Malaysia Urged to Protect Domestic Workers

KUALA LUMPUR, Malaysia — Malaysia must punish the recruitment agents accused of forcing more than 100 foreign women to work as domestic help without pay and enforce laws to protect migrant workers, the Indonesian Embassy in Kuala Lumpur and a migrant workers’ support group said on Monday.

Malaysian immigration officers on Saturday rescued 105 women, mostly Indonesians, who said they had been forced to work as domestic helpers and at food stalls, been given little food and been confined to a four-story building at night in the port town of Klang, near Kuala Lumpur.

“A few of them said they had been beaten by the supervisors,” said Chandran Muniandy, the assistant deputy director of immigration in Klang. “They locked them up. They couldn’t go anywhere.”

Some of the women in the group, which included 95 Indonesians, 6 Filipinos and 4 Cambodians, said that they had been forced to work for up to six months and had not been paid, Mr. Chandran added.

Twelve people who worked for the agency, including Malaysians and foreigners, have been arrested under Malaysia’s antitrafficking laws, Mr. Chandran said, adding that he expected to make more arrests.

The case is the latest in a series of episodes involving Indonesian domestic workers that have at times strained diplomatic relations between Indonesia and Malaysia. Last month, two Indonesian domestic workers reported that they had been raped. One alleged that she had been raped by three police officers, while the other woman said her employer had raped her.

In December 2011, Indonesia lifted a ban in place since 2009 that had prevented women from coming to Malaysia to work as domestic helpers.

“We will send a diplomatic note to the Malaysian government asking for tough punishment against them,” said Suryana Sastradiredja, a spokesman for the Indonesian Embassy, referring to those alleged to be the perpetrators in the Klang case.

Yusnida, an Indonesian woman, said that the agency had taken her and other women to work as maids in different homes each day from 5 a.m. to 8 p.m., according to a report in The Star, a Malaysian newspaper. “My hands and legs were swollen from the long hours of work every day,” she was quoted as saying. “The agent only provided us with two meals a day. There was not enough food, and the workload was heavy.”

The agency told her that she could leave only once she had paid the agency a fee for bringing her to Malaysia, according to the report.

Mr. Suryana, of the Indonesian Embassy, urged the Malaysian authorities to take swift action against those who committed crimes against domestic workers.

He expressed anger that the three police officers charged with the rape of the Indonesian worker last month had been released on bail.

“I’m very, very angry with the situation,” he said. “If one Indonesian commits a crime, the Malaysian government is very quick to react, but a crime involving Malaysians, they are very slow.”

Irene Fernandez, the executive director of Tenaganita, an advocacy group for migrant workers in Kuala Lumpur, said the Malaysian authorities needed to provide better protection for domestic helpers and more effectively prosecute unscrupulous agents who abuse workers.

“A lot of homes are looking for part-time workers and cleaners, and so they are using that now and providing this form of labor where the workers are in a slavery-like situation,” she said, adding that women were often lured to Malaysia by agents who promised them factory jobs, only to find themselves forced to work as domestic helpers after their arrival.

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John McAfee Plays Hide-and-Seek in Belize

Photo Illustration by The New York Times

John McAfee, right, a pioneer in computer security who lives in Belize, is a “person of interest” in the murder of his neighbor. More Photos »

DANIEL GUERRERO promised during his campaign for mayor here to clean up San Pedro, the only town on this island, a 20-minute puddle jump from the mainland. But if he ever runs for re-election, don’t expect him to mention that vow.

“I meant clean up the trash, the traffic, that sort of thing,” he says. “I didn’t mean this.”

“This” is a full-blown international media frenzy and the kind of mess that no politician could have seen coming. It started on Nov. 11, the morning that Gregory Faull, a 52-year-old American, was found dead, lying face up in a pool of blood in his home. He had been shot in the head. His laptop and iPhone were missing. A 9-millimeter shell was found nearby.

