Insurance Industry Report Faults High Fees for Out-of-Network Care

Michael Nagle for The New York Times

Angel Gonzalez, 36, faced huge bills after emergency gallbladder surgery, despite having good insurance coverage. “I was on the hook for more than I made in a year.”

Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.

Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not.

He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez’s policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. “I was on the hook for more than I made in a year,” Mr. Gonzalez said.

A health insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America’s Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.

Insurers hope to spotlight a vexing problem that they say the Affordable Care Act does little to address. “When you’re out of network, it’s a blank check,” said Karen Ignagni, president and chief executive of AHIP. “The consumer is vulnerable to ‘anything goes.’ ”

“Unless we deal with cost, we won’t have affordability,” she added. “And unless we have affordability, we won’t have people participating” under the Affordable Care Act.

Among the fees on the report’s list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon’s fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey.

Elisabeth R. Benjamin, co-founder of the Health Care for All New York coalition, who is often at odds with the insurance industry, said that “is one area we totally agree on.” She continued, “Out-of-network billing is just out of control.”

Even when out-of-network fees are compared with average commercial insurance reimbursements, which are usually greater than Medicare, she said, “It’s pretty outrageous.”

Doctors say the report is skewed because it focuses on a few dozen cases of overcharging that are not representative of their billing. In response to the insurers’ report, the American Medical Association noted on Thursday that a recent analysis found that doctors’ services account for just 16 percent of health care costs.

“There are outliers in every profession, in every business,” said Dr. Andrew Y. Kleinman, a plastic surgeon who is vice president of the Medical Society of the State of New York.

Dr. Kleinman also noted that insurers had effectively shifted the costs of out-of-network care onto patients by changing reimbursement formulas. Instead of the rates commercial insurers usually pay doctors, insurers increasingly are basing their out-of-network payments on Medicare rates, usually far lower.

A growing number of high-end, flexible health plans offer policies that cover outside providers at, for example, 140 percent of Medicare. “They’re selling you an insurance product you can’t use,” Dr. Kleinman said. “You’re buying an insurance policy where the out-of-network benefit is worthless.”

The industry’s own report suggests that using Medicare rates as a benchmark will lead to patients’ picking up much more of the cost for out-of-network care, whether they carefully select a specialist or, as in the case of Mr. Gonzalez and many others, have no choice in the matter.

Had Mr. Gonzalez been 65 or older, Medicare would have paid only $958 for the surgery. The average commercial price is $12,292, according to FAIR Health, an independent nonprofit group that tracks information on health care costs.

But Mr. Gonzalez’s health plan, United Healthcare, determined the fee should be $1,273, of which the company paid $838. Mr. Gonzalez filed appeals, which were rejected. He then contacted Community Health Advocates at the Community Service Society of New York for help, and the group’s caseworkers negotiated with the surgeon on his behalf.

After months of wrangling, the surgeon agreed to accept a significantly reduced payment: $340.

Consumer advocates and health insurance executives are calling for greater transparency in health care pricing, including upfront disclosure of prices of medical procedures and services.

“The health care industry can give you an estimate, just like any other industry,” said Carrie H. Colla, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, noting that the Dartmouth-Hitchcock Medical Center has a patient price estimator online.  

“It’s just not current practice right now,” Dr. Colla said. “Sometimes a doctor won’t even know. The patient really has to push for it.”

Read More..

Insurance Industry Report Faults High Fees for Out-of-Network Care

Michael Nagle for The New York Times

Angel Gonzalez, 36, faced huge bills after emergency gallbladder surgery, despite having good insurance coverage. “I was on the hook for more than I made in a year.”

Just over a year ago, Angel Gonzalez, 36, awoke with searing chest pain at 2 a.m. A friend drove him to the closest emergency room.

Though he was living on $18,000 a year as a graduate student, Mr. Gonzalez had good insurance and the hospital, St. Charles in Port Jefferson, N.Y., was in his network. But the surgeon who came in to remove Mr. Gonzalez’s gallbladder that Sunday night was not.

He billed Mr. Gonzalez $30,000, and an assistant billed an additional $30,000. Mr. Gonzalez’s policy covered out-of-network providers, but at a rate it considered appropriate: $2,000. “I was on the hook for more than I made in a year,” Mr. Gonzalez said.

