NHL, union reach tentative agreement









NEW YORK—





Hockey is back, and it took nearly four months and one long night to get the game back on the ice.

With the season on the line, the NHL and the players' association agreed on a tentative pact to end a 113-day lockout and save what was left of a fractured schedule.

Commissioner Gary Bettman and union executive director Donald Fehr ceased being adversaries and announced the deal while standing side by side near a wall toward the back of the negotiating room and showing a tinge of weariness.

"I want to thank Don Fehr," Bettman said. "We went through a tough period, but it's good to be at this point."

A marathon negotiating session that lasted more than 16 hours, stretching from Saturday afternoon until just before dawn Sunday, produced a 10-year deal.

"We've got to dot a lot of Is and cross a lot of Ts," Bettman said. "There's still a lot of work to be done, but the basic details of the agreement have been agreed upon."

Even players who turned into negotiators showed the strain of the long, difficult process.

"It was a battle," said Winnipeg Jets defenseman Ron Hainsey, a key member of the union's bargaining team. "Gary said a month ago it was a tough negotiation. That's what it was.

"Players obviously would rather not have been here, but our focus now is to give the fans whatever it is — 48 games, 50 games — the most exciting season we can. The mood has been nervous for a while. You want to be playing. You want to be done with this."

The collective bargaining agreement must be ratified by a majority of the league's 30 owners and the union's membership of approximately 740 players.

"Hopefully within a very few days the fans can get back to watching people who are skating, not the two of us," Fehr said.

All schedule issues, including the length of the season, still need to be worked out. The NHL has models for 50- and 48-game seasons.

The original estimate was regular-season games could begin about eight days after a deal was reached. It is believed that all games will be played within the two respective conferences, but that also hasn't been decided.

The players have been locked out since Sept. 16, the day after the previous agreement expired. That deal came after an extended lockout that wiped out the entire 2004-05 season.

"Any process like this is difficult. It can be long," Fehr said.

Time was clearly a factor, with the sides facing a deadline of Thursday or Friday to reach a deal that would allow for a 48-game season to start a week later. Bettman had said the league could not allow a season of fewer than 48 games per team.

All games through Jan. 14, along with the All-Star game and the New Year's Day Winter Classic had already been canceled, claiming more than 50 percent of the original schedule.

Without an agreement, the NHL faced the embarrassment of losing two seasons due to a labor dispute, something that has never happened in another North American sports league. The 2004-05 season was lost while the sides negotiated hockey's first salary cap.

Under the new CBA, free-agent contracts will have a maximum length of seven years, but clubs can go to eight years to re-sign their own players. Each side can opt out of the deal after eight years.

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Looney Gas and Lead Poisoning: A Short, Sad History



Author’s note: Most people don’t realize that we knew in the 1920s that leaded gasoline was extremely dangerous. And in light of a Mother Jones story this week that looks at the connection between leaded gasoline and crime rates in the United States, I thought it might be worth reviewing that history. The following is an updated version of an earlier post based on information from my book about early 10th century toxicology, The Poisoner’s Handbook.


In the fall of 1924, five bodies from New Jersey were delivered to the New York City Medical Examiner’s Office. You might not expect those out-of-state corpses to cause the chief medical examiner to worry about the dirt blowing in Manhattan streets. But they did.


To understand why you need to know the story of those five dead men, or at least the story of their exposure to a then mysterious industrial poison.


The five men worked at the Standard Oil Refinery in Bayway, New Jersey. All of them spent their days in what plant employees nicknamed “the loony gas building”, a tidy brick structure where workers seemed to sicken as they handled a new gasoline additive. The additive’s technical name was tetraethyl lead or, in industrial shorthand, TEL. It was developed by researchers at General Motors as an anti-knock formula, with the assurance that it was entirely safe to handle.


But, as I wrote in a previous post, men working at the plant quickly gave it the “loony gas” tag because anyone who spent much time handling the additive showed stunning signs of mental deterioration, from memory loss to a stumbling loss of coordination to  sudden twitchy bursts of rage. And then in October of 1924, workers in the TEL building began collapsing, going into convulsions, babbling deliriously. By the end of September, 32 of the 49 TEL workers were in the hospital; five of them were dead.


