Despite New Health Law, Some See Sharp Rise in Premiums

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Bob Chamberlin/Los Angeles Times

Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

 In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.

The proposed increases compare with about 4 percent for families with employer-based policies.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.

The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.

The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.

Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.

“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.

Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.

“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.

As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.

Read More..

Economic View: Pigovian Taxes May Offer Economic Hope

NO one enjoys paying taxes — and no politician relishes raising them. Yet some taxes actually make us better off, even apart from the revenue they provide for public services.

Taxes on activities with harmful side effects are a case in point. Strongly favored even by many conservative Republican economists, these levies are known as Pigovian taxes, after the British economist Arthur C. Pigou, who advocated them in his 1920 book, “The Economics of Welfare.” In today’s deeply polarized political climate, they offer one of the few realistic hopes for progress.

To see how Pigovian taxes work, consider a driver checking out the offerings at his local auto dealership. He is trying to decide between two vehicles, one weighing 6,000 pounds and the other, 4,000 pounds. After comparing sticker prices, mileage estimates and other features, he views the choice as roughly a tossup. But because he has a slight preference for the larger vehicle, he buys it. His decision, however, could be viewed as a bad choice for society as a whole, because of the side effects. The laws of physics tell us that heavier vehicles tend to cause more damage in crashes. They also spew more emissions into the air and cause more wear and tear on roads.

By providing an incentive to take those external costs into account, taxing vehicles by weight would make the total economic pie larger. Those who don’t really need heavier vehicles could buy lighter ones and pay less tax. Others could pay the extra tax as fair compensation for their heavier vehicles’ negative side effects.

But the mere fact that Pigovian taxes produce greater benefits than costs doesn’t make them an easy sell politically. Like other changes in public policy, a Pigovian tax produces winners and losers. And it’s an iron law of politics that prospective losers lobby harder to block change than prospective winners do for its adoption. That asymmetry creates a powerful status-quo bias that makes even broadly beneficial policy changes hard to achieve.

Yet, in principle, any change that makes the economic pie larger makes it possible for everyone to enjoy a bigger slice than before. The practical challenge is to slice the larger pie so that everyone comes out ahead. A first step toward a vehicle-weight tax would be to make it revenue-neutral — for example, by returning its revenue in the form of lump-sum rebates to each buyer. That would soften the blow, while preserving the incentive to buy lighter vehicles.

For example, if the tax were 20 cents a pound, a 6,000-pound vehicle would be taxed at $1,200, as opposed to $800 for a 4,000-pound one. If an equal number of vehicles of each weight were sold, all buyers would get a $1,000 rebate when the total tax income was redistributed. The buyer in our example would thus be making a net payment of $200 because of the tax, but his total outlay would have been $400 lower if he’d bought the smaller vehicle instead.

Although revenue neutrality would help, buyers who really need large vehicles might feel aggrieved. Paradoxically, the key to mollifying them is to propose Pigovian taxes not just on vehicle weight but also on a swath of other activities that cause undue harm to others. We could tax drivers contributing to traffic congestion, for example, on the grounds that entering a crowded roadway causes delays to others. We could tax noise, carbon emissions and other specific forms of air and water pollution. Although some people would end up as losers under any single one of these measures, virtually everyone would come out ahead under a broad suite of Pigovian taxes.

That’s because adopting a large number of them is like repeated flips of a coin whose odds are stacked heavily in your favor. If someone offered a chance to flip a coin that paid $10 for heads and lost $1 for tails, would you take it? It’s an attractive gamble, obviously, but if there is only a single flip, there’s a 50 percent chance that you’ll be a loser. After many flips, however, you’d almost certainly be a net winner.

Likewise, any single Pigovian tax is an attractive gamble for the average taxpayer, who would get a rebate equal to the amount she’d paid in tax and would benefit from the resulting reduction in harm. Under a collection of such taxes, the odds of being a net winner go up sharply. Only the minuscule minority who cause much more than average amounts of harm in almost every category might end up paying more total tax than before. And even those few would still be net winners, because of the corresponding reductions in harm.

A BROAD slate of Pigovian taxes would thus meet the challenge of how to divide the larger pie so everyone comes out ahead. And because the prospect of a continued divided government makes short-run legislative progress unlikely on other fronts, why not pick this low-hanging fruit right now?