What happened next turned this from a local crime story to worldwide news: The police announced that a “person of interest” in the investigation was a neighbor, John McAfee, a Silicon Valley legend who years ago earned millions from the computer virus-fighting software company that still bears his name.

A priapic 67-year-old, with an improbable mop of blond-highlighted hair and a rotating group of young girlfriends, Mr. McAfee quickly melted into the island’s lush green forest. Then, for Belizean authorities, the real embarrassment began.

Asserting his innocence, Mr. McAfee became a multiplatform cyberdissident, with a Twitter account, and a blog at whoismcafee.com with audio links, a comments section, photographs and a stream of invective against the government and the police of Belize. He has done interviews on podcasts, like the “Joe Rogan Experience,” and offered a $25,000 reward for information leading to the arrest of “the person or persons” who killed Mr. Faull. He has turned lamming it into a kind of high-tech performance art.

“I am asking all people of conscience to read this blog, especially the links in the ‘Background’ section,’ and see the ugly truth unfolding here,” he posted on Nov. 18. “Speak out. Write your congressmen. Write the prime minister. Do what you can.”

Before he went underground, Mr. McAfee led a noisy, opulent and increasingly stressful life here. He was known for the retinue of prostitutes who he says moved in and out of his house, and for employing armed guards, some of whom stood watch on the beach abutting his house. He also kept a pack of untethered dogs on his property who barked at and sometimes bit passers-by.

Two days before the murder, someone had poisoned a handful of those dogs. As it happens, Mr. Faull had complained about the animals, as well as the guards and the constant late-night inflow and outflow of taxis on the dirt path that runs behind his and Mr. McAfee’s homes — a path so tiny that it’s supposed to be off-limits to cars.

Mr. Faull had shown up at the town council office a few weeks ago with a letter decrying the din and the dogs, as well as Mr. McAfee’s guns and behavior. Nothing came of it.

“We were planning to meet with John McAfee and hand him the letter,” Mr. Guerrero said. “But it never happened. We were busy doing other work.”

In hindsight, that looks like a blunder. Mr. McAfee has since said on his blog that he had no choice but to flee because police and politicians in Belize are corrupt and eager to kill him. As proof, he has written at length about a late April raid that the country’s Gang Suppression Unit conducted at a property of his on the mainland, in a district called Orange Walk.

Some McAfee watchers have a different theory — namely, that he grew paranoid and perhaps psychotic after months of experimenting with and consuming MDPV, a psychoactive drug. These experiments were described in detail by Mr. McAfee himself, under the pseudonym “Stuffmonger” in a forum on Bluelight, a Web site popular with drug hobbyists.

So, here’s one hypothesis: Rich man doses himself to madness while seeking sexual bliss through pharmacology. Then shoots neighbor in a rage. Case closed, right? Ah, but those Bluelight posts were a ruse, Mr. McAfee would later blog, just one of the many pranks he has perpetrated over the years — part of a bet with a friend to see if he could create Bluelight’s largest-ever thread.

Read More..

Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

Read More..

Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

Read More..

John McAfee Plays Hide-and-Seek in Belize

Photo Illustration by The New York Times

John McAfee, right, a pioneer in computer security who lives in Belize, is a “person of interest” in the murder of his neighbor. More Photos »

DANIEL GUERRERO promised during his campaign for mayor here to clean up San Pedro, the only town on this island, a 20-minute puddle jump from the mainland. But if he ever runs for re-election, don’t expect him to mention that vow.

“I meant clean up the trash, the traffic, that sort of thing,” he says. “I didn’t mean this.”

“This” is a full-blown international media frenzy and the kind of mess that no politician could have seen coming. It started on Nov. 11, the morning that Gregory Faull, a 52-year-old American, was found dead, lying face up in a pool of blood in his home. He had been shot in the head. His laptop and iPhone were missing. A 9-millimeter shell was found nearby.

What happened next turned this from a local crime story to worldwide news: The police announced that a “person of interest” in the investigation was a neighbor, John McAfee, a Silicon Valley legend who years ago earned millions from the computer virus-fighting software company that still bears his name.

