Media

Researchers from Berkeley and the University of Illinois have found that most fast-food industry workers are paid so poorly that they receive public assistance, something that costs the federal government $7 billion a year. Contrary to industry propaganda, your typical fast-food worker isn't some teenager needing gas money: The median age is 28. Reuters: Data from the U.S. Census Bureau...

He gets up before dawn, ready to work when the rest of us are still rolling out of bed. His office is a shady patch on the corner of Broadway and 125th street in Manhattan. He spends hours trying to get people to take something for free. His name is Gregory Adams, and he is a newsie. On a Thursday...

DETROIT, MI -- When the Online News Association announced the finalists for its 2013 awards recently, it may have raised a few eyebrows: AxisPhilly--a public affairs news site in Philadelphia that was scarcely six months past its soft launch under its current name--had not one, but three citations. At the ONA awards banquet this Saturday, the site is in line...

by Nina Martin

Oct. 17: This story has been corrected.

Over the past few years, Washington state’s liberal voters have been on quite a roll. Same-sex marriage? Approved. Assisted suicide? Check. Legalized pot? That too. Strong abortion protections? Those have been in place for decades.

Now, though, the state finds itself in the middle of a trend that hardly anyone there ever saw coming: a wave of mergers and alliances between Catholic hospital chains and secular, taxpayer-supported community hospitals. By the end of this year, the ACLU estimates, nearly half of Washington’s hospital beds could be under Catholic influence or outright control.

Many of the deals have been reached in near secrecy, with minimal scrutiny by regulators. Virtually all involve providers in Western Washington, which voted heavily for same-sex marriage last November and the Death with Dignity Act in 2008. The cultural divide between the region’s residents (Seattle recently edged out San Francisco as the area with the largest proportion of gay couples) and the Catholic Church (whose local archbishop led the effort against marriage equality and is overseeing a Vatican crackdown on independent-minded American nuns) couldn’t be wider. And yet more and more hospitals there — sustained by taxpayers, funded by Medicare, Medicaid, and other government subsidies — could be bound by church restrictions on birth control, sterilization and abortion, fertility treatments, genetic testing, and assisted suicide.

In affected communities, the news is not going over well.

“It’s the perfect storm here,” said Kathy Reim, president of Skagit PFLAG (Parents, Families and Friends of Lesbians and Gays) north of Seattle, where four area hospitals have been in merger talks this year. “We are the only state that has all these rights and privileges available to our citizens. Yet many of our hospital beds are being managed by a system that, for the most part, cannot and will not honor these rights and laws.”

Meanwhile, the deals just keep coming. Earlier this month, hospital commissioners approved a letter of intent between Skagit Valley Hospital and PeaceHealth, a Catholic enterprise that runs nine medical centers and dozens of clinics in three states. The week before, Franciscan Health System (which already has six hospitals in the region) said it would affiliate with an acute-care facility in the sprawling suburbs south of Seattle. In mid- September, UW Medicine, which includes the University of Washington’s teaching centers, signed a “strategic collaboration” with PeaceHealth to provide advanced specialized in-patient care.

In all, Washington has seen at least 10 completed or proposed Catholic-secular affiliations in the past three years, more than anywhere else in the country, says Sheila Reynertson of MergerWatch, a New York-based nonprofit group that tracks hospital consolidations. Three of the state’s five largest health-care systems are Catholic.

.right-sidebar-media { width: 290px; float:right; margin: 0 0 12px 12px; } .right-sidebar-media h2.definition { font-size: 20px; font-weight: bold; font-family: "ff-meta-serif-web-1", "ff-meta-serif-web-2", "Georgia", serif; margin-bottom: 10px; } .right-sidebar-media ul { list-style: disc; margin-left: 1.2em; } .right-sidebar-media ul li { font-size: 13px; left: 1.2em; margin-right: 1.2em; font-family: "Helvetica Neue", Helvetica, Arial, sans-serif; padding-bottom:1.3em; } .right-sidebar-media p.definition .termtbd { text-transform: uppercase; font-weight: bold; } .annotation { background: #cecbc3 ; border-radius: 3px; padding: 0px 3px; transition: all 0.10s ease-in-out; -webkit-transition: all 0.10s ease-in-out; -moz-transition: all 0.10s ease-in-out; cursor:pointer; } .annotation.tweet { background: url("http://propublica.s3.amazonaws.com/projects/projectx/tweet_icon.png") no-repeat top left #e8eef1; padding-left: 24px; background-size: 13px; background-position: 5px 2px; text-decoration:none; } .annotation.tweet:hover { background: url("http://propublica.s3.amazonaws.com/projects/projectx/tweet_icon_hover.png") no-repeat top left #d7dee1; padding-left: 24px; background-size: 13px; background-position: 5px 2px; text-decoration:none; } .annotation.tweet a:hover {text-decoration:none} Further Reading

• "Unholy Alliance," by Jonathan Cohn, New Republic (2012)
• "Could Your Doctor Deny You Health Care?", by Sabrina Rubin Erdely, Self magazine (2007)
• "Faith Healers," by Cienna Madrid, The Stranger, an alt weekly in Seattle (2013)
• "Health Care Refusals: Undermining Quality Care for Women," National Health Law Program (2010)

Catholic providers have actually been an integral part of Washington state’s health-care infrastructure since the late 1800s, when nuns from the East Coast and Europe braved rain and worse to minister to loggers and miners in remote outposts around the region. A century later, those historical ties — and their relative robustness — have made them attractive partners for community hospitals for whom the choice is: affiliate or get crushed.