A health insurance industry report to be released on Friday highlights the exorbitant fees charged by some doctors to out-of-network patients like Mr. Gonzalez. The report, by America’s Health Insurance Plans, or AHIP, contrasts some of the highest bills charged by non-network providers in 30 states with Medicare rates for the same services. Some of the charges, the insurers assert, are 30, 40 or nearly 100 times greater than Medicare rates.

Insurers hope to spotlight a vexing problem that they say the Affordable Care Act does little to address. “When you’re out of network, it’s a blank check,” said Karen Ignagni, president and chief executive of AHIP. “The consumer is vulnerable to ‘anything goes.’ ”

“Unless we deal with cost, we won’t have affordability,” she added. “And unless we have affordability, we won’t have people participating” under the Affordable Care Act.

Among the fees on the report’s list are a $6,205 outpatient office visit to a doctor in Massachusetts for which Medicare would have paid $152; a $12,000 bill for examining a tissue specimen in New York for which Medicare would have paid $128; and a $48,983 surgeon’s fee for a total hip replacement in New Jersey that Medicare would have reimbursed at $1,543. Many of the highest billers were in New York, Texas, Florida and New Jersey.

Elisabeth R. Benjamin, co-founder of the Health Care for All New York coalition, who is often at odds with the insurance industry, said that “is one area we totally agree on.” She continued, “Out-of-network billing is just out of control.”

Even when out-of-network fees are compared with average commercial insurance reimbursements, which are usually greater than Medicare, she said, “It’s pretty outrageous.”

Doctors say the report is skewed because it focuses on a few dozen cases of overcharging that are not representative of their billing. In response to the insurers’ report, the American Medical Association noted on Thursday that a recent analysis found that doctors’ services account for just 16 percent of health care costs.

“There are outliers in every profession, in every business,” said Dr. Andrew Y. Kleinman, a plastic surgeon who is vice president of the Medical Society of the State of New York.

Dr. Kleinman also noted that insurers had effectively shifted the costs of out-of-network care onto patients by changing reimbursement formulas. Instead of the rates commercial insurers usually pay doctors, insurers increasingly are basing their out-of-network payments on Medicare rates, usually far lower.

A growing number of high-end, flexible health plans offer policies that cover outside providers at, for example, 140 percent of Medicare. “They’re selling you an insurance product you can’t use,” Dr. Kleinman said. “You’re buying an insurance policy where the out-of-network benefit is worthless.”

The industry’s own report suggests that using Medicare rates as a benchmark will lead to patients’ picking up much more of the cost for out-of-network care, whether they carefully select a specialist or, as in the case of Mr. Gonzalez and many others, have no choice in the matter.

Had Mr. Gonzalez been 65 or older, Medicare would have paid only $958 for the surgery. The average commercial price is $12,292, according to FAIR Health, an independent nonprofit group that tracks information on health care costs.

But Mr. Gonzalez’s health plan, United Healthcare, determined the fee should be $1,273, of which the company paid $838. Mr. Gonzalez filed appeals, which were rejected. He then contacted Community Health Advocates at the Community Service Society of New York for help, and the group’s caseworkers negotiated with the surgeon on his behalf.

After months of wrangling, the surgeon agreed to accept a significantly reduced payment: $340.

Consumer advocates and health insurance executives are calling for greater transparency in health care pricing, including upfront disclosure of prices of medical procedures and services.

“The health care industry can give you an estimate, just like any other industry,” said Carrie H. Colla, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice, noting that the Dartmouth-Hitchcock Medical Center has a patient price estimator online.  

“It’s just not current practice right now,” Dr. Colla said. “Sometimes a doctor won’t even know. The patient really has to push for it.”

Read More..

Wall Street Journal Reports Attack by China Hackers

One day after The New York Times reported that Chinese hackers had infiltrated its computers and stolen passwords for its employees, The Wall Street Journal announced that it too had been hacked.

On Thursday, The Journal reported that it had been attacked by Chinese hackers who were trying to monitor the company’s coverage of China. It said hackers had broken into its network through computers in its Beijing bureau.

In a written statement, the business newspaper owned by News Corporation described the attack as an “ongoing issue” and said it was working closely with authorities and security specialists to clean up its systems. It said that it completed a “network overhaul” on Thursday in an effort to rid its systems of hackers.

China’s Ministry of National Defense has denied any involvement in the cyberattack at The Times or any other American corporations.

