Rolling Stones rock Brooklyn at anniversary gig

NEW YORK (AP) — It sure didn’t feel like a farewell.

The Rolling Stones — average age 68-plus, if you’re counting — were in rollicking form as they rocked the Barclays Center in Brooklyn for 2½ hours Saturday night, their first U.S. show on a mini-tour marking a mind-boggling 50 years as a rock band.

And although every time the Stones tour, the inevitable questions arise, — whether it’s “The Last Time,” to quote one of their songs — there was no sign that anything is ending anytime soon.

“People say, why do you keep doing this?” mused 69-year-old Mick Jagger, the band’s impossibly energetic frontman, before launching into “Brown Sugar.” ”Why do you keep touring, coming back? The answer is, you’re the reason we’re doing this. Thank you for buying our records and coming to our shows for the last 50 years.”

Jagger was in fine form, with strong vocals and his usual swagger — strutting, jogging, skipping and pumping his arms like a man half his age. And though he briefly donned a flamboyant feathered black cape for “Sympathy for the Devil” and later, some red-sequined tails, he was mostly content to prowl the stage in a tight black T-shirt and trousers.

The band’s guitarists, the brilliant Keith Richards and Ronnie Wood, alternated searing solos and occasionally ventured onto a stage extension that brought them closer to the crowd. The now-gray Richards, wearing a red bandana, exuded the easy familiarity of a favorite uncle: “While we wait for Ronnie,” he said at one point, “I’ll wish you happy holidays.” Watts, the dapper drummer in a simple black T-shirt, smiled frequently at his band mates.

The grizzled quartet was joined on “Gimme Shelter” by Mary J. Blige, who traded vocals with Jagger and earned a huge cheer at the end. Also visiting: the Texas blues guitarist Gary Clark Jr.

The sense of nostalgia was heightened by projections on a huge screen of footage of the early days, when the Stones looked like teenagers. At one point, Jagger reminisced about the first time the band played New York — in 1964.

A carton of milk cost only a quarter then, he said. And a ticket to the Rolling Stones? “I don’t want to go there,” he quipped. It was a reference to the sky-high prices at the current “50 and Counting” shows, where even the “cheap” seats cost a few hundred dollars and a prime seat cost in the $ 700 range or higher.

From the opening number, “Get Off Of My Cloud,” the band played a generous 23 songs, including two new ones — “Doom and Gloom” and “One More Shot” — but mostly old favorites. The rousing encore included “Jumping Jack Flash,” of course, but the final song was “Satisfaction.” And though the song speaks of not getting any, the consensus of the packed 18,000-seat arena was that it was a satisfying evening indeed.

“If you like the Stones, this was as good a show as you could have had,” said one fan, Robert Nehring, 58, of Westfield, N.J., who’d paid $ 500 for his seat. “It was worth it,” he said simply.

The Brooklyn show was a coup for the new Barclays Center — there are no Manhattan shows. It followed two rapturously received Stones shows in London late last month. The band also will play two shows in Newark, N.J., on Dec. 13 and 15.

And just before that, the Stones will join a veritable who’s who of British rock royalty and U.S. superstars at the blockbuster 12-12-12 Superstorm Sandy benefit concert at Madison Square Garden. Also scheduled to perform: Paul McCartney, the Who, Eric Clapton, Bruce Springsteen & The E Street Band, Alicia Keys, Kanye West, Eddie Vedder, Billy Joel, Roger Waters and Chris Martin.

In a flurry of anniversary activity, the band also released a hits compilation last month with two new songs, “Doom and Gloom” and “One More Shot,” and HBO premiered a new documentary on their formative years, “Crossfire Hurricane.”

The Stones formed in London in 1962 to play Chicago blues, led at the time by the late Brian Jones and pianist Ian Stewart, along with Jagger and Richards, who’d met on a train platform a year earlier. Bassist Bill Wyman and Watts were quick additions.

