Preoccupations: Teaching Meditation Techniques to Organizations

IN 1972, I was a 30-year-old American traveling in India, with the smell of incense in my hair and mantras repeating in my ears. Back then, if you had told me that I would someday be training employees of corporate America to apply contemplative practices to help them become more successful, I would have said you’d been standing too long in India’s hot noonday sun.

Nancy Palmieri for The New York Times

Mirabai Bush is a co-founder and senior fellow at the Center for Contemplative Mind in Society, which offers meditation techniques to organizations.

Yet not long ago, I was standing in front of employees at Google in Mountain View, Calif. They were dutifully following my instructions to feel the sensations of their breath as it passed in and out of their nostrils, and learning how to send e-mail mindfully, by taking three deep breaths before hitting “send.”

I am a co-founder of the Center for Contemplative Mind in Society, a nonprofit organization that is now 16 years old, and we have undertaken a daunting task: to convince people in their workplaces that the simple meditation techniques developed 2,500 years ago by the Buddha might help increase productivity, reduce absenteeism and inspire greater creativity. We have introduced contemplative exercises that can reduce stress and heart rate and increase attention and awareness of self and others. We teach what we call “mindful listening,” so that a speaker is fully heard.

For our first project, we chose a large corporation in the Midwest whose C.E.O. knew one of our board members. We created a three-day, mostly silent retreat off site.

I encountered workers who were exhausted, overworked and stressed. They were curious whether these practices could help, but also skeptical. Before the retreat, several people said, in effect: “Stress got me where I am. I don’t want to lose my edge.”

I thought to myself: This won’t be easy; maybe they won’t even attend.

But they all showed up. First, I asked them to lie on the floor for a deep-relaxation exercise. They didn’t balk; instead, they followed my instructions to let go and relax their bodies. We also introduced mindfulness meditation, which we believe builds attention and insight and helps people become more kind and loving. We taught the practice of bringing our minds to our breath, noticing our breath, and returning to our breath each time the mind wanders off — a task that’s tougher than it sounds.

“This is the hardest thing I’ve ever done,” said the C.E.O., who had a brilliant mind and thousands of employees. But the participants learned how to bring their minds to a place that was calm and clear, a great place to begin thinking and making decisions. When it was over, all felt that it was helpful.

SINCE that first foray into the corporate world, we have worked with many other organizations. For a small group, we have had a big reach, working with high-profile organizations like Yale Law School, Hearst Publications and the Army. We’ve offered programs as diverse as one-hour introductions, four-day intensive retreats, and courses with six weekly sessions.

At first, resistance was everywhere, but so were the possibilities. A litigation lawyer thought that if he became more compassionate toward the opposition in his cases, he couldn’t be a zealous advocate for clients. But he found that being calm, clear and compassionate gave him better insights and better timing.

An environmental leader thought that if others knew he practiced meditation, they wouldn’t take him seriously — and would write him off as a tree-hugger without scientific rigor. Instead, he found that he became more resilient, and less overwhelmed by climate-change predictions, and that he collaborated better with colleagues.

Magazine editors thought that they would miss deadlines; in fact, they learned to focus on priorities and work better in teams to meet the deadlines in new ways. Data-driven Google engineers questioned the value of developing capacities that can’t be quantified, but many of them learned better ways to communicate. One engineer told me his wife had noticed a change in the way he listened to her. She asked him: “What happened to you?”

As we continue exploring the benefits of mindfulness for work, scientists are researching the effects of the practices on the brain. Neuroscientists have confirmed much of what we were experiencing: that meditation improves attention, reduces stress hormones, increases appreciation and compassion for others and helps us recover faster from negative information.

Personally, this work has made me feel more connected to the world. Watching the responses of so many people — from an economics professor to Army soldiers — I’ve come to believe that it’s a basic human need to be calm and clear, to be aware of ourselves and others, to be kind and collaborative, to be fully present in each moment.

It turns out that people work better when they are happy and feel aligned with their work. I know I do.

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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.

Read More..

Slipstream: Legislation Would Regulate Tracking of Cellphone Users

THERE are three things that matter in consumer data collection: location, location, location.

E-ZPasses clock the routes we drive. Metro passes register the subway stations we enter. A.T.M.’s record where and when we get cash. Not to mention the credit and debit card transactions that map our trajectories in comprehensive detail — the stores, restaurants and gas stations we frequent; the hotels and health clubs we patronize.

Each of these represents a kind of knowing trade, a conscious consumer submission to surveillance for the sake of convenience.

But now legislators, regulators, advocacy groups and marketers are squaring off over newer technology: smartphones and mobile apps that can continuously record and share people’s precise movements. At issue is whether consumers are unwittingly acquiescing to pervasive tracking just for the sake of having mobile amenities like calendar, game or weather apps.

For Senator Al Franken, the Minnesota Democrat, the potential hazard is that by compiling location patterns over time, companies could create an intimate portrait of a person’s familial and professional associations, political and religious beliefs, even health status. To give consumers some say in the surveillance, Mr. Franken has been working on a locational privacy protection bill that would require entities like app developers to obtain explicit one-time consent from users before recording the locations of their mobile devices. It would prohibit stalking apps — programs that allow one person to track another person’s whereabouts surreptitiously.

The bill, approved last month by the Senate Judiciary Committee, would also require mobile services to disclose the names of the advertising networks or other third parties with which they share consumers’ locations.

“Someone who has this information doesn’t just know where you live,” Mr. Franken said during the Judiciary Committee meeting. “They know the roads you take to work, where you drop your kids off at school, the church you attend and the doctors that you visit.”

Yet many marketers say they need to know consumers’ precise locations so they can show relevant mobile ads or coupons at the very moment a person is in or near a store. Informing such users about each and every ad network or analytics company that tracks their locations could hinder that hyperlocal marketing, they say, because it could require a new consent notice to appear every time someone opened an app.

“Consumers would revolt if this was the case, and applications could be rendered useless,” said Senator Charles Grassley, the Iowa Republican, who promulgated industry arguments during the committee meeting. “Worse yet, free applications that rely on advertising could be pushed by the consent requirement to become fee-based.”

Mr. Franken’s bill may seem intended simply to protect consumer privacy. But the underlying issue is the future of consumer data property rights — the question of who actually owns the information generated by a person who uses a digital device and whether using that property without explicit authorization constitutes trespassing.

In common law, a property intrusion is known as “trespass to chattels.” The Supreme Court invoked the legal concept last January in United States v. Jones, in which it ruled that the government had violated the Fourth Amendment — which protects people against unreasonable search and seizure — by placing a GPS tracking device on a suspect’s car for 28 days without getting a warrant.

