine Lateness,” “Delay As A Strategy,” “Trouble On The Bench” – all pack the right punch.</p>
<p>The only element missing was how Bronx District Attorney Robert Johnson, whose multi-dimensional incompetence is demonstrated in almost every other paragraph, has kept getting reelected to the point where, at 24 years, he’s the longest serving of New York’s five county prosecutors. I hope Glaberson will get to that. His Sunday story was introduced as the first in a series; yesterday’s second part zeroed in on another key player – a defense lawyer – who has perfected the art of delaying trials while the judges and the prosecutors DA Johnson supervises do nothing to stop him.</p>
<p><strong><span style="text-decoration: underline;">2. Keeping score on derivative journalism:</span></strong></p>
<p>The <em>Times</em>’s Bronx story was quickly picked up and parroted by New York’s local television news stations, which reminds me of a story I’ve wanted to see for a while: It seems that on almost any day one could take the enterprise stories (that is, stories not naturally emanating from obvious news events such as presidential announcements) in the <em>Times</em> and just a few other top news gathering organizations, such as the <em>Wall Street Journal</em>, the <em>Los Angeles Times</em>, and the <em>Washington Post</em>, and pretty much come up with the list of most of what passes for enterprise news stories that we see on television later that day. (A program like “60 Minutes” would be an obvious exception.) Similarly, it seems that local television news organizations, to the extent they continue to report on anything other than the weather, sports and crime, increasingly crib off their local newspapers.</p>
<p>I’d love to see the <em>Columbia Journalism Review</em> or Reuters media columnist Jack Shafer keep a log for a week and identify not only the biggest copy cats but also give us a sense of what we might lose on the air (as well as online) as these sources of real reporting in print continue to suffer budget cuts. There should be one log for, say, a week’s worth of national television news stories, and another targeting local television news in maybe a half a dozen cities of different sizes.</p>
<p><strong><span style="text-decoration: underline;">3. Vanderbilt Hospital’s national media campaign: How come? </span></strong></p>
<p><strong></strong>Lately I’ve been seeing ads on national cable networks advertising the expert care available at the Nashville-based Vanderbilt University Medical Center. Why? As health care costs continue to soar, is this the way hospitals should be spending their money?</p>
<p>The ads, <a href="http://news.vanderbilt.edu/2012/11/vumc-campaign-new-messaging/?utm_source=myvupreview&amp;utm_medium=myvu_email&amp;utm_c">according to the hospital’s website</a>, are meant to convey “the theme of physician-scientists discussing their innovative work in personalized medicine and add first-person vignettes to illustrate how patients and families benefit from the care they have received at VUMC.”</p>
<p>Fair enough, but why spend this money to reach a national audience when the hospital already appears to be booming with patients? According to financial reports filed with the federal Department of Health and Human Services and the IRS, the Nashville hospital’s patient revenue has jumped steadily in the last five years (up 46 percent from $1.2 billion to $1.76 billion) culminating in an operating profit for the last year on file with the IRS of $182.6 million.</p>
<p><a href="http://www.npr.org/2012/01/04/144622719/in-tight-times-medical-schools-market-themselves">An NPR report</a> last year on hospital marketing around the country that mentioned Vanderbilt hinted at one reason. It quoted the hospital’s chief marketing officer as explaining that &#8220;Ultimately, it helps us attract students to Vanderbilt [as well as] faculty and staff.”</p>
<p>But the marketing director added this: “We ourselves are proud of the work that we do, so it&#8217;s really focused in that direction.&#8221; So, is the hospital, flush with cash, spending millions to boost the egos of those who work there? Who decided to launch the ad campaign? How much does it cost? And who’s measuring whether it’s worth the money that otherwise might go to lowering patient bills or providing more aid to those who can’t pay the bills?</p>
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		<title>The revealing Rutgers report, job number revisions, and Trayvon, Inc</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/04/09/the-revealing-rutgers-report-job-number-revisions-and-trayvon-inc/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/04/09/the-revealing-rutgers-report-job-number-revisions-and-trayvon-inc/#comments</comments>
		<pubDate>Tue, 09 Apr 2013 11:05:58 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[charities]]></category>
		<category><![CDATA[college athletics]]></category>
		<category><![CDATA[drones]]></category>
		<category><![CDATA[jobs]]></category>
		<category><![CDATA[lobbying]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=807</guid>
		<description><![CDATA[Some of the stories about the firing of Rutgers basketball coach Michael Rice after a video of him abusing his players in practice was aired on ESPN referred to a 50 page report the university commissioned from an outside lawyer after the videos were first brought to school administrators’ attention. ]]></description>
			<content:encoded><![CDATA[<p><span style="text-decoration: underline;"><strong>1. The Rutgers basketball coach scandal as a window on NCAA sports:</strong></span></p>
<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/rice.jpg"><img class="alignleft size-medium wp-image-808" style="margin-left: 5px; margin-right: 5px;" title="Rutgers Scarlet Knights coach Rice reacts during the first half of their NCAA men's basketball game against the Syracuse Orange in Piscataway" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/rice-227x300.jpg" alt="" width="227" height="300" /></a>Some of the stories about the firing of Rutgers basketball coach Michael Rice after a video of him abusing his players in practice was aired on ESPN referred to a <a href="http://usatoday30.usatoday.com/sports/2013-04-05-rutgers-special-report-with-accepted-changes.pdf">50 page report</a> the university commissioned from an outside lawyer after the videos were first brought to school administrators’ attention. It’s this report that provided the rationale for the school initially to suspend and fine Rice but not dismiss him.</p>
<p>For reporters and columnists (like the <em>New York Times</em>’ Joe Nocera) who have been highlighting how the NCAA has become a profit machine that abuses its unpaid players, the report is worth diving into. It presents an amazingly candid, and grim, view of college athletics, and it would be great to get university presidents far and wide on the record commenting about it.</p>
<p>The report &#8212; written by John P. Lacey, the outside lawyer whose firm conducted the investigation &#8212; describes the offensive scenes shown on the videos and declares that it is “not acceptable for any coach at any time in a university setting to refer to players using curse words accompanied by slang and derogatory references to homosexuals such as “fags” or “faggots,” etc.” So far, so good. But here’s how the report, whose recommendations the Rutgers administration fully accepted, rationalized not jettisoning Rice:</p>