But security experts said that in 2008, Chinese hackers began targeting American news organizations as part of an effort to monitor coverage of Chinese issues.

In a report for clients in December, Mandiant, a computer security company, said that over the course of several investigations it found evidence that Chinese hackers had stolen e-mails, contacts and files from more than 30 journalists and executives at Western news organizations, and had maintained a “short list” of journalists for repeated attacks. Among those targeted were journalists who had written about Chinese leaders, political and legal issues in China and the telecom giant Huawei.

Bloomberg News, another American news organization, was targeted by Chinese hackers last year, and some computers were infected, according to a person with knowledge of the company’s internal investigation. The attack occurred after Bloomberg published an article on June 29 about the wealth accumulated by relatives of Xi Jinping, a Chinese official who is expected to become president in March.

Bloomberg has confirmed that hackers had made attempts but said that “no computer systems or computers were compromised.”

The timing of the attacks on The New York Times coincided with the reporting for an investigation, published online on Oct. 25, that found that the relatives of Wen Jiabao, China’s prime minister, had accumulated a fortune worth several billion dollars through business dealings.

Security experts hired by The Times to detect and block the computer attacks found digital evidence that Chinese hackers, using methods that some consultants have associated with the Chinese military in the past, breached The Times’s network.

The Associated Press reported Thursday that officials in the Obama administration were considering more assertive action against Beijing to stop Chinese computer espionage campaigns.

The Secretary of State, Hillary Clinton, said Thursday a global effort was needed o establish “rules of the road” for cyber activity.  In her final meeting with reporters at the State Department, Mrs. Clinton addressed a question about China’s efforts to infiltrate computer systems at The New York Times. 

 “We have seen over the last years an increase in not only the hacking attempts on government institutions but also non-governmental ones,” Mrs. Clinton said.

The Chinese, she said, “are not the only people who are hacking us.” 

 “There is a lot that we are working on that will be deployed in the event that we don’t get some kind of international effort under way,” Mrs. Clinton added without elaborating.

The United States has been increasingly vocal about such efforts against government and private industry. In a November 2011 intelligence report, government officials specifically accused China and Russia of stealing intellectual property for economic gain.

Michael Gordon contributed reporting from Washington.

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Explosion in Mexico City Kills at Least 25

Guillermo Gutierrez/Associated Press

Rescue workers dig for survivors after an explosion Thursday in the basement of an administrative building downtown.

MEXICO CITY — A mysterious explosion at the headquarters of Mexico’s state-owned oil company here on Thursday killed at least 25 people and injured 101, according to government officials, as windows shattered, the ground shook and thousands of employees fled into a panicked downtown.

The cause of the explosion was not immediately known. It occurred just before 4 p.m. in the basement of an administrative building next to the 52-story tower of Petroleos Mexicanos, or Pemex. Company officials said there was significant damage to the first floor and mezzanine of the building, and witnesses said they saw rescue workers helping trapped employees who had been pinned under falling debris, while others dragged out the injured and the dead. Officials said the dead included 17 women and 8 men.

“I saw them take out three people covered in blood,” said Trinidad Díaz, 31, the owner of a restaurant a block from the explosion. “And after that, ambulances started arriving, one after the other.”

The blast — in a highly protected but decaying office complex — comes in the middle of a heated debate over the future of Pemex, a national institution and a corporate behemoth that has been plagued by declining production, theft and an abysmal safety record that includes a major pipeline explosion almost every year, like the one in September that killed 30 workers.

Experts, while cautioning that it was too early to tell what had gone wrong, said the company would inevitably face more severe scrutiny as Mexico’s Congress returned to work in the coming weeks. The country’s new president, Enrique Peña Nieto, has pledged to submit a plan for overhauling Pemex, opening it to more private investment and perhaps greater consolidation. But with the blast, deliberations about the company could become more elemental.

“You pull all of this together and you say, well, if they can’t even guarantee safety in their own building, their own headquarters, what does that tell us about the company?” said Duncan Wood, director of the Mexico Institute at the Woodrow Wilson International Center for Scholars. “It tells us there are things seriously wrong there. It tells you things need to be seriously shaken up.”

George Baker, director of Energia.com, an energy research institute in Houston, said that previous safety scandals at Pemex had been used by Mexican leaders as an argument for making controversial changes. In 1992, he said, a major explosion in a residential Guadalajara neighborhood — caused by gas leaking into the sewers — was followed by calls for change, and a plan to break Pemex into smaller pieces.