Wyman, who left the band in 1992, was a guest at the London shows last month, as was Mick Taylor, the celebrated former Stones guitarist who left in 1974 and replaced by Wood, the newest Stone and the youngster at 65.

The inevitable questions have been swirling about the next step for the Stones: another huge global tour, on the scale of their last one, “A Bigger Bang,” which earned more than $ 550 million between 2005 and 2007? Something a bit smaller? Or is this mini-tour, in the words of their new song, really “One Last Shot?”

The Stones won’t say. But in an interview last month, they made clear they felt the 50th anniversary was something to be marked.

“I thought it would be kind of churlish not to do something,” Jagger told The Associated Press. “Otherwise, the BBC would have done a rather dull film about the Rolling Stones.”

There certainly was nothing dull about the band’s performance on Saturday, a show that brought together many middle-aged fans, to be sure, but also some of their children, who seemed to be enjoying the classic Stones brand of blues-tinged rock as much as their parents.

Yes, a Stone’s average age might be a bit higher than that of the average Supreme Court justice. (To be fair, the newest justices bring the average down). But to watch these musicians play with vitality and vigor a half-century on is to believe that maybe they were right when they sang, “Time Is On My Side.” At least for a few more years.

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Associated Press writer David Bauder contributed to this report.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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Arithmetic on Taxes Shows Top Rate Is Just a Starting Point

WASHINGTON — Despite hints in recent days that President Obama and House Speaker John A. Boehner might compromise on the tax rate to be paid by top earners, a host of other knotty tax questions could still derail a deal to avert a fiscal crisis in January.

The math shows why. Even if Republicans were to agree to Mr. Obama’s core demand — that the top marginal income rates return to the Clinton-era levels of 36 percent and 39.6 percent after Dec. 31, rather than stay at the Bush-era rates of 33 percent and 35 percent — the additional revenue would be only about a quarter of the $1.6 trillion that Mr. Obama wants to collect over 10 years. That would be about half of the $800 billion that Republicans have said they would be willing to raise.

That calculation alone suggests the scope of the other major tax issues to be negotiated beyond tax rates. And that is why many people in both parties remain unsure that a deal will come together before Jan. 1. Without agreement, more than $500 billion in automatic tax increases on all Americans and cuts in domestic and military programs will take hold, which could cause a recession if left in place for months, economists say.

“The question is making sure that we hit a revenue target that’s required for a truly balanced deficit-reduction plan,” said Representative Chris Van Hollen of Maryland, the senior Democrat on the House Budget Committee. “And when the president and all of us say this is a question of math, we mean it. It’s very hard to make the numbers work without the top rates going back to the full Clinton-era levels.”

The top tax rates are taking center stage right now because Mr. Obama believes he won a mandate after campaigning relentlessly on the idea of extending Mr. Bush’s tax cuts only for households with annual income below $250,000. But the two parties also have ideological differences on taxes affecting savings, investment and inheritance, which have flared in battles going back to the Reagan years. To get a deal in the coming weeks, those differences must be addressed at least in broad terms, even if the details are left to a battle over revamping the tax code next year.

The argument over rates is far from settled. Although the two sides seem close enough on the percentages for easy compromise, principle and politics loom large: Republicans oppose raising rates as a matter of ideology, saying that it kills jobs, and the president insists that he will not keep the Bush-era rates on income above roughly $250,000 after two campaigns in which he vowed to return them to the levels of the Clinton years.

“Just to be clear, I’m not going to sign any package that somehow prevents the top rate from going up for folks at the top 2 percent,” he said Thursday.

In recent days, comments from some Republicans, including Mr. Boehner, their chief negotiator, have hinted that the party — recognizing its weak hand — might be moving toward a concession on tax rates. Seldom mentioned is that Mr. Obama’s revenue total also reflects four other changes from Bush-era tax cuts: higher tax rates on investment income from capital gains and dividends, and the restoration of two other Clinton-era provisions limiting deductions and tax exemptions for affluent individuals.