Some advocacy groups view location tracking by mobile apps and ad networks as a parallel, warrantless commercial intrusion. To these groups, Mr. Franken’s bill suggests that consumers may eventually gain some rights over their own digital footprints.

“People don’t think about how they broadcast their locations all the time when they carry their phones. The law is just starting to catch up and think about how to treat this,” says Marcia Hofmann, a senior staff lawyer at the Electronic Frontier Foundation, a digital rights group based in San Francisco. “In an ideal world, users would be able to share the information they want and not share the information they don’t want and have more control over how it is used.”

Even some marketers agree.

One is Scout Advertising, a location-based mobile ad service that promises to help advertisers pinpoint the whereabouts of potential customers within 100 meters. The service, previously known as ThinkNear and recently acquired by Telenav, a personalized navigation service, works by determining a person’s location; figuring out whether that place is a home or a store, a health club or a sports stadium; analyzing weather and other local conditions; and then showing a mobile ad tailored to the situation.

Eli Portnoy, general manager of Scout Advertising, calls the technique “situational targeting.” He says Crunch, the fitness center chain, used the service to show mobile ads to people within three miles of a Crunch gym on rainy mornings. The ad said: “Seven-day pass. Run on a treadmill, not in the rain.”

When a person clicks on one of these ads, Mr. Portnoy says, a browser-based map pops up with turn-by-turn directions to the nearest location. Through GPS tracking, Scout Advertising can tell when someone starts driving and whether that person arrives at the site.

Despite the tracking, Mr. Portnoy describes his company’s mobile ads as protective of privacy because the service works only with sites or apps that obtain consent to use people’s locations. Scout Advertising, he adds, does not compile data on individuals’ whereabouts over time.

Still, he says, if Congress were to enact Mr. Franken’s location privacy bill as written, it “would be a little challenging” for the industry to carry out, because of the number and variety of companies involved in mobile marketing.

“We are in favor of more privacy,” Mr. Portnoy says, “but it has to be done within the nuances of how mobile advertising works so it can scale.”

A SPOKESMAN for Mr. Franken said the senator planned to reintroduce the bill in the new Congress. It is one of several continuing government efforts to develop some baseline consumer data rights.

“New technology may provide increased convenience or security at the expense of privacy and many people may find the trade-off worthwhile,” Justice Samuel Alito wrote last year in his opinion in the Jones case. “On the other hand,” he added, “concern about new intrusions on privacy may spur the enactment of legislation to protect against these intrusions.”

E-mail: slipstream@nytimes.com.

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Memo From London: Argentina’s Call for Return of Falkland Islands Causes a Stir

LONDON — They have barely 3,000 inhabitants and far more sheep than people. They are more than 8,700 miles from London. For much of the year, they are bitterly cold and wind-swept, with only open sea and ice between them and Antarctica. President Ronald Reagan, who tussled with Margaret Thatcher over them as he rarely did on any other issue that engaged the two leaders, described them once as “that little ice-cold bunch of land down there.”

But the Falkland Islands, the focus of a short war between Britain and Argentina in 1982, have been in the headlines again recently.

Politicians, newspapers and military leaders in both countries have been back at the barricades making the old arguments about who is the islands’ rightful owner. Their arguments suggest what has long been evident: nothing lasting was settled by the conflict that killed 255 British and 649 Argentine soldiers, sailors and airmen, as well as 3 civilians on the islands.

The British newspaper The Guardian heralded the latest outburst in an editorial on Friday that struck an exhausted note. “Here we go again,” it said, tacitly acknowledging that the paper has been stuck in something of a rut of its own on the issue for years in its calls for a negotiated settlement.

As it was in 1982, few British politicians, and only a minority of mostly left-of-center opinion in Britain, have been ready to deviate from the unyielding stance that Mrs. Thatcher adopted. She sent a British naval task force to recapture the islands after the Argentine military dictatorship of Leopoldo Galtieri dispatched troops to overrun the meager British garrison there.

To many on the British left, there is little to be served by rehashing the old arguments that were set off when President Cristina Fernández de Kirchner of Argentina wrote an open letter to Prime Minister David Cameron of Britain on Thursday. It was published as an advertisement in The Guardian and another left-of-center British daily, The Independent.

The letter appeared on the 180th anniversary of Jan. 3, 1833, when an armed clash between the two nations took place on the islands. The episode has been settled on by Argentina as a watershed moment in a convoluted colonial story that goes back to the 16th century and involves competing claims to sovereignty by Britain, France, Portugal and Spain, which was the colonial power in Argentina until the country gained independence in 1816. In the statement that ran in the British papers, Mrs. Kirchner asserted that “Argentina was forcibly stripped of the Malvinas Islands” — Argentina’s name for the territory — in the murky 1833 episode. The clash involved a British sloop, an outgunned Argentine vessel and an Argentine commander’s submission to a British demand that he remove the remnants of a mutinous Argentine garrison from the islands.

Britain has always rebutted Argentine claims that the people who were expelled included Argentine civilians, and it contends that British sovereignty was established by a much earlier settlement, dating to the mid-18th century.

The Guardian, in its editorial, dismissed this as political window dressing, ultimately irrelevant to the present dispute. Mrs. Kirchner’s letter, it said, had more to do with a populist bid to revive her slumping popularity in Argentina than “anything a British brig-sloop did 180 years ago.” The newspaper added, “Any objective reader of the history of these islands would more likely conclude that this history is mixed, to say the least, and that the rival sovereignty claims are finely balanced.” The editorial urged the two countries to grapple with the issue diplomatically and to aim, initially, for an agreement on sharing in the bounty of fisheries and in recently discovered offshore oil reserves that some economists believe could turn into a 21st-century bonanza for the islands.

Mr. Cameron, though, is having none of it. Within hours of Mrs. Kirchner’s statement, he went before television cameras, saying that the future of the islands would be determined by the Falkland Islanders and that they would make their feelings known in a referendum to be held in March on the islands’ political status.

That was the expedient Britain adopted last year when Mrs. Kirchner campaigned in Argentina, and at the United Nations in New York, for a reopening of the sovereignty issue on the 30th anniversary of the 1982 war.

“As long as they choose to stay with the United Kingdom, they have my 100 percent backing,” Mr. Cameron said.

For the British leader, it is a safe bet. About 70 percent of the islanders are of British descent, and visitors there say there is no more than a scattering of support for an Argentine takeover. Tying the Falklands’ future to the islanders’ choice leaves Britain essentially where it was under Mrs. Thatcher. She remains a revered figure for Mr. Cameron, not only for her conservative stewardship at 10 Downing Street but also for her success in turning the Falklands issue into her second general-election victory, in 1983. It is a precedent unlikely to be lost on the current prime minister as he contemplates the general election he must face in 2015.