<blockquote><p>Based on the credible information provided to us, we find that many of the actions of Coach Rice, while sometimes unorthodox, politically incorrect or very aggressive, were within the bounds of proper conduct and training methods in the context of preparing for the extraordinary physical and mental challenges that players would regularly face during NCAA Division I basketball games. This permissible training includes screaming at players, cursing, using other foul and distasteful language and expressing frustration and even anger at times. It also includes physical contact during drills and unorthodox training methods to simulate the dramatic and unexpected events that occur during actual games.</p></blockquote>
<p>Really?</p>
<p>The lawyer’s report also contains some fun illustrations of the legal gymnastics lawyers put themselves through at the sacrifice of common sense in the name of political correctness. One example: it seems not to be “harassment” to call someone a “faggot” if you don’t know he’s gay, because in that case you’re not knowingly harassing someone in a “protected class.”</p>
<p><strong><span style="text-decoration: underline;">2. Understanding those jobs numbers:</span></strong></p>
<p><strong></strong>Friday’s release of <a href="http://www.reuters.com/article/2013/04/05/us-usa-economy-jobless-idUSBRE9330HH20130405">March’s lower-than-expected new jobs number</a>, accompanied by significant upward revisions in the previously reported tallies for January and February, cries out for a story explaining exactly how the closely-watched numbers are counted (and revised later).</p>
<p>In <a href="http://blogs.reuters.com/stories-id-like-to-see/2012/03/13/afghan-justice-putins-palace-and-the-edwards-trial/">this space a year ago</a> , I tipped my hat to a <a href="http://www.washingtonpost.com/national/jobs-day-an-economic-and-political-obsession/2012/03/09/gIQADZPW1R_story.html">terrific <em>Washington Post</em> feature</a>  about how the staff at the Labor Department’s Bureau of Labor Statistics takes elaborate pains to keep the market-moving information secret until its public release at 8:30 on the morning of the first Friday of each month. But the piece did not spend much space nailing down exactly how the jobs survey is done, what its weaknesses and strengths are, and what its track record is vis-a-vis subsequent revisions – an especially pertinent question in light of last Friday’s significant upward adjustments for the prior two months.</p>
<p>I’d even like to know who gets surveyed and how, perhaps  by seeing or reading an account from a reporter who watches the BLS people conduct the surveys.</p>
<p><strong><span style="text-decoration: underline;">3. Trayvon, Inc?</span></strong></p>
<p><strong></strong>There were <a href="http://www.orlandosentinel.com/news/local/trayvon-martin/os-trayvon-martin-settlement-20130405,0,6893976.story">news reports last week</a>  that the parents of Trayvon Martin, the Florida teen killed by a neighborhood watch volunteer last year, settled a lawsuit, perhaps for as much as $1 million, that they brought against the homeowners association at the housing complex where their son was shot.</p>
<p>A story about the lawsuit might shed light on how highly-publicized tragedies in America almost always result in settlements like this no matter who, if anyone, is at fault or what the actual legal claim for damages would be. (After all, parents typically can’t claim lost earnings for a deceased child.)</p>
<p>This in turn suggests a broader story for which, sad to say, there is now a lot of fresh material: It would zero in on the curious economics of tragedies like this, focusing on Americans’ apparent impulse to send money to people they sympathize with even if they don’t need the money for anything related to the tragedy and it won’t alleviate their pain.</p>
<p>We saw it with the <a href="http://www.nytimes.com/2013/03/25/nyregion/views-diverge-on-dispersal-of-newtown-aid.html?pagewanted=all&amp;_r=0">more than $15 million</a>  sent to the families of the Newtown, Connecticut children – and you can <a href="http://justicetm.org/">see it here</a> at a website called “JusticeTM,” which solicits contributions for the “Trayvon Martin Foundation.” The purpose of that foundation, its website says, is to “pursue justice on behalf of Trayvon Benjamin Martin.”</p>
<p>What does that mean? The foundation’s required annual filing with the IRS isn’t due yet and won’t be publicly available for at least a year, but the website accepts donation by smart phone of as little as $10. What’s the money used for and how much has been raised?</p>
<p><strong><span style="text-decoration: underline;">4. Covering the AUVSI:</span></strong></p>
<p>What’s the AUVSI? It’s the Association of Unmanned Vehicle Systems International. In other words, it’s the drone lobby. And if you think it’s got to be a new organization because drones have only recently become a big deal, think again. It was founded, <a href="http://www.auvsi.org/AUVSI/Home">according to its website</a>, in 1978, although it went international, adding the “I,” in 1996. According to the website, AUVSI lobbies on issues from “air space” to “frequency spectrum.” Its “Diamond,” “Platinum,” “Gold” and “Silver” level members include corporations from Boeing to Raytheon to GE to Lockheed Martin to companies you’ve never heard of but that sound pretty out there &#8212; such as <a href="http://www.bluefinrobotics.com/">Blue Fin Robotics</a>, whose website says it makes “autonomous underwater vehicles.”</p>
<p>Any news organization looking for a window into this hot industry and all the regulatory, technical and policy issues associated with it, should drop in on the folks at AUVSI and see what they do all day.</p>
<p><em>PHOTO: Rutgers Scarlet Knights coach Mike Rice reacts during the first half of their NCAA men&#8217;s basketball game against the Syracuse Orange in Piscataway, New Jersey February 19, 2012. REUTERS/Bill Kostroun</em></p>
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		<title>Steve Cohen&#8217;s frustrated PR machine; unlikely lobbyists; and the $600 million train station</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/04/02/steve-cohens-frustrated-pr-machine-unlikely-lobbyists-and-the-600-million-train-station/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/04/02/steve-cohens-frustrated-pr-machine-unlikely-lobbyists-and-the-600-million-train-station/#comments</comments>
		<pubDate>Tue, 02 Apr 2013 11:30:18 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[government spending]]></category>
		<category><![CDATA[lobbying]]></category>
		<category><![CDATA[public relations]]></category>
		<category><![CDATA[Steven Cohen]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=797</guid>
		<description><![CDATA[Steven Cohen, the billionaire who is widely reported to be the ultimate target of prosecutors investigating insider trading at his hedge fund, has to be either crazy-reckless or supremely confident of his innocence.]]></description>
			<content:encoded><![CDATA[<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/cohen.jpg"><img class="alignleft size-medium wp-image-798" style="margin-left: 5px; margin-right: 5px;" title="Hedge fund manager Cohen, founder and chairman of SAC Capital Advisors, responds to a question during an interview at the SALT Conference in Las Vegas" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/04/cohen-300x204.jpg" alt="" width="300" height="204" /></a><strong><span style="text-decoration: underline;">1. Inside Steven Cohen’s frustrated PR machine: </span></strong></p>
<p>Steven Cohen, the billionaire who is widely reported to be the ultimate target of prosecutors investigating insider trading at his hedge fund, has to be either crazy-reckless or supremely confident of his innocence. Either way, the master-of-the-universe buying spree he went on last week must make him the ultimate nightmare for the savvy financial PR firm that represents him, Sard Verbinnen &amp;Co.</p>