Together those changes would raise $407.4 billion over a decade — nearly as much as the president’s proposal on higher rates, which would raise $441.6 billion by 2023, for a total of $849 billion. Another $119 billion would come from higher estate taxes, opposed by Republicans and some Democrats.

And both the president and Republicans are committed to raising hundreds of billions of dollars by overhauling the tax code to further limit or end the tax breaks that high-income taxpayers can claim, though they differ in how to do that.

Republicans want to raise all $800 billion from overhauling the tax code, erasing tax breaks for high-income households and using the new revenues both to reduce deficits and to lower everyone’s tax rates. But they have not proposed how to do that, and the president insists it cannot be done without hitting middle-income taxpayers.

Mr. Obama has proposed to keep existing tax breaks but to limit the rate of those breaks for people in higher tax brackets to 28 percent, which would raise $584 billion in a decade. He has proposed variations of that proposal for four years, only to be ignored by both parties because of opposition from charitable groups, the housing industry, insurers and others to curbing deductions for charitable giving, mortgage insurance and other purposes.

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Surgeon infected patients during heart procedure, Cedars-Sinai admits

A heart surgeon at Cedars-Sinai Medical Center unwittingly infected five patients during valve replacement surgeries earlier this year, causing four of the patients to need a second operation.

The infections occurred after tiny tears in the latex surgical gloves routinely worn by the doctor allowed bacteria from a skin inflammation on his hand to pass into the patients' hearts, according to the hospital. The patients survived the second operation and are still recovering, hospital officials said.

The outbreak led to investigations by the hospital and both the L.A. County and California departments of public health. The federal Centers for Disease Control and Prevention was also consulted.

Hospital officials called it a "very unusual occurrence" probably caused by an unfortunate confluence of events: the nature of the surgery, the microscopic rips in the gloves and the surgeon's skin condition. Valve replacement requires the surgeon to use thick sutures and tie more than 100 knots, which can cause extra stress on the gloves, they said.

Nevertheless, the hospital's goal is to have zero infections, said Harry Sax, vice chairman of the hospital's department of surgery. "Any hospital-acquired infection is unacceptable," he said.

The infections raise questions about what health conditions should prevent a surgeon from operating and how to get the best protection from surgical gloves. Surgeons with open sores or known infections aren't supposed to operate, but there is no national standard on what to do if they have skin inflammation, said Rekha Murthy, medical director of the hospital's epidemiology department. She added that there were also no national standards on types of gloves used, whether to wear double gloves or how many times surgeons should change those gloves during a procedure.

Healthcare-acquired infections are very common throughout the United States. Each year, infections cause 99,000 deaths in the country, including about 12,000 in California. Hospitals in the state are required to report certain infections to the California Department of Public Health. That reporting makes the public more aware of the quality of care provided at local hospitals and is an important tool for reducing infections, said Debby Rogers, deputy director of the department's Center for Health Care Quality.

Cedars-Sinai has low rates for hospital-acquired infections compared with the state and national average but has not performed as well on other surgical quality measures recently, according to the Leapfrog Group, an employer-backed nonprofit focused on healthcare quality. The organization gave the hospital a C rating last month on its national report card, down from an A in June, though it was not related to the infection outbreak.

"Clearly this hospital is making attempts to reduce infections, but they have more work to do," said Leah Binder, Leapfrog's chief executive.

Cedars-Sinai Medical Center conducts about 360 valve replacement surgeries each year and said infections occur in fewer than 1% of its cases — lower than the national average.

The hospital learned about the problem in June after three patients who had undergone valve replacement surgery showed signs of infection. Doctors diagnosed the patients with an infection called endocarditis. Concerned there might be a connection among the cases, epidemiologists analyzed the bacteria, staphylococcus epidermidis, and determined that it was an identical strain and therefore must have come from a single source. "It led to the question of gee, I wonder where it came from?" Murthy said.

