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« Reply #2616 on: Oct 07, 2012, 07:19 AM » |
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In the USA...
October 6, 2012
For those in America please read and absorb this healine....and what it actually means in terms of what is going on in your country .. the nature of your corporate media.
Unlike the Corporate Media, Citizens Aren’t Buying Romney’s Debate Lies
By: Sarah Jones
October 6th, 2012
A new tool was applied to social media following the presidential debate, and it showed that public sentiment was Obama won on substance, whereas Romney appeared to win by lying. The ability of social media to spread the word about fact-checks has changed the game.
NBC used a tool called ForSight, used to gauge public opinion in new media, to conclude that by Friday there was a sustained social media backlash against the punditry calling the Denver presidential debate for Romney. The new meme was that if Romney “won”, he did so by lying, whereas Obama had won on substance.
The immediate consensus that Mitt Romney won Wednesday’s presidential debate has eroded significantly as fact-checkers have weighed in and supporters of President Barack Obama have fought back, according to NBCPolitics’ computer-assisted analysis of more than 1.3 million post-debate comments on social media.
The analysis suggests that as debate over a news event continues unmediated over time, the impact of the conventional wisdom of journalists and partisan commentators can be mitigated…
By Friday morning, the counterargument that Obama had actually won on substance had taken root, with online sentiment now favoring the president.
I am not presenting these revelations to argue that Obama won the debate. It was established by the media that Romney won the debate, even if this study — based upon the post mortem fact-checking that damaged Romney’s “win” — says otherwise. Romney has also gotten a small bounce in post debate polls so far among undecideds.
However, to the point of the social media backlash, the debate bounce is not a shift in the electorate precisely for the reasons people were citing on social media; the public does not find Romney trustworthy or presidential. According to numbers from a Reuters/Ipsos survey released Saturday, the bounce is not a shift in the electorate, but a short term bounce. “We haven’t seen additional gains from Romney. This suggests to me that this is more of a bounce than a permanent shift,” Ipsos pollster Julia Clark concluded.
Furthermore, Obama gained ground post debate on matters of character and who understands the electorate more, even among voters who thought Romney “won” the debate. Obama is still more liked than Romney (53-29), and he still has a slim overall lead over Romney. Voters feel Obama has right values needed for a President by 43 to 37. Ironically given the narrative that came out of Denver’s debate, Obama still leads 42-38 on who is “tough” enough to be President.
So, Romney “won” the debate but did nothing he needed to do in order to present himself as more presidential. Worse, our media gave a debate to the person who by all fact-checkers’ accounts, lied his way through the entire debate to such an astonishing degree that there were times we did not know who was standing on that stage. This was not the Mitt Romney who has been campaigning for the past six years. Mitt Romney “won” by disavowing himself of Mitt Romney. How is that a real “win”? Perhaps he won the debate only to lose himself.
Not bothered in the least by Romney stabbing Republican ideology in the back in order to present himself as Obama lite during Denver’s debate, the Romney camp were out with champagne and snarls the day after the debate — high on their first “win” in a long and rather embarrassing campaign season for them. Republicans took to the airwaves to gloat like frat boys, demonstrating the very reason why they should not be in charge of anything. Ambition happily sacrificed principles in the Romney camp.
If this is “winning”, then we need to redefine the purpose of these debates. Ostensibly, they exist to inform the people. How exactly did Mitt Romney inform the people of his policy positions so that they were better equipped to vote their conscience? He misled them, if anything, and he seemed to only confirm voters’ already dim opinions of his character. The media dropped the ball on this one, including the allegedly liberal media.
Things are so bad in our corporate media that we were told a liar won a debate for the Presidency because the other guy didn’t hit him back hard enough. These folks are paid for their ability to see past the trees, even if they are the right height, and focus on more than political theater.
The debate is supposed to be about who is best suited to be President, not about who won the WWE show, unless the media is conceding that our presidential debates are nothing but entertainment not subject to rules. The Denver debate and the post debate coverage was an unmitigated fail.
Just like the trolled Town Halls of 2010, the media got punked by manic hysteria and distortions meant to distract from the very issues at hand. The media did nothing to clear the air. But citizens took to social media to point through the crazed haze, revealing the little man behind the curtain of lies.
Romney won the debate, but failed to achieve what should have been his biggest goals; to change public perception of him and to come off as presidential.
******
Error and Fraud at Issue as Absentee Voting Rises
By ADAM LIPTAK
TALLAHASSEE, Fla. — On the morning of the primary here in August, the local elections board met to decide which absentee ballots to count. It was not an easy job.
The board tossed out some ballots because they arrived without the signature required on the outside of the return envelope. It rejected one that said “see inside” where the signature should have been. And it debated what to do with ballots in which the signature on the envelope did not quite match the one in the county’s files.
