Sequester Could Cut Blue Angels, Medicare Payments

Mar 1, 2013 2:28pm

(Image Credit: Justin Sullivan/Getty Images)

Starting today, The Note will track how automatic budget cuts associated with the so-called sequester are hurting Americans at home. This story of the effects on one community is part of that series.

If nothing is done to avert “sequester” cuts, air-show fans can wave bye-bye to the Blue Angels.

The Navy’s demonstration air team plans to cancel the 28 performances it has scheduled between April 1 and Sept. 30 if the cuts go into effect as planned at midnight tonight and revenue is not somehow supplemented.

Read more: Sequester to Cut $85 Billion from Federal Agencies

It’s just one of the many sacrifices the Defense Department plans to make if its budget suffers the across-the-board cuts prescribed in the sequestration bill signed into law in August 2011.

Florida State Sen. Don Gaetz, R-Niceville, said the cancelled shows would mean the loss of what he called his constituents’ “civic religion.”

“If someone you don’t know gets furloughed from a job at a military base, that’s something you read about in the newspaper. But if the Blue Angels are grounded, that’s a highly visible symbol of government dysfunction,” Gaetz said today.

A performance in Indiana slated for June has already been cut, thanks to the sequester, but that was the choice of the organizers, not the Navy, according to Blue Angels Public Affairs Officer Lt. Kathryn Kelly.

The next show on the chopping block would be the April 6-7 Airfest performance at MacDill Air Force Base in Tampa, Fla.

Terry Montrose, deputy chief of public affairs for Macdill Air Force Base, said if that performance is cancelled, the whole air show will be shut down, a true disappointment for the Tampa community.

“I’m sure it would be a big blow to [Tampa residents], because it’s one of the largest events in Tampa every year or every other year,” Montrose said.

Read More: What Is Sequestration?

Montrose said the base is “hoping for a Hail Mary” to save the show.

But Kelly of the Blue Angels said the squadron’s fate is not sealed just yet. If Congress passes a full budget, another continuing resolution or an increase to the Navy’s transfer authority, more shows could be restored.

Sen. Gaetz pointed out that losing the Blue Angels wouldn’t be the worst of the sequester’s effects in the Sunshine State.

“As important as they are and as symbolic as they are, [the Blue Angels] aren’t as important as making sure that someone in a nursing home gets care or someone in aerospace gets a paycheck,” he said. “But, obviously, sometimes it’s the symbols that resonate with people and bring the issue home.”

The tourism, higher education, civilian defense contractor and hospital industries in Florida would all take hits as the cuts filter down, according to Chris McCarty, director of the Bureau of Economic and Business Research at the University of Florida in Gainesville.

Read more: Government Shutdown Looks Unlikely

In 2011, 17.6 percent of Florida’s population was eligible for Medicare, 4.3 points higher than the national average. That means scaling back Medicare payments to hospitals will disproportionately affect the health care industry in that state, according to Gaetz.

“When Medicare catches a cold,” he said,  “Florida hospitals get pneumonia.”

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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Polls close in crucial British by-election

LONDON: Polls closed in the southern English town of Eastleigh on Thursday in a by-election for a new member of parliament in a tight contest that threatens serious repercussions for Britain's main parties.

The election pits Prime Minister David Cameron's Conservative Party against its junior coalition partner, the Liberal Democrats, while the anti-EU UK Independence Party (UKIP) is hoping to capitalise on voter disillusionment. First results are expected around 0200 GMT.

The election was sparked by the resignation of disgraced former energy minister Chris Huhne, a Liberal Democrat who has pleaded guilty to trying to avoid a speeding fine.

Nick Clegg, the embattled deputy prime minister and Lib Dem leader, has called it a "two-horse race" between his party and the Conservatives, while UKIP leader Nigel Farage predicted a "big" swing to his party.

The Lib Dems have been damaged by an ongoing sex scandal surrounding the party's former chief executive Chris Rennard, and the vote looks set to cause ructions within an already strained coalition, whatever the result.

On the eve of polling, Cameron urged Conservatives to back candidate Maria Hutchings, who vowed to help "get the country back on its feet" if she won.

But senior Conservative David Davis warned that a loss for the party would place serious doubt over Cameron's leadership of the party.

"If we came third it would be a crisis," Davis told BBC television. "And if it's a close second with UKIP on our tail it will also be uncomfortable."

More than 79,000 people were eligible to vote for one of the 14 candidates, and residents have been subjected to incessant campaigning since the election was called after Huhne's resignation on February 5.

Clegg visited Eastleigh on Wednesday to pledge his support for candidate Mike Thornton, saying he was on the "cusp of a great, great victory".

Addressing supporters at Lib Dems headquarters, Clegg called the race the "most exciting and closely contested by-elections" that he could remember.

Farage backed his candidate, Diane James, to "come up on the rails" and cause a major shock.

"If you gave me evens on us gaining more than 20 percent in this by-election I would have a very big bet," he said. "This is the campaign that has got momentum."