<p>On the heels of a proposed $616 million insider trading civil settlement with the SEC – which <a href="http://dealbook.nytimes.com/2013/03/28/judge-questions-s-e-c-settlement-with-steven-cohens-hedge-fund/">a federal judge last week</a> said he was skeptical about approving because Cohen’s firm admitted no wrong-doing, and which prosecutors have taken pains to point out does not end their criminal investigation – Cohen made headlines last Monday by buying a Picasso for $155 million. The next day he got still more ink, this time for snagging a place in the Hamptons for $60 million down the road from an estate he already owns there.</p>
<p>That’s hardly the kind of keep-your-head-down behavior one might expect from someone trying to hold prosecutors at bay and soften public calls for his beheading. When a longtime top deputy was marched out of his Park Avenue coop early Friday morning after being arrested by the FBI, the bulls-eye on Cohen became that much more obvious and made his over-the-top buying spree that much more bizarre.</p>
<p>So, while the straight news stories about these purchases or about the ongoing investigation are fine, I’d like to read something about whether this guy is crazy, and about what his PR people at Sard Verbinnen – who’ve represented such villains-of-the-moment as Martha Stewart and former Lehman Brothers CEO Richard Fuld – have been telling him about this kamikaze behavior.</p>
<p>Could Cohen be so deluded that he thought that the purchases – which were destined to become highly publicized because of their size and which Cohen’s PR people made no effort to hide – would provide “What-me-worry?” reassurance to his investors or be an intimidating display of strength to the prosecutors? I’d pay a lot for the video rights to whatever discussions Cohen had about all of this with the Sard Verbinnen team, but I’ll settle for a print story with some leaks of the conversations.</p>
<p>Sard Verbinnen founder and CEO George Sard is usually the member of the firm most identified publicly with high profile clients; he memorably was photographed sitting just behind Fuld when the fallen Lehman CEO was dragged before a Congressional investigating committee. Yet only Jonathan Gasthalter, who works for Sard, has been named as speaking on behalf of Cohen. What’s the story behind that?</p>
<p><strong><span style="text-decoration: underline;">2. Unlikely lobbyists:</span></strong></p>
<p><strong></strong>Question: Why would the Corrections Corporation of America, a for-profit business that provides outsourced jail and prison facilities to cities and states hoping to save money on incarceration, be lobbying against immigration reform?</p>
<p>Stumped?</p>
<p>As explained in this item <a href="http://www.opensecrets.org/MT/mt-search.cgi?search=Corrections+Corporation&amp;IncludeBlogs=8">from the Center for Responsive Politics</a> (the terrific organization that monitors political spending in Washington), the company makes significant money jailing detained illegal immigrants, and immigration reform might result in reduced detentions.</p>
<p>This suggests an ongoing series for the <em>Washington Post</em> or Politico that covers Capitol Hill and, better yet, any newspaper covering a state capital: Spotlight the most unlikely special interest lobbying for or against something.</p>
<p>Sure, it’s easy to figure out that the soda industry will be wary of regulations aimed at curbing obesity. Or that the oil and gas people will line up against rail subsidies. But how about some special interest positions that are more interesting?</p>
<p>Are makers of CT scan and MRI equipment trying to block medical malpractice tort reform because it might reduce the number of unnecessary tests that doctors order in the emergency room just to protect themselves, thereby creating an unlikely alliance between big corporations like GE and Siemens and their traditional foes in the plaintiffs lawyers’ bar?</p>
<p>Or are police unions fighting laws allowing cameras to catch speeders because from their perspective anything that replaces a cop can’t be good? Yes, at least in Albany; <a href="http://www.nytimes.com/2013/03/28/nyregion/bloomberg-expresses-rage-over-failed-plan-for-speed-tracking-cameras.html">this story</a>  reports that the police unions’ successful opposition drove New York City Mayor Michael Bloomberg into a tirade last week against legislators who, in his view, caved to special interests.</p>
<p>A series like this would be a fun way to shine light on how, depending on your point of view, special interests selfishly block progress for the narrowest of reasons &#8212; or are there to make sure every side is heard.</p>
<p><strong><span style="text-decoration: underline;">3. A $600 million question:</span></strong></p>
<p><strong></strong>Sorry to repeat a trick, but here’s another quiz: Which part of <a href="http://www.nypost.com/p/news/local/manhattan/old_south_ferry_subway_station_to_KBaWOFzexDxcaYWkBA1FPL">this routine report</a> from the <em>New York Post</em> is loaded with story potential?</p>
<blockquote><p>The old South Ferry subway station will reopen for business in the first week of April, Gov. Cuomo announced today.</p>
<p>The 100-year-old loop station has been closed since 2009, when the MTA opened a $545 million replacement stop directly above it.</p>
<p>The MTA will use the old station while doing repairs on the new one, which was severely damaged in Hurricane Sandy.</p>
<p>The cost to fix the brand new station — which was heavily flooded — could be as high as $600 million.</p>
<p>It will take two years to complete the repairs, officials said.</p></blockquote>
<p><em></em>Answer: “$600 million” to <em>repair</em> a train station?  How can that be?</p>
<p>Other than <a href="http://secondavenuesagas.com/2012/11/27/the-600-million-south-ferry-conundrum/">this story</a> on a terrific website I found called “Second Avenue Sagas” that covers the New York City subway system, the reports I’ve seen on local New York television stations and in the press parrot the Metropolitan Transportation Authority’s  estimated $600 million tab for repairing a train station as a given, the way they might report on the weather. (Well, actually, that’s not true; the weather is often breathlessly hyped.)</p>
<p>A quick Google search puts $600 million in perspective. Airbus, the giant jet manufacturer , is <a href="http://live.wsj.com/video/airbus-plans-600-million-plant-in-us/40CB60D0-01E9-412F-917A-B2D9004013A6.html#!40CB60D0-01E9-412F">spending that much</a> to build and equip a vast assembly line plant in Alabama to churn out hundreds of jets a year. <a href="http://online.wsj.com/article/SB10001424127887323829504578269953013696498.html">GM is about to spend $600 million</a>  on a new 450,000 square ft. factory in Kansas. The Arizona Cardinals built their new football stadium in Phoenix for $456 million.  Add 10% to the $600 million – I’ll bet there’s a cost overrun at the subway station of that much and more – and you could cover the entire budget for the San Francisco school system. All to repair a subway station.</p>
<p>Can’t someone do a dollar by dollar breakdown of that $600 million and follow all the money? Let’s see which contractors are making what kinds of profits. Which architects or designers are getting rich off of the Hurricane Sandy repair? What are the suppliers’ profit margins? Are union rules forcing wasteful staffing?</p>
<p>Why does the press take these expenses as a necessary fact of life? Following the money is always a good story.</p>
<p><em>PHOTO: Hedge fund manager Steven A. Cohen, founder and chairman of SAC Capital Advisors, responds to a question during a one-on-one interview session at the SkyBridge Alternatives (SALT) Conference in Las Vegas, Nevada May 11, 2011. Reuters/Steve Marcus</em></p>