“This ‘r’ is not like that ‘r,’ ” Judge Augustus D. Aikens Jr. said, suggesting that a ballot should be rejected.
Ion Sancho, the elections supervisor here, disagreed. “This ‘k’ is like that ‘k,’ ” he replied, and he persuaded his colleagues to count the vote.
Scenes like this will play out in many elections next month, because Florida and other states are swiftly moving from voting at a polling place toward voting by mail. In the last general election in Florida, in 2010, 23 percent of voters cast absentee ballots, up from 15 percent in the midterm election four years before. Nationwide, the use of absentee ballots and other forms of voting by mail has more than tripled since 1980 and now accounts for almost 20 percent of all votes.
Yet votes cast by mail are less likely to be counted, more likely to be compromised and more likely to be contested than those cast in a voting booth, statistics show. Election officials reject almost 2 percent of ballots cast by mail, double the rate for in-person voting.
“The more people you force to vote by mail,” Mr. Sancho said, “the more invalid ballots you will generate.”
Election experts say the challenges created by mailed ballots could well affect outcomes this fall and beyond. If the contests next month are close enough to be within what election lawyers call the margin of litigation, the grounds on which they will be fought will not be hanging chads but ballots cast away from the voting booth.
In 2008, 18 percent of the votes in the nine states likely to decide this year’s presidential election were cast by mail. That number will almost certainly rise this year, and voters in two-thirds of the states have already begun casting absentee ballots. In four Western states, voting by mail is the exclusive or dominant way to cast a ballot.
The trend will probably result in more uncounted votes, and it increases the potential for fraud. While fraud in voting by mail is far less common than innocent errors, it is vastly more prevalent than the in-person voting fraud that has attracted far more attention, election administrators say.
In Florida, absentee-ballot scandals seem to arrive like clockwork around election time. Before this year’s primary, for example, a woman in Hialeah was charged with forging an elderly voter’s signature, a felony, and possessing 31 completed absentee ballots, 29 more than allowed under a local law.
The flaws of absentee voting raise questions about the most elementary promises of democracy. “The right to have one’s vote counted is as important as the act of voting itself,” Justice Paul H. Anderson of the Minnesota Supreme Court wrote while considering disputed absentee ballots in the close 2008 Senate election between Al Franken and Norm Coleman.
Voting by mail is now common enough and problematic enough that election experts say there have been multiple elections in which no one can say with confidence which candidate was the deserved winner. The list includes the 2000 presidential election, in which problems with absentee ballots in Florida were a little-noticed footnote to other issues.
In the last presidential election, 35.5 million voters requested absentee ballots, but only 27.9 million absentee votes were counted, according to a study by Charles Stewart III, a political scientist at the Massachusetts Institute of Technology. He calculated that 3.9 million ballots requested by voters never reached them; that another 2.9 million ballots received by voters did not make it back to election officials; and that election officials rejected 800,000 ballots. That suggests an overall failure rate of as much as 21 percent.
Some voters presumably decided not to vote after receiving ballots, but Mr. Stewart said many others most likely tried to vote and were thwarted. “If 20 percent, or even 10 percent, of voters who stood in line on Election Day were turned away,” he wrote in the study, published in The Journal of Legislation and Public Policy, “there would be national outrage.”
The list of very close elections includes the 2008 Senate race in Minnesota, in which Mr. Franken’s victory over Mr. Coleman, the Republican incumbent, helped give Democrats the 60 votes in the Senate needed to pass President Obama’s health care bill. Mr. Franken won by 312 votes, while state officials rejected 12,000 absentee ballots. Recent primary elections in New York involving Republican state senators who had voted to allow same-sex marriage also hinged on absentee ballots.
There are, of course, significant advantages to voting by mail. It makes life easier for the harried, the disabled and the elderly. It is cheaper to administer, makes for shorter lines on election days and allows voters more time to think about ballots that list many races. By mailing ballots, those away from home can vote. Its availability may also increase turnout in local elections, though it does not seem to have had much impact on turnout in federal ones.
Still, voting in person is more reliable, particularly since election administrators made improvements to voting equipment after the 2000 presidential election.
There have been other and more controversial changes since then, also in the name of reliability and efficiency. Lawmakers have cut back on early voting in person, cracked down on voter registration drives, imposed identification requirements, made it harder for students to cast ballots and proposed purging voter rolls in a way that critics have said would eliminate people who are eligible to vote.
But almost nothing has been done about the distinctive challenges posed by absentee ballots. To the contrary, Ohio’s Republican secretary of state recently sent absentee ballot applications to every registered voter in the state. And Republican lawmakers in Florida recently revised state law to allow ballots to be mailed wherever voters want, rather than typically to only their registered addresses.
“This is the only area in Florida where we’ve made it easier to cast a ballot,” Daniel A. Smith, a political scientist at the University of Florida, said of absentee voting.