If there is a worry for Mr. Cameron, it lies in the possibility that Argentina, with popular passions heightened by Mrs. Kirchner, may make another attempt to seize the islands by force. British military commanders say they consider that highly unlikely, since Argentina’s armed forces have been barely modernized since the military junta there collapsed in the wake of the 1982 conflict, and they lack the power they had then to project air and naval power.

British forces on the islands have been expensively upgraded, with 800 troops, a new military airfield equipped to take heavy transport jets, a squadron of Typhoon fighter-bombers and, at times of tension, a nuclear attack submarine prowling the South Atlantic.

But Britain miscalculated before, in 1982, when Mrs. Thatcher’s government brushed aside diplomatic warnings of an invasion.

“I never, never expected the Argentines to invade the Falklands head-on,” she told an inquiry after the war, according to secret cabinet papers from the period that were released in late December. “It was such a stupid thing to do, as events happened, such a stupid thing even to contemplate doing.”

The papers included another kind of warning. Little noticed among the newly published documents was the last dispatch of Britain’s ambassador to Argentina when the Falklands invasion took place.

The envoy, Anthony Williams, who was never assigned as an ambassador again, argued eloquently that Britain had been wrong to regard the Argentine invasion as “a simple act of brigandage.” He said that although the country had “its share of vandals, hooligans and roughs,” it also had a case that the ambassador suggested could be compared to the seizure of the Suez Canal from its British and French owners in 1956 by President Gamal Abdel Nasser of Egypt.

“If our rightness is not so absolute as it now seems to us, no more is Argentine wrongness,” he said.

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F.D.A. Offers Rules to Stop Food Contamination

The Food and Drug Administration on Friday proposed two sweeping rules aimed at preventing the contamination of produce and processed foods, which has sickened tens of thousands of Americans annually in recent years.

Nicole Bengiveno/The New York Times

Checking the temperature of lettuce at an Arizona farm. Safety measures would start at farms.

The proposed rules represent a sea change in the way the agency polices food, a process that currently involves taking action after contamination has been identified. It is a long-awaited step toward codifying the food safety law that Congress passed two years ago.

Changes include requirements for better record keeping, contingency plans for handling outbreaks and measures that would prevent the spread of contaminants in the first place. While food producers would have latitude in determining how to execute the rules, farmers would have to ensure that water used in irrigation met certain standards and food processors would need to find ways to keep fresh food that may contain bacteria from coming into contact with food that has been cooked.

New safety measures might include requiring that farm workers wash their hands, installing portable toilets in fields and ensuring that foods are cooked at temperatures high enough to kill bacteria.

Whether consumers will ultimately bear some of the expense of the new rules was unclear, but the agency estimated that the proposals would cost food producers tens of thousands of dollars a year.

A big question to be resolved is whether Congress will approve the money necessary to support the oversight. President Obama requested $220 million in his 2013 budget, but Dr. Margaret Hamburg, commissioner of the F.D.A., said “resources remain an ongoing concern.”

Nonetheless, agency officials were optimistic that the new rules would protect consumers better.

“These new rules really set the basic framework for a modern, science-based approach to food safety and shift us from a strategy of reacting to problems to a strategy for preventing problems,” Michael R. Taylor, deputy commissioner for foods and veterinary medicine, said in an interview. The Food and Drug Administration is responsible for the safety of about 80 percent of the food that Americans consume. The rest falls to the Agriculture Department, which is responsible for meat, poultry and some eggs.

One in six Americans becomes ill from eating contaminated food each year, the government estimates; most of them recover without concern, but roughly 130,000 are hospitalized and 3,000 die. The agency estimated the new rules could prevent about 1.75 million illnesses each year.

Congress passed the Food Safety Modernization Act in 2010 after a wave of incidents involving tainted eggs, peanut butter and spinach sickened thousands of people and led major food makers to join consumer advocates in demanding stronger government oversight.

But it took the Obama administration two years to move the rules through the regulatory agency, prompting complaints that the White House was more concerned about protecting itself from Republican criticism than about public safety.

Mr. Taylor said that the delay was a function of the wide variety of foods and the complexity of the food system. “Anything that is important and complicated will always take longer than you would like,” he said.

The first rule would require manufacturers of processed foods sold in the United States to come up with ways to reduce the risk of contamination. Food companies would be required to have a plan for correcting problems and for keeping records that government inspectors could audit.

An example might be to require the roasting of raw peanuts at a temperature guaranteed to kill salmonella, which has been a problem in nut butters in recent years. Roasted nuts would then have to be kept separate from raw nuts to further reduce the risk of contamination, said Sandra B. Eskin, director of the safe food campaign at the Pew Charitable Trusts.

“This is very good news for consumers,” Ms. Eskin said. “We applaud the administration’s action, which demonstrates its strong commitment to making our food safer.”

The second rule would apply to the harvesting and production of fruits and vegetables in an effort to combat bacterial contamination like E. coli, which is transmitted through feces. It would address what advocates refer to as the “four Ws” — water, waste, workers and wildlife.

Read More..

F.D.A. Offers Rules to Stop Food Contamination

The Food and Drug Administration on Friday proposed two sweeping rules aimed at preventing the contamination of produce and processed foods, which has sickened tens of thousands of Americans annually in recent years.

Nicole Bengiveno/The New York Times

Checking the temperature of lettuce at an Arizona farm. Safety measures would start at farms.

The proposed rules represent a sea change in the way the agency polices food, a process that currently involves taking action after contamination has been identified. It is a long-awaited step toward codifying the food safety law that Congress passed two years ago.

Changes include requirements for better record keeping, contingency plans for handling outbreaks and measures that would prevent the spread of contaminants in the first place. While food producers would have latitude in determining how to execute the rules, farmers would have to ensure that water used in irrigation met certain standards and food processors would need to find ways to keep fresh food that may contain bacteria from coming into contact with food that has been cooked.

New safety measures might include requiring that farm workers wash their hands, installing portable toilets in fields and ensuring that foods are cooked at temperatures high enough to kill bacteria.

Whether consumers will ultimately bear some of the expense of the new rules was unclear, but the agency estimated that the proposals would cost food producers tens of thousands of dollars a year.

A big question to be resolved is whether Congress will approve the money necessary to support the oversight. President Obama requested $220 million in his 2013 budget, but Dr. Margaret Hamburg, commissioner of the F.D.A., said “resources remain an ongoing concern.”

Nonetheless, agency officials were optimistic that the new rules would protect consumers better.