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		<title>Obamacare and hospital costs; sourcing Leno stories; and firing civil servants</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/03/26/obamacare-and-hospital-costs-sourcing-leno-stories-and-firing-civil-servants/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/03/26/obamacare-and-hospital-costs-sourcing-leno-stories-and-firing-civil-servants/#comments</comments>
		<pubDate>Tue, 26 Mar 2013 10:50:28 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[government spending]]></category>
		<category><![CDATA[health care costs]]></category>
		<category><![CDATA[nbc]]></category>
		<category><![CDATA[television]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=789</guid>
		<description><![CDATA[Here’s a compelling story for any reporter who wants to shine light on a failure of basic competence – or maybe it’s backbone – by the Obama administration on an issue that affects millions of middle class and poor Americans and that was supposed to be the president’s number one priority.]]></description>
			<content:encoded><![CDATA[<p><span style="text-decoration: underline;"><strong>1.  Obama administration malingers on hospital bill collecting abuses:</strong></span></p>
<p><strong></strong>Here’s a compelling story for any reporter who wants to shine light on a failure of basic competence – or maybe it’s backbone – by the Obama administration on an issue that affects millions of middle class and poor Americans and that was supposed to be the president’s number one priority.</p>
<p>In the article about healthcare prices that <a href="http://www.time.com/time/magazine/article/0,9171,2136864,00.html">I wrote last month for TIME</a>, I reported that supposedly non-profit hospitals not only charge ridiculously inflated prices (from a price list called the chargemaster) to people who are uninsured or underinsured, but they also routinely sue and demand that those full prices be paid. It’s a prime reason medical bills are the cause of more than 60% of personal bankruptcies and even more demolished credit ratings across the country.</p>
<p>However, one of the little-noticed provisions of Obamacare, which was passed three years ago this week, requires that non-profit hospitals, as a condition of keeping their tax exempt status, must adhere to rules to be promulgated by the IRS that would, among other things, not allow them to send bill collectors or lawyers after patients except under certain conditions. Those conditions include that the patients first be informed through aggressive outreach efforts of the availability of financial aid for patients unable to afford the bills and, more important, that for patients whose incomes are below certain levels, hospitals can only dun them or sue them for the discounted amounts they usually charge insurance companies, rather than the far higher chargemaster prices.</p>
<p>In theory, the IRS, which is a unit of the Obama Administration’s Treasury Department, could have promulgated those regulations at any time after March 23, 2010, the day Obamacare was signed into law. But the first draft of the rules was not issued until two and a half years later – last summer. And then the American Hospital Association’s lobbyists pushed back, calling the proposed rules “too prescriptive.” (To me, if anything, they seemed not prescriptive enough.) Since then, nothing has happened. No final rules have been published. That means that three years after the Obamacare signing ceremony in the White House there is still no protection from hospital lawyers and bill collectors for the patients least able to pay.</p>
<p>Any reporter who wants a legitimate gotcha story should ask the people drawing salaries at the Tax Exempt Government Entities division of the IRS and at its Chief Counsel&#8217;s office, as well as the Office of Tax Policy in the Treasury Department, why it takes more than three years to write rules that would immediately protect millions of Americans from the most blatantly unfair aspect of our healthcare system.  Or, next time he has a presidential press conference, why not ask the man who said health care reform was his highest priority?</p>
<p><strong><span style="text-decoration: underline;">2. Another story behind the Jay Leno story?</span></strong></p>
<p><strong></strong><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/lenobama.jpg"><img class="alignleft size-medium wp-image-790" style="margin-left: 5px; margin-right: 5px;" title="U.S. President Barack Obama smiles during taping of the Tonight Show with Jay Leno Show in Burbank" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/lenobama-300x215.jpg" alt="" width="300" height="215" /></a>Yes, it’s interesting that NBC is moving to replace late night host Jay Leno with Jimmy Fallon. But to me what’s more interesting is how the entire story, which has made headlines across the country and especially in New York, has relied wholly on anonymous sources. <a href="http://www.nytimes.com/2013/03/21/business/media/tonight-show-expected-to-return-to-new-york-with-fallon.html?ref=media&amp;"><em>The New York Times</em> scoop last week</a> by Bill Carter – who wrote a best-selling book on the network’s late-night competition and seems to have access to everyone involved – contained not a single named source.</p>
<p>Carter’s lead, that “NBC has settled on two new stars for ‘The Tonight Show’: Jimmy Fallon and New York City,” explained that the news that Fallon was going to succeed Leno and move the show to New York was “according to several senior television executives involved in the decision.” (By the way, how many is “several”? Couldn’t Carter at least tell us that?)</p>
<p>From there the sources became “the executives,” “one senior executive,” “the executives,” “many TV executives speculated” (how many is “many”?), “two executives” and, finally, an “NBC spokeswoman,” who “declined comment on the move.”</p>
<p>I don’t doubt that the story is true. But I wish another reporter would try to figure out who those sources were – because that may be at least as interesting a story.</p>
<p>Here’s why: Depending on who the sources are, the leaks to Carter and others might either have been a concerted effort by both the Leno and NBC camps to begin a gradual and trouble-free transition, or they could have been the opening round in new game of corporate back stabbing.</p>
<p>Interestingly, Carter never writes about whether he asked Leno to comment. That seems to suggest that the leaks came only from the NBC side, in which case they would be evidence of an NBC effort to push Leno out early.</p>
<p>Carter writes that despite the fact that Leno is still leading in the ratings, “many TV executives speculated that NBC could not wait too long to promote Mr. Fallon, or it might risk having Mr. Kimmel [Jimmy Kimmel, who is on ABC opposite Leno], 45, lock up the young adult viewers who are the lifeblood of late-night television.”</p>
<p>So, was Leno blindsided by the stories? Is this a reprise of NBC’s ham-handed effort in 2010 to juggle Leno and Conan O’Brien?</p>
<p>In short, the fact that all of these sources are anonymous and don’t seem to include anyone from the Leno camp suggests that Carter’s story should become part of another fun story: “Network Moves to Push Out Popular Late Night Star Without Leaving Fingerprints.”</p>
<p><strong><span style="text-decoration: underline;">3. What do you have to do to get fired in Washington?</span></strong></p>
<p><a href="http://www.washingtonpost.com/politics/gsa-executive-fired-after-las-vegas-scandal-ordered-to-get-his-job-back/2013/03/13/279ad318-8b5b-11e2-b63f-f53fb9f2fcb4_story.html">The week before last</a> the <em>Washington Post</em>  reported that the federal General Services Administration “was ordered…to reinstate a senior executive who lost his job last year amid revelations of <a href="http://www.washingtonpost.com/politics/gsa-chief-resigns-amid-reports-of-excessive-spending/2012/04/02/gIQABLNNrS_story.html">lavish spending</a> at a Las Vegas conference.”  Something called the Merit Systems Protection Board, the <em>Post</em> reported, had “ruled the agency failed to prove that the career civil servant in charge of federal buildings in the Rocky Mountain region was guilty of misconduct.”</p>