He posited a reason that Republican officials in particular have pushed to expand absentee voting. “The conventional wisdom is that Republicans use absentee ballots and Democrats vote early,” he said.
Republicans are in fact more likely than Democrats to vote absentee. In the 2008 general election in Florida, 47 percent of absentee voters were Republicans and 36 percent were Democrats.
There is a bipartisan consensus that voting by mail, whatever its impact, is more easily abused than other forms. In a 2005 report signed by President Jimmy Carter and James A. Baker III, who served as secretary of state under the first President George Bush, the Commission on Federal Election Reform concluded, “Absentee ballots remain the largest source of potential voter fraud.”
On the most basic level, absentee voting replaces the oversight that exists at polling places with something akin to an honor system.
“Absentee voting is to voting in person,” Judge Richard A. Posner of the United States Court of Appeals for the Seventh Circuit has written, “as a take-home exam is to a proctored one.”
Fraud Easier Via Mail
Election administrators have a shorthand name for a central weakness of voting by mail. They call it granny farming.
“The problem,” said Murray A. Greenberg, a former county attorney in Miami, “is really with the collection of absentee ballots at the senior citizen centers.” In Florida, people affiliated with political campaigns “help people vote absentee,” he said. “And help is in quotation marks.”
Voters in nursing homes can be subjected to subtle pressure, outright intimidation or fraud. The secrecy of their voting is easily compromised. And their ballots can be intercepted both coming and going.
The problem is not limited to the elderly, of course. Absentee ballots also make it much easier to buy and sell votes. In recent years, courts have invalidated mayoral elections in Illinois and Indiana because of fraudulent absentee ballots.
Voting by mail also played a crucial role in the 2000 presidential election in Florida, when the margin between George W. Bush and Al Gore was razor thin and hundreds of absentee ballots were counted in apparent violation of state law. The flawed ballots, from Americans living abroad, included some without postmarks, some postmarked after the election, some without witness signatures, some mailed from within the United States and some sent by people who voted twice. All would have been disqualified had the state’s election laws been strictly enforced.
In the recent primary here, almost 40 percent of ballots were not cast in the voting booth on the day of the election. They were split between early votes cast at polling places, which Mr. Sancho, the Leon County elections supervisor, favors, and absentee ballots, which make him nervous.
“There has been not one case of fraud in early voting,” Mr. Sancho said. “The only cases of election fraud have been in absentee ballots.”
Efforts to prevent fraud at polling places have an ironic consequence, Justin Levitt, a professor at Loyola Law School, told the Senate Judiciary Committee September last year. They will, he said, “drive more voters into the absentee system, where fraud and coercion have been documented to be real and legitimate concerns.”
“That is,” he said, “a law ostensibly designed to reduce the incidence of fraud is likely to increase the rate at which voters utilize a system known to succumb to fraud more frequently.”
Clarity Brings Better Results
In 2008, Minnesota officials rejected 12,000 absentee ballots, about 4 percent of all such votes, for the myriad reasons that make voting by mail far less reliable than voting in person.
The absentee ballot itself could be blamed for some of the problems. It had to be enclosed in envelopes containing various information and signatures, including one from a witness who had to attest to handling the logistics of seeing that “the voter marked the ballots in that individual’s presence without showing how they were marked.” Such witnesses must themselves be registered voters, with a few exceptions.
Absentee ballots have been rejected in Minnesota and elsewhere for countless reasons. Signatures from older people, sloppy writers or stroke victims may not match those on file. The envelopes and forms may not have been configured in the right sequence. People may have moved, and addresses may not match. Witnesses may not be registered to vote. The mail may be late.
But it is certainly possible to improve the process and reduce the error rate.
Here in Leon County, the rejection rate for absentee ballots is less than 1 percent. The instructions it provides to voters are clear, and the outer envelope is a model of graphic design, with a large signature box at its center.
The envelope requires only standard postage, and Mr. Sancho has made arrangements with the post office to pay for ballots that arrive without stamps.
Still, he would prefer that voters visit a polling place on Election Day or beforehand so that errors and misunderstandings can be corrected and the potential for fraud minimized.
“If you vote by mail, where is that coming from?” he asked. “Is there intimidation going on?”
Last November, Gov. Rick Scott, a Republican, suspended a school board member in Madison County, not far from here, after she was arrested on charges including absentee ballot fraud.
The board member, Abra Hill Johnson, won the school board race “by what appeared to be a disproportionate amount of absentee votes,” the arrest affidavit said. The vote was 675 to 647, but Ms. Johnson had 217 absentee votes to her opponent’s 86. Officials said that 80 absentee ballots had been requested at just nine addresses. Law enforcement agents interviewed 64 of the voters whose ballots were sent; only two recognized the address.
