President Bush often tells audiences that when it comes to health care and prescription drugs, what's good enough for Congress is good enough for America's senior citizens. Many lawmakers agree, saying Medicare recipients deserve the same medical benefits they receive. . . . But the reality is that the two Medicare drug bills passed by the House and Senate do not come close to providing the level of coverage given to 8.5 million federal workers, including lawmakers, White House staff and the president. Both measures would require senior citizens to buy an auxiliary prescription plan, whereas all 188 health plans offered to federal employees include drug coverage -- and at far more generous reimbursement rates. "In effect, the president and congressional leadership is talking the talk but not walking the walk in terms of providing comparable coverage," said Ron Pollack, executive director of Families USA, an advocacy group promoting comprehensive health care for all. "The drug benefit [proposed] for seniors provides merely a fraction of the drug coverage that members of Congress receive today."

In a speech laced with praise of U.S. troops and of freedom, Bush portrayed his anti-terrorist focus as an extension of the colonial resentments of British tyranny that produced the Revolutionary War. . . . [Bush] indicated that he would not hesitate to deploy forces whenever, and wherever, he considers military intervention in the best interest of the United States and local populations around the globe. . . . "Without America's active involvement in the world, the ambitions of tyrants would go unopposed, and millions would live at the mercy of terrorists," he said before a wildly receptive crowd estimated at 25,000 at Wright-Patterson Air Force Base. "We will act whenever it is necessary to protect the lives and the liberty of the American people."

Over the last 30 years, Medicare has more effectively controlled health care costs than private insurers did, according to a recent study by the Urban Institute. The study found that since 1970 spending per enrollee had grown an average of 9.6 percent a year at Medicare, and 11.1 percent at private insurers. In 1997, under a program called Medicare+Choice, the government tried to encourage the elderly to enroll in H.M.O.'s, including well-known health companies like Aetna. But then medical costs began to rise sharply and the federal government reduced payments to the plans as part of a larger clampdown on Medicare costs under the Balanced Budget Act of 1997. The plans could then no longer afford to offer the generous benefits that lured people to enroll in the first place. Half of the plans disappeared and many others cut benefits drastically. Today there are 4.6 million Medicare beneficiaries enrolled in managed care, more than 25 percent fewer than there were six years ago. According to Stuart H. Altman, a health care policy professor at Brandeis University, the private plans operate under a number of disadvantages to the traditional Medicare program. First, Medicare operates with much lower administrative costs: those costs eat up as much as 15 percent of the revenue of private plans. Medicare's administrative costs are typically one-fifth that. Second, Medicare is able to drive a much harder bargain with hospitals and doctors than the private plans can.

Once again failing to live up to politicians' hopes and economists' expectations, the labor market got tougher for job seekers last month. The unemployment rate rose to 6.4 percent, the highest in nine years, and the economy lost 30,000 jobs. The Labor Department also said that job losses were much more severe in May than originally reported — 70,000 outside of farming, rather than 17,000. In all, the economy has lost 236,000 jobs this year.

. . . Job losses occurred across almost all industries, but blacks had considerably more trouble finding work than whites. Many more people started looking for work, but the number of employed blacks shrank, while the number of employed whites grew. "It's hard to put a positive spin on this report," said Ethan S. Harris, chief economist of Lehman Brothers. Not only did overall unemployment rise, he said, but "the rest of the report didn't look good, either." The unemployment rate in May was 6.1 percent.

. . . "This is another indication that these ideologically focused, supply-side tax cuts are not the way to get at the fundamental problem," said Senator Jon Corzine, a Democrat from New Jersey. "It's increasingly becoming clear the policies aren't having the result that was, at least, their stated intention. These have been very inefficient uses of resources to try to stimulate growth or jobs."

. . . The latest figures on new applications for unemployment benefits also offered little encouragement. Last week, 430,000 people filed first-time claims, up from a revised figure of 409,000 in the previous week, the Labor Department reported yesterday. Many economists regard any figure above 400,000 as a sign of continued weakness in the labor market.

But the chamber report, written by economist Todd Buchholz, counters that the fast-food companies are not to blame for America's increasing girth. The report says the problem lies in the lower cost of food, increased portion sizes, today's sedentary lifestyle and a tendency to snack more. Instead of blame, Buchholz contends that fast-food companies have actually done a service to the general population by making the cost of protein more affordable. ''Fast food is no more culpable than any other institution,'' Buchholz said during a news conference Wednesday. ``In the end it's about consumer choice.''