“It’s harder than ever before for independent health-care organizations to thrive without alliances,” said PeaceHealth spokesman Tim Strickland. One of the main reasons: health-care reform. “It’s happening all over the country, with all kinds of providers,” he said. “We don’t perceive this trend as a Catholic scenario so much as a health-care scenario.” (Indeed, the consulting firm Booz & Company predicts that a fifth of the nation’s 5,000 hospitals could merge over the next few years.)

In some places — including big swaths of Western Washington — Catholic providers are becoming the only source of health care for an entire region. (Approximately 8 percent of what the federal government calls “sole community hospitals” are Catholic.)

The dilemma is that Catholic hospitals — there are 630 or so in the United States, representing 15 percent of all admissions every year — are not independent entities. They are bound by a 43-page document called the Ethical and Religious Directives for Catholic Health Care Services, which have been around in some form since 1921 and were last revised by the U.S. Conference of Catholic Bishops in 2009.

The 72 directives explicitly ban abortion and sterilization. They restrict other types of care as well, including emergency contraception for rape victims (“It is not permissible... to initiate or to recommend treatments [for sexual assault] that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum”), in vitro fertilization and artificial insemination (“contrary to the covenant of marriage, the unity of the spouses, and the dignity proper to parents and the child”), surrogate pregnancy, and anything that remotely resembles assisted suicide (the bishops’ preferred term is “euthanasia”).

Then there’s this:

5. Catholic health care services must adopt these Directives as policy, require adherence to them within the institution as a condition for medical privileges and employment, and provide appropriate instruction regarding the Directives for administration, medical and nursing staff, and other personnel.

Over the years, the ERDs have had their greatest impact on women and people too sick or poor to look around for another provider. Some states (including Washington) have laws requiring emergency birth control, but there have been numerous reports of Catholic-affiliated doctors and nurses who were prevented from treating female patients — including pregnant women with serious complications — in accordance with best medical practices and the patients’ own wishes. In a study last year by researchers at the University of Chicago, 52 percent of OB/GYNs affiliated with Catholic providers reported having conflicts over religious policies dictating medical care.

But the ERDs are guidelines, not hard-and-fast rules. Depending on the local bishop, Catholic providers have a certain amount of leeway in how they interpret them. In Washington state, religious hospitals have been more willing than in some other places to negotiate and accommodate their partners’ concerns — an attitude Reynertson and others call “Catholic lite.”

PeaceHealth, for example, “strongly respects the patient-physician relationship and decisions that are made jointly by physicians and patients in the best interests of those patients,” Strickland said. This means that it will allow its affiliates to dispense birth control and do emergency abortions to save the life of the mother, he said. Franciscan is seen as being stricter, but even so, its secular partner in the small city of Bremerton is continuing to perform tubal ligations on women immediately after they give birth — the medical standard in most hospitals for women seeking such procedures, but verboten in most Catholic ones.

But usually, it’s the non-religious partner that has to give. The most high-profile example involves Swedish Health Services, a secular hospital system that partnered last year with Providence Health & Services. Like most of the recent Washington deals, this one was a kind of workaround, crafted to protect Swedish’s autonomy, reassure its patients, and mollify its critics. “To ensure Providence remained Catholic and Swedish remained secular, the partnership was intentionally structured as an affiliation, not a merger or acquisition,” Swedish said in a statement to ProPublica, adding: “As a secular organization, Swedish is not subject” to the ERDs. Among other things, this allows it to continue providing the full range of birth control services, including tubal ligations and vasectomies.

But a few days after the partnership was announced, Swedish said it would stop doing elective abortions, which it had been offering as part of its reproductive health services for years. Instead, it gave $2 million to Planned Parenthood to open a clinic adjacent to Swedish’s main Seattle hospital.

By structuring deals as “affiliations,” “partnerships” or “collaborations,” hospitals gain another advantage: sidestepping regulators. Washington’s process for scrutinizing hospital mergers only kicks in if there’s a sale, purchase or lease of an existing hospital, but most of the recent agreements have stopped short of that line. Thus, the Swedish-Providence deal did not go through a full review, even though the combined health care system is by far the largest in the state. Nor did Franciscan’s affiliation with Harrison Medical Center, the only full-service hospital serving much of the hard-to-reach Kitsap Peninsula and nearby islands, which ACLU-Washington criticized as “a thinly veiled ... transfer of assets” tantamount to a sale. Terms like “affiliation” and “alliance” leave “a lot of room to maneuver,” said the ACLU’s state legislative director, Shankar Narayan. “Without government oversight, once the camel’s nose is in the pen, you don’t have much control of where the affiliation is going to go.”