A priapic 67-year-old, with an improbable mop of blond-highlighted hair and a rotating group of young girlfriends, Mr. McAfee quickly melted into the island’s lush green forest. Then, for Belizean authorities, the real embarrassment began.

Asserting his innocence, Mr. McAfee became a multiplatform cyberdissident, with a Twitter account, and a blog at whoismcafee.com with audio links, a comments section, photographs and a stream of invective against the government and the police of Belize. He has done interviews on podcasts, like the “Joe Rogan Experience,” and offered a $25,000 reward for information leading to the arrest of “the person or persons” who killed Mr. Faull. He has turned lamming it into a kind of high-tech performance art.

“I am asking all people of conscience to read this blog, especially the links in the ‘Background’ section,’ and see the ugly truth unfolding here,” he posted on Nov. 18. “Speak out. Write your congressmen. Write the prime minister. Do what you can.”

Before he went underground, Mr. McAfee led a noisy, opulent and increasingly stressful life here. He was known for the retinue of prostitutes who he says moved in and out of his house, and for employing armed guards, some of whom stood watch on the beach abutting his house. He also kept a pack of untethered dogs on his property who barked at and sometimes bit passers-by.

Two days before the murder, someone had poisoned a handful of those dogs. As it happens, Mr. Faull had complained about the animals, as well as the guards and the constant late-night inflow and outflow of taxis on the dirt path that runs behind his and Mr. McAfee’s homes — a path so tiny that it’s supposed to be off-limits to cars.

Mr. Faull had shown up at the town council office a few weeks ago with a letter decrying the din and the dogs, as well as Mr. McAfee’s guns and behavior. Nothing came of it.

“We were planning to meet with John McAfee and hand him the letter,” Mr. Guerrero said. “But it never happened. We were busy doing other work.”

In hindsight, that looks like a blunder. Mr. McAfee has since said on his blog that he had no choice but to flee because police and politicians in Belize are corrupt and eager to kill him. As proof, he has written at length about a late April raid that the country’s Gang Suppression Unit conducted at a property of his on the mainland, in a district called Orange Walk.

Some McAfee watchers have a different theory — namely, that he grew paranoid and perhaps psychotic after months of experimenting with and consuming MDPV, a psychoactive drug. These experiments were described in detail by Mr. McAfee himself, under the pseudonym “Stuffmonger” in a forum on Bluelight, a Web site popular with drug hobbyists.

So, here’s one hypothesis: Rich man doses himself to madness while seeking sexual bliss through pharmacology. Then shoots neighbor in a rage. Case closed, right? Ah, but those Bluelight posts were a ruse, Mr. McAfee would later blog, just one of the many pranks he has perpetrated over the years — part of a bet with a friend to see if he could create Bluelight’s largest-ever thread.

Read More..

IHT Rendezvous: Christmas Tree Controversy Fires Multicultural Belgium

LONDON — It’s that time of year again. As November turned to December, a work gang just arrived outside the front window to set up the neighbourhood Christmas tree and mark the approach of the annual season of peace and good will.

Meanwhile, across the Channel in Brussels, there is a distinct lack of good will this year as locals in the Belgium capital tangle over a controversial decision by the city fathers to replace the traditional pine tree with an abstract structure of illuminated cubes.

The 25-meter, or 82-foot, tree of light installed this year on the Grand Place, the main square in Brussels, has sparked a protest movement and an online petition, demanding respect for “values and traditions”, which has so far attracted 25,000 signatures.

Some are claiming, however, that the campaign amounts to a thinly veiled attack on multiculturalism in the capital of the European Union, with undertones of Islamophobia.

The controversy was sparked by remarks by Bianca Debaets, a city councilor from the Christian Democrat and Flemish Party, who claimed the Socialist-run municipality was pandering to the sensitivities of non-Christians by scrapping the traditional tree.