The case for Pigovian taxes isn’t easily reduced to bumper-sticker slogans. Still, the basic ideas are not complicated, and President Obama has the biggest megaphone on the planet. It should be easy for him to persuade rational voters to embrace policies that would make virtually everyone better off.

But he must also persuade House Republicans. Getting their votes will be the real test of his celebrated rhetorical skills.

Robert H. Frank is an economics professor at the Johnson Graduate School of Management at Cornell University.

Read More..

McChrystal Book Details Tensions With Obama

WASHINGTON — In a memoir, Gen. Stanley A. McChrystal, the former American commander in Afghanistan, writes that tensions between the White House and the Pentagon were evident in the Obama administration from its opening months in office.

The beginning of President Obama’s first term “saw the emergence of an unfortunate deficit of trust between the White House and the Department of Defense, largely arising from the decision-making process on Afghanistan,” General McChrystal writes. “The effects were costly.”

The book by General McChrystal, who was fired from his post in 2010 after an article in Rolling Stone quoted him and his staff making dismissive comments about the White House, is likely to disappoint readers who are looking for a vivid blow-by-blow account of infighting within the administration.

The book, titled “My Share of the Task: A Memoir,” does not provide an account of the White House meeting at which Mr. Obama accepted the general’s resignation. General McChrystal’s tone toward Mr. Obama is respectful, and he notes that his wife, Annie, joined the crowd at Mr. Obama’s inauguration. The book is to be released on Monday.

An advance copy of the book provides revealing glimpses of the friction over military planning and comes as Mr. Obama is weighing, and perhaps preparing to overrule, the troop requests that have been presented by the current American commander in Afghanistan, Gen. John R. Allen.

The account is all the more noteworthy since General McChrystal, who retired from the Army, remains a respected voice within the military and teaches a course on leadership at Yale.

According to the book, the tensions began before General McChrystal took command in Kabul, Afghanistan, and were set off by a request from his predecessor, General David D. McKiernan, for 30,000 additional troops at the end of the Bush administration.

Instead of approving the entire request, in February 2009, Mr. Obama decided that 17,000 would be sent, adding that decisions on additional deployments would be based on further analysis.

From the White House perspective, General McChrystal writes, “this partial decision was logical.” After less than a month, the president had increased American forces in Afghanistan by 50 percent. Though Mr. Obama had cast the conflict in Afghanistan as a “war of necessity,” as a candidate he was nonetheless wary about a prolonged American military involvement there.

But the Pentagon pressed for an additional 4,000 troops, fearing that there was little time to reverse the Taliban’s gains before the August elections in Afghanistan.

“The military felt a sense of urgency, seeing little remaining time if any forces approved were to reach Afghanistan in time to improve security in advance of the elections,” he wrote.

The White House later approved the 4,000 troops, but the dispute pointed to a deeper clash of cultures over the use of force that continued after General McChrystal took command.

“Military leaders, many of whom were students of counterinsurgency, recognized the dangers of an incremental escalation, and the historical lesson that ‘trailing’ an insurgency typically condemned counterinsurgents to failure,” he writes.

In May 2009, soon before he assumed command in Kabul, General McChrystal had a “short, but cordial” meeting with Mr. Obama at which the president “offered no specific guidance,” he notes.

The next month, General McChrystal was surprised when James L. Jones, Mr. Obama’s first national security adviser, told him that the Obama administration would not consider sending more forces until the effect of arriving units could be fully evaluated.

That contradicted the guidance that General McChrystal had received from Defense Secretary Robert M. Gates that he should submit an assessment in August of the additional forces that might be required, he writes.

At an Oct. 8, 2009, video conference with Mr. Obama’s National Security Council, differences again emerged when General McChrystal outlined his goals: “Defeat the Taliban. Secure the population.”

That prompted a challenge by a Washington-based official, whom General McChrystal does not name, that the goal of defeating the Taliban seemed too ambitious and that the command in Kabul should settle instead for an effort to “degrade” the Taliban.

At the next video conference, General McChrystal presented a slide showing that his objectives had been derived from Mr. Obama’s own speeches and a White House strategy review. “But it was clear to me that the mission itself was now on the table for review and adjustment,” he wrote.

After General McChrystal determined that at least 40,000 additional forces were needed to reverse the deteriorating situation in Afghanistan, Mr. Obama provided 30,000 and said he would ask allied nations to contribute the rest.