Epidemiologists homed in on the surgeon with the skin inflammation. The bacteria matched, and then they made a surprising discovery: microscopic tears in the gloves typically worn by surgeons after performing valve replacement surgery. The surgeon, whose name was not released, was not allowed to operate again until he healed. He is still a member of the medical staff but no longer performs surgeries at the hospital.

The hospital soon found the same infection in two more patients. Officials also reached out to 67 patients who had heart valve replacements with the same surgeon but didn't find any other cases. One of the five infected patients was treated with antibiotics, and the other four had new valve replacement surgeries. Sax said the hospital apologized to the patients and has continued to monitor their health. The hospital has also covered the cost of their care, including follow-up treatment and all the related surgeries.

All surgeons doing valve replacements are now required to change gloves more frequently, officials said. Some surgeons are wearing double gloves during the operations, Sax said.

Following the outbreak, Cedars-Sinai did the proper follow-up to ensure the safety of their patients, said Dawn Terashita, a medical epidemiologist with L.A. County, who was notified in September. What occurred at Cedars-Sinai was an unintentional consequence of the surgery, she said.

"There is no way to keep a room entirely sterile and all the people in it sterile," she said. "You will always have risk of infection."

anna.gorman@latimes.com

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15 Agonizing Automotive Atrocities

Yugo.

There, we got it out of the way. When you read the headline, of course an image of a tiny Cold War-era hatchback popped into your head. We bet you also shuddered at the thought of a Pontiac Aztek.

We love to poke fun at failure, and no failure made a punchline better than the Yugo. We found that out while talking with Jason Vuic, author of The Yugo: The Rise and Fall of the Worst Car in History. Vuic was aware that the Yugo fell far short of being a good car, but what truly amazed him was how many people who had never driven a Yugo knew just how bad it was. In failure, it became a wild viral marketing success.

Not all cars rose to level of infamy embodied by the Yugo. To paraphrase Shakespeare, some cars were born awful while others had awfulness thrust upon them. Some automotive atrocities were the result of automakers trying something new and falling far short of the mark, while other cars failed from a lack of effort. Still others were perfectly adequate cars but came to represent a regrettable moment in time.

Here we display all three kinds of auto-trocities, highlighting famous failures and digging deep to dredge up detritus better off forgotten. Yes, we know there are many, many more automotive atrocities and this list only scratches the surface of the heap. You’ll have a chance to list your favorite heaps tomorrow, so stay tuned.

Above: Peel Trident 1965-1966

Famous from appearances on Top Gear and Monster Garage, the Peel Trident was a “shopping car” built on the Isle of Man. Along with the bubblelicious BMW Isetta and the fiberglass Reliant Robin, the Trident was ridiculed for its small size and three wheels.

Photo: Casaflamingo/Flickr

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Reinhold Weege, creator of “Night Court,” dies at 63

LOS ANGELES (TheWrap.com) – Reinhold Weege, the creator of the hit NBC sitcom “Night Court,” has died, a spokeswoman for the family told TheWrap. He was 63 years old.

He also wrote for other notable television shows, including “Barney Miller” and “M*A*S*H.”

However, it was “Night Court,” a show that poked gentle fun at bureaucratic absurdity, that would become his signature work. The series centered on a young judge (Harry Anderson) saddled with handling the bottom of the barrel cases that come into Manhattan’s night court and featured a breakout performance by John Larroquette as a skirt-chasing lawyer.

The show started out tackling serious legal issues, but over the course of its nine seasons, slowly expunged commentary in favor of broad humor.

Weege might never have entered show business had he not been fired from a job in journalism. In a 1994 piece in the Chicago Tribune, he wrote that he was working as a reporter and editor of a tiny suburban paper when he reported on a secret meeting, between the town and the Pritzker hotel chain about a proposal to build a monorail, hotels and a 60-story office building.