Corporate fraud has emerged as "one of our top priorities, second only to fighting terrorism," says Jeffrey Collins, the U.S. Attorney in Detroit who's investigating alleged fraud at Kmart. In 2002, investigations by the Securities and Exchange Commission resulted in 259 criminal filings brought by 30 U.S. Attorneys' offices. "That is an astounding statistic in terms of the number of cases and the breadth of interest among criminal prosecutors," says Stephen Crimmins, a former SEC attorney. "Never before in the history of the SEC has there been such interest by criminal prosecutors."

Central to that story are the slavery compromises at the Constitutional Convention . . ., which left a mixed legacy of prosperity and victimization, unity and civil war, treasured diversity and modern-day racism. Efforts to portray that legacy are often caught between two camps: those who say there's not enough truth-telling about racial injustice, and those who say that a patriotic view of the Founding Fathers will be unnecessarily sullied by dwelling too much on slavery.

[I]n recent decades, historians have shown that slavery provided the primary financial support of the Colonies and the United States in its first 50 years, she says. "If you look at what was moving across the Atlantic [during the Colonial period], it was either slaves, the products of slaves, supplies to sustain slaves, or things bought with the earnings of slave labor. Seventy-five percent of Colonial New England's exports went to the Caribbean to support the slave system."

. . . "The old history separated 'American capitalism' and 'democracy' from 'slavery.' " Dr. Beckert says. "In the 'new history,' the three are organically connected." . . . Nash agrees that only in this generation have historians come to accept the idea that "Slavery allowed there to be liberty.... There could not have been as much liberty as the colonists gained had there not been enslavement of a fifth of the population."

Thirty-four percent of US nursing home patients who suffer from Alzheimer's disease and other forms of dementia receive their food through a stomach tube, even though the practice is of dubious medical value, according to a study published today in the Journal of the American Medical Association. The study suggests the economics of Medicaid reimbursements favor the potentially harmful practice and that large, for-profit nursing homes were more likely to use the devices. In addition, the study found that nonwhites were more likely to be given feeding tubes than whites.

"Are we aware of litigation? Of course," Mudd said. "We made these commitments because it's the right thing to do -- for the people who use our products and for our business. If, along the way, this discourages a plaintiff's attorney or unwarranted legislation, well, that's just fine."

The Bush tax cuts risk undermining confidence in the health of US public finances, according to the Bank for International Settlements, the forum for the world's central banks. The BIS said in its annual report that the Bush administration and the US Federal Reserve had been right to take action to boost the economy. But it said the $350bn tax cuts package agreed by Congress had "not been helpful" and there was a danger that debt would reach unsustainable levels. . . . Its report also echoes private-sector economists' concerns that the US government may be reluctant to rein in fiscal policy when the economy is out of danger.

The Bush administration, intent on exempting U.S. citizens from prosecution by the International Criminal Court, is drawing fresh accusations of diplomatic heavy-handedness by threatening to cut off military aid to dozens of allies that refuse to sign immunity deals with the United States. A deadline for cooperation expired at midnight, freezing money not yet spent this year by about 35 countries and putting the countries on notice that they could be denied millions for military equipment and training programs in the next budget year if they do not comply with U.S. wishes. President Bush and his aides are reviewing projects in a number of countries for waivers that could be announced soon. Other nations, including the NATO allies, receive automatic exemptions. But a fierce struggle is underway -- with the United States facing off against much of Europe -- that has led to bad feelings and leaves some small countries feeling squeezed.

. . . The Bush administration withdrew its signature last year from the treaty that created the court -- ratified by more than 90 countries -- and embarked on a vast diplomatic campaign to persuade nearly 180 countries to sign the immunity pledges. U.S. officials argued that Americans need protection from politically motivated prosecutions at the court, which opened for business July 1, 2002. To press its point, the Bush administration threatened to shut down U.N. peacekeeping missions worldwide until the United Nations provided immunity to Americans. The Security Council granted the demand, then extended it for another year June 12. Secretary General Kofi Annan criticized the resolution. France, Germany and Syria abstained, contending that the exemption weakens the court.

The Environmental Protection Agency for months has withheld key findings of its analysis showing that a Senate plan [(the "Carper bill")] to combat air pollution would be more effective in reducing harmful pollutants -- and only marginally more expensive -- than would President Bush's Clear Skies initiative for power plant emissions. . . . [T]he president's plan does not address carbon dioxide emissions, which many scientists consider an important greenhouse gas that may contribute to the Earth's warming. . . . Unreleased information from an EPA internal analysis concludes that the competing bill would provide health benefits substantially superior to those envisioned under Clear Skies.