The problem, at that point, was that no one knew exactly why. Oh, they knew – or should have known – that tetraethyl lead was dangerous. As Charles Norris, chief medical examiner for New York City pointed out, the compound had been banned in Europe for years due to its toxic nature. But while U.S. corporations hurried TEL into production in the 1920s, they did not hurry to understand its medical or environmental effects.


In 1922,  the U.S. Public Health Service had asked Thomas Midgley, Jr. – the developer of the leaded gasoline process – for copies of all his research into the health consequences of tetraethyl lead (TEL).


Midgley, a scientist at General Motors, replied that no such research existed. And two years later, even with bodies starting to pile up,  he had still not looked into the question.  Although GM and Standard Oil had formed a joint company to manufacture leaded gasoline – the Ethyl Gasoline Corporation - its research had focused solely on improving the TEL formulas. The companies disliked and frankly avoided the lead issue. They’d deliberately left the word out of their new company name to avoid its negative image.


In response to the worker health crisis at the Bayway plant, Standard Oil suggested that the problem might simply be overwork. Unimpressed, the state of New Jersey ordered a halt to TEL production. And because the compound was so poorly understood, state health officials asked the New York City Medical Examiner’s Office to find out what had happened.



In 1924, New York had the best forensic toxicology department in the country; in fact,, it had one of the few such programs period. The chief chemist was a dark, cigar-smoking, perfectionist named Alexander Gettler, a famously dogged researcher who would sit up late at night designing both experiments and apparatus as needed.


It took Gettler three obsessively focused weeks to figure out how much tetraethyl lead the Standard Oil workers had absorbed before they became ill,  went crazy, or died. “This is one of the most difficult of many difficult investigations of the kind which have been carried on at this laboratory,” Norris said, when releasing the results. “This was the first work of its kind, as far as I know. Dr. Gettler had not only to do the work but to invent a considerable part of the method of doing it.”


Working with the first four bodies, then checking his results against the body of the last worker killed, who had died screaming in a straitjacket, Gettler discovered that TEL and its lead byproducts formed a recognizable distribution, concentrated in the lungs, the brain, and the bones. The highest levels were in the lungs suggesting that most of the poison had been inhaled; later tests showed that the types of masks used by Standard Oil did not filter out the lead in TEL vapors.


Rubber gloves did protect the hands but if TEL splattered onto unprotected skin, it absorbed alarmingly quickly. The result was intense poisoning with lead, a potent neurotoxin. The loony gas symptoms were, in fact, classic indicators of heavy lead toxicity.


After Norris released his office’s report on tetraethyl lead, New York City banned its sale, and the sale of “any preparation containing lead or other deleterious substances” as an additive to gasoline. So did New Jersey. So did the city of Philadelphia. It was a moment in which health officials in large urban areas were realizing that with increased use of automobiles, it was likely that residents would be increasingly exposed to dangerous lead residues and they moved quickly to protect them.


But fearing that such measures would spread,  that they would be forced to find another anti-knock compound, as well as losing considerable money, the manufacturing companies demanded that the federal government take over the investigation and develop its own regulations. U.S. President Calvin Coolidge, a Republican and small-government conservative, moved rapidly in favor of the business interests.


The manufacturers agreed to suspend TEL production and distribution until a federal investigation was completed. In May 1925, the U.S. Surgeon General called a national tetraethyl lead conference, to be followed by the formation of an investigative task force to study the problem. That same year, Midgley published his first health analysis of TEL, which acknowledged  a minor health risk at most, insisting that the use of lead compounds,”compared with other chemical industries it is neither grave nor inescapable.”


It was obvious in advance that he’d basically written the conclusion of the federal task force. That panel only included selected industry scientists like Midgely. It had no place for Alexander Gettler or Charles Norris or, in fact, anyone from any city where sales of the gas had been banned, or any agency involved in the producing that first critical analysis of tetraethyl lead.


In January 1926, the public health service released its report which concluded that there was “no danger” posed by adding TEL to gasoline…”no reason to prohibit the sale of leaded gasoline” as long as workers were well protected during the manufacturing process.