“The provocation, the pretext was that we had this terrible thing happen and now we are going to have a response from Pemex,” Mr. Baker said, adding that the explosion on Thursday would also now become part of the political calculations over what to do about the company.

“This may be used, may be manipulated, used as a pretext to do something,” he said. “Who knows what that something is, but they may exploit it to do something they were going to do anyway.”

At the scene, employees who were visibly shaken said the explosion felt like a bomb or an earthquake. After a deep rumble, a plume of smoke rose skyward and people rushed into the streets. Four rescue helicopters landed in the area to remove the dead or injured, while a half-dozen more helicopters hovered overhead. Soldiers, police officers and ambulances filled the area, and streets were quickly cordoned off.

A team of three emergency responders who had entered the building soon after the blast said that it appeared that two basement floors and parts of three upper floors had collapsed. Papers were strewed everywhere, and the scent of dust lingered in the air. Those on the emergency team said another rescue worker who had gone inside told them he saw eight lifeless bodies.

Just before dark, local news outlets reported that President Peña Nieto had arrived. He had already demanded an investigation and expressed remorse, using his Twitter account. “I profoundly lament the death of our fellow workers at Pemex,” he said on Twitter just before arriving. “My condolences to their families.”

Pemex officials, using the company’s official Twitter account to confirm that at least 14 people had died, said around the time of the explosion that its offices were being evacuated because of an electrical problem. Later, the company said forensic teams were investigating the cause, which had not been determined. “Any other explanation with respect to this is speculation.”

Read More..

Chinese Hackers Infiltrate New York Times Computers

SAN FRANCISCO — For the last four months, Chinese hackers have persistently attacked The New York Times, infiltrating its computer systems and getting passwords for its reporters and other employees.

The New York Times published an article in October about the wealth of the family of China's prime minister, Wen Jiabao, in both English and Chinese.

After surreptitiously tracking the intruders to study their movements and help erect better defenses to block them, The Times and computer security experts have expelled the attackers and kept them from breaking back in.

The timing of the attacks coincided with the reporting for a Times investigation, published online on Oct. 25, that found that the relatives of Wen Jiabao, China’s prime minister, had accumulated a fortune worth several billion dollars through business dealings.

Security experts hired by The Times to detect and block the computer attacks gathered digital evidence that Chinese hackers, using methods that some consultants have associated with the Chinese military in the past, breached The Times’s network. They broke into the e-mail accounts of its Shanghai bureau chief, David Barboza, who wrote the reports on Mr. Wen’s relatives, and Jim Yardley, The Times’s South Asia bureau chief in India, who previously worked as bureau chief in Beijing.

“Computer security experts found no evidence that sensitive e-mails or files from the reporting of our articles about the Wen family were accessed, downloaded or copied,” said Jill Abramson, executive editor of The Times.

The hackers tried to cloak the source of the attacks on The Times by first penetrating computers at United States universities and routing the attacks through them, said computer security experts at Mandiant, the company hired by The Times. This matches the subterfuge used in many other attacks that Mandiant has tracked to China.

The attackers first installed malware — malicious software — that enabled them to gain entry to any computer on The Times’s network. The malware was identified by computer security experts as a specific strain associated with computer attacks originating in China. More evidence of the source, experts said, is that the attacks started from the same university computers used by the Chinese military to attack United States military contractors in the past.

Security experts found evidence that the hackers stole the corporate passwords for every Times employee and used those to gain access to the personal computers of 53 employees, most of them outside The Times’s newsroom. Experts found no evidence that the intruders used the passwords to seek information that was not related to the reporting on the Wen family.

No customer data was stolen from The Times, security experts said.

Asked about evidence that indicated the hacking originated in China, and possibly with the military, China’s Ministry of National Defense said, “Chinese laws prohibit any action including hacking that damages Internet security.” It added that “to accuse the Chinese military of launching cyberattacks without solid proof is unprofessional and baseless.”

The attacks appear to be part of a broader computer espionage campaign against American news media companies that have reported on Chinese leaders and corporations.

Last year, Bloomberg News was targeted by Chinese hackers, and some employees’ computers were infected, according to a person with knowledge of the company’s internal investigation, after Bloomberg published an article on June 29 about the wealth accumulated by relatives of Xi Jinping, China’s vice president at the time. Mr. Xi became general secretary of the Communist Party in November and is expected to become president in March. Ty Trippet, a spokesman for Bloomberg, confirmed that hackers had made attempts but said that “no computer systems or computers were compromised.”