. . . EPA gave Carper information showing that his bill would cut power plant emissions of sulfur dioxide, nitrogen oxide and mercury earlier and by larger amounts than would the president's bill. Not provided to Carper, however, was the conclusion that these cuts could be achieved while increasing electricity prices by two-tenths of a cent per kilowatt hour more than the Clear Skies initiative would require. [It also showed that the Carper bill] by 2020 would result in 17,800 fewer premature deaths from power plant air pollution than would Clear Skies. That would save $140 billion a year in health benefits -- about $50 billion more than Clear Skies. . . . Bush disavowed a campaign pledge to regulate carbon dioxide emissions, saying such regulations would hurt the economy and consumers by proving too costly to the power industry.

Private health insurance plans began lobbying Congress today for major changes in the Medicare drug legislation passed just three days ago. Without increased subsidies and more stability, they said, few private plans will enter the Medicare market, and the legislation will not work as intended. Lobbyists for the health insurance industry praised Congress for its efforts to inject market forces and competition into Medicare. But they said Congress needed to change the rules for such competition and to increase payments for private plans to make Medicare an attractive business proposition.

[T]he most radical idea presented at the conference belonged to Richard H. Thaler. His paper, written with the legal scholar Cass R. Sunstein, was called "Libertarian Paternalism Is Not an Oxymoron." . . . Mr. Thaler has concluded that too many people, no matter how educated or vigilant, are poor planners, inconsistent savers and haphazard investors. His solution: public and private institutions should gently steer individuals toward more enlightened choices. That is, they must be saved from themselves. Mr. Thaler's most concrete idea is Save More Tomorrow (SMarT), a savings plan whereby employees pledge a share of their future salary increases to a retirement account. In test cases, the plan has proved remarkably successful. "This was not pulled out of thin air," Mr. Thaler said. "It was done using what I call first-grade psychology. We knew this was going to work, no question." Indeed, the SMarT plan takes advantage of behavioral economics' basic tenets: "loss aversion" (people fear loss because it causes them far more pain than the pleasure they receive from gain; but since the SMarT plan covers a future raise, they never feel its loss); "status-quo bias" (since people are reluctant to change, the change can be made for them); and "mental accounting" (people have a pressing need to direct different streams of money into different "accounts").

For years, automakers have cited studies contending that thousands of people die annually because fuel economy regulations force the companies to make cars that are not heavy enough. Larger vehicles, the argument goes, may guzzle more gas but they offer more protection, whether one hits a tree or another car. . . . The problem with this argument is that it now has little relationship to the American road. As safety advocates point out, the lightest cars have virtually disappeared from American roads over the last 15 years, while the largest vehicles — including sport utilities and pickups — have ballooned, both in number and heft. . . . [T]he growth of the largest vehicles has only expanded weight differences that are widely acknowledged to be deadly in collisions. Moreover, the largest vehicles are increasingly not cars but sport utilities and pickups, which ride much higher than cars, increasing the danger to people in cars and the likelihood of deadly rollovers.

Ms. Brotz, who said that TAP was run by managers independent of Abbott, said Abbott's other troubles should be seen in context. "Many companies in the industry are under investigation and settling similar matters," she said.

The Bench Marks states standards and expectations fundamental to a responsible company's action:

A new relationship between corporations and communities;

Sustainable systems of production and equitable systems for distribution;

Participation in the decision-making processes of companies;

Preservation and protection of the environment for present and future generations;

Respect for the dignity of every person;

Strong codes of conduct for corporations and suppliers;

Affirmation of indigenous peoples' rights;

Development of a human rights policy based on the Universal Declaration of Human Rights;

Commitment to the principle that every worker has the right of access to health care;

Balanced Corporate governance policies.

While the sharp growth in incomes over that period coincided with the stock market bubble, other factors appear to account for much of the increase. A cut in capital gains tax rates in 1997 to 20 percent from 28 percent encouraged long-term holders of assets, like privately owned businesses, to sell them, and big increases in executive compensation thrust corporate chiefs into the ranks of the nation's aristocracy. This year's tax cut reduced the capital gains rate further, to 15 percent. . . . In 2000, the top 400 on average paid 22.3 percent of their income in federal income tax, down from 26.4 percent in 1992 and a peak of 29.9 percent in 1995. Two factors explain most of this decline, according to the I.R.S.: reduced tax rates on long-term capital gains and bigger gifts to charity. . . . The rate actually paid by the top 400 in 2000 was about the same as that paid by a single person making $123,000 or a married couple with two children earning $226,000, according to Citizens for Tax Justice, a labor-backed group whose calculations are respected by a broad spectrum of tax experts.