After his paper was less than thrilled with the piece he copyrighted it and had it picked up by a larger paper — the result was he got canned.

“Shortly after that, I sold our couch, the only asset my wife and I had, got in the car and headed toward Hollywood,” Weege wrote.

The rest is history.

Weege is survived by his ex-wife Shelley, two daughters and a granddaughter.

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7.3 quake off Japan prompts tsunami warning

TOKYO—

A strong earthquake struck Friday off the coast of northeastern Japan in the same region that was hit by a massive earthquake and tsunami last year. A city in the region reported that a small tsunami had hit, but there were no immediate reports of injuries or damage.

The Japan Meteorological Agency said the earthquake had a preliminary magnitude of 7.3 and struck in the Pacific Ocean off Miyagi prefecture at 5:18 p.m. (0818 GMT). The epicenter was 6.2 miles beneath the seabed.

After the quake, which caused buildings in Tokyo to sway for at least several minutes, authorities issued a warning that a tsunami potentially as high as 2.19 yards could hit. Ishinomaki, a city in Miyagi, reported that a tsunami of 1 yard hit at 6:02 p.m. (0902 GMT).

The Pacific Tsunami Warning Center said there was no risk of a widespread tsunami.

Miyagi prefectural police said there were no immediate reports of damage or injuries from the quake or tsunami, although traffic was being stopped in some places to check on roads.

Shortly before the earthquake struck, NHK television broke off regular programming to warn that a strong quake was due to hit. Afterward, the announcer repeatedly urged all near the coast to flee to higher ground.

The magnitude-9.0 earthquake and ensuing tsunami that slammed into northeastern Japan on March 11, 2011, killed or left missing some 19,000 people, devastating much of the coast. All but two of Japan's nuclear plants were shut down for checks after the earthquake and tsunami caused meltdowns at the Fukushima Dai-Ichi nuclear plant in the worst nuclear disaster since the 1986 Chernobyl disaster.

Immediately following Friday's quake, there were no problems at any of the nuclear plants operated by Fukushima Dai-Ichi operator Tokyo Electric Power Co., said a TEPCO spokesman, Takeo Iwamoto.

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Apple Builds a New Home on Facebook's Back Porch

We knew that Apple was building a pair of new data centers close to Facebook’s operation in Prineville, Oregon. But we didn’t realize just how close they were until we spent a plane over Oregonian high desert.

The notoriously secretive Apple is especially secretive about its data centers. So while Google and Facebook have opened up their doors to Wired reporters over the past year, Apple has not only rolled up the welcome mat. They’ve disconnected the front doorbell.

That’s what forced us to take to the skies. In April, we published our first overhead shots of Apple’s Maiden, North Carolina, data center, and a few weeks ago, we sent our iSpy plane over Prineville, where Apple has just broken ground on a $68 million data center, just down the road from Facebook.

So here’s the world’s first look at the future home of the West Coast iCloud:

You can see Apple’s mini data center — they call it a tactical data center — up in the northeast corner of the property. Here’s a close-up shot:

Apple finished this building earlier this year, but just south of it, you can see what will be the site of its much larger 338,000-square-foot data center. Apple wants to eventually build two of these monster data centers on the 160-acre site, but right now, there’s no sign of the second facility.

When it goes fully online, Prineville will be fully powered by alternative energy. That might help cut it some slack from Greenpeace, which has been known to launch unexpected protests on Apple property armed with window-washers and black balloons.

Apple showed up in Prineville only after Facebook had built its own 330,000-square-foot data center just outside of town. The internet giants love locations like this, primarily because of their cheap real estate, local tax breaks, cool climates, and reliable and abundant power supplies.