“These new rules really set the basic framework for a modern, science-based approach to food safety and shift us from a strategy of reacting to problems to a strategy for preventing problems,” Michael R. Taylor, deputy commissioner for foods and veterinary medicine, said in an interview. The Food and Drug Administration is responsible for the safety of about 80 percent of the food that Americans consume. The rest falls to the Agriculture Department, which is responsible for meat, poultry and some eggs.

One in six Americans becomes ill from eating contaminated food each year, the government estimates; most of them recover without concern, but roughly 130,000 are hospitalized and 3,000 die. The agency estimated the new rules could prevent about 1.75 million illnesses each year.

Congress passed the Food Safety Modernization Act in 2010 after a wave of incidents involving tainted eggs, peanut butter and spinach sickened thousands of people and led major food makers to join consumer advocates in demanding stronger government oversight.

But it took the Obama administration two years to move the rules through the regulatory agency, prompting complaints that the White House was more concerned about protecting itself from Republican criticism than about public safety.

Mr. Taylor said that the delay was a function of the wide variety of foods and the complexity of the food system. “Anything that is important and complicated will always take longer than you would like,” he said.

The first rule would require manufacturers of processed foods sold in the United States to come up with ways to reduce the risk of contamination. Food companies would be required to have a plan for correcting problems and for keeping records that government inspectors could audit.

An example might be to require the roasting of raw peanuts at a temperature guaranteed to kill salmonella, which has been a problem in nut butters in recent years. Roasted nuts would then have to be kept separate from raw nuts to further reduce the risk of contamination, said Sandra B. Eskin, director of the safe food campaign at the Pew Charitable Trusts.

“This is very good news for consumers,” Ms. Eskin said. “We applaud the administration’s action, which demonstrates its strong commitment to making our food safer.”

The second rule would apply to the harvesting and production of fruits and vegetables in an effort to combat bacterial contamination like E. coli, which is transmitted through feces. It would address what advocates refer to as the “four Ws” — water, waste, workers and wildlife.

Read More..

Op-Ed Contributors: Is Google Like Gas or Like Steel?

AFTER a two-year investigation, the Federal Trade Commission concluded this week that Google’s search practices did not violate antitrust law. Those who wanted to see an epic battle like the one the government fought with Microsoft in the 1990s were sorely disappointed. But the analogy to the browser war of the Web’s early days was never the right one. It failed to capture the dangers free speech would have faced if regulators had agreed with Google’s critics.

The theories that many critics advanced — that search must be “neutral” because it is akin to a public utility, or that computer-generated search results are not speech and therefore not protected under the First Amendment — would have undermined free press principles across the Internet. That the F.T.C. decision permits Google to continue to use its judgment in analyzing search requests and presenting pertinent results is a victory for online expression and is consistent with First Amendment law since the 1940s.

Seven decades ago, a lawsuit against The Associated Press applied antitrust rules to the media and was resolved in a way that ultimately protected First Amendment interests. This case was always a better parallel than Microsoft to the F.T.C. investigation of Google. Like Google today, The A.P. had extraordinary influence. Then as now there were questions about whether something more than common antitrust law should govern companies that play such an important role in the delivery of information to the public.

Back then, the Justice Department alleged that A.P. bylaws allowed its member papers to impede local competitors by denying them access to The A.P.’s expansive news network. A trial court agreed but applied a theory far broader than routine antitrust law. It held that news was not an “ordinary” product like “steel” governed solely by antitrust, but rather something more “vital” because it was “clothed with a public interest.”

In other words, the trial court wanted to treat the mass media like a public utility, which carried considerable consequences. For example, while it would be illegal under antitrust law for a large steel company to conspire with competitors to fix prices, that company has no obligation to sell to every carmaker that wants steel. A public utility, on the other hand, has to serve everyone in the marketplace equally. Applying that standard to The A.P. would have opened the door to far broader regulation and could, in theory, have meant something as absurd as requiring newspapers to cover every press release or publish every letter to the editor.

When the case reached the Supreme Court in 1945, the modern understanding of the First Amendment, with its insistence on an independent news media, had yet to take shape. So it was with great significance that — even though The A.P. lost its appeal and had to allow more access to its services — the court steered entirely clear of the public-utility model. It looked instead to standard antitrust law in finding The A.P.’s conduct to be a classic restraint on trade.

The court went further in setting down a marker that to this day restrains government regulation of the media. Justice Hugo L. Black, who would become a leading champion of the First Amendment, wrote that nothing in the ruling could “compel A.P. or its members to permit publication of anything which their ‘reason’ tells them should not be published.”

This began a historic run in which the court transformed the media into an institution with the autonomy to serve as a check on government power. The First Amendment as we know it would look very different if public utility obligations had been forced onto the press that day.

If The A.P. was concerned about a regulator in every newsroom, Google was concerned about a regulator in every algorithm.

Advocates of aggressive action against Google saw the computer algorithms behind search as a utility that should be heavily regulated like the gas or electricity that flows into our homes. But search engines need to make choices about what results are most relevant to a query, just as a news editor must decide which stories deserve to be on the front page. Requiring “search neutrality” would have placed the government in the business of policing the speech of the Internet’s information providers. To quote Justice Black, it would have made search engines publish those results “which their ‘reason’ tells them should not be published.”

Others argued that the F.T.C. did not need to be guided by First Amendment concerns at all because search results are created by computers, not by human beings. Yet computers “speak” in many ways today. Lawmakers could have used F.T.C. precedent against Google to regulate the content of Amazon’s book recommendations, the locations on Bing’s maps, the news stories that trend on Facebook and Twitter, and many other online expressions of social and political importance.

The F.T.C. resisted these harmful theories, and as a result speakers all over the Internet won. But that doesn’t mean Google is exempt from regulation. The First Amendment is not a grant of immunity for any business, and antitrust scrutiny does not end where editorial judgment begins. But the A.P. case shows that antitrust laws can be enforced while protecting the right of a free press to print what it chooses and nothing more.

This makes regulation of the media difficult. But regulating speech should not be easy, like regulating a public utility, but hard, as the F.T.C. has correctly found.

Bruce D. Brown is the executive director of the Reporters Committee for Freedom of the Press and a lecturer at the University of Virginia Law School. Alan B. Davidson is a visiting scholar at M.I.T.’s Technology and Policy Program and a former director of public policy for the Americas at Google.

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Undecided Syrians Could Tip Balance of Rebellion

BEIRUT, Lebanon — At his government office in the Syrian capital, Damascus, the civil servant avoids discussing what Syrians call “the situation.” But he quietly ponders his own private endgame, toying with defecting to the rebels, yet clinging to his post, increasingly sure there are no fighters worth joining.