General McChrystal acknowledges that he had concerns that Mr. Obama’s decision to announce a date for beginning the withdrawal of the additional “surge” forces might embolden the Taliban. But the general writes that he did not challenge the decision.

“If I felt like the decision to set a withdrawal date would have been fatal to the success of our mission, I’d have said so,” he writes.

General McChrystal has little to say about the episode that led to the article in Rolling Stone. He writes that the comments attributed to his team were “unacceptable” but adds that he was surprised by the tone of the article, which he had expected would show the camaraderie among the American, British, French and Afghan officers.

As the controversy over the article grew, General McChrystal did not seek advice before offering his resignation. The book does not say if he was disappointed when Mr. Obama accepted it at a brief White House meeting.

Returning to his quarters at Fort McNair after that White House meeting, he broke the news to his wife: “I told her that our life in the Army was over.”

Read More..

App City: Taking Stock of Mobile Apps

Testing apps from week to week, it’s easy to fill my phone with a seemingly endless number of theoretically helpful programs. But how many of them do I actually use? To start off 2013, I decided to take stock of my apps, with a focus on those that relate to my life as a New Yorker. Here are my favorites, many — but not all — of which I reviewed for App City. — JOSHUA BRUSTEIN

Christoph Hitz

Embark NYC

Free for iOS and Android

For directions, the default is Google Maps. But Embark, which helps you chart a trip on the New York City subway, is the other transportation app I use regularly, largely because it can generate directions without a data connection. After all, plans can change while you are underground. Offline, you can get only directions between stations, not for street addresses, but it’s a start.

Instapaper

$3.99 for iOS; $2.99 for Android

Instapaper is not new, but the idea of setting aside articles that I see online so that I can read them when I get stuck on the subway never gets old.

---

Seamless

Free for iOS and Android

This tool for placing orders for delivery or takeout food through a smartphone app has drastically increased the likelihood that I will order in on any given day. I do not know if this is a good thing, but it is certainly a testament to its effectiveness.

Christoph Hitz

Immaculate Infatuation

Free for iOS

Apps for finding restaurants are plentiful, but most of them leave me feeling overwhelmed. I want someone to choose for me, and I trust the authors of this app to do that. Their taste has never led me astray — although unlike them, I have no problem with the immense popularity of brussels sprouts.

Christoph Hitz

Taskrabbit

Free for iOS

One of the neatest things to come from the current generation of tech companies are informal communities where strangers do things for one another, like share a ride or a spare room. Taskrabbit allows people to hire one another for odd jobs. These jobs can be pretty much anything, but for tasks like taking in clothing for donation, I would much rather give $20 to a neighbor with a car than figure it out myself. Getting tasks done may be easy, but becoming someone who does the tasks isn’t: there are 1,500 people on the waiting list in New York City.

Songkick

Free for iOS and Android

It analyzes the music you listen to and tells you when bands you may like are playing nearby. It has successfully kept me away from Seamless on a number of nights. But being constantly reminded of great shows has the potential to be somewhat expensive.

---

Nike+ Fuelband

Wristband $149, app free for iOS and Android

This setup serves as a pedometer for the digital age, keeping track of your physical activity 24 hours a day. The app’s graphical representations of miles walked and calories burned are addictive. While the Fuelband does not do a good job of measuring exercise in a gym, it is a great way to keep a tally of all the walking you do. And if I’m going to spend my life wandering around the city, I might as well get credit for it.

Christoph Hitz

Craft Beer New York

$1.99 for iOS

This app is great when deciding which bars to visit. Of course, it works only for beer drinkers; good bars without good beer selections do not make the cut. There is a nice coffee app designed by the same team, and I use it in essentially the same way, although a bit earlier in the day.

Read More..

The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

The New Old Age: Murray Span, 1922-2012

One consequence of our elders’ extended lifespans is that we half expect them to keep chugging along forever. My father, a busy yoga practitioner and blackjack player, celebrated his 90th birthday in September in reasonably good health.

So when I had the sad task of letting people know that Murray Span died on Dec. 8, after just a few days’ illness, the primary response was disbelief. “No! I just talked to him Tuesday! He was fine!”

And he was. We’d gone out for lunch on Saturday, our usual routine, and he demolished a whole stack of blueberry pancakes.

But on Wednesday, he called to say he had bad abdominal pain and had hardly slept. The nurses at his facility were on the case; his geriatrician prescribed a clear liquid diet.