<p>The official, Paul Prouty, was awarded eleven months’ back pay and returned to his job as head of federal buildings in the agency’s Rocky Mountain region.</p>
<p>As the <em>Post</em> reminded it readers, “The $823,000 conference… became an embarrassment for the Obama administration after GSA Inspector General Brian Miller [reported] last April on a four-day junket that had spun out of control. Lodging at an opulent hotel, entertainment by a $3,200 mind reader, after-hours parties in 2,400-square-foot loft suites, a $7,000 sushi reception, a bicycle-building exercise — all took place at taxpayers’ expense. The planning included about six scouting trips, at a tab of $130,000.”</p>
<p>According to the <em>Post</em>, “dozens of employees from Prouty’s staff in Region 8 attended the conference.” But his lawyer told the <em>Post</em> that although Prouty “engaged in some of the planning, GSA was unable to provide any evidence of misconduct.”</p>
<p>“At least two other fired senior executives are awaiting rulings from the merit board on similar appeals,” the <em>Post</em> noted.</p>
<p>So here’s an obvious follow-up: What does it take to fire a senior civil servant? Can incompetence ever be good enough, or must there be proof of misconduct, which has more to do with motive than performance? And is anyone in Congress or elsewhere pushing for a change in these budget-challenged times? (Then again, it would seem odd for anyone in Congress to want simple incompetence to be a trigger for losing a job.)</p>
<p>I bet a good reporter with a knack for conveying the absurd would have a field day attending a few Merit Systems Protection Board hearings.</p>
<p><em>PHOTO: U.S. President Barack Obama smiles during taping of the Tonight Show with Jay Leno Show in Burbank, California October 25, 2011.  REUTERS/Jason Reed </em></p>
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		<title>Presidential aloofness, a patent rush, and disclosing Washington corruption</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/03/19/presidential-aloofness-a-patent-rush-and-disclosing-washington-corruption/</link>
		<comments>http://blogs.reuters.com/stories-id-like-to-see/2013/03/19/presidential-aloofness-a-patent-rush-and-disclosing-washington-corruption/#comments</comments>
		<pubDate>Tue, 19 Mar 2013 10:08:46 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[congress]]></category>
		<category><![CDATA[government contracting]]></category>
		<category><![CDATA[homeland security]]></category>
		<category><![CDATA[obama administration]]></category>
		<category><![CDATA[patents]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=782</guid>
		<description><![CDATA[Can you do a comparison of how many times before his recent flurry of congressional encounters President Obama has met with members of the House and Senate? ]]></description>
			<content:encoded><![CDATA[<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/Obamahill.jpg"><img class="alignleft size-medium wp-image-783" style="margin-left: 5px; margin-right: 5px;" title="U.S. President Obama departs the U.S. Capitol after meeting with Senate Democrats in Washington" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/Obamahill-300x209.jpg" alt="" width="300" height="209" /></a><strong>1.   </strong><strong><span style="text-decoration: underline;">A scorecard on presidential aloofness:</span></strong></p>
<p>Mark Knoller is the award-winning, long time CBS News White House correspondent famous for keeping count of everything that goes on in the White House, such as presidential press conferences, speeches, visits to various states and even golf outings. Memo to Mark or anyone else who wants to put some meat on the bones of all the reports about how President Obama &#8212; whose charm offensive on Capitol Hill has dominated last two weeks’ headlines  &#8212; has until now been so unusually disengaged with Congress: Can you do a comparison of how many times before his recent flurry of congressional encounters President Obama has met with members of the House and Senate? It could include a sub-category of one-on-one sessions, and compare Obama’s record, if possible, with the stats for presidents going as far back as you can. (Maybe Bob Caro can help you even get the LBJ numbers.)</p>
<p>A tally of one-on-one phone calls would be great, too.<strong></strong></p>
<p><strong>2.   </strong><strong><span style="text-decoration: underline;">Black Friday at the patent office?</span></strong></p>
<p>Saturday morning at 12:01 marked a key deadline in the world of intellectual property. Under a change in patent law passed in September 2011 and scheduled to take effect on Saturday, March 16, 2013, rules governing new applications for seemingly the same inventions will shift from giving priority to whoever first invented a claimed invention to whoever first filed a patent application for it. It’s complicated, but this is a drastic change in patent law and means that anyone claiming a patent who is worried about competing claims would have a huge leg up by filing the application as soon as possible beginning on March 16.</p>
<p>Patent law has become a multi-billion dollar legal sweepstakes. So was the patent office flooded over the weekend? Was there a run up to March 16 equivalent for patent lawyers to the black Friday holiday rush for retailers?</p>
<p><strong>3.   </strong><strong><span style="text-decoration: underline;">Dealing with D.C. corruption:</span></strong></p>
<p><a href="http://www.washingtonpost.com/politics/grand-jury-investigating-sen-robert-menendez-d-nj-people-familiar-with-probe-say/2013/03/14">On Friday</a>, the <em>Washington Post</em>  reported that a grand jury had been convened to hear federal prosecutors’ evidence against New Jersey Democratic Senator Bob Menendez, who is under a cloud following reports that he interceded on behalf of an ophthalmologist friend who gave him plane rides to and lodging at the doctor’s vacation home in the Dominican Republic and contributed $700,000 to a campaign fund for senate Democrats that Menendez ran. Menendez is charged with interceding with State Department officials to protect a security contract a company owned by the doctor had with a Dominican port agency, and with prodding senior Department of Health and Human Services officials to cut off an investigation regarding hundreds of thousands of dollars the doctor allegedly overbilled Medicare.</p>
<p>Here’s what’s more disturbing about the article than the senator’s possible misconduct: The <em>Post</em> accurately reported that, “Federal bribery laws require proof that a politician received something of value with the express purpose and understanding that it was to influence his or her official action.” As Stewart Brand, a lawyer who specializes in defending politicians on corruption charges explained to the <em>Post</em>, “You must show an absolutely direct nexus between the thing of value and the intent and the official act&#8230;.Unless you have a wiretap or direct evidence of an official saying, ‘I’ll do this for that,’ it’s too hard to show that.”</p>
<p>In other words, favoritism toward a huge donor without proof of an explicit quid pro quo is not going to land a politician in prison. In terms of our high standards of proof beyond a reasonable doubt before we convict someone, that may make sense. But it’s a pretty poor standard when it comes to the people we entrust to run our country.</p>