“The legitimate concern is: What happens to this relationship later?” Reynertson said. “Is this affiliation, this engagement, going to last? When are they going to get married? Once things like IT infrastructure ... are intertwined, a full merger may become inevitable. It’s a connection that can never be undone. And of course, at that point the mergers will be approved, because look how well they’re working already.”

Robb Miller, executive director of Compassion & Choices, which helped pass Washington’s assisted-suicide law, doesn’t actually think things are working all that well right now. The Death With Dignity Act isn’t mandatory for providers, and even before the wave of mergers, many secular hospitals had opted not to dispense or administer lethal medications to terminally ill patients. The Catholic partnerships have drastically shrunk the pool of providers willing or able to help dying patients end their lives. Since PeaceHealth took over the public hospital serving Clark County (in the southwestern part of the state) in 2010, Miller says, doctors, nurses and social workers have stopped referring patients for counseling to groups like his. “They went from a secular organization with reasonably good policies on death with dignity to an organization with anti-choice policies based on the ERDs.” The practical result is that many terminally ill patients “simply lose their medical options” for a peaceful death, Miller said.

Strickland acknowledges that PeaceHealth forbids both physician-assisted suicide and elective abortions at its affiliates. But he insists that this not as big a change as it sounds, since many community hospitals don’t offer those health care options anyway. “We only go into communities where we’re invited,” he said, “and we have a very strong track record of adding services, not taking them away.”

But what about the future, asks PFLAG’s Reim. She notes that PeaceHealth and other Catholic-affiliated providers are unlikely to add health care services restricted by the ERDs.

“We’re expecting another 40,000 people to move to this part of the state,” she pointed out. Some of these newcomers are likely to be gay couples and transgender people who could find themselves unable get fertility treatments or hormonal therapy in their communities. “This isn’t just about protecting the rights of the people who already here, but the rights of the people who are coming,” she said.

For Mary Kay Barbieri, co-chair of a Skagit Valley group called People for Healthcare Freedom, the other big fear is that the Catholic Church and the men who run it could suddenly decide to take a harder line in how they interpret the ERDs. Or a Catholic lite provider could be gobbled up by one with stricter views, as almost happened this year when PeaceHealth and Franciscan's parent company, Colorado-based Catholic Health Initiatives, were in talks to merge (later scuttled). “That was very worrisome,” Barbieri said.

Meanwhile, the state’s largely hands-off attitude may be ending. This summer, Gov. Jay Inslee, a Democrat, directed the Department of Health to update its hospital merger oversight process, while Democratic Attorney General Bob Ferguson issued an opinion requiring all public hospital districts that offer maternity services to also provide birth control and abortions. But how those orders will play out remains a very big question. “We will be watching closely,” Barbieri said.

Correction (10/17): An earlier version of this article said that after PeaceHealth took over the public hospital serving Clark County in 2010, it closed the hospice program. It actually did not discontinue that program.

Let's face it: The bulk of journalism produced is inessential. This isn't to say it's not valuable, just that the bulk of what appears in America's newspapers, magazines, airwaves, and media sites is not exposing government waste or corporate misdeeds. Despite the characterization of this fact as a digital-era problem, this was always the case. It's just that the internet...

by Jake Bernstein

Beds in closets. Vermin infestations. Drug-dealing house managers. Fire hazards hidden from building inspectors.

These are just some of the conditions turned up by the John Jay College of Criminal Justice during a year-long examination of New York City’s shadowy network of residences for indigent addicts and alcoholics.

John Jay’s report on these so-called “sober” homes, released today, paints a picture of an unsafe and unregulated housing system for which no government agency wants to take ownership, leaving tenants at landlords’ mercy.

Beyond being subjected to dangerous and unsanitary living conditions, many residents of sober homes, also known in New York as “three-quarter houses,” told John Jay’s team they were required to attend specific outpatient drug treatment programs or face eviction. These programs, some of dubious quality, allegedly pay home operators fees for referring patients for services from Medicaid and other government programs. Such referrals are illegal under federal and state law.

“Many of the houses have ongoing relationships with particular [state]-licensed substance abuse treatment programs, and evidence suggests that these programs may be paying the houses kickbacks for referrals of clients,” the John Jay report says.

The report’s conclusions echo those in an investigation published in September by ProPublica that detailed links between sober home operators and an outpatient drug treatment program called New York Service Network (NYSN). The New York Attorney General’s office has received allegations of fraud and kickbacks concerning the clinic. NYSN owner Lazar Feygin adamantly denies that he makes payments to sober home operators in exchange for patient referrals.

Eight days after ProPublica’s story, auditors with the New York State Office of Alcoholism and Substance Abuse Services (OASAS) began a surprise inspection of NYSN. OASAS auditors spent five days in the clinic for what a spokeswoman termed “a routine unannounced regulatory compliance review.” The agency has not yet announced the results of the review.