Signs of a Campaign

The mounting number of attacks that have been traced back to China suggest that hackers there are behind a far-reaching spying campaign aimed at an expanding set of targets including corporations, government agencies, activist groups and media organizations inside the United States. The intelligence-gathering campaign, foreign policy experts and computer security researchers say, is as much about trying to control China’s public image, domestically and abroad, as it is about stealing trade secrets.

This article has been revised to reflect the following correction:

Correction: January 31, 2013

An earlier version of this article misstated the year that the United States and Israel were said to have started a cyber attack that caused damage at Iran’s main nuclear enrichment plant, and the article misstated the specific type of attack. The attack was a computer worm, not a virus, and it started around 2008, not 2012.

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Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

---

Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

Read More..

Well: Waiting for Alzheimer's to Begin

My gray matter might be waning. Then again, it might not be. But I swear that I can feel memories — as I’m making them — slide off a neuron and into a tangle of plaque. I steel myself for those moments to come when I won’t remember what just went into my head.

I’m not losing track of my car keys, which is pretty standard in aging minds. Nor have I ever forgotten to turn off the oven after use, common in menopausal women. I can always find my car in the parking lot, although lots of “normal” folk can’t.

Rather, I suddenly can’t remember the name of someone with whom I’ve worked for years. I cover by saying “sir” or “madam” like the Southerner I am, even though I live in Vermont and grown people here don’t use such terms. Better to think I’m quirky than losing my faculties. Sometimes I’ll send myself an e-mail to-do reminder and then, seconds later, find myself thrilled to see a new entry pop into my inbox. Oops, it’s from me. Worse yet, a massage therapist kicked me out of her practice for missing three appointments. I didn’t recall making any of them. There must another Nancy.

Am I losing track of me?

Equally worrisome are the memories increasingly coming to the fore. Magically, these random recollections manage to circumnavigate my imagined build-up of beta-amyloid en route to delivering vivid images of my father’s first steps down his path of forgetting. He was the same age I am now, which is 46.

“How old are you?” I recall him asking me back then. Some years later, he began calling me every Dec. 28 to say, “Happy birthday,” instead of on the correct date, Dec. 27. The 28th had been his grandmother’s birthday.

The chasms were small at first. Explainable. Dismissible. When he crossed the street without looking both ways, we chalked it up to his well-cultivated, absent-minded professor persona. But the chasms grew into sinkholes, and eventually quicksand. When we took him to get new pants one day, he kept trying on the same ones he wore to the store.

“I like these slacks,” he’d say, over and over again, as he repeatedly pulled his pair up and down.

My dad died of Alzheimer’s last April at age 73 — the same age at which his father succumbed to the same disease. My dad ended up choosing neurology as his profession after witnessing the very beginning of his own dad’s forgetting.

Decades later, grandfather’s atrophied brain found its way into a jar on my father’s office desk. Was it meant to be an ever-present reminder of Alzheimer’s effect? Or was it a crystal ball sent to warn of genetic fate? My father the doctor never said, nor did he ever mention, that it was his father’s gray matter floating in that pool of formaldehyde.

Using the jarred brain as a teaching tool, my dad showed my 8-year-old self the difference between frontal and temporal lobes. He also pointed out how brains with Alzheimer’s disease become smaller, and how wide grooves develop in the cerebral cortex. But only after his death — and my mother’s confession about whose brain occupied that jar — did I figure out that my father was quite literally demonstrating how this disease runs through our heads.

Has my forgetting begun?

I called my dad’s neurologist. To find out if I was in the earliest stages of Alzheimer’s, he would have to look for proteins in my blood or spinal fluid and employ expensive neuroimaging tests. If he found any indication of onset, the only option would be experimental trials.

But documented confirmation of a diseased brain would break my still hopeful heart. I’d walk around with the scarlet letter “A” etched on the inside of my forehead — obstructing how I view every situation instead of the intermittent clouding I currently experience.

“You’re still grieving your father,” the doctor said at the end of our call. “Sadness and depression affect the memory, too. Let’s wait and see.”

It certainly didn’t help matters that two people at my father’s funeral made some insensitive remarks.