<p>So here’s an idea for any reporter covering Congress. Grab a microphone and ask members on both sides of the aisle if they would support a rule – if not a law, just a simple ethics rule that could be promulgated by both the Senate and the House as a housekeeping measure – that would require any legislator to disclose any conflict of interest when performing any official act, such as voting on legislation, holding hearings, or interceding with a federal agency.</p>
<p>In other words, when Menendez or a staff member wrote to the State Department about his pal’s port deal, he would have been required to disclose to those officials, and also make public on his own website that the doctor was a good friend who had paid for his vacations and donated $700,000 to his campaign fund. More generally, whenever a member of the House or Senate cast a vote that helped a campaign donor, hurt a campaign donor’s competitors or aided the cause of a lobbyist- donor, he or she would be required to disclose it.</p>
<p>Would this result in a blizzard of disclosures accompanying almost every vote or other official act? Probably. But that kind of sunlight and accompanying embarrassment would be the point.</p>
<p>It would be fun to watch politicians squirming to figure out a way to avoid supporting a basic public policy principal – transparency – that seems as American as apple pie and that is free of the First Amendment issues that trump most efforts to regulate lobbying or campaign contributions. This, after all, is only about disclosure, not about prohibiting anything. The first interview, of course, should be with Menendez, who has repeatedly said he has nothing to hide. So doesn’t he think it would have been better to disclose his relationship with the good doctor when he took these unusually aggressive steps to intercede on the doctor’s behalf so that his constituents could then judge whether he was acting in the public interest?</p>
<p><strong><span style="text-decoration: underline;">4. Procurement Follies and the sequester:</span></strong></p>
<p><strong></strong>A favorite line of liberals to explain their support of Rand Paul having used a 13-hour filibuster to question the president’s drone strike policies is that, as the saying goes, “a broken clock is right twice a day.”</p>
<p>Lately a lot of conservative blogs, <a href="http://theconservativetreehouse.com/2013/03/04/the-buildup-continues-dept-of-homeland-security-purchases-2700-mraps-mine-">like this one</a> , have sounded the alarm that the Department of Homeland Security (DHS) has ordered more than 2,700 “mine-resistant armor protected vehicles” for domestic use. Could this be the second time the clock has been right?</p>
<p>My guess is that despite the right wing bloggers’ theory that these armored vehicles are for general “domestic use” on the “streets of the United States,” if they were ordered, the explanation from DHS will be that they are needed for border patrols. While not a tip-off to an Obama declaration of martial law or some such thing, that explanation would be a good lead-in to a sequester-oriented story about how so many of DHS’s procurement programs are emblematic of rampant waste and cronyism in Washington. For a refresher on one such multi-billion dollar fiasco – in this case, the failed deployment of high-tech sensors on the border rather than armored vehicles &#8212; see <a href="http://blogs.reuters.com/stories-id-like-to-see/2012/01/24/more-primary-math-boeings-second-chance-and-dhs-mission-creep">an item I wrote in this space</a> last year.</p>
<p>That in turn suggests a broader, more fundamental story: Why hasn’t the <em>Washington Post</em> or Politico (assuming it aspires to go beyond D.C. process stories in a big, substantive way) scoured the various agencies and done its own thinking man’s sequester budget by finding obvious waste and expendable programs, the elimination of which would yield the $85 billion targeted in the sequester?</p>
<p><em>PHOTO: U.S. President Barack Obama departs the U.S. Capitol after meeting with Senate Democrats in Washington March 12, 2013. REUTERS/Kevin Lamarque</em></p>
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		<title>Congress&#8217;s friendly skies, and battle of the dumb lawyers</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/03/12/congresss-friendly-skies-and-battle-of-the-dumb-lawyers/</link>
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		<pubDate>Tue, 12 Mar 2013 12:42:14 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[airlines]]></category>
		<category><![CDATA[congress]]></category>
		<category><![CDATA[lawyers]]></category>
		<category><![CDATA[teachers' unions]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=774</guid>
		<description><![CDATA[I was told that each airline has a travel agency-like staff in Washington that is an adjunct of its lobbying office.]]></description>
			<content:encoded><![CDATA[<p><strong>1.   </strong><strong><span style="text-decoration: underline;">Air Congress:</span></strong></p>
<p><strong></strong><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/snow1.jpg"><img class="alignleft size-medium wp-image-779" style="margin-left: 5px; margin-right: 5px;" title="A man walks past the U.S. Capitol during a second major snow storm to affect the Atlantic coast in five days, in Washington" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/snow1-300x227.jpg" alt="" width="300" height="227" /></a>As a snowstorm threatened Washington, D.C., last Wednesday night, there were TV news reports showing members of the House hustling down the Capitol steps so they could get to the airport to catch flights home. This reminded me of something I’ve been curious about for a while.</p>
<p>Several years ago, when I was doing reporting for a book on the aftermath of 9/11 about how the airlines lobbied Congress to block airport security initiatives that they thought would be too onerous, I was told that each airline has a travel agency-like staff in Washington that is an adjunct of its lobbying office. Its sole purpose, one airline lobbyist told me, is to assist members of the House and Senate with their weekly trips home and back. These staffers get the call if a legislator has to change flights because of a last-minute vote.</p>
<p>That sounds innocent enough, but does it mean that someone else gets bumped off a full flight? What kind of other special arrangements, if any, do these airline facilitators make for our legislators that help them avoid the hassles of modern air travel faced by their constituents? How “white glove” is this service?</p>
<p>Do they provide priority upgrades into first class? Do they hold planes for their friends in Congress if they are running late? What about cutting through the security lines? (I bet the more recognizable pols would be afraid to do this at their home airports, but who knows? That’s why I’d assign the story.)</p>
<p>Which airline floods the zone the most with this kind of assistance?</p>
<p>I’m not sure how much we should begrudge these super-frequent-flier public servants some accommodation, but it would be fun to find out just how much of a break they actually get.</p>
<p>2. <strong><span style="text-decoration: underline;">Who’s dumber, Martha’s lawyers or JCPenney</span></strong><strong><span style="text-decoration: underline;">’s?</span></strong></p>
<p>There was only one item missing from <a href="http://www.nytimes.com/2013/03/09/business/the-headache-in-housewares-for-j-c-penney.html?ref=business&amp;_r=0">this terrific column</a>   by James Stewart in last Saturday’s <em>New York Times</em> business section, taking us inside the litigation involving Martha Stewart’s alleged breach of her exclusivity contract with Macy’s by agreeing to sell her merchandise in JCPenney stores. Stewart artfully pointed out the laughable transparency of Martha’s scheme to claim that Penney was going to set up “Martha Stewart stores” within it JC Penney department stores. Because her Macy’s deal allowed her to sell her merchandise if she set up her own stores, this arrangement was not a breach, according to the Stewart-Penney side.</p>