OASAS oversees one of the nation’s largest addiction services systems with more than 1,600 prevent, treatment and recovery programs, according to its website. It operates its own addiction treatment centers as well as licensing and supervising more than 1,000 others. The agency does not regulate the New York three-quarter houses where many people treated at such clinics live. Nor does any other governmental agency. John Jay teamed with several not-for-profit advocacy groups to interview 43 three-quarter house residents for its report. Those interviewed are not named; nor are the residences or drug clinics described in the report.

The report estimates that as many as 10,000 New Yorkers currently reside in three-quarter houses. Residents are often former prisoners or recent patients of residential drug treatment programs. Most are unemployed and receive Medicaid. A little less than half have been homeless at one point in their lives.

Since no governmental agency regulates three-quarter houses, there are no precise numbers for how many exist in New York. The John Jay study found 317 addresses but does not claim to be comprehensive. Almost 90 percent of the addresses had a building code complaint between 2005 and 2012 that resulted in at least one violation or stop-work order by the New York City building department, the report says. The houses are concentrated in some of New York City’s poorest neighborhoods.

Residents described crowded, hazardous living conditions: 30 to 40 people residing in a single house, with as many as 16 men sharing one bathroom. In some cases, the report said, houses have no smoke detectors. Electrical wiring is jerry-rigged. Heat can be scarce. Residents resort to using kitchen ovens or space heaters to stay warm. Though the houses are touted as drug free, residents told interviewers that drug use is common and that if they complain, house managers threaten eviction or in the case of parolees, a return to prison for manufactured parole violations.

The overcrowding may partly reflect insufficient affordable housing in New York City. The New York City Human Resource Administration pays individuals undergoing drug or alcohol treatment a monthly rental shelter stipend of $215. The amount was last raised in 1988, according to the New York State Office of Temporary and Disability Assistance. The median monthly rent, not including utilities, in New York City is $1,100, according to the report.

“It comes down to being a housing issue,” said Ann Jacobs, director of the John Jay College of Criminal Justice Prisoner Reentry Institute. “There needs to be an expansion of funding into that area.”

Though the report describes poor conditions at sober homes, advocates are equally concerned that the government will respond to the findings by shutting them down, Jacobs said. Most of the residents don’t want to live in homeless shelters, which don’t have the space for them anyway.

“What would happen to these people then?” Jacobs asked.

Ultimately, substandard sober homes are no bargain for taxpayers, putting residents in jeopardy of relapsing, of getting sick, causing fires and falling into homelessness, Jacobs added. Given a clean, safe place to live, more of them could return to work and contribute to their families.

“The problem is solvable,” Jacobs said. “I think the obstacle is political will.”

Make no mistake, news that Glenn Greenwald is leaving The Guardian to start a new publication funded by eBay billionaire Pierre Omidyar is giant news—a bigger deal, in my book, than Jeff Bezos buying the Washington Post. (UPDATE: I should disclose that the Omidyar Network helps fund CJR, something I didn't know until shortly after I published this post.) This...

by Charles Ornstein and Tracy Weber

Elderly Americans are prescribed medications in inexplicably different ways depending on where they live, according to a new report from Dartmouth researchers.

The most depressed older patients—or at least the ones being medicated -- live in parts of Louisiana and Florida. There’s a cluster with dementia around Miami. And the seniors who have the most trouble sleeping? They live, perhaps unsurprisingly, in Manhattan.

The study by the Dartmouth Institute for Health Policy and Clinical Practice examined geographic variations in the drugs elderly Medicare patients received in 2010. Researchers mapped where patients got medications they clearly needed and where they got drugs deemed risky for the elderly. They also looked at differences in the use of so-called discretionary drugs, which they say are widely prescribed but of uncertain benefits.

The report’s findings underscore those of a ProPublica investigation in May, which found that some doctors who treat Medicare patients often prescribe drugs that are dangerous or inappropriate for certain patients. ProPublica also found that the federal officials who run Medicare have done little to scrutinize prescribing patterns in their drug program, known as Part D, or question doctors whose practices differ from their peers.

Officials from the Centers for Medicare and Medicaid Services could not be reached to answer questions about the study. They have previously said that the primary responsibility for overseeing prescribing belongs to private insurers that administer the program. Still, they have acknowledged that Medicare should and will do more to track prescribing in Part D and follow up on unusual patterns.

The Dartmouth researchers did not look at the habits of individual doctors, as ProPublica did, but instead looked at the percent of patients in each region who received certain types of medications. Regionals boundaries were based on where patients would be referred for hospital care.

For example, 17 percent of elderly patients in Miami received a prescription for a dementia drug in 2010, while less than 4 percent of patients in Rochester, Minn., and Grand Junction, Colo., got one. Nationally, the average was 7 percent, according to the report, titled the Dartmouth Atlas of Medicare Prescription Drug Use.

There were similar differences by location for antidepressants. In Miami, almost one-third of elderly Medicare enrollees received at least one prescription for such drugs and about one-quarter of those in a swath of Louisiana did. In Honolulu, just 7 percent got one.

The report does not address whether the patients had diagnoses that would warrant the use of these medications. It also does not include disabled patients under 65 who are also covered by Part D.