Ms. Johnson has pleaded not guilty.
Election law experts say that pulling off in-person voter fraud on a scale large enough to swing an election, with scores if not hundreds of people committing a felony in public by pretending to be someone else, is hard to imagine, to say nothing of exceptionally risky.
There are much simpler and more effective alternatives to commit fraud on such a scale, said Heather Gerken, a law professor at Yale.
“You could steal some absentee ballots or stuff a ballot box or bribe an election administrator or fiddle with an electronic voting machine,” she said. That explains, she said, “why all the evidence of stolen elections involves absentee ballots and the like.”
Amanda Cox contributed reporting from New York.
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October 6, 2012
Voters in Florida Are Set to Weigh in on Two Contentious Ballot Questions
By LIZETTE ALVAREZ
MIAMI — In a year in which most states have steered clear of contentious ballot initiatives, Florida voters are facing two proposed constitutional amendments — one on abortion, the other on the separation of church and state — that could have far-reaching repercussions.
Drafted by the Florida Legislature, along with nine other proposed amendments that will appear on the ballot in November, the first measure would restrict abortions and the second would allow public money to flow to religious institutions — an effort, opponents say, to revive school vouchers. The initiatives would require the approval of 60 percent of voters to take effect.
Both issues have galvanized supporters and opponents, including the Roman Catholic Church, reproductive rights groups, religious conservatives and the state teachers’ union, all of which are plunging money and volunteers into an effort to reach weary, long-badgered voters in this swing state.
Critics and backers of the amendments said they were concerned that voters, who will face long ballots printed in multiple languages and laden with various candidates and issues, may be unprepared to fully understand the consequences of the measures. In Miami-Dade County, for example, the ballot is 12 pages long, and some voters are likely to misunderstand the breadth of the amendments or run out of patience or time to make selections all the way down the ballot, policy analysts say.
“The bills are not that complicated,” said Tony Carvajal, the chief operations officer for the Collins Center for Public Policy in Tallahassee, which has analyzed the 11 amendments. “But the implications are huge.”
The abortion initiative, Amendment 6, seeks to bring Florida laws into line with more restrictive federal laws. The measure would ban state tax money from being used for abortions or for health insurance coverage of abortion, except in rare circumstances, among them rape, incest and when a woman’s life is endangered. The proposal would also narrow the definition of privacy in Florida as it relates to abortion, making it no broader than federal law.
If the amendment passes, the practical effect, analysts say, will be that state employees, with few exceptions, will not be able to use their insurance policies to cover abortions.
Also, by narrowing privacy laws, the Legislature, which is overwhelmingly Republican, will have an easier time approving, among other things, a bill requiring minors to get parental consent for an abortion. Currently, parents are notified if a minor seeks an abortion, but their consent is not required. A Florida law on parental consent was overturned in 1989 because of the state’s constitutional language regarding privacy.
“A minor child can’t get an aspirin at school, or a body piercing or a tattoo, but can get an abortion,” said Jim Frankowiak, the campaign manager for Citizens for Protecting Taxpayers and Parental Rights, which supports Amendment 6. “An abortion is a very serious health consideration.”
But opponents of the measure said the most immediate threat is for state employees, including teachers and police officers, whose insurance would not cover abortions, even if a pregnancy is detrimental to their health. A pregnant woman with cancer who requires chemotherapy, for example, would probably have to terminate her pregnancy to receive treatment, analysts said. But because she is not in “danger of death,” as the measure would require, her insurance might not cover the procedure, they said.
“In the real world, things can go tragically wrong in pregnancy, and women need all their options,” said Lillian Tamayo, the campaign chairwoman for Vote No on Amendment 6 and the president and chief enforcement officer of Planned Parenthood of South Florida and the Treasure Coast. “We should not be punishing or withholding care from public trusted servants.”
Ms. Tamayo portrayed Amendment 6 as part of a broader strategy by the Legislature to erode abortion rights by presenting voters with a little-understood measure. Planned Parenthood has raised nearly $2 million to defeat it and plans to run television advertisements against it.
“It’s not for politicians to decide what should or should not be covered as part of a woman’s health plan,” Ms. Tamayo said. “What keeps them from next preventing birth control as a health insurance benefit?”
A second initiative, pitting teachers and school boards against conservatives and many religious institutions, seeks to soften the barrier between church and state in Florida. The initiative, Amendment 8, would remove 19th-century language in the State Constitution that bars religious or sectarian institutions, or people, from receiving state money. Many states have similar provisions. The language was rooted in anti-Catholic sentiment and was written when Catholics were arriving in the country in large numbers.
Religious groups in Florida already receive state money, despite the language, but they are barred from using the money to proselytize. Typically, the money is used for social services and health programs run through organizations like Catholic Charities.