Like many in his generation, my dad tended towards stoicism. When he said, the following morning, “the pain is terrible,” that meant agony. I drove over.

His doctor shared our preference for conservative treatment. For patients at advanced ages, hospitals and emergency rooms can become perilous places. My dad had come through a July heart attack in good shape, but he had also signed a do-not-resuscitate order. He saw evidence all around him that eventually the body fails and life can become a torturous series of health crises and hospitalizations from which one never truly rebounds.

So over the next two days we tried to relieve his pain at home. He had abdominal x-rays that showed some kind of obstruction. He tried laxatives and enemas and Tylenol, to no effect. He couldn’t sleep.

On Friday, we agreed to go to the emergency room for a CT scan. Maybe, I thought, there’s a simple fix, even for a 90-year-old with diabetes and heart disease. But I carried his advance directives in my bag, because you never know.

When it is someone else’s narrative, it’s easier to see where things go off the rails, where a loving family authorizes procedures whose risks outweigh their benefits.

But when it’s your father groaning on the gurney, the conveyor belt of contemporary medicine can sweep you along, one incremental decision at a time.

All I wanted was for him to stop hurting, so it seemed reasonable to permit an IV for hydration and pain relief and a thin oxygen tube tucked beneath his nose.

Then, after Dad drank the first of two big containers of contrast liquid needed for his scan, his breathing grew phlegmy and labored. His geriatrician arrived and urged the insertion of a nasogastric tube to suck out all the liquid Dad had just downed.

His blood oxygen levels dropped, so there were soon two doctors and two nurses suctioning his throat until he gagged and fastening an oxygen mask over his nose and mouth.

At one point, I looked at my poor father, still in pain despite all the apparatus, and thought, “This is what suffering looks like.” I despaired, convinced I had failed in my most basic responsibility.

“I’m just so tired,” Dad told me, more than once. “There are too many things going wrong.”

Let me abridge this long story. The scan showed evidence of a perforation of some sort, among other abnormalities. A chest X-ray indicated pneumonia in both lungs. I spoke with Dad’s doctor, with the E.R. doc, with a friend who is a prominent geriatrician.

These are always profound decisions, and I’m sure that, given the number of unknowns, other people might have made other choices. Fortunately, I didn’t have to decide; I could ask my still-lucid father.

I leaned close to his good ear, the one with the hearing aid, and told him about the pneumonia, about the second CT scan the radiologist wanted, about antibiotics. “Or, we can stop all this and go home and call hospice,” I said.

He had seen my daughter earlier that day (and asked her about the hockey strike), and my sister and her son were en route. The important hands had been clasped, or soon would be.

He knew what hospice meant; its nurses and aides helped us care for my mother as she died. “Call hospice,” he said. We tiffed a bit about whether to have hospice care in his apartment or mine. I told his doctors we wanted comfort care only.

As in a film run backwards, the tubes came out, the oxygen mask came off. Then we settled in for a night in a hospital room while I called hospices — and a handyman to move the furniture out of my dining room, so I could install his hospital bed there.

In between, I assured my father that I was there, that we were taking care of him, that he didn’t have to worry. For the first few hours after the morphine began, finally seeming to ease his pain, he could respond, “OK.” Then, he couldn’t.

The next morning, as I awaited the hospital case manager to arrange the hospice transfer, my father stopped breathing.

We held his funeral at the South Jersey synagogue where he’d had his belated bar mitzvah at age 88, and buried him next to my mother in a small Jewish cemetery in the countryside. I’d written a fair amount about him here, so I thought readers might want to know.

We weren’t ready, if anyone ever really is, but in our sorrow, my sister and I recite this mantra: 90 good years, four bad days. That’s a ratio any of us might choose.

---

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

Read More..

Greece Tax Scandal Shifts Focus From Collection Problem

The tax scandal that reignited in Greece over the holidays had all the makings of a grade-B drama. A former finance minister, George Papaconstantinou, was accused of scrubbing his relatives’ names from a CD containing the identities of thousands of possible Greek tax dodgers. Within hours, his chief political rival tossed him from their party.

Thanassis Stavrakis/Associated Press

George Papaconstantinou, a former finance minister, was accused of scrubbing relatives’ names from a CD with the identities of possible tax dodgers.