Researchers examined whether patients in different regions had been given widely accepted drug treatments following health emergencies, for instance a beta blocker after a heart attack or an osteoporosis drug after certain fractures.  And they calculated the percentage of seniors who were given drugs labeled risky by the American Geriatrics Society because they are known to affect their cognition and balance.

“We see that some clinicians are not achieving a level of effective medication use” compared to their peers, said Dr. Nancy Morden, a lead author of the report. “Conversely, some clinicians are putting their patients at much higher risk by using hazardous medications at a much higher rate than their peers.”

The report does not tackle two of the most fraught issues in prescribing today: the use of narcotic painkillers and anti-psychotics, especially to treat dementia in the elderly.

Morden said she was surprised to find that, in some regions, large percentages of patients were getting discretionary drugs that were moderately beneficial, like those for acid reflux -- and not getting the ones that could save their lives, like the beta blockers or cholesterol-lowering drugs.

 “What are we doing?” she said. “It’s surprising to me that we can use so much of our energy to pursue medications that give us far less in terms of health. I worry that it’s coming at the cost of getting the effective medications.”

People in some regions of the country are healthier than in others. But Morden said that does not explain the wide variations her group found in so many different categories of drugs. That may be a signal that patients are not being adequately informed about the risks, benefits and costs of the drugs, she said. Doctors also may be unaware of how different their practices are from the peers in other parts of the country.

Overall, researchers found that the elderly in Miami fill more prescriptions than anywhere else. On average Miami area patients got nearly 63 per person, including refills, in 2010, compared to a national average of 49. Seniors in Miami also had the highest average spending on prescriptions that year, $4,738 compared to $2,670 nationally.

In the report, Morden and her co-authors encourage policymakers to seek ways of reducing geographic variation in the way medications are prescribed. They also urge patients to ask their doctors about whether a drug is truly needed for them.

The Dartmouth group has previously examined how costs and use of services in the Medicare program differ markedly across the country. They note that some of the highest-spending regions in terms of drug costs were also among the highest users of other types of medical services.

Since its 2007 launch, QUEST, a public radio and television program airing on northern California's KQED, has been quietly producing some of the most interesting and innovative science coverage in the country--an unusual role for a local affiliate. But as QUEST has proved time and again, northern California is a place replete with environmental issues of national consequence, as the...

by Kim Barker

In a sharply worded ruling, a federal judge in Montana said Tuesday that documents found inside a Colorado meth house pointing to possible election law violations will not be returned to the couple claiming the papers were stolen from one of their cars.

Instead, the thousands of pages will remain where they are -- with a federal grand jury in Montana, investigating the dark money group American Tradition Partnership, once known as Western Tradition Partnership, or WTP.

The documents, detailed last fall in a Frontline documentary and ProPublica coverage, point to possible illegal coordination between candidates and WTP, which since 2008 has worked to replace moderate Republicans with more conservative candidates in both Montana and Colorado. The documents, including a folder labeled “Montana $ Bomb,” provided the first real glimpse inside a dark money group. Such so-called social welfare nonprofits, which have poured more than $350 million into federal election ads in recent years, don’t have to disclose their donors.

Conservative political consultant Christian LeFer, a former WTP official, and his wife, Allison LeFer, who helped run the couple’s printing shop, sued Montana’s former Commissioner of Political Practices Jim Murry and the state of Montana to recover the documents.

On Tuesday, the LeFers lost in almost every way possible. They didn’t get their documents. They didn’t get any money; instead, they’ll have to pay Murry’s fees, which haven’t yet been totaled. They won’t be able to file their complaint against Murry ever again.

And on every page of his ruling, U.S. District Judge Donald Molloy seemed to somehow insult them.

At one point in his 34-page ruling, Molloy referred to “the procedural morass caused by the LeFers’ posturing.” Since last fall, the LeFers have filed at least five separate complaints in different courts, sometimes with factual errors.

Molloy’s colorful order is a fitting coda for one of the strangest stories about how dark money groups have tried to influence elections.

Although WTP operated at the state level, it won national attention for its fight against campaign-finance restrictions. It sued successfully to overturn Montana’s ban on corporate spending in elections, which meant the U.S. Supreme Court’s Citizens United decision applied to all states. WTP also fought with state regulators for more than two years over their ruling that the group was a political committee and should have to report its donors. (Last year, ProPublica and Frontline obtained the bank records of the group, the first time a dark money group’s donors have been made public.)

The mysterious boxes of documents, found in a meth house in Colorado, were sent to Montana investigators in March 2011, months after state investigators wrapped up their initial case. After Frontline obtained them in 2012, ProPublica and Frontline spent months investigating how Western Tradition Partnership and LeFer appealed to donors and worked with candidates to shape elections. Coordination between outside groups and candidates is not allowed.

The federal grand jury subpoenaed the documents last December, along with other documents relating to complaints against WTP. Grand jury proceedings are secret, so it’s not clear what is being investigated. But the judge’s order Tuesday indicates that the investigation involves more than just the Colorado documents. It’s also the first sign in months that the grand jury is still hearing evidence.