“Nancy, you must be scared to death.”

“Is it hard knowing the same thing probably will happen to you?”

Maybe the real question is what to do when the forgetting begins. My dad started taking 70 supplements a day in hopes of saving his mind. He begged me to kill him if he wound up like his father. He retired from his practice and spent all day in a chair doing puzzles. He stopped making new memories in an all-out effort to preserve the ones he already had.

Maybe his approach wasn’t the answer.

Just before his death — his brain a fraction of its former self — my father managed to offer up a final lesson. I was visiting him in the memory-care center when he got a strange look on his face. I figured it was gas. But then his eyes lit up and a big grin overtook him, and he looked right at me and said, “Funny how things turn out.”

An unforgettable moment?

I can only hope.

---

Nancy Stearns Bercaw is a writer in Vermont. Her book, “Brain in a Jar: A Daughter’s Journey Through Her Father’s Memory,” will be published in April 2013 by Broadstone.

Read More..

Chinese Hackers Infiltrate New York Times Computers

SAN FRANCISCO — For the last four months, Chinese hackers have persistently attacked The New York Times, infiltrating its computer systems and getting passwords for its reporters and other employees.

The New York Times published an article in October about the wealth of the family of China's prime minister, Wen Jiabao, in both English and Chinese.

After surreptitiously tracking the intruders to study their movements and help erect better defenses to block them, The Times and computer security experts have expelled the attackers and kept them from breaking back in.

The timing of the attacks coincided with the reporting for a Times investigation, published online on Oct. 25, that found that the relatives of Wen Jiabao, China’s prime minister, had accumulated a fortune worth several billion dollars through business dealings.

Security experts hired by The Times to detect and block the computer attacks gathered digital evidence that Chinese hackers, using methods that some consultants have associated with the Chinese military in the past, breached The Times’s network. They broke into the e-mail accounts of its Shanghai bureau chief, David Barboza, who wrote the reports on Mr. Wen’s relatives, and Jim Yardley, The Times’s South Asia bureau chief in India, who previously worked as bureau chief in Beijing.

“Computer security experts found no evidence that sensitive e-mails or files from the reporting of our articles about the Wen family were accessed, downloaded or copied,” said Jill Abramson, executive editor of The Times.

The hackers tried to cloak the source of the attacks on The Times by first penetrating computers at United States universities and routing the attacks through them, said computer security experts at Mandiant, the company hired by The Times. This matches the subterfuge used in many other attacks that Mandiant has tracked to China.

The attackers first installed malware — malicious software — that enabled them to gain entry to any computer on The Times’s network. The malware was identified by computer security experts as a specific strain associated with computer attacks originating in China. More evidence of the source, experts said, is that the attacks started from the same university computers used by the Chinese military to attack United States military contractors in the past.

Security experts found evidence that the hackers stole the corporate passwords for every Times employee and used those to gain access to the personal computers of 53 employees, most of them outside The Times’s newsroom. Experts found no evidence that the intruders used the passwords to seek information that was not related to the reporting on the Wen family.

No customer data was stolen from The Times, security experts said.

Asked about evidence that indicated the hacking originated in China, and possibly with the military, China’s Ministry of National Defense said, “Chinese laws prohibit any action including hacking that damages Internet security.” It added that “to accuse the Chinese military of launching cyberattacks without solid proof is unprofessional and baseless.”

The attacks appear to be part of a broader computer espionage campaign against American news media companies that have reported on Chinese leaders and corporations.

Last year, Bloomberg News was targeted by Chinese hackers, and some employees’ computers were infected, according to a person with knowledge of the company’s internal investigation, after Bloomberg published an article on June 29 about the wealth accumulated by relatives of Xi Jinping, China’s vice president at the time. Mr. Xi became general secretary of the Communist Party in November and is expected to become president in March. Ty Trippet, a spokesman for Bloomberg, confirmed that hackers had made attempts but said that “no computer systems or computers were compromised.”

Signs of a Campaign

The mounting number of attacks that have been traced back to China suggest that hackers there are behind a far-reaching spying campaign aimed at an expanding set of targets including corporations, government agencies, activist groups and media organizations inside the United States. The intelligence-gathering campaign, foreign policy experts and computer security researchers say, is as much about trying to control China’s public image, domestically and abroad, as it is about stealing trade secrets.