For religious leaders, the initiative is about protecting their ability to receive the money, a longstanding practice that they said is being threatened by a 2007 lawsuit against two religious groups that minister to Florida prisoners. The suit accuses the groups of pushing religion on the prisoners and raises questions about the separation of church and state.
Supporters say that Amendment 8 seeks to make the Florida Constitution no more restrictive on the issue than the United States Constitution.
“By getting rid of the language, we will protect the funding of these agencies,” said Archbishop Thomas Wenski of Miami, who is working to get the amendment passed. “In fact, it has nothing to do with vouchers.”
But public school advocates and civil liberties supporters say the initiative is, in fact, about vouchers. Calling the amendment sweeping and misleading, opponents say it does not limit itself to social services. Instead, they said, it opens the door to another effort by the Florida Legislature to institute a voucher system that would allow public money to go to religious schools.
And by calling it the “religious freedom” amendment, critics say, the Legislature is being disingenuous with voters. “It’s not about religious freedom, which is guaranteed in our Constitution,” said Karen Aronowitz, the president of United Teachers of Dade. “It’s another attempt to make vouchers a funding item from our public tax dollars and take the money away from public schools.”
Experts on the initiative said that it would not automatically lead to vouchers, mostly because vouchers were overturned by the Florida Supreme Court in 2006 on different grounds.
But it would remove one of the obstacles standing in the way of vouchers, the experts said. If the initiative were to pass, Florida lawmakers could draft new voucher legislation based on the new language, they said.
“It is possible,” said Tim McLendon, a staff lawyer at the University of Florida law school’s Center for Government Responsibility. “They could redo it, and it could reappear.”
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Court orders Ohio to restore early voting for all residents
By Arturo Garcia
Friday, October 5, 2012 17:43 EDT
A federal appeals court has ruled that the state of Ohio extend early voting hours to all residents, overturning a measure that limited the practice to military members and voters living overseas.
Talking Points Memo reported that the ruling by the Sixth U.S. Circuit Court of Appeals allows for voting to take place on the weekend before the Nov. 6 general election.
“The State’s asserted goal of accommodating the unique situation of members of the military, who may be called away at a moment’s notice in service to the nation, is certainly a worthy and commendable goal,” the court said in its ruling (PDF). “However, while there is a compelling reason to provide more opportunities for military voters to cast their ballots, there is no corresponding satisfactory reason to prevent non-military voters from casting their ballots as well.”
Earlier this year, President Barack Obama’s re-election campaign and the Ohio Democratic Party sued Ohio Secretary of State Jon Husted, calling state Senate Bill 295 “a cynical ploy.” State Sen. Nina Turner (D) called the bill a resurrection of Jim Crow, saying it was designed to suppress voting in precincts with a heavy African-American population.
According to MSNBC, about 93,000 residents vote during the three-day period preceding the election, many of them African-American voters who do so after their local church services.
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Seven dead as meningitis outbreak reaches nine states
By Arturo Garcia
Saturday, October 6, 2012 19:54 EDT
Seven people have died in a meningitis outbreak that has affected 64 people in nine states, The Associated Press reported Saturday.
The Centers for Disease Control and Prevention (CDC) updated its website Saturday to confirm that there have been cases connected to the outbreak reported in Minnesota and Ohio, joining Tennessee, Florida, North Carolina, Indiana, Michigan, Virginia and Maryland.
The AP also reported that 30 cases of the outbreak of aspergillus meningitis have been reported in Tennessee. All of them are being blamed on injections of a contaminated spinal steroid from the New England Compounding Center (NECC) used to treat back pain.
The family of one victim, Janet Russell, told the AP Russell has been in intensive care since being injected with the steroid at a Nashville hospital a month and a half ago.
“She has headaches, and she cannot eat,” said her daughter, Teresa Russell. “She cannot even take a sip of water and hold it down to take her medication orally, the medication she can take orally. And she has been sick for a very long time now.”
ABC News reported that NECC has recalled three lots of the drug and shut down operations.
The Associated Press report on the Russell family’s case, posted Friday, can be seen below.
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October 6, 2012
Scant Oversight of Drug Maker in Fatal Meningitis Outbreak
By DENISE GRADY, ANDREW POLLACK and SABRINA TAVERNISE
Eddie C. Lovelace, a Kentucky judge still on the bench into his late 70s, had a penchant for reciting Shakespeare from memory and telling funny stories in his big, booming voice. But a car accident last spring left him with severe neck pain, and in July and August he sought spinal injections with a steroid medicine for relief.
Instead, Judge Lovelace died in Nashville in September at age 78, one of the first victims in a growing national outbreak of meningitis caused by the very medicine that was supposed to help him. Health officials say they believe it was contaminated with a fungus.