“What next?” she asked. “Will Easter eggs be banned from the city because they make us think of Easter?”

The municipality has defended its choice, saying it wanted to blend the modern and the traditional to show off the city’s annual winter fair. More traditional Christmas symbols would also be on display in the Grand Place, including a Nativity scene, officials said.

Ms. Debaets has since distanced herself from openly racist comments that have attached themselves to an otherwise innocent online protest movement, some of which claimed the city was bowing to pressure from its estimated one-in-five Muslim minority.

In online comments, Muslims ridiculed the claims and Semsettin Ugurlu, chairman of the Belgian Muslim Executive that represents the Muslim community, said his organization did not object to any kind of Christmas tree.

“We know we are living in a country with a Christian culture, we take no offense over a traditional Christmas tree,” the BBC quoted him as saying.

The organizer of the online protest petition, identified as Olivier, told Belgian television he was not a racist and merely wanted his children to enjoy the pleasure of seeing the traditional tree.

The wording of the petition, and some of the comments attached by signatories, nevertheless revealed a wider agenda. It said the scrapping of the traditional tree at the Grand Place followed a ban on Christmas trees at law courts, the suppression of religious symbols at school and a ban on pork at school canteens.

The Christmas tree controversy comes after two members of an Islamic list, who said they might one day seek a referendum on establishing Sharia law in Belgium, were elected last month as councilors in Flemish-speaking districts of the Brussels region.

That prompted its own online petition, sponsored by a far-right party, to have their grouping banned.

Their election embarrassed moderate Muslim organisations, one of which started its own petition rejecting Sharia law. The Belgian Muslim Executive also said it was inconceivable to most Muslims that Belgium would ever become a Muslim state.

Olivier Mangain, a center-right Francophone politician, meanwhile called for secularism to be written into the Belgian Constitution in order to prevent any religious or other group from undermining fundamental rights such as gender equality.

La Vie, a Christian weekly in neighboring France, commented: “In a country hit by economic crisis, in the grip of regional tensions, and now starting an annual battle over how to mark Christmas, this affair has once more sparked a debate over the identity of Belgium.”

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Most Americans Face Lower Tax Burden Than in the 80s

What Is Fair?:
Taxes are still a hot topic after the presidential election. But as a country that spends more than it collects in taxes, are we asking the right taxpayers to pay the right amounts?

BELLEVILLE, Ill. — Alan Hicks divides long days between the insurance business he started in the late 1970s and the barbecue restaurant he opened with his sons three years ago. He earned more than $250,000 last year and said taxes took more than 40 percent. What’s worse, in his view, is that others — the wealthy, hiding in loopholes; the poor, living on government benefits — are not paying their fair share.

Kirsten Luce for The New York Times

"I don't have the answer of where to pull back. I want the state parks to stay open. I want, I want, I want. I want Big Bird, I think it's beautiful. What don't I want? I don't know," said Anita Thole, a safety supervisor for a utility contractor.

“It feels like the harder we work, the more they take from us,” said Mr. Hicks, 55, as he waited for a meat truck one recent afternoon. “And it seems like there’s an awful lot of people in the United States who don’t pay any taxes.”

These are common sentiments in the eastern suburbs of St. Louis, a region of fading factory towns fringed by new subdivisions. Here, as across the country, people like Mr. Hicks are pained by the conviction that they are paying ever more to finance the expansion of government.

But in fact, most Americans in 2010 paid far less in total taxes — federal, state and local — than they would have paid 30 years ago. According to an analysis by The New York Times, the combination of all income taxes, sales taxes and property taxes took a smaller share of their income than it took from households with the same inflation-adjusted income in 1980.

Households earning more than $200,000 benefited from the largest percentage declines in total taxation as a share of income. Middle-income households benefited, too. More than 85 percent of households with earnings above $25,000 paid less in total taxes than comparable households in 1980.