A multilingual former military officer, he says he is among many friends and colleagues who feel trapped: disenchanted with President Bashar al-Assad, disgusted by the violence engulfing Syria and equally afraid of the government and the rebels, with both sides, as he puts it, ready to sacrifice “the innocents.”

Mr. Assad remains in power in part because two years into the uprising, a critical bloc of Syrians remains on the fence. Among them are business owners who drive the economy, bankers who finance it, and the security officials and government employees who hold the keys to the mundane but crucial business of maintaining an authoritarian state. If they abandoned the government or embraced the rebels en masse, they might change the tide. Instead, their uncertainty contributes to the stalemate.

The Egyptian and Tunisian rebellions that inspired Syria’s initially peaceful uprising reached tipping points within weeks, with far less bloodshed. In those cases, widespread desire for change overwhelmed the fear of the unknown, and toppled governments — or rather, the dictatorial cliques that headed them — fell.But in Syria, each side has bloodied the other while many stay on the sidelines, and a core contingent of supporters feels obligated to stick with the government even as their doubts grow. That is in part because the government’s ruthless crackdown has made protest far more risky than in other uprisings. But it is also because of doubts, among the urban elite and others, about the direction of the revolution and how a rebel-ruled Syria would look.

“Me and my neighbors, we were the first to go down to the street and scream that we want a country, a real country, not a plantation,” said Samar Haddad, who runs a Syrian publishing house. “But this armed revolution, I refuse it as much as I refuse the regime.”

Ms. Haddad, who is in her late 40s and now spends much of her time outside Damascus, said that she and her circle of intellectuals and professionals embrace unarmed Syrian protesters as heroes, but believe that the armed rebellion is creating warlords and cycles of revenge that will be hard to uproot.

The fence sitters include government employees, security forces, intellectuals and wealthy Syrians. Some, including members of Mr. Assad’s minority Alawite sect, say they fear the rule of Islamists, or the calls for vengeance from some factions of the Sunni Muslim-dominated uprising.

Some are former soldiers who say they defected only to be disappointed by rebels who lack discipline or obsess about religious ideology. One young man, Nour, said he gave up on revolution when he tried to join an Islamist brigade, Al Tawhid, but was rejected for wearing skinny jeans.

Others, like the Damascus civil servant, a Sunni, simply fear a post-Assad vacuum and are confused about the safest course for their families and the country.

Fewer and fewer Syrians appear to believe the government can restore order; the fraying of the country has become hard to miss. This has resulted in countless private debates over how to survive — amid growing alarm that without a political settlement or intervention, endless fighting will gut the Syrian state.

For those who support neither Mr. Assad nor his opponents, life has become a fearful wait.

In Damascus, little gets done in offices that tremble with explosions and empty out by dusk. Government salaries are still paid, the civil servant said, but fewer workers show up. Ms. Haddad said her publishing employees still come to work, in what has become an act of defiance to show that life goes on.

Many people express a wish for a political solution — perhaps a transitional government involving moderate government officials — but believe that decisions are being made by armed men on both sides who refuse to compromise.

“Both sides have the same mind,” said Abu Tony, a shopkeeper in central Damascus who favors a compromise and gave only a nickname for safety reasons.

“This is not life,” he said, “to spend half of the day without electricity, without heating oil and without even bread just because the two sides refuse to give up some of their demands.”

Ms. Haddad said she and like-minded friends were trying quietly to build civil society. But she said: “We feel depressed, useless, helpless. We are not the decision makers.”

Even as some Alawites grow frustrated with Mr. Assad — believing he has poisoned their future in Syria — many believe there is no safe place for them on the other side. In part for this reason, there have not been mass defections by senior Alawite military officers.

But even Sunni soldiers under strong pressure to defect sometimes feel that “we can’t offer them much,” said one rebel commander based in the northern province of Idlib.

He said many were in touch with colleagues who defected earlier, who recount months without salaries, and the humiliation of former colonels commanded by junior fighters with swollen egos.

One such disappointed defector is Nour, who said he served in the feared Fourth Division commanded by Mr. Assad’s brother Maher. He said he defected after security forces raped and killed his fiancée and many friends begged him to join the rebels.

But he was let down, first by fighters who drank and took drugs and offered him money for sexual acts; then by Al Tawhid Brigade, whose fighters, he said, taunted him, saying “You want to join us and you’re wearing skinny trousers?” He said he had decided to stay in Turkey and avoid both sides in the conflict.

The Damascus civil servant and would-be defector — who has talked for months about defecting, first to rebels from his hometown and then to a reporter — said he hesitates over many questions about the rebels and their plans: “Are the people aware enough? Can they practice self-control? Can the rebels set up a security zone?”

“Many questions need answers,” he said.

The government, he added, long ago stopped forcing him to attend pro-Assad demonstrations, but rebel supporters call him a traitor for asking questions.

“Why should I join a group where I am obliged to curtsy?”

An employee of The New York Times contributed reporting from Damascus, Syria, and Hania Mourtada from Beirut.

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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Scant Proof Is Found to Back Up Claims by Energy Drinks

Energy drinks are the fastest-growing part of the beverage industry, with sales in the United States reaching more than $10 billion in 2012 — more than Americans spent on iced tea or sports beverages like Gatorade.

Their rising popularity represents a generational shift in what people drink, and reflects a successful campaign to convince consumers, particularly teenagers, that the drinks provide a mental and physical edge.

The drinks are now under scrutiny by the Food and Drug Administration after reports of deaths and serious injuries that may be linked to their high caffeine levels. But however that review ends, one thing is clear, interviews with researchers and a review of scientific studies show: the energy drink industry is based on a brew of ingredients that, apart from caffeine, have little, if any benefit for consumers.

“If you had a cup of coffee you are going to affect metabolism in the same way,” said Dr. Robert W. Pettitt, an associate professor at Minnesota State University in Mankato, who has studied the drinks.

Energy drink companies have promoted their products not as caffeine-fueled concoctions but as specially engineered blends that provide something more. For example, producers claim that “Red Bull gives you wings,” that Rockstar Energy is “scientifically formulated” and Monster Energy is a “killer energy brew.” Representative Edward J. Markey of Massachusetts, a Democrat, has asked the government to investigate the industry’s marketing claims.

Promoting a message beyond caffeine has enabled the beverage makers to charge premium prices. A 16-ounce energy drink that sells for $2.99 a can contains about the same amount of caffeine as a tablet of NoDoz that costs 30 cents. Even Starbucks coffee is cheap by comparison; a 12-ounce cup that costs $1.85 has even more caffeine.

As with earlier elixirs, a dearth of evidence underlies such claims. Only a few human studies of energy drinks or the ingredients in them have been performed and they point to a similar conclusion, researchers say — that the beverages are mainly about caffeine.