The rising toll — 7 dead, 57 ill and thousands potentially exposed — has cast a harsh light on the loose regulations that legal experts say allowed a company to sell 17,676 vials of an unsafe drug to pain clinics in 23 states. Federal health officials said Friday that all patients injected with the steroid drug made by that company, the New England Compounding Center in Framingham, Mass., which has a troubled history, needed to be tracked down immediately and informed of the danger.
“This wasn’t some obscure procedure being done in some obscure hospital,” said Tom Carroll, a close friend to the Lovelace family, and their lawyer. “They had sought out a respected neurosurgeon who had been referred by their family doctor, at a respected hospital,” he said, referring to the St. Thomas Outpatient Neurosurgery Center. “How does this happen?”
The answer, at least in part, is that some doctors and clinics have turned away from major drug manufacturers and have taken their business to so-called compounding pharmacies, like New England Compounding, which mix up batches of drugs on their own, often for much lower prices than major manufacturers charge — and with little of the federal oversight of drug safety and quality that is routine for the big companies.
“The Food and Drug Administration has more regulatory authority over a drug factory in China than over a compounding pharmacy in Massachusetts,” said Kevin Outterson, an associate professor of law at Boston University.
The outbreak has also brought new scrutiny to the widely used procedure that Judge Lovelace and millions of Americans undergo each year.
Patients most likely assumed there was strong evidence that the procedure itself works. But the Cochrane Collaboration, an international group of medical experts, reviewed the data last year and found there was “no strong evidence for or against” the injections. Patients exposed to the drug in the current outbreak may have risked their health or even their lives for an elusive goal.
A Large Demand
Over the past two decades, pain control has become a growth industry, bolstered by the worn-out knees and aching backs of baby boomers. Pain clinics began popping up around the country.
Starting in the 1990s, spinal injections for back pain, known as lumbar epidural steroid injections, skyrocketed. They have since leveled off, but the number remains high. In 2011, 2.5 million Medicare recipients had the injections, as did an equal number of younger people, according to Dr. Ray Baker, president of the International Spine Intervention Society.
Many people seek them in hopes of avoiding surgery. The injections combine a steroid and a numbing drug in an effort to soothe inflamed and irritated nerves. Patients are told they may get weeks, months or even a year of relief.
The injections created a demand for steroids, including methylprednisolone acetate, the drug that New England Compounding was making.
To be sure, many compounding pharmacies perform well, producing formulations of drugs for specialized needs. Compounders have also provided hospitals and doctors with cheaper alternatives to F.D.A.-approved drugs.
For example, they are providing a far cheaper alternative to a drug called Makena, a new brand name version of an old drug used to reduce the risk of premature births. Once the drug got F.D.A. approval, the manufacturer of Makena began charging about a hundred times more for the drug than compounders. Officials from the F.D.A. wanted to ban the pharmacy-made versions on the grounds that Makena had met the agency’s rigorous safety standards, but senior Obama administration officials, concerned about Makena’s much higher price, stepped in to halt the ban.
In recent years, compounding pharmacies have sometimes filled gaps left by shortages of drugs made by pharmaceutical companies.
“As drug shortages have become more complex and common, pharmacies are turning to external compounding companies to help them,” said Cynthia Reilly, of the American Society of Health-System Pharmacists, referring to hospital pharmacies.
Shortages may have played a role in the large purchases of the injectable steroid now under suspicion from New England Compounding. The two manufacturers of the generic version of the drug had stopped making it.
Teva halted production in 2010 when it temporarily closed its Irvine, Calif., factory after receiving a warning letter from the F.D.A. about manufacturing quality problems.
The other manufacturer, Sandoz, stopped selling the product in the United States this year, according to the company, which would not provide a reason. Sandoz has also been reprimanded by the F.D.A. for manufacturing problems.
While the F.D.A. says the drug is not in short supply, the brand name product still available may have been considered too expensive, prompting some medical practices to turn to compounding pharmacists.
PainCare, a medical practice with 12 locations in New Hampshire, turned to New England Compounding for the injectable steroid now under suspicion when its usual supplier ran out, said the company’s chief executive, Dr. Michael J. O’Connell. The company’s two main locations alone do more than 100 injections a week.
Dr. O’Connell said he preferred compounding pharmacies because they could make the drug free of an alcohol often used as a preservative in drugs manufactured by big companies that he worried could damage nerves.
In addition, Medicare and many private insurers reimburse a fixed amount for the injections, about $300, giving doctors a financial incentive to prefer the less costly compounded versions, he said. “If you are using a more expensive product, there would be less left over,” Dr. O’Connell said.
PainCare paid New England Compounding $25 for a vial containing five 80-milligram doses, he said. A similar vial of the Depo-Medrol by Pfizer, with the alcohol preservative, costs about $40 to $46, according to the Web site of Clint Pharmaceuticals, a distributor.