Lower-income households, however, saved little or nothing. Many pay no federal income taxes, but they do pay a range of other levies, like federal payroll taxes, state sales taxes and local property taxes. Only about half of taxpaying households with incomes below $25,000 paid less in 2010.

The uneven decline is a result of two trends. Congress cut federal taxation at every income level over the last 30 years. State and local taxes, meanwhile, increased for most Americans. Those taxes generally take a larger share of income from those who make less, so the increases offset more and more of the federal savings at lower levels of income.

In a half-dozen states, including Connecticut, Florida and New Jersey, the increases were large enough to offset the federal savings for most households, not just the poorer ones.

Now an era of tax cuts may be reaching its end. The federal government depends increasingly on borrowed money to pay its bills, and many state and local governments are similarly confronting the reality that they are spending more money than they collect. In Washington, debates about tax cuts have yielded to debates about who should pay more.

President Obama campaigned for re-election on a promise to take a larger share of taxable income above roughly $250,000 a year. The White House is now negotiating with Congressional Republicans, who instead want to raise some money by reducing tax deductions. Federal spending cuts also are at issue.

If a deal is not struck by year’s end, a wide range of federal tax cuts passed since 2000 will expire and taxes will rise for roughly 90 percent of Americans, according to the independent Tax Policy Center. For lower-income households, taxation would spike well above 1980 levels. Upper-income households would lose some but not all of the benefits of tax cuts over the last three decades.

Public debate over taxes has typically focused on the federal income tax, but that now accounts for less than a third of the total tax revenues collected by federal, state and local governments. To analyze the total burden, The Times created a model, in consultation with experts, which estimated total tax bills for each taxpayer in each year from 1980, when the election of President Ronald Reagan opened an era of tax cutting, up to 2010, the most recent year for which relevant data is available.

The analysis shows that the overall burden of taxation declined as a share of income in the 1980s, rose to a new peak in the 1990s and fell again in the 2000s. Tax rates at most income levels were lower in 2010 than at any point during the 1980s.

Governments still collected the same share of total income in 2010 as in 1980 — 31 cents from every dollar — because people with higher incomes pay taxes at higher rates, and household incomes rose over the last three decades, particularly at the top.

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The New Old Age Blog: Forced to Choose: Nursing Home vs. Hospice

An older person, someone who will die within six months, leaves a hospital. Where does she go?

Almost a third of the time, according to a recent study from the University of California, San Francisco, records show she takes advantage of Medicare’s skilled-nursing facility benefit and enters a nursing home. But is that the best place for end-of-life care?

In terms of monitoring her vital signs and handling IVs — the round-the-clock nursing care the skilled-nursing facility benefit is designed to provide — maybe so. But for treating end-of-life symptoms like pain and shortness of breath, for providing spiritual support for her and her family, for palliative care that helps her through the ultimate transition – hospice is the acknowledged expert.

She could receive hospice care, also covered by Medicare, while in the nursing home. But since Medicare only rarely reimburses for both hospice and the skilled-nursing facility benefit at the same time, this hypothetical patient and her family face a financial bind. If she opts for the hospice benefit, which does not include room and board at the nursing home, then she will be on the hook for hundreds of dollars a day to remain in the facility.

She could use the hospice benefit at home, of course. But, “we know these patients are medically complex,” said Katherine Aragon, lead author of the study in The Archives of Internal Medicine, and now a palliative care specialist at Lawrence General Hospital in Massachusetts. “And we know that taking care of someone near the end of life can be very demanding, hard for families to manage at home.” And that assumes the patient has a family or a home.

For some patients, a nursing home, though possibly dreaded, is the only place that can provide 24/7 care.

But if she uses the skilled-nursing facility benefit to pay for room and board in a facility, she probably has to forgo hospice. (The exception: if she was hospitalized for something unrelated to her hospice diagnosis. If she has cancer, then trips and breaks a hip, she can have both nursing home coverage and hospice. If cancer itself caused the bone to fracture, no dice.)

Let’s acknowledge that these are lousy choices.