Christian LeFer hasn’t yet responded to an email asking about the Tuesday ruling.

Meanwhile, because you rarely see a federal court ruling replete with descriptions like “Groundhog Day litigation,” “the ship of litigation” and “the curate’s egg,” we decided to compile our Top 12 list of quotes from the judge’s order.

1. “...the Lefers’ Complaint presents [sic] fanciful screed replete with distorted accusations implying and attributing bias and nefarious motive on the part of the Commissioner....This politicized rhetoric has no place in proper pleading and appears to serve but one purpose: it grabbed headlines.”

2. “The pleadings evidence the Plaintiffs’ belief that the end justifies the means, a principle that has no safe harbor in the rule of law.”

3. “In January 2013....the LeFers served the Commissioner with a Motion seeking to hold the Commissioner in contempt. This Motion was never filed with the state district court or with this Court...It served as political theater rather than legitimate legal practice.”

4. “Groundhog Day litigation, repeating the same case over and over again, amounts to little more than harassment.”

5. “There was a time for LeFers to abandon the ship of litigation. They did not timely use the Rule 41(a)(1)(B) lifeboat, so now their case sinks and they, like captains, sink with it.”

6. “Transparency is a (Montana) constitutional requirement because it is crucial to an informed electorate.”

7. “The LeFers’ insistence that the Colorado Documents are private property holds no water.”

8. “Nothing in the record shows he (the commissioner) did not act in good faith or that he acted with malice or corruption.”

9. “Furthermore, as this matter stands today, there is no means by which the Colorado Documents may be delivered to the LeFers, as they are in possession of a federal grand jury.”

10. “The LeFers’ claims repeatedly impute illicit conduct to the Commissioner and his office without a hint of proof or any factual support. As discussed earlier, this lawsuit began couched in nasty and unprofessional rhetoric, and continued with hyperbole.”

11. “When the Complaint was filed, and continuously throughout this litigation, the LeFers advanced their case without factual or legal foundation. Their litigation tactics were not only unreasonable; they reflect a sad view of the democratic process and the rule of law.”

12. “The Complaint is not even like the curate’s egg.”

There's nothing like Twitter to remind a reporter that, in the age of BuzzFeed, an exclusive does not necessarily command the attention it once did. Last week, Variety's Ted Johnson was the first to report that broadcasting giants like Comcast and Fox were about to try to take their fight with the startup Aereo--which, for a fee, will stream network...

by Charles Ornstein

#twitter-widget-1 { margin:20px 0px !important; width: 100%; } body.article-page .article-full .article img { box-shadow: 1px 1px 5px #cecece; border-radius: 3px; margin: 10px 0px; max-width: 630px; } body.article-page .article-full .article p.healthsource { font-size:13px; font-family: "Helvetica Neue", Helvetica, sans-serif } .article-full .photo-caption { margin:0px; padding:0px; }

For the past two weeks, healthcare.gov, the federal government’s new health insurance marketplace, has been bogged down by problems, preventing users (including me) from viewing insurance options and plans on the website.

Federal officials have pointed to overwhelming demand to explain the site’s problems. But web developers, other experts and journalists have uncovered more fundamental issues with the design and functioning of the site.

Here are excerpts from five of the better stories explaining what happened:

Healthcare.Gov’s Flaws Found, Fixes Eyed

By Christopher Weaver and Louise Radnofsky, The Wall Street Journal

Much of the problem stems from a design element that requires users of the federal site, which serves 36 states, to create accounts before shopping for insurance, according to policy and technology experts. The site, healthcare.gov, was initially going to include an option to browse before registering, but that tool was delayed, people familiar with the situation said.

The decision to move ahead without that feature proved crucial because, before users can begin shopping for coverage, they must cross a busy digital junction in which data are swapped among separate computer systems built or run by contractors including CGI Group Inc., the healthcare.gov developer; Quality Software Services Inc., a UnitedHealth Group Inc. unit; and credit-checker Experian PLC.

If any part of the web of systems fails to work properly, it could lead to a traffic jam blocking most users from the marketplace. That’s just what happened: On Oct. 2, officials identified a bottleneck where those systems intersect at a software component sold by Oracle Corp. that still hasn’t been cleared.

Tech experts wary of more Obamacare glitches

By Brett Norman and Jason Millman, Politico

Some software engineers have suggested that the consumer end of the website, designed by one contractor, is not “talking to” the back end of the website, developed by a different company.

Diagnostic tools in Web browsers have identified coding issues that may be complicating account creation. The Wall Street Journal reported Friday that the administration is considering an overhaul of the registration system this weekend to allow people to browse health plan options without first creating an account. The paper said the tech experts are focused on a bottleneck where a flood of data meets an Oracle software component involved in identification verification.

From the Start, Signs of Trouble at Health Portal

By Robert Pear, Sharon LaFraniere and Ian Austen, The New York Times

Confidential progress reports from the Health and Human Services Department show that senior officials repeatedly expressed doubts that the computer systems for the federal exchange would be ready on time, blaming delayed regulations, a lack of resources and other factors.