Mr. Papaconstantinou, in turn, hinted darkly that he was the victim of a plot masking malfeasance at higher levels.

While the firestorm may have made for political theater of a sort, it has diverted attention from a much bigger problem: Greece, its foreign lenders say, has fallen woefully short of its tax collection targets and is still not moving hard enough to tackle widespread tax evasion — long tolerated, particularly among the country’s richest citizens.

Greek officials agreed to the targets as part of an international lending pact last year, but there is no penalty for missing them. In recent weeks, however, two reports by Greece’s foreign lenders have found that Athens pulled in less than half of the additional tax income that it expected last year and performed fewer than half of the expected audits.

One report said that Athens had brought in a little less than $1.3 billion in additional taxes of the $2.6 billion it had hoped to collect in 2012. Only 88 major taxpayers, including corporations, were the subject of full-scope audits, well below a target of 300, the report said, while just 467 audits of high-wealth individuals were completed, compared with a goal of 1,300.

The fragile, three-party coalition government of Prime Minister Antonis Samaras continues to vow it will crack down on corruption and tax evasion, but a blunt assessment last month by a task force of Greece’s foreign lenders said, “These changes have not yet been reflected in results in terms of improved tax inspection and collection.” Analysts say the failure to pursue tax evaders aggressively is deepening social tensions. “It’s a weak government with very difficult work to do, and this is very, very bad for the morale of the people,” said Nikos Xydakis, a political columnist for Kathimerini, a daily newspaper. “This year will be hell for the middle-class people. And the rich people are untouchable. This is very bad.”

In a separate report, the European Union and the International Monetary Fund said they were concerned that the “authorities are falling idle and that the drive to fight tax evasion by the very wealthy and the free professions is at risk of weakening.”

The report added that total unpaid taxes amounted to nearly $70 billion, about 25 percent of Greece’s gross domestic product. But only about 15 percent to 20 percent of the amount is actually collectible, either because the statute of limitations has run out or the scofflaws do not have the money.

It pressed Greece to focus on the cases most likely to produce real revenues, especially in vocations where tax evasion has become pernicious. “Doctors and lawyers are a good place to start,” it said.

Critics, especially the leftist party Syriza, which leads in opinion polls, say the government has not done enough to stop corruption because its members are tied to the country’s business elite and do not want to jeopardize their political careers.

“The problem is not simply tax evasion among the rich,” said Zoe Konstantopoulou, a member of Parliament from Syriza who serves on a panel investigating the so-called Lagarde list, a compilation of more than 2,000 Greeks with accounts in a Swiss branch of HSBC that had been sent to Mr. Papaconstantinou in 2010 by Christine Lagarde, then the finance minister of France. “The problem is tax evasion among the rich with the complicity and the aiding and abetting of those who govern.”

While Greece received a badly needed $45 billion in aid last month to help it avoid defaulting on its debts, critics say that unless Athens can more forcefully tap the billions it is owed in taxes, it will never pay off its debts, even if its moribund economy eventually starts to recover.

A dysfunctional bureaucracy weakened by budget cuts, two destabilizing rounds of elections last spring and an economy decimated by austerity have hampered tax collections further. But a thicket of regulations and a culture of resistance also fuel a shadow economy that includes an estimated 25 percent of economic activity.

Liz Alderman reported from Paris, and Rachel Donadio from Rome. Niki Kitsantonis contributed reporting from Athens.

Read More..

Afghan Soldier’s Journey From Friend to Killer of Americans

Video Image via Site Monitoring Service

Mahmood is shown being welcomed by the Taliban after he opened fire on American trainers in Kunar Province.

KABUL, Afghanistan — It was only after the young Afghan soldier’s hatred of Americans had grown murderous that he reached out to the Taliban.

The soldier, named simply Mahmood, 22, said that in May he told the insurgents of his plan to shoot Americans the next time they visited the outpost where he was based in northeastern Afghanistan. He asked the Taliban to take him in if he escaped.

The Taliban veterans he contacted were skeptical. Despite their public insistence that they employ vast ranks of infiltrators within the Afghan Army and the police, they acknowledged that many of the insider attacks they take credit for start as offers by angry young men like Mahmood. They had seen many fail, or lose their nerve before even starting, and they figured that Mahmood, too, would prove more talk than action or would die in the attempt.

“Even the Taliban didn’t think I would be able to do this,” Mr. Mahmood said in an interview.