The study, using data from the National Health and Retirement Study from 1994 through 2007, looked at more than 5,000 people who initially lived in the community – that is, not in a facility. About 30 percent used the skilled-nursing facility benefit during the final six months of life; those people were likely to be over 85 and family members said, after their deaths, that they had expected them to die soon. (The benefit is commonly referred to as S.N.F., which people in the field pronounce as “sniff”).

The choice to use S.N.F. had ongoing repercussions. Almost 43 percent of those who used it died in a nursing home and almost 40 percent in a hospital. Just 11 percent died at home, though that is where most people prefer to die, studies repeatedly show.

Among those who didn’t use the S.N.F. benefit, more than 40 percent died at home.

In effect, nursing homes were providing end-of-life care, expensively and probably not so well, for almost a third of the elderly population.

The skilled-nursing facility benefit, Dr. Aragon pointed out in an interview, is meant to provide rehabilitation. “The hope is that someone will get stronger and go home,” she said.

Sometimes, of course, that is what happens.

“What we may be missing is that this patient is on an end-of-life trajectory,” she continued. “Maybe they can’t get stronger.”

Moreover, Dr. Aragon pointed out, nursing homes often have financial incentives to keep re-hospitalizing patients. After three days in a hospital, the skilled-nursing facility benefit starts anew, and it reimburses at a higher level than Medicaid, which pays for most nursing home care.

Because this unhappy choice between hospice care and nursing home reimbursement reflects federal policy, there may be little that individual families can do. If physicians are willing to honestly discuss their patients’ prognosis, to assess whether a nursing home stay will lead to rehabilitation or whether it is where a patient will likely die, sooner rather than later, families may have some personal options.

If they knew that death was likely within a few months, they might try to provide care at home with hospice help for that limited time, difficult as that is. Or they might be able to muster enough money to pay for a few months in a nursing home, so that their parent can be a resident and still receive hospice care.

But these are still lousy choices. “Palliative care should be part of nursing home care,” said Alexander K. Smith, the study’s senior author and a palliative care specialist at the University of California, San Francisco. “And that regulation that prevents concurrent use of the S.N.F. benefit and hospice isn’t in the interest of patients and families.”

Coming up in a future post: Experimenting with a concurrent-coverage option.

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

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The New Old Age Blog: Forced to Choose: Nursing Home vs. Hospice

An older person, someone who will die within six months, leaves a hospital. Where does she go?

Almost a third of the time, according to a recent study from the University of California, San Francisco, records show she takes advantage of Medicare’s skilled-nursing facility benefit and enters a nursing home. But is that the best place for end-of-life care?

In terms of monitoring her vital signs and handling IVs — the round-the-clock nursing care the skilled-nursing facility benefit is designed to provide — maybe so. But for treating end-of-life symptoms like pain and shortness of breath, for providing spiritual support for her and her family, for palliative care that helps her through the ultimate transition – hospice is the acknowledged expert.

She could receive hospice care, also covered by Medicare, while in the nursing home. But since Medicare only rarely reimburses for both hospice and the skilled-nursing facility benefit at the same time, this hypothetical patient and her family face a financial bind. If she opts for the hospice benefit, which does not include room and board at the nursing home, then she will be on the hook for hundreds of dollars a day to remain in the facility.

She could use the hospice benefit at home, of course. But, “we know these patients are medically complex,” said Katherine Aragon, lead author of the study in The Archives of Internal Medicine, and now a palliative care specialist at Lawrence General Hospital in Massachusetts. “And we know that taking care of someone near the end of life can be very demanding, hard for families to manage at home.” And that assumes the patient has a family or a home.

For some patients, a nursing home, though possibly dreaded, is the only place that can provide 24/7 care.

But if she uses the skilled-nursing facility benefit to pay for room and board in a facility, she probably has to forgo hospice. (The exception: if she was hospitalized for something unrelated to her hospice diagnosis. If she has cancer, then trips and breaks a hip, she can have both nursing home coverage and hospice. If cancer itself caused the bone to fracture, no dice.)