Deadline after deadline was missed. The biggest contractor, CGI Federal, was awarded its $94 million contract in December 2011. But the government was so slow in issuing specifications that the firm did not start writing software code until this spring, according to people familiar with the process. As late as the last week of September, officials were still changing features of the Web site, HealthCare.gov, and debating whether consumers should be required to register and create password-protected accounts before they could shop for health plans.

Some say health-care site’s problems highlight flawed federal IT policies

By Craig Timberg and Lena H. Sun, Washington Post

The U.S. government spends more than $80 billion a year for information-technology services, yet the resulting systems typically take years to build and often are cumbersome when they launch. While the error messages, long waits and other problems with www.healthcare.gov have been spotlighted by the high-profile nature of its launch and unexpectedly heavy demands on the system, such glitches are common, say those who argue for a nimbler procurement system.

They say most government agencies have a shortage of technical staff and long have outsourced most jobs to big contractors that, while skilled in navigating a byzantine procurement system, are not on the cutting edge of developing user-friendly Web sites.

These companies also sometimes fail to communicate effectively with each other as a major project moves ahead. Dozens of private firms had a role in developing the online insurance exchanges at the core of the health-care program and its Web site, working on contracts that collectively were worth hundreds of millions of dollars, according to a Government Accountability Office report in June.

How The First Internet President Produced The Government’s Biggest, Highest-Stakes Internet Failure

By Alex Howard, Buzzfeed

The debacle is merely the most visible example of how $80 billion spent annually by the federal government on information technology falls far short of delivering the quality or service any private company would expect at a fraction of that cost.

...

At the heart of the federal IT crisis is a complex system of regulations that rewards contractors that are better at bidding on giant federal contracts than at building software. While the political figures who commission or oversee those contractors are ultimately culpable, the work itself is done by the private sector. That’s not only true of civilian agencies, as the world was reminded when a private contractor for the National Security Agency, Edward Snowden, leaked key documents from the government and gave then to the press.

Finally, explore the contractors who worked on healthcare.gov and their campaign contributions, courtesy of the Sunlight Foundation.

Here are all the contractors working on Obamacare -- and all the money they spent on lobbying and campaigns. http://t.co/qGvaJlvFtM

— Nick Confessore (@nickconfessore) October 10, 2013

There are many problems with Timothy B. Lee's Washington Post blog post on Hollywood's supposed culpability for the theft of its own movies, beginning with the morally unserious jujitsu deployed in arguing that Hollywood is culpable for the theft of its own movies. The Mercatus- and Cato-connected editor of the Washington Post tech blog that aims "to be indispensable to...

Audit pal Felix Salmon has an important piece on the Republicans' debt-ceiling insanity, writing that "the default has already begun"—as has the irreparable damage: The harm done to the global financial system by a Treasury debt default would not be caused by cash losses to bond investors. If you needed that interest payment, you could always just sell your Treasury...

The power of short documentary video to rally viewers to a cause is nothing new, these days. Social justice giant WITNESS pioneered the video-for-action model 20 years ago, when few people had cameras at their disposal, by sharing equipment and training with citizen-activists around the world. Today, with smartphone-bulging pockets, everyone's a filmmaker. And for fast-film consumers, it seems like...

by Jake Bernstein

A federal judge rejected the Federal Reserve Bank of New York’s plea to seal documents in a wrongful termination lawsuit filed by a former bank examiner who claims she was fired for doing her job.

U.S. District Judge Ronnie Abrams ruled today in the case by Carmen Segarra against the New York Fed and three employees. Much of the material the Fed hoped to keep off limits, including 67 paragraphs from Segarra’s complaint and multiple exhibits, can be found on ProPublica’s website and others.

“I am not convinced that anything will be accomplished to seal or redact a complaint that is publicly available,” said Abrams in the hearing held at the federal courthouse in lower Manhattan.

Segarra worked for the New York Fed for seven months before being fired in May of last year. She was assigned to examine Goldman Sachs and its conflict-of-interest policies, she said. Segarra said she determined that Goldman’s policies did not meet Fed requirements. Her lawsuit alleges that her bosses tried to convince her otherwise and that she was fired after refusing to change her findings.

Goldman says it has robust methods for managing conflicts of interest and has declined comment on Segarra.

At today’s hearing, New York Fed attorney David Gross accused Segarra of stealing confidential documents, including her own internal emails and meeting minutes. Were the court to allow them to remain public on its own electronic records system, called Pacer, it “would be helping this improper conduct,” Gross said.

Gross compared the New York Fed’s relationship with the financial institutions it supervises to attorney-client privilege. Should the institutions lose faith in the Fed’s ability to keep communications and documents secret, it could spell trouble, he said.

“If [the supervised banks] don’t think it will be confidential, they will be less willing to give that information, to the detriment of the financial system,” said Gross.

Although ruling against the Fed, Abrams asked Segarra and her attorney, Linda Stengle, not to reveal any more confidential supervisory information without first consulting with her. “This is not a gag order,” the judge said. “I am not telling plaintiff she cannot talk about her case.”