<p>Columnist Stewart, who seemed to be restraining himself from outright ridiculing Martha’s and Penney’s argument on the pages of the <em>Times</em>, matter-of-factly cited testimony that Penney, not Martha Stewart’s company, would “set prices of the merchandise, decide when it would be promoted, employ the people who sold the goods, own the goods, source the goods, book the sales, bear the risk and own the shop. No space would be leased to Martha Stewart’s company.”</p>
<p>But the <em>Times</em>’s Stewart and everyone else whose reports on this I’ve read have so far left one thing out: Who indemnified whom  for what everyone had to know would be an inevitable lawsuit from Macy’s?</p>
<p>Typically a buyer (in this case, Penney) will seek to be indemnified in licensing and resale deals by the seller (Martha Stewart) for any litigation arising out of the relationship, or at the least for any litigation arising out of the seller’s representation in the contract that the seller is not bound by any other contract from agreeing to the new contract.</p>
<p>But Martha’s lawyers had to know that at best they were skating on thin ice with their interpretation of the Macy’s contract and the loophole they were going to use to do the Penney deal. (I think I’m being generous here.)</p>
<p>So, I’m certain they would have negotiated hard not to indemnify Penney. Perhaps they even balked at providing the absolutely routine seller’s warranties and representations that no other contracts or obligations prevented them from entering into the Penney contract. In fact, maybe they even tried to have Penney indemnify them. That, of course, should have been a giveaway to the Penney side that this deal could be big trouble, just as it should be the best evidence at the trial that Martha and her team knew they were doing something wrong. On the other hand, if Penney and its lawyers yielded on these issues, it would mean they were colossally clueless or so desperate to strike a deal that they ignored the inevitable consequences.</p>
<p>In short, for me, the negotiation over the indemnity clause and the warranties and representations could be the most interesting part of this story – a tale of who’s dumb and who’s dumber.</p>
<p>Ron Johnson, the former head of Apple’s retail operation whom JC Penney hired as CEO at the end of 2011, has already become a Wall Street piñata for having made a slew of strategic pricing and marketing decisions that have nearly tanked his company. In addition to all that, it’s now clear that he made a deal with Martha Stewart that so obviously flouted a contract that it was destined to end up in court. What were he and his lawyers thinking? The indemnities and warranties and representations clauses and the negotiation over them will tell that story.</p>
<p><strong><span style="text-decoration: underline;">3. Union boss, Mexican-style:</span></strong></p>
<p><strong></strong><a href="http://qz.com/59797/the-fall-of-a-latin-american-leader-this-week-that-matters-more-than-hugo-chavez/">This story</a> on Quartz.com, the smart new digital-only daily business report, deserves follow-up by broader news outlets. It’s about Elba Esther Gordillo, who has just been jailed in Mexico for alleged embezzlement.</p>
<p>According to Quartz, Gordillo is:</p>
<blockquote><p>the head of the Mexican teachers’ union, which, with 1.5 million members, is the largest union in Latin America. She used union contributions of Mexican teachers to become a millionaire who flew in private jets, owned two mansions in San Diego, California, and spent $3 million shopping in Neiman Marcus alone. She and her allies had other sources of income, though. She turned the union’s control over all teaching positions in the country into a private ownership system—ownership meaning that union bosses could inherit, bequeath, sell or rent these positions to other people.</p></blockquote>
<p>Other news outlets, including the <em>Guardian</em> and Huffington Post, have run stories about her, but there are lots of good angles still to be explored. For example, what does Dennis Van Roekel, the hard-line president of the National Education Association, America’s largest teachers’ union, have to say about Gordillo and her arrest? What dealings have the two leaders and their unions had, if any?</p>
<p>What about Randi Weingarten the less-hard-line head of the smaller American Federation of Teachers? Both unions in the past have preached international solidarity. Did Gordillo and her alleged wrongdoing make them back off when it came to Mexico?</p>
<p>This story also makes me curious about the general political standing and challenges faced by unions and their leaders in developing countries and in countries, such as those in Europe, where traditional union perquisites are now under such heavy challenge.</p>
<p>Beyond that, if I were still writing about education reform in the United States and spending time with Weingarten, I’d love to ask her why she never tried to put me on to Gordillo and Mexico to make herself look good and her tough stance on union rights look moderate by comparison. As in, “If you think I’m bad, take a look south of the border.”</p>
<p><em>PHOTO: A man walks past the U.S. Capitol during a second major snow storm to affect the Atlantic coast in five days, in Washington February 10, 2010. REUTERS/Jason Reed</em></p>
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		<title>Coming up with “A Bitter Pill”</title>
		<link>http://blogs.reuters.com/stories-id-like-to-see/2013/03/05/coming-up-with-a-bitter-pill/</link>
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		<pubDate>Tue, 05 Mar 2013 12:02:02 +0000</pubDate>
		<dc:creator>Steven Brill</dc:creator>
				<category><![CDATA[health care costs]]></category>
		<category><![CDATA[time]]></category>

		<guid isPermaLink="false">http://blogs.reuters.com/stories-id-like-to-see/?p=764</guid>
		<description><![CDATA[Since this is supposed to be a column about good story ideas, I think I’ll use it to explain the genesis of “A Bitter Pill” in more detail than I’ve been able to on the talk show circuit.]]></description>
			<content:encoded><![CDATA[<p><a href="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/TIMEcover.jpg"><img class="alignleft size-medium wp-image-765" style="margin-left: 5px; margin-right: 5px;" title="TIMEcover" src="http://blogs.reuters.com/stories-id-like-to-see/files/2013/03/TIMEcover-225x300.jpg" alt="" width="225" height="300" /></a>For the past 10 days I’ve been interviewed on various <a href="http://www.thedailyshow.com/watch/thu-february-21-2013/steven-brill">television</a> and <a href="http://thedianerehmshow.org/shows/2013-02-27/us-health-care-costs/transcript">radio</a> shows about the article I wrote for the March 4 issue of <em>T</em><em>ime</em>, called “A Bitter Pill.”  It’s all about how exorbitant prices and profits are at the core of the crisis America uniquely faces when it comes to financing healthcare, the cost of which now accounts for roughly a fifth of our gross domestic product. The article took a new approach to reporting on an overreported issue by avoiding “on the one hand, on the other hand” policy analysis. Instead, I took actual medical bills and dissected them line by line.</p>
<p>Invariably a question has come up in these interviews about how I thought of that approach. So, since this is supposed to be a column about good story ideas, I think I’ll use it to explain the genesis of “A Bitter Pill” in more detail than I’ve been able to on the talk show circuit.</p>