Facebook’s first data center was up and running a year ago. The company is now putting the finishing touches on a second data center (at the bottom of the photo below) and has also broken ground on a new cold-storage facility, which is designed to save power by icing backup data on servers that are only rarely switched on. That smoothed-out rectangular patch just beneath the second data center is the future site of cold storage:

Apple operates three other data centers: in Newark, California; in Maiden, North Carolina; and at the company’s Cupertino headquarters. Earlier this year, it started work on a fifth facility in Reno, Nevada.

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Deportation looms for tech guru McAfee after heart drama

GUATEMALA CITY (Reuters) – Software guru John McAfee, fighting deportation to Belize, was rushed to a hospital in Guatemala on Thursday shortly after his asylum request was rejected, but a suspected heart attack turned out to be stress in a fresh twist to the saga.

The 67-year-old U.S. computer software pioneer was taken swiftly from a hospital in a police car out of the sight of media, after earlier arriving in an ambulance lying on a stretcher.

His lawyer said he was being taken back to an immigration department cottage where he has been detained since crossing illegally into Guatemala from neighboring Belize, where police want to question him in connection with his neighbor’s murder.

“He never had a heart attack, nothing like that,” said Telesforo Guerra, a former attorney general who had earlier said McAfee had two mild heart attacks.

“I’m not a doctor. I’m just telling you what the doctors told me,” he added. “He was suffering from stress, hypertension and tachycardia (an abnormally fast heartbeat).”

McAfee was posting on his blog www.whoismcafee.com in the morning, the time he suffered the stress attack.

“I don’t think a heart attack prevents one from using one’s blog,” Guerra had said at the time.

Guerra’s assistant, Karla Paz, earlier said she found McAfee lying on the ground and unable to move his body or speak.

McAfee was detained by Guatemalan police on Wednesday for illegally sneaking across the border with his 20-year-old girlfriend to escape authorities in Belize. He has said he fears authorities in Belize will kill him if he returns.

Guatemala’s foreign minister, Harold Caballeros, said earlier McAfee’s request for asylum was rejected.

Constitutional lawyer Gabriel Orellana, a former foreign minister, said the government should have given more weight to the asylum request rather than rush to a decision.

“We should take into account the fact that McAfee has not been accused of any crime in Belize,” he said.

QUARRELED WITH FELLOW AMERICAN

Police in Belize want to quiz McAfee as “a person of interest” in the killing of a fellow American, Gregory Faull, with whom he had quarreled. But they say he is not a prime suspect in the probe.

McAfee says he has been persecuted by Belize’s ruling party because he refused to pay around $ 2 million he says it is trying to hustle out of him, he said.

Belize’s prime minister denies this and said McAfee, who made millions from the Internet anti-virus software that bears his name, was “bonkers.” McAfee later lost much of his fortune and turned to a life of semi-reclusion by the Belizean beach.

McAfee spent Wednesday night reading his blog and posting his thoughts on a laptop he said was lent to him by the warden of the cottage where he was staying.

One person asked him if he felt like committing suicide.

“I enjoy living, and suicide is absurdly redundant,” he wrote. “The world, from the very beginning, hurls viruses, accidents, hungry animals, defective DNA – and uncountable more – in an attempt to kill us. It always succeeds. Suicide is simply aiding and abetting.”

McAfee’s earlier posts spoke of his relief at arriving in Guatemala, thinking he had found a way out of his troubles.

One of his readers posted a message offering him just that.

“John. I have a special ops team near the La Aurora International Airport. I can get you out of jail and provide safe passage back to the States for a fee. Please let me know if this interests you.”

DRUG PAST

Guatemala’s government originally said the eccentric tech entrepreneur, who loves guns and young women and has tribal tattoos covering his shoulders, would be expelled to Belize within hours. But it later rowed back.

The U.S. State Department said it was aware of McAfee’s arrest and its embassy was providing “appropriate consular services,” but could not comment further.

On the island of Ambergris Caye, where McAfee has lived for about four years, residents and neighbors say he is eccentric and at times unstable. He was seen to travel with armed bodyguards, sporting a pistol tucked into his belt.