Caffeine is called the world’s most widely used drug. A stimulant, it increases alertness, awareness and, if taken at the right time, improves athletic performance, studies show. Energy drink users feel its kick faster because the beverages are typically swallowed quickly or are sold as concentrates.

“These are caffeine delivery systems,” said Dr. Roland Griffiths, a researcher at Johns Hopkins University who has studied energy drinks. “They don’t want to say this is equivalent to a NoDoz because that is not a very sexy sales message.”

A scientist at the University of Wisconsin became puzzled as he researched an ingredient used in energy drinks like Red Bull, 5-Hour Energy and Monster Energy. The researcher, Dr. Craig A. Goodman, could not find any trials in humans of the additive, a substance with the tongue-twisting name of glucuronolactone that is related to glucose, a sugar. But Dr. Goodman, who had studied other energy drink ingredients, eventually found two 40-year-old studies from Japan that had examined it.

In the experiments, scientists injected large doses of the substance into laboratory rats. Afterward, the rats swam better. “I have no idea what it does in energy drinks,” Dr. Goodman said.

Energy drink manufacturers say it is their proprietary formulas, rather than specific ingredients, that provide users with physical and mental benefits. But that has not prevented them from implying otherwise.

Consider the case of taurine, an additive used in most energy products.

On its Web site, the producer of Red Bull, for example, states that “more than 2,500 reports have been published about taurine and its physiological effects,” including acting as a “detoxifying agent.” In addition, that company, Red Bull of Austria, points to a 2009 safety study by a European regulatory group that gave it a clean bill of health.

But Red Bull’s Web site does not mention reports by that same group, the European Food Safety Authority, which concluded that claims about the benefits in energy drinks lacked scientific support. Based on those findings, the European Commission has refused to approve claims that taurine helps maintain mental function and heart health and reduces muscle fatigue.

Taurine, an amino acidlike substance that got its name because it was first found in the bile of bulls, does play a role in bodily functions, and recent research suggests it might help prevent heart attacks in women with high cholesterol. However, most people get more than adequate amounts from foods like meat, experts said. And researchers added that those with heart problems who may need supplements would find far better sources than energy drinks.

Hiroko Tabuchi contributed reporting from Tokyo and Poypiti Amatatham from Bangkok.

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Google’s Lawyers Work Behind the Scenes to Carry the Day

SAN FRANCISCO — For 19 months, Google pressed its case with antitrust regulators investigating the company. Working relentlessly behind the scenes, executives made frequent flights to Washington, laying out their legal arguments and shrewdly applying lessons learned from Microsoft’s bruising antitrust battle in the 1990s.

After regulators had pored over nine million documents, listened to complaints from disgruntled competitors and took sworn testimony from Google executives, the government concluded that the law was on Google’s side. At the end of the day, they said, consumers had been largely unharmed.

That is why one of the biggest antitrust investigations of an American company in years ended with a slap on the wrist Thursday, when the Federal Trade Commission closed its investigation of Google’s search practices without bringing a complaint. Google voluntarily made two minor concessions.

“The way they managed to escape it is through a barrage of not only political officials but also academics aligned against doing very much in this particular case,” said Herbert Hovenkamp, a professor of antitrust law at the University of Iowa who has worked as a paid adviser to Google in the past. “The first sign of a bad antitrust case is lack of consumer harm, and there just was not any consumer harm emerging in this very long investigation.”

The F.T.C. had put serious effort into its investigation of Google. Jon Leibowitz, the agency’s chairman, has long advocated for the commission to flex its muscle as an enforcer of antitrust laws, and the commission had hired high-powered consultants, including Beth A. Wilkinson, an experienced litigator, and Richard J. Gilbert, a well-known economist.

Still, Mr. Leibowitz said during a news conference announcing the result of the inquiry, the evidence showed that Google “doesn’t violate American antitrust laws.”

“The conclusion is clear: Google’s services are good for users and good for competition,” David Drummond, Google’s chief legal officer, wrote in a company blog post.

The main thrust of the investigation was into how Google’s search results had changed since it expanded into new search verticals, like local business listings and comparison shopping. A search for pizza or jeans, for instance, now shows results with photos and maps from Google’s own local business service and its shopping product more prominently than links to other Web sites, which has enraged competing sites.

But while the F.T.C. said that Google’s actions might have hurt individual competitors, over all it found that the search engine helped consumers, as evidenced by Google users’ clicking on the products that Google highlighted and competing search engines’ adopting similar approaches.

Google outlined these kinds of arguments to regulators in many meetings over the last two years, as it has intensified its courtship of Washington, with Google executives at the highest levels, as well as lawyers, lobbyists and engineers appearing in the capital.

One of the arguments they made, according to people briefed on the discussions, was that technology is such a fast-moving industry that regulatory burdens would hinder its evolution. Google makes about 500 changes to its search algorithm each year, so results look different now than they did even six months ago.

The definition of competition in the tech industry is also different and constantly changing, Google argued.

For instance, just recently Amazon and Apple, which used to be in different businesses than Google, have become its competitors. Google’s share of the search market has stayed at about two-thirds even though competing search engines are “just a click away,” as the company repeatedly argued. That would become the company’s mantra to demonstrate that it was not abusing its market power.

Claire Cain Miller reported from San Francisco, and Nick Wingfield from Seattle.

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In Chile, Abortion Hot Line Is in Legal Gray Area

Roberto Candia for The New York Times

Volunteers for the Safe Abortion Hot Line in Chile routinely wear masks when showing support in public for the organization in a country where abortion is illegal under any circumstances.

SANTIAGO, Chile — Every time the phone rings, Angela Erpel feels her nerves swell. Sometimes it is a scared teenager on the other end, or a desperate mother of three. There are the angry ones, too, with callers playing the sounds of crying babies or sending text messages with pictures of aborted fetuses.

Then Ms. Erpel, 38, a sociologist who volunteers at Chile’s Safe Abortion Hot Line, gathers herself and settles into a familiar dialogue on the use of misoprostol, a drug that will induce a medical abortion.

“We don’t give them a moral guide or advice; we only provide information,” she said.

Since the hot line began in 2009, volunteers spread across this long, thin country have taken turns answering tense calls from women seeking information about abortion every evening from 7 p.m. to 11 p.m. There have been more than 12,000 calls so far, and they continue rolling in at a steady clip.

In a country where abortion is entirely illegal, even in cases of rape or when a woman’s life is in danger, the hot line is a risky endeavor. Operating in a legal gray area, volunteers face a daunting prison sentence if a conversation veers too far from a lawyer-approved script. The hot line already has had three lawsuits brought against it, though all were eventually dropped.