John O'Farrell, the candidate for the main opposition Labour party, is fighting not to finish in fourth place, and said he hoped voters would register their dissatisfaction at living standards by voting for his party.

-AFP/ac

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Sariska villagers block tourists’ entry

ALWAR: About 2,500 villagers on Thursday blocked the main entrance of the Sariska Tiger Reserve, protesting their relocation from areas near the sanctuary.

Sariska field director RS Shekhawat said the villagers had locked the entrance and didn't allow tourists to enter the park. "We are trying to sort out the problem on a priority basis," Shekhawat said.

The villagers, who are on an indefinite sit-in, said they would not clear the blockade unless their demands were met. This is the third such protest in the past eight months against the relocation plan.

Tension began in Sariska when about 2,500 people from 50 villages gathered for a mahapanchayat against the alleged "cheating" by the district administration. "We had called off the agitation in May last year when the district administration agreed on some of our demands including lifting ban on the registry of land, construction of a concrete road and earmarking a grazing area. But now they have backtracked on the promise citing the Supreme Court orders," said Jaikishan Gujjar, a villager.

Since 2008, the farmers in the periphery of the reserve have been protesting the state government and wildlife authorities' decision to relocate them. On February 20, villagers thrashed a few senior sanctuary officials when 70 cattle were seized while grazing in the sanctuary area.

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Obama Admin to Court: End Calif. Gay Marriage Ban

In a historic argument for gay rights, President Barack Obama on Thursday urged the Supreme Court to overturn California's same-sex marriage ban and turn a skeptical eye on similar prohibitions across the country.

The Obama administration's friend-of-the-court brief marked the first time a U.S. president has urged the high court to expand the right of gays and lesbians to wed. The filing unequivocally calls on the justices to strike down California's Proposition 8 ballot measure, although it stops short of the soaring rhetoric on marriage equality Obama expressed in his inaugural address in January.

California is one of eight states that give gay couples all the benefits of marriage through civil unions or domestic partnership, but don't allow them to wed. The brief argues that in granting same-sex couples those rights, California has already acknowledged that gay relationships bear the same hallmarks as straight ones.

"They establish homes and lives together, support each other financially, share the joys and burdens of raising children, and provide care through illness and comfort at the moment of death," the administration wrote.

Justin Sullivan/Getty Images

The brief marks the president's most expansive view of gay marriage and signals that he is moving away from his previous assertion that states should determine their own marriage laws. Obama, a former constitutional law professor, signed off on the administration's legal argument last week following lengthy discussions with Attorney General Eric Holder and Solicitor General Donald Verrilli.

In a statement following the filing, Holder said "the government seeks to vindicate the defining constitutional ideal of equal treatment under the law."

Obama's position, if adopted by the court, would likely result in gay marriage becoming legal in the seven other states: Delaware, Hawaii, Illinois, Nevada, New Jersey, Oregon and Rhode Island.

In the longer term, the administration urges the justices to subject laws that discriminate on sexual orientation to more rigorous review than usual, as is the case for claims that laws discriminate on the basis of race, sex and other factors.

The Supreme Court has never given gay Americans the special protection it has afforded women and minorities. If it endorses such an approach in the gay marriage cases, same-sex marriage bans around the country could be imperiled.

Friend-of-the-court briefs are not legally binding. But the government's opinion in particular could carry some weight with the justices when they hear oral arguments in the case on March 26.

Despite the potentially wide-ranging implications of the administration's brief, it still falls short of what gay rights advocates and the attorneys who will argue against Proposition 8 had hoped for. Those parties had pressed the president to urge the Supreme Court to not only overturn California's ban, but also declare all gay marriage bans unconstitutional.

Still, marriage equality advocates publicly welcomed the president's legal positioning.

"President Obama and the solicitor general have taken another historic step forward consistent with the great civil rights battles of our nation's history," said Chad Griffin, president of the Human Rights Campaign and co-founder of the American Foundation for Equal Rights, which brought the legal challenge to Proposition 8.

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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Japan's factory output up 1.0% in January

TOKYO: Japan's factory output for January rose a smaller-than-expected 1.0 per cent from the previous month, official data showed on Thursday.

The rise was weaker than a 1.5 per cent expansion expected by the market and a revised 2.4 per cent increase in December.

But the ministry maintained a positive view, saying in a monthly report: "Industrial production has bottomed out and shows some signs of picking up."

- AFP/ck

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CBI seeks more documents, looks at tweaking of specifications

NEW DELHI: The CBI on Wednesday said it had sought more documents related to the AgustaWestland helicopter deal from the defence ministry as it prepares to question suspected beneficiaries about alleged kickbacks received in the Rs 3,600 crore deal.

The agency will also seek all documents related to changes made in the specifications of 12 VVIP choppers by the office of former IAF chief S P Tyagi to allegedly benefit Italian firm Finmeccanica, sources said.