The predicament of the former Lockheed systems consultant is a far cry from his heyday in the late 1980s, when he started McAfee Associates. McAfee has no relationship now with the company, which was sold to Intel Corp.

McAfee was previously charged in Belize with possession of illegal firearms, and police had raided his property on suspicions that he was running a lab to produce illegal synthetic narcotics. He says he has not taken drugs since 1983.

“I took drugs constantly, 24 hours of the day. I took them for years and years. I was the worst drug abuser on the planet,” he told Reuters just before his arrest. “Then I finally went to Alcoholics Anonymous, and that was the end of it.”

(With reporting by Andrew Quinn in Washington; Writing by Simon Gardner and Dave Graham; Editing by Doina Chiacu and Philip Barbara)

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Economix Blog: Uwe E. Reinhardt: How Medicare Is Misrepresented

Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.

A common phrase in the current debate over the so-called fiscal cliff is “Medicare needs to be restructured.” The term serves as code for policies unlikely to be appealing to voters, a term that can mean everything and, thus, nothing.

The question is what problem restructuring is to solve in traditional Medicare, which remains one of the most popular health insurance programs in this country. People who use this vague term should always be challenged to explain exactly why and how Medicare should be changed.

Critics of traditional Medicare – even those who should know better – often accuse it of being “fee for service.” It is a strange accusation. After all, fee-for-service remains the dominant method of paying the providers of health care under private insurance, including Medicare Advantage, the option of private coverage open to all Medicare beneficiaries.

Describing Medicare as fee-for-service insurance is about as thoughtful as describing a horse as “an animal that has four legs,” a characteristic shared by many other animals. The practice is particularly odd, given that traditional Medicare as early as the 1970s was the first program to develop so-called “bundled payments” for hospital inpatient care – the diagnostically related groupings, known as D.R.G. – in place of fee-for-service payment of hospitals, an innovation that has since been copied around the globe.

A more descriptive term for traditional Medicare would be “free choice of providers” or “unmanaged care” insurance. These features, of course, would hardly be viewed as shortcomings among people covered by traditional Medicare or their families. Neither term would be a good marketing tool among voters for proposals to abandon traditional Medicare.

In this regard, it may be helpful to list the various contractual relationships that can exist between the insured and insurers, on the one hand, and the various methods of paying the providers of care, on the other:

Indemnity Insurance: This is the oldest form of health insurance. It offers the insured free choice of health care provider and of treatment, which is why such policies tend to be expensive.

Under indemnity insurance, providers of care are typically paid on a fee-for-service basis. Insurers usually pay a stipulated fraction (say 80 percent) of the providers’ bills for covered services. Patients absorb the rest in the form of deductibles and coinsurance (e.g., 20 percent of the providers’ bill). Under some policies, insurers ask patients to pay providers first and then seek reimbursement from the insurer.

Managed-Care Contracts: The other three insurance contracts shown in the display – H.M.O., P.P.O. and P.O.S. contracts – are generally lumped together under the generic term “managed care.” It is another ill-defined term that can mean a host of specific limitations on the insured’s freedom of choice.

Doctors may assert that it is they who manage the medical treatments. But in health-policy circles, the term managed care means that the doctor’s medical treatments are subject to external constraints imposed by a private regulator — the patient’s health insurer — although, in principle, public insurers could “manage” care as well, if legislators permitted it.

These externally imposed constraints may take the form of formularies for prescription drugs or prior authorization by the insurer for specific procedures – e.g., expensive imaging or elective surgery – before the insurer agrees to pay for the procedures. They may mean exclusion from coverage of procedures deemed by the insurer to have a low expected benefit-cost ratio. While Congress forbids Medicare to let cost-benefit analysis guide its coverage decisions, private insurers are not subject to that constraint.