<p>I always tell the students in a journalism seminar I teach at Yale that the best stories come from what you’re most curious about. Because I’m interested in business (as well as legal and political issues), questions about business and money often are what make me most curious, sometimes to the point of idiosyncrasy. For example, when I read last week that Jeff Zeleny, a star political reporter for the <em>New York Times</em>, had been hired away by ABC News, one of my first thoughts was that I’d like to see a story detailing how much more money he’ll be making – I bet it’s as much as twice his <em>Times</em> salary – and perhaps analyzing whether for Zeleny and other journalists his move represented a wrenching market misallocation of talent, given that his work is likely to have more impact, not to mention space, in the <em>Times</em> than on network television.</p>
<p>Similarly, during the long debate over President Barack Obama’s health insurance reform proposals, a question kept nagging at me: Everyone on all sides seemed to accept as a given that healthcare was wildly expensive, and the only debate seemed to be over who should pay for it. I wondered: Well, why is it so expensive in the first place?</p>
<p>At about the same time, a relative suffered a series of medical crises that produced hundreds of thousands of dollars in bills. For him, it was no problem because he had Medicare and terrific insurance to supplement what Medicare didn’t cover, leaving him on the hook for just a few hundred dollars. But again, I wondered, why were the bills so high?</p>
<p>What finally got me to act on that curiosity and turn it into a reporting project was a chance event, which I recounted in the <em>Time</em> article as follows:</p>
<blockquote><p>I got the idea for this article when I was visiting Rice University last year. As I was leaving the campus, which is just outside the central business district of Houston, I noticed a group of glass skyscrapers about a mile away lighting up the evening sky. The scene looked like Dubai. I was looking at the Texas Medical Center, a nearly 1,300-acre, 280-building complex of hospitals and related medical facilities, of which MD Anderson [Cancer Center] is the lead brand name. Medicine had obviously become a huge business. (In fact, of Houston’s top 10 employers, five are hospitals, including MD Anderson with 19,000 employees; three, led by ExxonMobil with 14,000 employees, are energy companies.) How did that happen, I wondered. Where’s all that money coming from? And where is it going?</p></blockquote>
<p>I had no idea what the answers were. But it seemed obvious that there was only one way to find out: If you want to know why something is so expensive, figure out every element of its costs. In other words, follow the money.</p>
<p>Perhaps doctors were overcharging and making out like bandits while the rest of us suffered. Maybe the unions representing nurses and other hospital workers were so strong that they were driving sky-high prices at hospitals, which I had always thought of as benevolent, non-profit pillars of our communities. This was something I was particularly inclined to suspect because I’d recently written a book about how the teachers’ unions had made public education so cost-inefficient.</p>
<p>Maybe the reason drugs cost so much was because the process of inventing them is such a crapshoot that research and development expenses really do, as the pharmaceutical companies argue, justify the price tag for the drugs that end up on the market.</p>
<p>Perhaps inflated insurance company profits were the culprit.</p>
<p>Maybe it was all of these factors. Or could it be some combination of them, plus the fact that American healthcare is so much more meticulous and effective that the high cost is simply the product of caring for the sick better than any other country does?</p>
<p>The truth is, I had no idea. But I thought I could find out if I could dissect a bunch of bills, then trace the money back to who got paid what and look at who was making what levels of profit or sustaining what levels of losses.</p>
<p>As those who have read the article or heard about it now know, I found that all my initial suspicions were wrong. By following the money, I discovered that our healthcare prices are out of whack for a reason that was hiding in plain sight &#8212; a reason that should be obvious to anyone who has ever been a healthcare consumer, which means all of us: There is no such thing as a free market in healthcare, if one defines a free market as a place where there is some balance of power between the buyer and the seller. Instead, healthcare is – except when Medicare is the buyer – a lopsided seller’s market. That became clear at both ends of the money trails I followed – from the patients’ lack of any knowledge of what they were buying or its prices, much less any leverage to bargain over it, to the sellers’ ability and willingness to charge absurdly high prices on everything from gauze pads to ambulance services to cancer wonder drugs.</p>
<p>To take one example, when I decoded a line in one bill to find that $1.50 was being charged for a generic version of Tylenol, while Amazon sells bottles of 100 for $1.49, the explanation offered by the MD Anderson Cancer Center was that the profit on the pill helped defray the costs of all the other care involved in housing and treating the patient. That seemed logical enough until I found another line item for $1,791 just for each night of the patient’s stay, along with dozens of other ridiculously high charges for everything from blood tests to cotton swabs. But the best evidence ‑ what allowed for a final verdict ‑ was found at the bottom line, in the financial report the hospital has to file with the government every year. The revered nonprofit Houston cancer center had an operating profit of $531 million – an astounding 26 percent margin. That certainly meant they could have thrown in the Tylenol with the $1,791 room charge.</p>
<p>When I followed the money trail behind the drugs, medical devices or CT scan equipment that the patients or their insurance companies were billed for, the profit margins for the hospitals that supplied them, as high as they were, were eclipsed by the margins of the manufacturers that sold them to the hospitals. In the case of the drug companies, their research and development costs, it turned out when their securities filings were examined, were not nearly high enough to justify prices whose only real justification seemed to be that in the United States, unlike other developed countries that control drug prices, they can charge whatever they want because their patents give them a legal monopoly.</p>
<p>In other words, everyone along the supply chain – from hospital administrators (who enjoy multimillion-dollar salaries) to the salesmen, executives and shareholders of drug and equipment makers ‑ was reaping a bonanza. The only exceptions, I found, were those actually treating the patients ‑ the nurses and doctors (unless the doctors were gaming the system by reaping consulting fees from drug or device makers or setting up diagnostic clinics in their practices in order to steer patients there for expensive tests).</p>
<p>It really mattered that I was so curious about all this, and that I became almost obsessively curious as I began to discover what was behind these bills. For there was a mountain of grunt work involved in following the money line by line, from the patient, to the doctor’s office or the clinic or the hospital, and then back to supplier.</p>
<p>That brings to mind another lesson I push on my students, which, because they are a bunch of smart Yalies, sometimes rubs them the wrong way: In journalism, hard work is a lot more important than a high IQ.</p>
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