About 186 of PainCare’s patients were injected with the suspect product. About two dozen have had symptoms that could indicate meningitis and have come in for spinal taps. The lab results are not back, Dr. O’Connell said, but the fluid samples were clear, rather than cloudy, as they would be if infected by a fungus.
Questions of Origins
Some physicians who work in big hospitals may not even know whether the drug they use is from a compounder.
Dr. Anders Cohen, the chief of neurosurgery and spine surgery at the Brooklyn Hospital Center, said: “We ask for the medication, it’s in stock, we use it. I don’t know if it’s coming from A, B or C. This is kind of a wake-up call about where your stuff is coming from.”
Because of the outbreak, Dr. Cohen has stopped performing spinal injections for now, and he was planning to declare a moratorium on them at his hospital until he was certain all the medicine was clean, even though his hospital is not on the list of facilities that received the potentially contaminated drug.
The size of New England Compounding appears to have reassured some doctors, who thought dealing with a large company might be safer than buying from a mom-and-pop compounder.
One pain specialist said he had heard from colleagues that the company had a good reputation and that even prestigious hospitals had used it. His practice did not buy the steroid medicine from New England Compounding but a contrast agent, a type of dye used for imaging. After he first contacted the Massachusetts company, it flew in a sales representative to meet him.
“We were impressed,” said the doctor, who spoke on the condition of anonymity because he had not yet consulted his malpractice insurer about whether he should publicly identify himself as having bought products from New England Compounding. “It seemed like big time.” The representative “assured me that all standards are being met.”
But all the dye the doctor bought from New England Compounding has had to be thrown out on the chance that it also might be contaminated, he said.
And the Massachusetts company itself has a troubled past. A series of complaints had been lodged against New England Compounding over the past decade. The State Health Department inspected in 2006. According to a warning letter sent by the F.D.A. from that year, the company was accused of illegally producing a standardized anesthetic topical cream, inappropriately repackaging a drug, and telling doctors that using an office staff member’s name was enough to put in an order, even though rules require a prescription for a particular patient.
Issues of Law
Meningitis can be caused by viruses, bacteria or fungi. Doctors say that the fungal type is the hardest to treat and devastating to patients because it can cause strokes. And indeed, some of the patients in the current outbreak have suffered strokes.
Federal inspectors last week removed samples of the suspect drug from New England Compounding to test for fungal contamination. The center, which takes in about $2.2 million a year, according to its corporate filings, is housed in a two-story brick building.
The company’s offices in suburban Boston were locked Friday, with a “no soliciting” sign on the door. The company did not respond to repeated requests for comment last week. Before it went offline, the company’s Web site said New England Compounding was licensed in all 50 states. State and federal officials said it had shipped out a prodigious amount of the potentially contaminated medicine to 75 pain clinics in 23 states.
Traditionally, the law meant compounding to be a local service in which pharmacists could tailor-make prescriptions for patients with special needs. Compounding pharmacies were not supposed to become miniature drug companies.
It is not clear how much large-scale compounding actually goes on. David G. Miller, executive vice president of the International Academy of Compounding Pharmacists, estimated that large-scale compounders represented about 10 percent of all compounding pharmacies, but he could not say what percentage of compounded medicines they made.
As state and federal authorities pored over information about New England Compounding last week, there was little agreement among experts on whether the company broke the law by making products in bulk and shipping them around the country.
Compounding falls in a legal no man’s land, between the federal government and the states. The F.D.A. regulates manufacturers, but compounders register as pharmacies, putting them under a patchwork of state rules. The F.D.A. did develop a clear set of rules for compounding, but subsequent litigation that culminated in a Supreme Court decision in 2002 struck them down, and Congress never re-established the agency’s clear authority, Professor Outterson said.
Jeff Gibbs, a lawyer in Washington who has represented compounders and drug companies, said it was unusual for a compounding pharmacy to produce large quantities of a drug that is commercially available. Policies of the F.D.A. were more concerned about compounders’ making drugs that are already approved and on the market, and not so much about compounders’ producing large volumes of medicine, he said.
But Sheldon T. Bradshaw, a lawyer in Washington who was chief counsel for the F.D.A. from 2005 to 2007, said large-scale compounders often behave like manufacturers, complete with sales teams that market their products to doctors. And they do not have to abide by the F.D.A.’s regulations, which require that problems with products be reported to the agency. In effect, he said, the companies are circumventing the regulatory process.
He contended that the F.D.A. could invoke the Food, Drug and Cosmetic Act of 1938, which makes it a criminal act “to introduce into interstate commerce an unapproved drug.” That is what New England Compounding’s products would most likely be considered because the company was doing more than traditional compounding, yet had not obtained a new drug approval, something that large drug makers spend millions of dollars and years to get. He said the agency has often sent letters to producers telling them to stop, and they usually comply, knowing there might be criminal charges if they do not.