Finally, managed care techniques might include the external coordination of medical treatments that involved multiple providers of health care, especially the treatment of chronic disease, often by subcontracted companies specializing in care coordination.

These are the major forms of managed care insurance contracts.

Health Maintenance Organizations (H.M.O.): These contracts represent the most restrictive form of managed care. The insurer provides covered health care benefits through a network of health care providers under contract to the insurer, with zero or very modest cost-sharing at point of service on the part of the insured.

In a staff model H.M.O., the insurer actually owns the health care facilities and health professionals are the insurer’s salaried employees. More commonly, the H.M.O. merely contracts with a set of otherwise independent providers that are paid negotiated fees or, for primary care, sometimes annual capitation payments per patient on the doctor’s list.

Usually, in an H.M.O., the insured is asked to select one from a roster of primary-care doctors who regulates referrals to specialists. In principle, under an H.M.O. contract the insured is confined to the H.M.O.’s network of providers for covered services and pays in full out-of-pocket for health care procured outside that network.

Preferred Provider Organizations (P.P.O.): A popular alternative to the strictly limited choice under H.M.O.’s is a Preferred Provider Organization. Under that contract, the insurer negotiates prices with a network of “preferred” providers of care and the insured can contact specialists without a required referral by a primary-care doctor.

For the most part these providers in the network are paid on a fee-for-service basis as well, often X times the Medicare fee schedule, where X could be smaller than 1 but usually exceeds 1, where X is negotiated between the insurer and providers. The insured usually faces an annual deductible and relatively modest copays (dollar amounts, not fractions of the fees) if they obtain care from a provider in the network.

If the insured obtains care from a provider outside the P.P.O.’s network, the insurer will reimburse the insured only at what the insurer considers a reasonable fee, leaving the insured to pay any billed fee above that reimbursement. According to a report by the American Health Insurance Plans, these out-of-network fees can be exorbitantly high, which serves as a natural constraint on the free choice of provider under P.P.O.’s.

Point of Service (P.O.S.) Contracts: These contracts are combinations of H.M.O. and P.P.O. contracts. The insured still must select a primary-care doctor who coordinates the insured’s overall medical care, but patients can procure covered care from providers outside the H.M.O.’s network, albeit at high rates of cost-sharing. In that regard the arrangement resembles a P.P.O.

High-Deductible Health Plans (H.D.H.P.): These contracts couple indemnity- or preferred-provider (P.P.O.) insurance with very high annual deductibles, sometimes exceeding $10,000 for a family. The theory is that by putting the insured’s skin in the game, these plans will give patients an incentive to shop around for cost-effective health care. Some call them “Consumer-Directed Health Plans” (C.D.H.P.’s), because in theory they elevate “consumers” (formerly “patients”) to act as the chief managers of their own health care. However, the requisite information for shopping around has not generally been available to patients, forcing them to function in health care as would blindfolded shoppers in a department store.

What the critics of traditional, government-run Medicare actually find wanting in traditional Medicare is that it basically is classic indemnity insurance. It offers its enrollees free choice of doctor, hospital and other providers, and doctors relatively free choice of treatments, while most private insurers typically no longer do.

In other words, the complaint is that health care rendered under traditional Medicare is unmanaged care. These features, of course, are precisely the reason why in the eyes of the public traditional Medicare is still one of the most popular insurance products.

A case can be made, on theoretical and sometimes empirical grounds, that properly managed or coordinated care can on average yield superior medical treatments, at lower cost, than completely unmanaged care under classical indemnity insurance.

The problem has been and continues to be that this is not the folklore among patients or doctors. The latter, as noted, generally believe they can manage their patients’ care properly without outside interference into their clinical decisions. Among patients and doctors, the term managed care is still not quite respectable.

This can explain why critics of traditional Medicare delicately but nonsensically prefer to decry it as being fee for service rather than as free-choice-of-providers insurance or unmanaged-care insurance.

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