This article has been revised to reflect the following correction:

Correction: January 31, 2013

An earlier version of this article misstated the year that the United States and Israel were said to have started a cyber attack that caused damage at Iran’s main nuclear enrichment plant, and the article misstated the specific type of attack. The attack was a computer worm, not a virus, and it started around 2008, not 2012.

Read More..

Chinese Hackers Infiltrate New York Times Computers

SAN FRANCISCO — For the last four months, Chinese hackers have persistently attacked The New York Times, infiltrating its computer systems and getting passwords for its reporters and other employees.

The New York Times published an article in October about the wealth of the family of China's prime minister, Wen Jiabao, in both English and Chinese.

After surreptitiously tracking the intruders to study their movements and help erect better defenses to block them, The Times and computer security experts have expelled the attackers and kept them from breaking back in.

The timing of the attacks coincided with the reporting for a Times investigation, published online on Oct. 25, that found that the relatives of Wen Jiabao, China’s prime minister, had accumulated a fortune worth several billion dollars through business dealings.

Security experts hired by The Times to detect and block the computer attacks gathered digital evidence that Chinese hackers, using methods that some consultants have associated with the Chinese military in the past, breached The Times’s network. They broke into the e-mail accounts of its Shanghai bureau chief, David Barboza, who wrote the reports on Mr. Wen’s relatives, and Jim Yardley, The Times’s South Asia bureau chief in India, who previously worked as bureau chief in Beijing.

“Computer security experts found no evidence that sensitive e-mails or files from the reporting of our articles about the Wen family were accessed, downloaded or copied,” said Jill Abramson, executive editor of The Times.

The hackers tried to cloak the source of the attacks on The Times by first penetrating computers at United States universities and routing the attacks through them, said computer security experts at Mandiant, the company hired by The Times. This matches the subterfuge used in many other attacks that Mandiant has tracked to China.

The attackers first installed malware — malicious software — that enabled them to gain entry to any computer on The Times’s network. The malware was identified by computer security experts as a specific strain associated with computer attacks originating in China. More evidence of the source, experts said, is that the attacks started from the same university computers used by the Chinese military to attack United States military contractors in the past.

Security experts found evidence that the hackers stole the corporate passwords for every Times employee and used those to gain access to the personal computers of 53 employees, most of them outside The Times’s newsroom. Experts found no evidence that the intruders used the passwords to seek information that was not related to the reporting on the Wen family.

No customer data was stolen from The Times, security experts said.

Asked about evidence that indicated the hacking originated in China, and possibly with the military, China’s Ministry of National Defense said, “Chinese laws prohibit any action including hacking that damages Internet security.” It added that “to accuse the Chinese military of launching cyberattacks without solid proof is unprofessional and baseless.”

The attacks appear to be part of a broader computer espionage campaign against American news media companies that have reported on Chinese leaders and corporations.

Last year, Bloomberg News was targeted by Chinese hackers, and some employees’ computers were infected, according to a person with knowledge of the company’s internal investigation, after Bloomberg published an article on June 29 about the wealth accumulated by relatives of Xi Jinping, China’s vice president at the time. Mr. Xi became general secretary of the Communist Party in November and is expected to become president in March. Ty Trippet, a spokesman for Bloomberg, confirmed that hackers had made attempts but said that “no computer systems or computers were compromised.”

Signs of a Campaign

The mounting number of attacks that have been traced back to China suggest that hackers there are behind a far-reaching spying campaign aimed at an expanding set of targets including corporations, government agencies, activist groups and media organizations inside the United States. The intelligence-gathering campaign, foreign policy experts and computer security researchers say, is as much about trying to control China’s public image, domestically and abroad, as it is about stealing trade secrets.

This article has been revised to reflect the following correction:

Correction: January 31, 2013

An earlier version of this article misstated the year that the United States and Israel were said to have started a cyber attack that caused damage at Iran’s main nuclear enrichment plant, and the article misstated the specific type of attack. The attack was a computer worm, not a virus, and it started around 2008, not 2012.

Read More..

DealBook: Top Federal Prosecutor of Corporate Crime Will Resign

Lanny A. Breuer, the federal prosecutor who led the Justice Department’s response to corporate crime in the wake of the financial crisis, will announce on Wednesday that he is stepping down after nearly four years in the post.

As head of the Justice Department’s criminal division, one of the most senior roles at the agency, Mr. Breuer tackled corporate bribery and public corruption. But it was his focus on Wall Street that received the most attention, from supporters and critics alike.