In Washington, President Bush and Congressional leaders praise the Medicare legislation as historic. But here, as elsewhere in the country, retirees are experiencing what Robert J. Blendon, a health policy expert at the Harvard School of Public Health, calls "sticker shock" — the realization that, after so many promises, the proposed drug benefit will look nothing like what they expected. . . . Those who already have benefits fear they will be forced into a less generous government plan. And there is a strong sense that Congress is all talk and no action, and that nothing will be passed in the end. . . . The sentiments of Mrs. Fox, Mr. Human and others are testimony to the difficult task Congress has before it: meeting retirees' high expectations while at the same time keeping the cost of the benefit to $400 billion over the next 10 years. Drew Altman, president of the Kaiser Family Foundation, describes the job as "mission impossible." So it is "absolutely critical," he said, for lawmakers to begin "leveling with seniors about what this does and doesn't do."

Both [House and Senate versions] feature a $420 annual premium and a deductible: $250 in the House and $275 in the Senate. But here they diverge. Under the House bill, Medicare would pay 80 percent of drug costs up to $2,000 a year. Then beneficiaries would absorb all costs, up to $4,900. Finally, "catastrophic coverage" would kick in, with Medicare paying 100 percent. Under the Senate bill, Medicare would pay half of drug costs up to $4,500 a year. Then the beneficiary would pay, until costs reached about $5,800. After that, Medicare would pay 90 percent. "There's a huge gap where you have to pay the entire thing," Ms. Hailey said, looking bewildered. "People who can't afford it now certainly can't afford that in-between cost."

The financial distress is due to rising costs and stagnant revenues, Agwunobi said. For instance, Grady experienced a 15 percent increase in the cost of pharmaceuticals in one year. . . . Agwunobi noted the contributions to Grady for uninsured and nonpaying residents have been decreasing. Grady got $113 million from the two counties in 1992 - $10 million more than in 2002.

Michelle Houston thought a quick $300 from Cash In Advance would help her get out of a financial hole. Instead, it saddled her with a contract to pay the company $1,755 during the next year - nearly six times her cash advance - and helped push her into filing for bankruptcy. . . . Houston signed a contract obligating her to pay $67.50 every two weeks for a year to buy telephone calling cards - cards she didn't want or need. Cards, she said, that often didn't even work. . . . Her contract with Cash In Advance allowed her to call it quits by paying a one-time fee of $390. But she could never get that much together at one time.

. . . "The interest rates were just outrageous. On a twice-a-month basis, the interest rate is 780 percent," he said. Some of them paid thousands of dollars in exchange for an advance of just a few hundred, he said. He called it usury - making loans at illegal interest rates. "The position that we have taken in this case is that if a loan is usurious, the lender forfeits all interest," Braun said. "He's not entitled to collect any interest." 'I'm in retailing' Griffin and his lawyers deny that Cash In Advance is in the loan business at all. "I'm in retailing," Griffin said in the September hearing. He added later, "We do phone-card sales."

A 2002 opinion from Georgia Attorney General Thurbert Baker on the payday-loan business supports [a finding that this is a loan, not a sale transaction]: "If the substance of the transaction is the advance of money in return for a fee, then the transaction should be considered a loan and subject to the terms of (Georgia's small-loan act.) "It is my opinion that the transaction should be considered a loan if money is advanced pursuant to an agreement or understanding that it be repaid within a specified period of time, and the borrower's intent in entering the transaction is to obtain the use of money rather than to purchase the token consideration."

For three years, Georgia lawmakers have struggled with a choice: Regulate payday lending or run it out of the state. Powerful legislators, as well as some of the state's most prominent lobbyists, weighed in on the side of the payday-loan industry. Consumer advocates, Georgia's licensed small-loan companies and their legislative allies opposed it. The debate is unfolding in a state that historically has been friendly to small lenders who charge high interest. Georgia's usury law permits up to 60 percent in annual interest charges. That compares with 25 percent in New York and 30 percent in New Jersey, according to the Consumer Federation of America. In the meantime, the payday-loan industry - which Georgia regulatory officials deem illegal - is flourishing in the open, unlicensed and unregulated. Customers routinely pay fees that translate into annual interest rates of 400 percent and more, far higher than Georgia's usury threshold.

The proposed aid package, the details of which are to be worked out, will be divided equally between military and economic development aid, administration officials said. It is likely to include debt relief, and the expansion of aid for education and children's health services. Musharraf told ABC's "Nightline" that some of the money might be used to pay for Pakistani troops that would support U.S. operations in Iraq.