Linda Stengle said afterward she was pleased about the ruling but unhappy that there were constraints placed on her client. “It’s important that the public have access to the information” in support of Segarra’s case, she said.

A spokesperson for the New York Fed did not immediately respond to a request for comment.

by Theodoric Meyer

Congress did something unusual last year. It passed a bill that acknowledged that sea levels are rising — i.e., that climate change is happening.

The measure in question, buried near the end of a 584-page transportation funding bill, also required some modest action: That the Federal Emergency Management Agency use “the best available climate science” to figure out how the flood insurance program it administers should handle rising seas.

FEMA’s first step was supposed to be to set up an advisory body, the Technical Mapping Advisory Council, that would make recommendations on how the agency could take the effects of climate change into account in its flood insurance maps.

But more than a year later, FEMA hasn’t named a single member to the council. Without any members, it has been unable to meet or make any recommendations. In July, the council missed a deadline set out in the law for submitting written recommendations for how the flood insurance program might deal with future risks related to climate change.

FEMA had developed a charter for the council by the end of August and was in the process of finalizing letters to solicit council members, according to the agency. Dan Watson, the FEMA press secretary, said he was unable to provide more up-to-date information because much of the agency’s staff has been furloughed under the government shutdown.

Few areas of the federal government are more directly affected by climate change than the flood insurance program and its maps, which determine the premiums that 5.6 million American households pay for flood insurance. The program fell deeply into the red after Hurricane Katrina in 2005 and Hurricane Sandy last year. It’s currently $25 billion in debt.

Many of the maps are decades out of date and therefore don’t reflect the rise in sea levels since the time they were drawn.

FEMA released a report in June estimating that sea levels will rise an average of four feet by 2100, increasing the portion of the country at high risk of flooding by up to 45 percent. The number of Americans who live in those areas could double by the century’s end, according to the report.

The law requires the council to outline steps for improving the “accuracy, general quality, ease of use, and distribution and dissemination” of the maps. Josh Saks, legislative director for the National Wildlife Federation, which pushed for the legislation, said that might include figuring out how to better take into account the way new development along a river, say, worsens flooding for those who live downstream.

Jimi Grande, the senior vice president for federal and political affairs for the National Association of Mutual Insurance Companies, a lobbying group, said the council would “absolutely” help make the flood maps more accurate.

“We need to know what the risks are to have an intelligent conversation as a country” about development in areas that are vulnerable to flooding, he said.

The measure was part of a broader package of reforms to the National Flood Insurance Program that phased out many of the government subsidies that had kept flood insurance premiums artificially cheap for many homeowners. The full-risk rates phased in for many policyholders on Oct. 1, despite vocal protests against them.

An operational mapping advisory council wouldn’t fix everything that’s wrong with the flood insurance program. As ProPublica has reported, some of the maps FEMA has issued in recent years have been based on outdated, inaccurate data, giving homeowners a misleading impression of flood risk and, in some cases, forcing them to buy insurance when they were not at great risk of flooding.

Taking climate change into account when setting flood insurance rates is also a complex task.

“That’s why we put the council in charge,” said Saks, from the National Wildlife Federation. “I can read the science and say storms are happening more often, and I can read the numbers and see that sea-level rise is happening. But I’m not an actuary, and I don’t know how you then translate that to” setting insurance rates.

The risk-modeling companies that private insurers rely on have struggled to take climate change into account in their models, but they are making progress.

“I wouldn’t be too surprised if within the next five years we could credibly start to incorporate climate change into aspects of the modeling,” said David F. Smith, the vice president of the model development group at Eqecat, a risk-modeling firm.

Michael B. Gerrard, director of the Center for Climate Change Law at Columbia University, said he wasn’t surprised FEMA had been slow in setting up the council.

“It’s the rule, rather than the exception, that federal agencies miss the rule-making deadlines” set out in laws, he said. “Often they have to be sued to get back on schedule.”

In his "Stories I'd like to see" column, journalist and entrepreneur Steven Brill spotlights topics that, in his opinion, have received insufficient media attention. This article was originally published on Reuters.com. 1. How Boehner can save his speakership: Conventional wisdom is that House Speaker John Boehner has been afraid to defy the Ted Cruz-inspired House members who have insisted on...

ProPublica's Jake Bernstein reports on the intriguing tale of Carmen Segarra, a former Goldman Sachs bank examiner at the New York Federal Reserve who was fired for determining—and then insisting, after being told from superiors to say otherwise—that the bank's conflict-of-interest policies were sorely lacking. Finding conflicts of interest at Goldman Sachs, of course, is like finding gambling in the...

When The New York Times published "Snow Fall," its celebrated multimedia narrative extravaganza, in late 2012, the project sparked a ton of future-of-news buzz (along with the inevitable backlash). But in the months that followed, other projects that looked and felt like "Snow Fall"--from The Washington Post, Grantland, and the Times--followed a similar pattern: they focused on stories about sports,...