The agency has also sought the reply given by Finmeccanica to the questions raised by the ministry, CBI sources said. They added the agency was focusing on the circumstances in which the requirements were tweaked in the defence ministry to allegedly suit Finmeccanica and its subsidiary AgustaWestland.

They said files related to alterations in the helicopter's specifications will help the agency identify defence ministry officials who could be questioned. A CBI team is in touch with defence ministry officials who have been asked to produce these files at the earliest, they said.

The CBI is also likely to seek documents from the corporate affairs ministry on the shareholding pattern of Aeromatrix and IDS Infotech, allegedly involved in the kickbacks trail.

The agency has registered a preliminary enquiry against 11 people including former IAF chief S P Tyagi, his three cousins, European middlemen and four companies. Two Indian firms allegedly used to route bribe money are among these four companies.

Tyagi has refuted all allegations against him. The agency has also got some documents from Finmeccanica on the basis of which it has started a probe in the matter.

CBI sources said during the preliminary enquiry, the agency's powers in summoning and carrying out searches were limited and it was trying to complete the enquiry as early as possible so that a clear view of alleged corruption could emerge based on which future course of action would be taken.

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Holder Says Sequester Makes America Less Safe

The looming budget sequestration will make Americans less safe, Eric Holder says—and anyone who says otherwise isn't telling the truth.

"This is something that is going to have an impact on the safety of this country," the U.S. attorney general told ABC's Pierre Thomas on Wednesday in a wide-ranging, exclusive interview.

"And anybody that says otherwise is either lying or saying something that runs contrary to the facts," Holder said.

In his interview with ABC News, Holder reiterated warnings that if automatic spending cuts are triggered on Friday, the Justice Department will be handicapped in some of its most vital missions to prevent terrorist attacks and crime.

"The Justice Department is going to lose nine percent of its budget between now and September 30th. We're going to lose $1.6 billion. There are not going to be as many FBI agents, ATF agents, DEA agents, prosecutors who are going to be able to do their jobs," Holder said. "They're going to be furloughed. They're going to spend time out of their offices, not doing their jobs."

Portions of the interview will air Wednesday, February 27 on "ABC World News"

Patrick Semansky/AP Photo

Eric Holder Says Homegrown Terror Threat Equals International: Exclusive Watch Video

Eric Holder Remembers Newtown, His Worst Day on the Job: Exclusive Watch Video

President Obama's Cabinet members have been warning for weeks that budget sequestration, which will begin Friday unless Obama and Republicans reach a deficit-reduction deal to avoid it, will leave their agencies shorthanded and could bring about disastrous consequences. Homeland Security Secretary Janet Napolitano and Transportation Secretary Ray LaHood have both appeared at the White House press briefing room to warn that furloughs for border-patrol agents, TSA agents and air-traffic controllers will mean weakened border and port security, longer waits in airport security lines, and logjammed air travel.

Holder, for his part, warned in a Feb. 1 letter to the Senate Appropriations Committee that cuts to the FBI, the ATF, the U.S. Marshals Service, and U.S. Attorneys would limit the department's capacity to investigate crimes. Cuts at the Bureau of Prisons, Holder wrote, would mean lockdowns and potential violence, with fewer staff members on hand. In a separate letter, FBI Director Robert Mueller warned that counterterrorism operations would be affected, with the possible elimination of some joint terrorism task forces with state and local police. Limited surveillance and slower response times would mean unwatched targets and the possibility that individuals on terrorism watch lists could gain entry to the U.S.

"FBI's ability to proactively penetrate and disrupt terrorist plans and groups prior to an attack would be impacted," Mueller wrote.

To Holder, the problem is simple.

"If you don't have prosecutors and agents doing what we expect them to do, and we won't if this thing actually takes place, we are going to be a nation that is going to be less safe. And that is simple fact," Holder said.

Some Republicans have claimed the Obama administration is exaggerating the sequester's purported consequences as a ploy to campaign for tax hikes. On "Fox News Sunday" this week, Sen. Tom Coburn, R-Okla., posited that federal agencies enjoy enough flexibility to avoid the worst consequences of the cuts.

On Wednesday, Holder acknowledged that the Justice Department will do what it can to avoid compromised security, while maintaining that furloughs can't be avoided.

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Vt. lye victim gets new face at Boston hospital

BOSTON (AP) — A Vermont woman whose face was disfigured in a lye attack has received a face transplant.

Doctors at Boston's Brigham and Women's Hospital say 44-year-old Carmen Blandin Tarleton underwent the surgery earlier this month.

A team worked 15 hours to transplant the facial skin, including the neck, nose, lips, facial muscles, arteries and nerves.

The 44-year-old Tarleton, of Thetford, Vt., was attacked by her former husband in 2007. He doused her with industrial strength lye. She suffered chemical burns over 80 percent of her body. The mother of two wrote a book about her experience that describes her recovery.

It was the fifth face transplant at the Boston hospital.

Physicians are planning to discuss the case Wednesday at the hospital.

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