According to the law, having an abortion carries a penalty of 5 to 10 years in prison, depending on the circumstances, while doctors and others who perform an abortion or assist with one could face up to 15 years, prosecutors say. In practice, however, fewer than 500 cases have been prosecuted over the last several years.

“I think there is a certain sensitivity to the social conditions behind these abortions, such as poverty or rape or teenage pregnancy,” explained Paula Vial, a lawyer and former public defender in Santiago.

Beyond the legal consequences, the 30 hot line volunteers are keenly aware of the social ramifications of taking an active role in such a polarizing issue. They wear masks when promoting the hot line at public gatherings, and are often vague about the details of their volunteer work in their daily lives. Many fear losing their jobs or driving a wedge into personal and family relationships. Indeed, Ms. Erpel was the only volunteer willing to go on the record about her work with the hot line, and even she is usually circumspect about it.

“It’s complicated,” she explained. “I’m open about being in an organization, but not necessarily that I work directly with abortion.”

Abortion was not always a clandestine affair in Chile. The current law that strictly bans it was one of the final acts of the dictatorship. In 1989, shortly before relinquishing power, Gen. Augusto Pinochet ended a tradition of legal abortion dating to 1931, in which a pregnancy that threatened a woman’s life, or a fetus that was not viable outside the womb, could be terminated. Chile’s law now is one of the strictest in the world.

By contrast, Uruguay legalized abortions in the first trimester for any reason last October, joining Guyana and Cuba as Latin American countries with broadly legalized procedures. Abortion is also legal in Mexico City. But Chile has remained a socially conservative country, after 20 years of economic growth and the election in 2006 of a woman as president.

“The hierarchy of the Catholic Church has had a very strong influence in public policy,” said Claudia Dides, a spokeswoman for the Movement for the Legal Interruption of Pregnancy.

In a pivotal case in 2008, Karen Espíndola, then 22, learned in her 12th week of pregnancy that her fetus had holoprosencephaly. Fetuses with the condition have a single-lobed brain, and most die before they are born. It is a common reason for terminating a pregnancy.

Ms. Espíndola sought an abortion, appealing to the president and setting off a national conversation over abortion. In February 2009, Ms. Espíndola gave birth to Osvaldo, who died in 2011.

“In reality he was never conscious he was alive,” she lamented. “He fought to breathe; he was fed through a tube. We all suffered a lot. Nobody here is a winner.”

Chile has witnessed a swell of liberal social movements in recent years, with gay men and lesbians pressing for the country’s first hate-crime legislation, environmentalists stalling dam-building projects in Patagonia, and students pushing for an overhaul of the education system.

Advocates contend that abortion rights sentiment bubbles near the surface as well, but the government has pushed back.

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Some Breaks for Industries Are Retained in Fiscal Deal

Nearly $250 million for Hollywood. Over $330 million for the railroad industry. More than $220 million for rum producers. And $62 million for doing business in American Samoa.

While taxes are expected to increase for most Americans as a result of the deal between the White House and Congress to end the fiscal impasse in Washington, corporate America was more fortunate. A bevy of tax breaks and credits that had been scheduled to expire at the end of 2012 will be extended for another year, costing taxpayers $46.1 billion over the next decade, according to Congress’s Joint Committee on Taxation.

The preservation of these subsidies and deductions has become a perennial Washington ritual in recent years, with lobbyists and companies and their allies on Capitol Hill securing their survival in the fine print of the tax code. Washington’s inability to close many of these loopholes is a sign of just how reluctant business is to sacrifice prized subsidies despite loud calls from many chief executives in recent months to raise taxes, cut spending and deal with huge budget deficits.

“Except for the people who like it, it’s a giveaway,” said Eric Toder, co-director of the Urban-Brookings Tax Policy Center. “It’s hard to mobilize opposition, but the people who benefit from it benefit a lot.”

Many of the provisions survive because they are so obscure. A $62 million tax credit for employers in American Samoa benefits StarKist, which is the largest private employer in the South Pacific island chain, with nearly 2,000 workers there. The tax break was supported by Jeff Bingaman, Democrat of New Mexico, who as former chairman of the Senate Energy and Natural Resources Committee was an advocate for American territories that lack formal Senate representation.

“We support the development credit, and it’s a key factor in our ability to maintain competitive operations in American Samoa,” said Mary Sestric, a spokeswoman for StarKist. “This is a big priority for us.”

Corporations were keenly sensitive to changes in broader tax policy, in addition to benefiting from direct tax breaks. For example, Goldman Sachs distributed $65 million in stock to 10 senior executives in December instead of January, when the firm typically makes such awards. That move helped them avoid the higher tax rates that will now be imposed on income of $400,000 or more.

The chief executive of Goldman, Lloyd C. Blankfein, was among the most prominent corporate executives who backed higher taxes as part of a broader deficit-reduction package. He and other business leaders also met with President Obama late last year as the White House sought support from corporate America during negotiations with Republicans in Congress.

Some subsidies, like a break for research by companies, can actually have long-term benefits for the economy, defenders argue.

Others, like the one that allows filmmakers to deduct the first $15 million in production expenses for movies made in the United States, are much more narrowly focused but have loyal supporters that manage to keep them alive year after year. Another beneficiary of Congressional largess is Nascar, which will enjoy a $78 million subsidy for racetrack construction over the next 10 years.

“Once they get in, they tend to stay in,” said Alan Auerbach, director of the Robert D. Burch Center for Tax Policy and Public Finance at the University of California, Berkeley.

Besides the $46.1 billion in corporate incentives over the next 10 years, there is another $18.1 billion in breaks for alternative energy, much of that going to companies as well. Producers of biodiesel, for example, will reap more than $2 billion in tax breaks. And while it may not exactly be an alternative source of energy, producers of coal on Indian lands retained $1 million in tax breaks — a provision backed by Max Baucus, the Montana Democrat who is chairman of the Finance Committee.

The wind industry, a chief beneficiary of support from Washington, will get $12 billion in subsidies over the next decade. In fact, the benefits that were included for the wind sector are slightly broader now than in previous years.

Under the new rules, contained in the legislation that Mr. Obama signed on Wednesday, new wind farms will be covered by a production tax credit or an investment tax credit similar to the ones that just expired, but the projects will not need to be finished by the end of this year to qualify; they simply must have been started in 2013.

The American Wind Energy Association, a trade group, said in an e-mail to its members that the change was made by Congress “specifically in order to accommodate the business timelines of our industry.” The business has been in a tax-driven boom-and-bust cycle.