He proved them wrong days later, on the morning of May 11, when he opened fire on American trainers who had gone to the outpost in the mountains of Kunar Province. One American was killed and two others were wounded. Mahmood escaped in the ensuing confusion, and he remains free in Kunar after the Taliban welcomed him into their ranks.

It was, he said, his “proudest day.”

Such insider attacks, by Afghan security forces on their Western allies, became “the signature violence of 2012,” in the words of one former American official. The surge in attacks has provided the clearest sign yet that Afghan resentment of foreigners is becoming unmanageable, and American officials have expressed worries about its disruptive effects on the training mission that is the core of the American withdrawal plan for 2014.

“It’s a game changer on all levels,” said First Sgt. Joseph Hissong, an American who helped fight off an insider attack by Afghan soldiers that left two men in his unit dead.

Cultural clashes have contributed to some of the insider attacks, with Afghan soldiers and police officers becoming enraged by what they see as rude and abusive behavior by Americans close to them. In some cases, the abusive or corrupt behavior of Afghan officers prompts the killer to go after Americans, who are seen as backing the local commanders. On rare occasions, like the killing of an American contractor by an Afghan policewoman late last month, there seems to be no logical explanation.

But behind it all, many senior coalition and Afghan officials are now concluding that after nearly 12 years of war, the view of foreigners held by many Afghans has come to mirror that of the Taliban. Hope has turned into hatred, and some will find a reason to act on those feelings.

“A great percentage of the insider attacks have the enemy narrative — the narrative that the infidels have to be driven out — somewhere inside of them, but they aren’t directed by the enemy,” said a senior coalition officer, who asked not to be identified because of Afghan and American sensitivities about the attacks.

The result is that, although the Taliban have successfully infiltrated the security forces before, they do not always have to. Soldiers and police officers will instead go to them, as was the case with Mr. Mahmood, who offered a glimpse of the thinking behind the violence in one of the few interviews conducted with Afghans who have committed insider attacks.

“I have intimate friends in the army who have the same opinion as I do,” Mr. Mahmood said. “We used to sit and share our hearts’ tales.”

But he said he did not tell any of his compatriots of his plan to shoot Americans, fearing that it could leak out and derail his attack. The interviews with Mr. Mahmood and his Taliban contacts were conducted in recent weeks by telephone and through written responses to questions. There are also two videos that show Mr. Mahmood with the Taliban: an insurgent-produced propaganda video available on jihadi Web sites, and an interview conducted by a local journalist in Kunar.

Though Mr. Mahmood at times contradicted himself, falling into stock Taliban commentary about how it had always been his ambition to kill foreigners, much of what he said mirrored the timelines and versions of events provided by Taliban fighters who know him, as well as Afghan officials familiar with his case.

Mr. Mahmood grew up in Tajikan, a small village in the southern province of Helmand. The area around his village remains dominated by the Taliban despite advances against the insurgents made in recent years by American and British troops. Even Afghans from other parts of Helmand are hesitant to travel to Tajikan for fear of the Taliban.

Sangar Rahimi and Jawad Sukhanyar contributed reporting from Kabul, and an employee of The New York Times from Asadabad.

Read More..

Europe Likely to Be Harder on Google Over Search

SAN FRANCISCO — By some accounts, the United States let Google off the hook by finding that the technology giant had not abused its dominance in the Internet search market.

Few expect the European antitrust watchdog to be as lenient.

The Federal Trade Commission ruled Thursday that Google had not broken antitrust laws, after a 19-month inquiry into how it operates its search engine. But the European Commission, which is pursuing assertions that the company rigs results to favor its own businesses, operates according to a different standard.

The agreement with the American authorities, analysts and competition lawyers say, is unlikely to alter the demands of European regulators, led by the E.U. competition commissioner, Joaquín Almunia.

“We have taken note of the F.T.C. decision, but we don’t see that it has any direct implications for our investigation, for our discussions with Google, which are ongoing,” said Michael Jennings, a spokesman for the European Commission in Brussels.

Faced with nearly $4 billion in possible penalties and restrictions on its business in Europe, Google in July submitted proposals to remedy the concerns of the European Commission, which covered four areas. In its deal with the F.T.C., Google made concessions in two of those areas but was not required to do so in the rest.

A Google spokesman, Al Verney, declined to comment on the content of the company's proposals to Mr. Almunia but said it would “continue to work cooperatively with the European Commission.”