"Fair enough," say many conservatives, "only those who pay taxes should get the child tax credit." But this rhetorical flourish belies reality. The child tax credit is a government benefit. You can pay an enormous amount in taxes and yet if you do not have children, you will not get this benefit. This benefit has to do with having children. Preventing lower-income households from benefiting from this government benefit saved $3.5 billion, a mere 1% of the total tax cut package. Yet, it was apparently necessary to make room for $150 billion of relief to those with capital gains and dividend income.

"Fair enough," say conservatives, "we need to aim tax breaks at investors who will invest in jobs." Yet, the capacity utilization rate has fallen significantly over the last few years. What this means is that the country can produce much more than it is currently producing without increasing investment. Investors know this, which is why investment has recently been low. While deficit spending can stimulate the economy, most economists agree that little if any economic benefits will come from tax cuts. These deficits will mean a higher debt burden for the workers of tomorrow: the children of today.

"The drug industry contends that it needs high prices to finance the discovery of new, innovative drugs," Clemente said. "But a closer look shows that drug-makers make far more money in profits than they spend on research and development."

The U.S. attorney in Philadelphia announced yesterday that he is joining a complaint against Medco Health Solutions Inc. that alleges the nation's second-largest pharmacy-benefit manager improperly canceled prescriptions, switched medications without physician approval and sent patients partially filled orders. . . . The government has decided to intervene in two lawsuits brought by three whistle-blowers. Those suits allege that Medco changed prescriptions without a physician's approval to favor more expensive drugs produced by Merck & Co. and induced physicians with false information to switch to higher cost Merck drugs. Medco also destroyed mail order prescriptions without filling them and in other cases mailed patients less than the number of pills ordered but charged for the full amount, the lawsuits allege. . . . George Bradford Hunt and Walter W. Gauger, who both worked as pharmacists in Medco's Las Vegas processing facility, and Joseph Piacentile, a physician, allege in their complaints that on busy days Medco would cancel or destroy prescriptions to avoid penalties for delays in filling orders. Customers would be told that the prescriptions had never been received, Sheehan said. The company is also accused of fabricating records and, when the handwriting on prescriptions was unclear or difficult to read, simply guessing at what they said, according to Sheehan.

Nationwide, the average cost of workers' compensation insurance has risen 50 percent in the last three years, according to Robert P. Hartwig, the chief economist at the Insurance Information Institute, a trade group in New York. . . . Prices are escalating, government and industry officials said, because of rising medical and legal costs; a recent devastating price war by insurers; and, many insurers and business executives say, a significant amount of fraud. [Of course they say this - how else can they attempt to ignore their own responsibility? - funny that fraud must have been invented three years ago - CMC] . . . Part of the problem has been created by the insurers and the boom-and-bust cycle of their industry. In the mid-90's, expenses for workers' compensation insurers dipped and profits skyrocketed just as the stock and bond markets were at their most exuberant. Now, after dropping their prices below the cost of covering claims in a fierce battle for market share, and confronted with dismal investment returns, the insurers are hitting their customers with astounding price increases. The pace of the premium increases picked up after the insurance industry lost at least $40 billion in the terrorist attacks on Sept. 11. Another factor pushing up workers' compensation prices has been medical costs. While a shift away from manufacturing jobs to less-dangerous service work, broad improvements in safety and reductions in workers' eligibility for benefits has led to a drop of 36 percent in workers' compensation claims over the last decade, the average medical cost per claim has nearly doubled, to $15,300, Mr. Hartwig said. In California, the average medical cost has nearly quadrupled, to $35,201 over the past decade, according to Mr. Bellusci.

Even the best available science about ephedra is ambiguous. The Food and Drug Administration has collected reports linking it to more than 100 deaths. But by and large, the studies done have been too small and too limited — using only healthy subjects — to assess the actual danger. In March, the RAND Corporation issued an analysis combining the results of the many small studies; the analysis found evidence that ephedra works for weight loss in the short term, but can produce numerous cardiac side effects.

Documents from the lawsuits, including e-mail correspondence and detailed experiment records, provide an inside look at how, for the supplement makers, the demands of marketing have sometimes compromised those of science. They show how companies and researchers suppressed negative data; removed product names from abstracts when the conclusions showed no positive effects; changed statistical methods to see if results improved; and left out subjects who complained of troublesome side effects like heart palpitations and high blood pressure.

. . . Suppression of study results is a common practice in the dietary supplement industry, said Mr. Almada, the consultant. "You wouldn't believe how many studies are done on products like that and the data are buried," he said.