The task force did look briefly at risks associated with every day exposure by drivers, automobile attendants, gas station operators, and found that it was minimal. The researchers had indeed found lead residues in dusty corners of garages. In addition,  all the drivers tested showed trace amounts of lead in their blood. But a low level of lead could be tolerated, the scientists announced. After all, none of the test subjects showed the extreme behaviors and breakdowns associated with places like the looney gas building. And the worker problem could be handled with some protective gear.


There was one cautionary note, though. The federal panel warned that exposure levels would probably rise as more people took to the roads. Perhaps, at a later point, the scientists suggested, the research should be taken up again. It was always possible that leaded gasoline might “constitute a menace to the general public after prolonged use or other conditions not foreseen at this time.”


But, of course, that would be another generation’s problem. In 1926, citing evidence from the TEL report, the federal government revoked all bans on production and sale of leaded gasoline. The reaction of industry was jubilant; one Standard Oil spokesman likened the compound to a “gift of God,” so great was its potential to improve automobile performance.


In New York City, at least, Charles Norris decided to prepare for the health and environmental problems to come. He suggested that the department scientists do a base-line measurement of lead levels in the dirt and debris blowing across city streets. People died, he pointed out to his staff; and everyone knew that heavy metals like lead tended to accumulate. The resulting comparison of street dirt in 1924 and 1934 found a 50 percent increase in lead levels – a warning, an indicator of damage to come, if anyone had been paying attention.


It was some fifty years later – in 1986 – that the United States formally banned lead as a gasoline additive. By that time, according to some estimates, so much lead had been deposited into soils, streets, building surfaces, that an estimated 68 million children would register toxic levels of lead absorption and some 5,000 American adults would die annually of lead-induced heart disease. As lead affects cognitive function, some neuroscientists also suggested that chronic lead exposure resulted in a measurable drop in IQ scores during the leaded gas era. And more recently, of course, researchers had suggested that TEL exposure and resulting nervous system damage may have contributed to violent crime rates in the 20th century.


Which is just another way of say that we never got out of the loony gas building after all.


Images: 1) Manhattan, 34th Street, 1931/NYC Municipal Archives 2) 1940s gas station, US Route 66, Illinois/Deborah Blum


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French actor Depardieu meets Putin, picks up Russian passport






MOSCOW (Reuters) – French film star Gerard Depardieu met Russian President Vladimir Putin in the Black Sea town of Sochi and obtained his Russian passport, the Kremlin said on Sunday, after he left his homeland to avoid a new tax rate for millionaires.


Putin signed a decree on Thursday granting Russian citizenship to Depardieu, who objected to French Socialist president Francois Hollande‘s plan to impose the 75 percent tax rate. His decision to quit France had prompted accusations of national betrayal.






The Russian president and Depardieu were shown on state-run Channel One shaking hands and hugging each other early on Sunday during what the Kremlin said was a private visit by the actor to Russia.


“A brief meeting between the president and Depardieu took place,” Kremlin spokesman Dmitry Peskov said. “On the occasion of his visit to Russia, he was handed a Russian passport.”


Peskov did not say whether Putin personally gave Depardieu the passport or if he picked it up through standard procedures. He said the actor also told Putin about his career plans.


Depardieu, star of the movies “Cyrano de Bergerac” and “Green Card”, is a popular figure in Russia, where he has appeared in many advertising campaigns, including for ketchup. He also worked there in 2011 on a film about the eccentric Russian monk Grigory Rasputin.


Putin asked Depardieu whether he was pleased with his work in the movie, TV footage of their meeting showed, with the French actor saying he had already sent Putin some excerpts from it.


Depardieu bought a house in Belgium last year to avoid the French income tax increase. French Prime Minister Jean-Marc Ayrault called Depardieu’s decision to seek Belgian residency “pathetic” and unpatriotic, prompting an angry response from the actor.


Putin said last month that Depardieu would be welcome in Russia, which has a flat income tax rate of 13 percent, compared to the 75 percent on income over 1 million euros ($ 1.30 million) that Hollande wants to levy in France.


He offered Depardieu a Russian passport, saying he had a close, special relationship with France and had developed warm ties with the actor, even though they had rarely met.