The Google case underscores a basic difference between the European and U.S. approaches to monopoly power. American antitrust regulators tend to focus on whether a company’s dominance is harmful to consumers; the European system seeks to maintain competitors in the market. Mr. Almunia has vowed to restore competition to the Internet search business in Europe.

“History shows that competition law is applied to monopoly power more stringently in the E.U. than in the U.S.,” said Jacques Lafitte, head of the competition practice at Avisa Partners, a consultancy in Brussels, who brought one of the original complaints against Google. “Whether the E.U. is right or not is a different question.”

Mr. Lafitte has some expertise in the matter. He is the former head of corporate affairs at Microsoft Europe and watched as that company did battle with regulators over its dominant computer operating system. Microsoft won a lenient settlement with the U.S. Justice Department in October 2001, he noted, only to be slapped with nearly €1.6 billion, or $2.1 billion, in E.U. fines and penalties from 2004 to 2008.

Google learned from Microsoft’s mistakes, engaging in discussions with both the U.S. and European authorities to reach a deal rather than fighting a desperate legal action. That approach appears to have paid off: Last month, after a meeting with Eric E. Schmidt, Google’s executive chairman, Mr. Almunia said that the sides had “substantially reduced our differences.”

In its deal with the F.T.C., Google agreed to make concessions in two areas that concern European regulators. In one, it will allow rivals to opt out of allowing Google to “scrape,” or copy, text from their sites. It is probable that Google will offer the same concession to European authorities.

But in a second area of European concern — whether Google deliberately favors its own content in search results — the F.T.C. did not require changes.

Mr. Almunia has also demanded that Google put fewer restrictions on advertising distribution deals, an area that his U.S. counterparts did not explore.

The company will make a detailed set of proposed remedies in January, after which the European Commission will allow the complainants to review them in a period of what is known as “market testing.” Antitrust lawyers say a final denouement could arrive by spring, depending on how hostile Google’s rivals are to the proposed remedies.

FairSearch, an alliance of Google rivals, accused the U.S. trade commission of rushing its decision. It said in a statement that closing the F.T.C. investigation “with only voluntary commitments from Google is disappointing and premature.”

Read More..

Well: Vegan Recipes for Health

If one of your goals for 2013 is more healthful eating, the Recipes for Health columnist Martha Rose Shulman can get you started. She has proposed five delicious vegan meals for the New Year that may also save you some money. She writes:

Here is a New Year’s project for you. Take an inventory of your pantry, freezer and refrigerator and cook for a week without buying anything except items that you and your children may consume on a daily basis (for me that means bananas). That is what I’m doing this week, and I have decided that I will also make my meals vegan.

Here are some of the items ending the year in my pantry, freezer and produce bins: quinoa (regular, red and rainbow); a bag of mixed dried sprouted lentils packaged by Tru Roots (“Sprouted Lentil Medley”); a bag of yellow lentils (toor dal) from the Indian grocery store across the street (how handy that Mark Bittman had inspired me to explore the world of dals with his New York Times Magazine article in early December); rice in various colors – brown, Alter Eco’s purple jasmine; red Bhutanese; wild, Arborio and basmati; a bag of black beans; rice noodles; farro. I have had a big acorn squash lying around for over a month now, and in my refrigerator there are a few carrots, half of a purple cabbage, tofu, celery, beets and beet greens and a red pepper. There are various frozen stocks in my freezer, including a vegan pho broth from my recipe tests of a few months ago.

This is a healthy, hearty and inexpensive way to begin the New Year and we have been eating extremely well. In fact there is enough on hand that I might extend this to a two-week exercise.

Here are five vegan meals from the pantry to get you started on a year of healthful eating.

Quinoa With Spiced Lentil Dal: A dal that is spiced up by a little bit of cayenne.

---

Warm Lentil Salad With Balsamic Roast Squash: A lentil salad with a cumin-scented vinaigrette.

---

Vegan Pho With Carrots, Noodles and Edamame: A pho without some traditional ingredients is still very much pho.

---

Rice Bowl With Sweet and Sour Purple Cabbage, Red Peppers and Baked Marinated Tofu: A colorful dish that uses up any sticky rice left in your pantry.

---

Enfrijoladas: A simple delicious dish that will use up corn tortillas in your freezer and black beans from the pantry.

---

Read More..