While he has come under fire for a dearth of prosecutions on Wall Street in response to the crisis, Mr. Breuer also oversaw an aggressive crackdown on money-laundering and interest-rate manipulation at some of the world’s biggest banks. In two weekslast month, he joined a nearly $2 billion case against HSBC for money-laundering and a $1.5 billion settlement with UBS for rate-rigging. Next week, he is expected to take a similar rate-rigging action against the Royal Bank of Scotland.

“I think the criminal division is a fundamentally different place than it was four years ago,” Mr. Breuer said in an interview. “It’s the highlight of my professional career.”

His departure, effective March 1, was widely expected. Mr. Breuer had told friends for weeks that he was ready to leave the public sector. While he has not announced his next step, it is expected that he will return to private practice. He was previously a partner at Covington & Burling, a white-shoe law firm.

By virtue of his perch at the Justice Department in Washington, Mr. Breuer became the face of Wall Street prosecutions in the aftermath of the financial crisis. But when few such cases materialized, critics like the Occupy Wall Street protesters turned on him, portraying him as an apologist for banks at the center of the mortgage mess.

In contrast, he drew praise for the sweeping crackdown on rate-rigging in the banking industry, which has largely involved international benchmark rates.

In a rate manipulation case last month, Mr. Breuer’s team secured a major payout from UBS and a guilty plea from the bank’s Japanese unit, making UBS the first big global bank in more than two decades to have a subsidiary plead guilty to fraud. Mr. Breuer, who announced the action after rejecting a last-minute plea from the bank’s chairman, also filed criminal charges against two former employees at the bank.

The deal sent a strong signal that the authorities wanted to hold banks responsible for their wrongdoing.

Following the UBS model, the Justice Department is now pursuing a guilty plea from a Royal Bank of Scotland subsidiary in Asia over its role in the interest rate manipulation scandal, people briefed on the matter said. That settlement, which could come as soon as next week, is likely to include more than $650 million in fines imposed by American and British authorities, two other people with direct knowledge of the matter said.

In an interview, Mr. Breuer said the rate-rigging case amounted to “egregious criminal conduct.” He struck a similar tone about two other major financial cases — the convictions of executives from Taylor, Bean & Whitaker, a now-defunct mortgage lender, and the 110-year prison term imposed on R. Allen Stanford for his Ponzi scheme.

Mr. Breuer has also focused on money-laundering, creating a task force in 2010 that has levied more than $3 billion in fines from banks, including the record fine against HSBC. He stopped short of indicting HSBC after some regulators warned that doing so could destabilize the global financial system.

Mr. Breuer argued that the charges he did not bring — for example, against Goldman Sachs and other banks suspected of fraud after selling toxic mortgage securities to investors — could not have been proved. It was not for a lack of trying, he said, noting that United States attorneys across the country, after reviewing the same evidence he did, also declined to act.

“It’s important for me to hold the financial institutions accountable,” he said. “There’s never been a time that a prosecutor said we should bring a securitization case and I said no.”

Under Mr. Breuer, the division has also increasingly used a 1977 law, the Foreign Corrupt Practices Act, to prosecute corporate bribery.

He also helped run the Justice Department’s investigation of the BP oil spill in the Gulf of Mexico, resulting in the company paying $4.5 billion in fines and other penalties and pleading guilty to 14 criminal charges related to the rig explosion in 2010.

In a statement, Attorney General Eric H. Holder Jr. praised Mr. Breuer. “Lanny has led one of the most successful and aggressive criminal divisions in the history of the Department of Justice,” he said.

Mr. Holder stood behind Mr. Breuer when questions arose about his involvement in the botched gun-trafficking case known as Operation Fast and Furious. The pair, who were both largely cleared after an inspector general investigation, worked together at Covington.

For years, Mr. Breuer moved in and out of government. The son of Holocaust survivors who fled Europe and settled in Queens, he landed at the Manhattan district attorney’s office after graduating from Columbia Law School. In between stints at Covington, he worked as a White House special counsel, defending President Bill Clinton amid federal investigations and impeachment proceedings.

In the interview on Tuesday, Mr. Breuer reflected on his unusual path to the Justice Department.

“The fact that I got to go from Elmhurst, Queens, to the criminal division is remarkable,” he said.

Read More..