The renewal of the tax benefits was pushed strongly by Mr. Bingaman, Mr. Baucus and Charles E. Grassley, Republican of Iowa. When the Senate began considering “tax extenders,” or continuations of various tax breaks, wind advocates pushed to have all of them included.

“There always seemed to be some bipartisan support for this,” said Philip D. Tingle, a lawyer who specializes in energy taxes. “The element, the issue was, how they were going to pay for it.” The renewal will probably cost the Treasury about $12 billion, although the wind industry insists that it will generate so much taxable activity that total tax revenue, including those at the state and local level, will exceed the tax expenditure.

The industry undertook a large lobbying campaign and says it generated more than 750,000 letters, e-mails and other communications with Congress. It took nearly 100 members of Congress on tours of wind farms and factories where components are built. The issue may be more regional than partisan; according to the American Wind Energy Association, 80 percent of wind farms are in Congressional districts represented by Republicans, as are 67 percent of the factories.

The tax credits were also extended to cover electricity made from biomass, tides and ocean waves, landfill methane and improvements to hydroelectric stations.

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Hillary Clinton Is Discharged From Hospital After Blood Clot

Hillary Rodham Clinton, whose globe-trotting tour as secretary of state was abruptly halted last month by a series of health problems, was discharged from a New York hospital on Wednesday evening after several days of treatment for a blood clot in a vein in her head.

The news of her release was the first welcome sign in a troubling month that grounded Mrs. Clinton — preventing her from answering questions in Congress about the State Department’s handling of the lethal attack on an American mission in Libya or being present when President Obama announced Senator John Kerry as his choice for her successor when she steps down as secretary of state.

“Her medical team advised her that she is making good progress on all fronts, and they are confident she will make a full recovery,” Philippe Reines, a senior adviser to Mrs. Clinton, said in a statement.

Mrs. Clinton, 65, was admitted to NewYork-Presbyterian/Columbia hospital on Sunday after a scan discovered the blood clot. The scan was part of her follow-up care for a concussion she sustained more than two weeks earlier, when she fainted and fell, striking her head. According to the State Department, the fainting was caused by dehydration, brought on by a stomach virus. The concussion was diagnosed on Dec. 13, though the fall had occurred earlier that week.

The clot was potentially serious, blocking a vein that drains blood from the brain. Untreated, such blockages can lead to brain hemorrhages or strokes. Treatment consists mainly of blood thinners to keep the clot from enlarging and to prevent more clots from forming, and plenty of fluids to prevent dehydration, which is a major risk factor for blood clots.

Photographed leaving the hospital, Mrs. Clinton and her husband, former President Bill Clinton, and their daughter, Chelsea, appeared elated. In a Twitter post on Wednesday, Chelsea Clinton said, “Grateful my Mom discharged from the hospital & is heading home. Even more grateful her medical team confident she’ll make a full recovery.”

Dr. David J. Langer, a brain surgeon and associate professor at Hofstra North Shore-LIJ School of Medicine, said that Mrs. Clinton would need close monitoring in the next days, weeks and months to make sure her doses of blood thinners are correct and that the clot is not growing. Dr. Langer is not involved in her care.

Mrs. Clinton’s illness cuts short what would have been a victory lap for her at the State Department. With only a few weeks before the end of President Obama’s first term — the time frame she set for own departure — she will be able to do little more than say goodbye to her troops.

But she will, at least theoretically, be able to testify before the Senate and House about the attack on the American mission in Benghazi, Libya, which killed four Americans, including Ambassador J. Christopher Stevens. She was not able to appear at a hearing in December because of her illness. Republicans, who have sharply criticized the Obama administration’s handling of the attack and its aftermath, had demanded that she appear to explain the department’s role, though in recent days they have modulated their request.

Mrs. Clinton’s blood clot formed in a large vein along the side of her head, behind her right ear, between the brain and the skull. The vein, called the right transverse sinus, has a matching vessel on the left side. These veins drain blood from the brain; blockages can cause strokes or brain hemorrhages. But if only one transverse sinus is blocked, the vein on other side can usually handle the extra flow.

In one sense, Mrs. Clinton was lucky: a clot higher in this drainage system, in a vessel with no partner to take the overflow, would have been far more dangerous, according to Dr. Geoffrey T. Manley, the vice chairman of neurological surgery at the University of California, San Francisco. He is not involved in her care.

The fact that Mrs. Clinton had a blood clot in the past — in her leg, in 1998 — suggests that she may have a tendency to form clots, and may need blood-thinners long-term or even for the rest of her life, Dr. Manley said.

One major risk to people who take blood thinners is that the drugs increase bleeding, so blows to the head from falls or other accidents — like the fall that caused Mrs. Clinton’s concussion — become more dangerous, and more likely to cause a brain hemorrhage. Even so, the medication should not interfere with Mrs. Clinton’s career, Dr. Manley said.

“There are lots of people running around on anticoagulants today,” he said. “I don’t see any way it would have any long-term consequences.”

He also said there was no reason to think that this type of clot would recur; he said he had treated many patients for the same condition and had never seen one come back with it again.

Dr. Langer said the vein blocked by the clot might or might not reopen. Sometimes, he said, the clot persists and the body covers it with tissue that closes or narrows the blood vessel. As long as the vein on the other side of the head is open, there is no problem for the patient.

One thing that is unclear, and that may never be known for sure, is what caused Mrs. Clinton’s blood clot. Around the second week in December, she reportedly contracted a stomach virus that caused vomiting and dehydration, passed out, fell and struck her head. A concussion was diagnosed several days after the fall, on Dec. 13, and the public was told Sunday that she had a blood clot, though its location was not revealed until the next day.

She had several risk factors for clots, including dehydration and her previous history of a clot. In addition, women are more prone than men to this type of clot, particularly when dehydrated. The fall may also have been a factor, though it is not clear whether her head injury was serious enough to have caused a blood clot. The type of clot she had is far more likely to be associated with a skull fracture than with a concussion, several experts said.

Did overwork — frequent overseas trips, perpetual jet lag, high-pressure meetings — make her ill? Mrs. Clinton has kept up a punishing schedule since she declared her candidacy for president in 2007. Having logged more than 950,000 miles and visited 112 countries, she is one of the most-traveled secretaries of state in history. She has put on weight and in recent times appeared fatigued. But the same could be said of plenty of people who do not develop clots in their heads.

“You cannot tell me that her hard work resulted in this,” Dr. Langer said. “I can’t imagine that you could make that judgment.”

In theory, Dr. Manley said, exhaustion can weaken the immune system temporarily, and lower a person’s resistance to infections like the stomach virus that apparently started Mrs. Clinton’s problems. But in his opinion, the most important contributing factor to her blood clot was probably the head injury from her fall.

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