“Some of these companies are just setting up big manufacturing shops in the guise of traditional compounding and making drugs that are, for the most part, commercially available,” Mr. Bradshaw said. “Instead of making fake Rolexes, they are making fake drugs.”
Jess Bidgood and Sheelagh McNeill contributed reporting.
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What an example of Neptune In Pisces !!
Maddow: Right wing copying Iranian mullas by creating their own reality
By David Ferguson
Saturday, October 6, 2012 11:02 EDT
Friday night on “The Rachel Maddow Show,” host Rachel Maddow compared so-called conservative “poll-truthers” to the mullahs and theocrats of Iran, who would rather construct an artificial, sanitized Internet than risk having their fellow Iranians access the wider internet and be exposed to new information.
Iran, Maddow began, is about to get its own Internet. The religious leaders who control the country have always had an uneasy relationship with the Internet, blocking certain sites that could undermine their hardline religious rule.
“So they’ve been busy closing off bits of the Internet to the Iranian public,” she said. ”You can’t use Google. Now you can’t use YouTube. You can’t use specific sites where the government doesn’t like what you can read there or what you can see there.”
Now, rather than continue to try and manage the crazy patchwork of censored and uncensored sites, Iran is creating its own, government-sponsored Internet environment for Iranians, keeping them from accessing anything too provocative or secular.
This week, the U.S. Bureau of Labor Statistics (BLS) issued some of the best jobs numbers the nation has seen since President Barack Obama took office, with the unemployment rate falling below 8 percent for the first time since January of 2009. Some Republicans have reacted to this, Maddow said, just like Iranian mullahs. Rather than accepting a reality they don’t like, they’re just constructing a safer, alternate reality.
The host then rolled clips of conservatives loudly declaiming election polls from summer and fall 2012 that show Obama ahead of the Republican candidate, former Gov. Mitt Romney (R-MA). Rather than accept that these polls might be telling the truth, Republicans flocked to Unskewed.com, a polling site that purports to correct mainstream polls for “liberal media bias,” therefore pushing Romney ahead of the president.
Similarly, when too many conservatives began to read things they didn’t like on Wikipedia, they decided to invent Conservapedia, which also purports to eliminate “liberal bias” and only gives conservatives information that will square with their view of the world.
“If you don’t like the real world,” she said, “invent your own.”
Conservatives are not alone in this, she said, talking about the new theory that Romney cheated during the debate by bringing a cheat sheet. Maddow dismissed the theory out of hand, saying that whether or not Romney cheated, the reason that he won the debate was because the president turned in a lackluster performance.
“The worst example of this, though, the invention of a comforting new parallel reality that means you do not need to face hard truths,” she said, are the “poll-truthers,” people who allege that the Obama administration has fudged the new BLS numbers, accusing the president, the bureau and its head, Hilda Solis, of doctoring the unemployment rate in order to reinforce Obama’s re-election chances.
Maddow pointed to former GE CEO Jack Welch’s outburst on Twitter from Friday morning, in which he wrote, “Unbelievable jobs numbers..these Chicago guys will do anything..can’t debate so change numbers.”
The right picked up that ball and ran with it all day Friday, from Rep. Allen West (R-FL) to Fox host Eric Bolling to conservative radio host Laura Ingraham. Ingraham called the new data “total pro-Obama propaganda.”
“Forget the real world,” Maddow said. ”They were going to build their own private world that made them happier.”
Maddow was joined by Jared Bernstein, senior fellow at the Center on Budget and Policy Priorities.
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Joseph Stiglitz tells jobs ‘truthers’ the idea of a conspiracy is ‘literally absurd’
By Roxanne Cooper
Saturday, October 6, 2012 10:37 EDT
Appearing on Saturday morning’s edition of Up with Chris Hayes , Joseph Stiglitz took on jobs “truthers.”
The Columbia University professor and Nobel Laureate in Economics explained the absurdity of former GE CEO Jack Welch’s assertion that the Obama administration cooked the books on yesterday’s jobs numbers in order to gain in the upcoming presidential election.
Let me give you a story that illustrates why it’s so implausible. Back when President Clinton was running for his second term, the Bureau of Labor Statistics and the Bureau of Economic Affairs that comes up with the GDP number were changing the way we measure GDP growth, okay? And they were going to something that is a technical term called chained-weighted GDP. And the result of going to chain-weighted GDP was that the GDP number would be lower than the old methodology.
The President was furious because everyone thought they were coming up with a number that was lower. He said, ‘Can’t you stop this? Can’t you wait until after the election?’ We said, ‘No, they’re an independent agency. We can’t touch them.’
…but the point is no president –except maybe Nixon– would try to change what the Bureau of Labor Statistics does or what the BEA does. These are really independent statistical agencies. The idea that they would do that is …literally absurd.
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