Some of Putin’s critics said the passport move was a stunt and pointed out that the president announced last month a campaign to prevent rich Russians keeping their money offshore.


($ 1 = 0.7666 euros)


(Reporting By Alexei Anishchuk; Editing by Pravin Char)


Celebrity News Headlines – Yahoo! News





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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..

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.


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Report: Lance Armstrong weighing doping confession













Lance Armstrong


Lance Armstrong reportedly is weighing confessing to using performance-enhancing drugs.
(Thao Nguyen / Associated Press / February 15, 2011)





































































Lance Armstrong reportedly is weighing confessing to using banned performance-enhancing drugs and blood transfusions during his run of seven Tour de France titles.


Armstrong, who was stripped in October of his Tour titles and banned for life from competition by the U.S. Anti-Doping Agency, is pursuing the admission as a route to regain his eligibility to compete, the New York Times first reported Friday.


Armstrong’s attorney, Tim Herman, told the newspaper, “I suppose anything is possible. Right now, that’s not really on the table.”





Citing pressure from the cancer-fighting charity he helped create, Livestrong, Armstrong, 41, reportedly has held discussions with his longtime nemesis, USADA Chief Executive Travis Tygart, in an attempt to negotiate a lifting of the ban, one person told the New York Times.


Armstrong has competed in triathlons and running events since his lifetime ban took effect.


Efforts to reach Tygart and Armstrong’s representatives Friday night were not immediately successful.


The World Anti-Doping Code allows for lightened punishment for those who fully detail their doping protocol in a confession.


Armstrong lost a slew of endorsement deals after he was banned, and any confession would probably leave him in jeopardy of perjury accusations since he has given sworn statements denying he used banned substances in prior legal cases.


ALSO:


Kansas City Chiefs, Andy Reid in negotiations


Ray Lewis, once shunned by Disney, reportedly near ESPN deal


Rex Ryan tattoo: woman wearing Sanchez jersey, possibly 'Tebowing'






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Wired Science Space Photo of the Day: Colorful Lunar Mare


Galileo false-color image of the Mare Tranquillitatis and Mare Serenitatis areas of the Moon. The picture was made from four exposures taken during Galileo's second Earth/Moon flyby.

The colors are enhanced to highlight compositional differences.


Mare Tranquillitatis at left appears blue due to titanium enrichment. Orange soil in Mare Sarenitatis at lower right indicates lower titanium. Dark purple areas at left center mark the Apollo 17 landing site, composed of explosive volcanic deposits.

Red lunar highlands indicate low iron and titanium. Mare Serenitatis is roughly 1300 km across and North is at 5:00. The 95 km diameter crater Posidonius, centered at 32 N, 30 E, is at the middle of the bottom of the frame.


Image: NASA [high-resolution]


Caption: NASA

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Boyz II Men to Vegas for extended gig at the Mirage






(Reuters) – One-time boy band Boyz II Men is Vegas-bound for an extended stay at the Mirage hotel and casino, the group said on Friday.


The Grammy-award winning R&B trio will begin performances on March 1, with 78 shows slated through December 2013.






“We’ve been dreaming of this day since we performed an extended holiday show two years ago in Las Vegas,” said founding member Nathan Morris in a statement, adding “we can’t wait to take the stage in March and be a part of the Las Vegas community.”


Formed in 1990 and known for hits including “I’ll Make Love To You” and “End of the Road,” the group includes tenors Wanya Morris and Shawn Stockman, in addition to baritone Morris.


With more than 60 million albums sold, it is reportedly the best-selling R&B group of all time.


(Reporting by Chris Michaud, editing by Jill Serjeant and Sandra Maler)


Music News Headlines – Yahoo! News





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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.”

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After Fiscal Deal, Tax Code May Be Most Progressive Since 1979





WASHINGTON — With 2013 bringing tax increases on the incomes of a small sliver of the richest Americans, the country’s top earners now face a heavier tax burden than at any time since Jimmy Carter was president.




The last-minute deal struck by the departing 112th Congress raised taxes on a handful of the highest-earning Americans, with about 99.3 percent of households experiencing no change in their income taxes. But the Tax Policy Center estimates that the average family in the top 1 percent will pay a federal tax rate of more than 36 percent this year, up from 28 percent in 2008. That is the highest rate since 1979, at least.