Let’s acknowledge that these are lousy choices.

The study, using data from the National Health and Retirement Study from 1994 through 2007, looked at more than 5,000 people who initially lived in the community – that is, not in a facility. About 30 percent used the skilled-nursing facility benefit during the final six months of life; those people were likely to be over 85 and family members said, after their deaths, that they had expected them to die soon. (The benefit is commonly referred to as S.N.F., which people in the field pronounce as “sniff”).

The choice to use S.N.F. had ongoing repercussions. Almost 43 percent of those who used it died in a nursing home and almost 40 percent in a hospital. Just 11 percent died at home, though that is where most people prefer to die, studies repeatedly show.

Among those who didn’t use the S.N.F. benefit, more than 40 percent died at home.

In effect, nursing homes were providing end-of-life care, expensively and probably not so well, for almost a third of the elderly population.

The skilled-nursing facility benefit, Dr. Aragon pointed out in an interview, is meant to provide rehabilitation. “The hope is that someone will get stronger and go home,” she said.

Sometimes, of course, that is what happens.

“What we may be missing is that this patient is on an end-of-life trajectory,” she continued. “Maybe they can’t get stronger.”

Moreover, Dr. Aragon pointed out, nursing homes often have financial incentives to keep re-hospitalizing patients. After three days in a hospital, the skilled-nursing facility benefit starts anew, and it reimburses at a higher level than Medicaid, which pays for most nursing home care.

Because this unhappy choice between hospice care and nursing home reimbursement reflects federal policy, there may be little that individual families can do. If physicians are willing to honestly discuss their patients’ prognosis, to assess whether a nursing home stay will lead to rehabilitation or whether it is where a patient will likely die, sooner rather than later, families may have some personal options.

If they knew that death was likely within a few months, they might try to provide care at home with hospice help for that limited time, difficult as that is. Or they might be able to muster enough money to pay for a few months in a nursing home, so that their parent can be a resident and still receive hospice care.

But these are still lousy choices. “Palliative care should be part of nursing home care,” said Alexander K. Smith, the study’s senior author and a palliative care specialist at the University of California, San Francisco. “And that regulation that prevents concurrent use of the S.N.F. benefit and hospice isn’t in the interest of patients and families.”

Coming up in a future post: Experimenting with a concurrent-coverage option.

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

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Gadgetwise Blog: Q&A: Avoiding the Unwanted Beach Ball Party

Why does my Mac’s cursor often turn into rotating color pinwheel that freezes up my screen until I restart the computer?

The “rotating color pinwheel” goes by many names, both official and colloquial (Spinning Wait Cursor, Spinning Disc Pointer, Beach Ball of Doom, Rolling Rainbow of Death and so on). It usually appears temporarily when the Mac is busy with a task, like saving a large file. In most cases, the wait cursor should disappear after a few seconds. If it sticks around until you have to restart the Mac, it sounds like time to do some troubleshooting.

If you regularly get the wait cursor when working on the Mac, it could be because of a number of things, including lack of memory (the RAM kind) to efficiently complete the task on screen, not enough available hard-drive space or an overworked processor. If the cursor appears only when using a certain program, the issue may be with that piece of software. If this turns out to be the case, check the program’s online forums to see if this is a known issue, hopefully one with a workaround or solution.

Instead of restarting the entire computer, you may want forcibly close the program you have open when the wait cursor appears, to see if the problem is just with that one particular application. To force-quit an unresponsive program, press the Mac’s Option, Command and Escape keys at the same time. In the box that appears, select the stalled program in the list and click the Force Quit button.

If more than one program keeps stalling out and the Mac is underpowered, adding more memory to the computer and deleting unneeded files from an overstuffed hard drive might help, as can downloading system and program updates. But before you dive into hardware upgrades, check out The X Lab’s frequently asked questions page for a collection of suggested solutions to various problems regarding the Spinning Beach Ball of Death.

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