By some measures, the tax code might now be the most progressive in a generation, tax economists said, while noting that every American is paying a lower burden currently than they did then. In fact, the total federal tax rate is still vastly lower for the very rich than it was at any point in the 1940s through 1970s. It has risen from historical lows, but is still closer to those lows than where it was in the postwar decades.


“We made the system more progressive by raising rates at the top and leaving them for everyone else,” said Roberton Williams of the Tax Policy Center, a research group based in Washington. “The offsetting issue is that the rich have gotten a lot richer.”


Indeed, over the last three decades the bulk of pretax income gains have gone to the wealthy — and the higher up on the income scale, the bigger the gains, with billionaires outpacing millionaires who outpaced the merely rich. Economists doubted that the tax increases would do much to reverse that trend.


With the recovery failing to improve incomes for millions of average Americans and the country running trillion-dollar deficits, President Obama made “tax fairness” a centerpiece of his re-election campaign. In the heated negotiations with House Speaker John A. Boehner, that translated into the White House’s insistence on tax increases for the top 2 percent of households and a continuation of tax breaks and cuts for a vast number of taxpayers.


Republicans resisted increasing tax rates and aimed for lower revenue targets, arguing that spending was the budget’s primary problem and that no American should see his or her taxes go up too much in such a sluggish economy. But ultimately they relented, and Congress cut a last-minute deal.


“A central promise of my campaign for president was to change the tax code that was too skewed towards the wealthy at the expense of working middle-class Americans,” Mr. Obama said after Congress reached an agreement.


That deal includes a host of tax increases on the rich. It raises the tax rate to 39.6 percent from 35 percent on income above $400,000 for individuals, and $450,000 for couples. The rate on dividends and capital gains for those same taxpayers was bumped up 5 percentage points, to 20 percent. Congress also reinstated limits on the amount households with more than $300,000 in income can deduct. On top of that, two new surcharges — a 3.8 percent tax on investment income and a 0.9 percent tax on regular income — hit those same wealthy households.


As a result of the taxes added in both the deal and the 2010 health care law, which came into effect this year, taxpayers with $1 million in income and up will pay on average $168,000 more in taxes. Millionaires’ share of the overall federal tax burden will climb to 23 percent from 20 percent.


The result is a tax code that squeezes hundreds of billions of dollars more from the very well off — about $600 billion more over 10 years — while leaving the tax burden on everyone else mostly as it was. And the changes come after 30 years of both Republican and Democratic administrations doing the converse: zeroing out federal income taxes for many poor working families while also reducing the tax burden for households on the higher end of the income scale.


“Back at the end of the Carter and beginning of the Reagan administrations, we had a pretty severe income-tax burden for people at a low level of income. It was actually kind of appalling,” said Alan D. Viard, a tax expert at the American Enterprise Institute, a right-of-center research group in Washington. “Policy makers in both parties realized that was bad policy and started whittling away at it” by expanding credits and tinkering with tax rates.


After those changes and the new law, comparing average tax rates for poor households and wealthy households, 2013 might be the most progressive tax code since 1979. But economists cautioned that measuring progressivity is tricky. “It’s not like there is some scientific measure of progressivity all economists agreed upon,” said Leonard E. Burman, a professor of public affairs at Syracuse University. “People look at different numerical measures and they’ve changed in different ways at different income levels.”


Mr. Viard said that over time the code had become markedly more progressive for the poor compared with the middle class. But it arguably did not become much more progressive for the rich compared with the middle class, or the very rich compared with the rich, in part because of the George W. Bush-era tax cuts on investment income.


An anesthesiologist who earns a $500,000 salary subject to payroll and income taxes might pay a higher tax rate than a hedge fund manager making $1 billion subject mostly to capital-gains taxes, for instance.


Economists are also divided on the ultimate effect of those tax increases on the wealthy to income growth and income inequality in the United States. The recession hit the incomes of the rich hard, but they have snapped back much more strongly than those for middle or low-income workers.


“I’d still rather be really rich, even if I’m getting taxed much more than a low-income person” would be, Mr. Williams of the Tax Policy Center added.


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