Still Hating America.

[Mmmm, Burger (C.J.)]

Originally posted by taxwonk
That ain't politics; it was nepotism.

He had that defense only because of the good fortune of birth.

[Mmmm, Burger (C.J.)]

Originally posted by Adder
Again, I don't think that anyone is arguing that DOJ is not political. But that is not the same as making decisions about which cases to prosecute based only on the political value news that the cases will generate rather than on the merits of the case.

Has anyone identified a case that a USA brought because s/he was directed to do so by the White House for political reasons?

According to all the reports, every termination was at most for failing to bring a case against a D or bringing a case against an R.

[ltl/fb]

Originally posted by Mmmm, Burger (C.J.)
Has anyone identified a case that a USA brought because s/he was directed to do so by the White House for political reasons?

According to all the reports, every termination was at most for failing to bring a case against a D or bringing a case against an R.

(Surprisingly) I didn't read Adder's email to say that the WH was directing the USAs to bring particular cases. Though, I'm having a little trouble distinguishing (in practical terms) how being fired for not bringing a particular case is different from being directed to bring a particular case, or how being fired for bringing a particular case is different from being directed not to bring a particular case.

I guess if you never told the person what s/he was doing wrong, and just fired them for not doing those things, it makes sense. But it seems wrong to fire someone for doing/not doing something without telling him/her what s/he was doing wrong. And if the terminated people were told that they weren't bringing the right cases, and given specific examples, that is the same thing as directing them to bring particular cases (or drop particular cases).

ETA I can see the distinction you are making, but it doesn't seem to have practical application. I guess in theory the AUSAs could be expected to understand w/o being told that they should bring cases against Ds, and should not bring cases against Rs, so there was no need to give them e.g. bad performance reviews or talk to them about the fact that by bringing (too many) cases against Rs and not bringing (enough) cases against Ds, they were failing to do a part of their job. In that case, though, the only reason you can give for them being fired is "no comment, they're an at-will employee, we don't have to say anything" or "because they should have known they were bringing too many cases against Rs and not enough against Ds" (or, less inflammatorily, "they should have known that they weren't hewing to the proper agenda").

[Shape Shifter]

Originally posted by Mmmm, Burger (C.J.)
According to all the reports, every termination was at most for failing to bring a case against a D or bringing a case against an R.

You don't have a problem with this?

[Tyrone Slothrop]

Originally posted by Mmmm, Burger (C.J.)
Has anyone identified a case that a USA brought because s/he was directed to do so by the White House for political reasons?

"directed"?

What about Wisconsin?

[Adder]

Originally posted by Mmmm, Burger (C.J.)
Has anyone identified a case that a USA brought because s/he was directed to do so by the White House for political reasons?

I think that is what we are trying to find out.

According to all the reports, every termination was at most for failing to bring a case against a D or bringing a case against an R.

I think that is a good faith basis to ask questions.

[taxwonk]

Originally posted by Mmmm, Burger (C.J.)
He had that defense only because of the good fortune of birth.

So what?

[Replaced_Texan]

I've been in a practice area conference for the last two days, and something came to mind as I listened, for the third year in a row, to another discussion on the Alvarado hospital case. I'm wondering now if this case had any relation to the termination of AUSA Carol Lam in San Diego.

For those of you who are not as rivited by health care prosecutions as I am, the Feds went after Tenet-owned Alvarado Hospital in San Diego and some physician recruitment agreements that the hospital had taken part in for about twelve years. What was unusual (for us healthcare attorneys) was that the physician recruitment agreements looked no different than physician recruitment agreements we see all the time. There were about 100 of them over a twelve year period of time.

(Physician recruitment agreements are essentially forgivable loans in the six figures that hospitals use to entice physicians to move to an area to serve a population. The hospital guarantees a salary in the first year and helps front equipment costs. The physician has to stay in the area for a precribed amount of time (usually three to five years), and the agreement has to expressly state that in no way is the loan tied to the physician's referring patients to that hospital. I used to negotiate these all the time when I lived in California, and I wouldn't be surprised if I'd looked over some of the Alvarado hosptial agreements. Like I said, they're pretty common, and there's a specific safe-harbor in the anti-kickback regs for these sorts of arrangements.)

What was REALLY unusual about the case was that the AUSA decided to criminally prosecute Tenet. (Lam's indictment here) Generally, this is the sort of thing is handled by a terrifying discussion with some people from the DHHS's Office of Inspector General, a "please don't hurt us" plea, and the payment of several million dollars and agreement to go under a Corporate Integrity Agreement for the whole thing to go away.

Instead, Tenet and the feds went to a four month trial in 2004, centering on the obscure provisions of the anti-kickback statute and physician agreements. The jury came back hung.

The feds weren't happy about that at all, so they brought Tenet back again to court and retried the case in 2005-6. Carol Lam is a very well respected health care attorney, and she decided to try the case herself. This time the trial took seven months, the jury deliberations took four months, and again, the jury came back hung.

DHHS wasn't happy about any of this, so they sent their OIG folks to talk to Tenent, and after a terrifying discussion (they threatened to exclude the hospital from participation in Medicare and Medicaid, the death sentence), a "please don't hurt us" plea, the payment of over $900 million and an agreement to go under a Corporate Integrity Agreement, Tenent sold the hosptial and the whole thing went away. (Except for at health lawyer conferences, where we all sort of listen to the tale with our mouths gaping open and thanking whatever diety we believe in that it wasn't us.)

Anyhow, I'm wondering if Lam's zeal in this health care anti-kickback case was what did her in instead of the Randy Cunningham thing. I will say, I've heard nothing but good things about her as an attorney from both sides of the case. Obviously Tenet is still a little miffed about the whole thing, but then who wouldn't be?

[Hank Chinaski]

Originally posted by Replaced_Texan
I've been in a practice area conference for the last two days, and something came to mind as I listened, for the third year in a row, to another discussion on the Alvarado hospital case. I'm wondering now if this case had any relation to the termination of AUSA Carol Lam in San Diego.

For those of you who are not as rivited by health care prosecutions as I am, the Feds went after Tenet-owned Alvarado Hospital in San Diego and some physician recruitment agreements that the hospital had taken part in for about twelve years. What was unusual (for us healthcare attorneys) was that the physician recruitment agreements looked no different than physician recruitment agreements we see all the time. There were about 100 of them over a twelve year period of time.

(Physician recruitment agreements are essentially forgivable loans in the six figures that hospitals use to entice physicians to move to an area to serve a population. The hospital guarantees a salary in the first year and helps front equipment costs. The physician has to stay in the area for a precribed amount of time (usually three to five years), and the agreement has to expressly state that in no way is the loan tied to the physician's referring patients to that hospital. I used to negotiate these all the time when I lived in California, and I wouldn't be surprised if I'd looked over some of the Alvarado hosptial agreements. Like I said, they're pretty common, and there's a specific safe-harbor in the anti-kickback regs for these sorts of arrangements.)

What was REALLY unusual about the case was that the AUSA decided to criminally prosecute Tenet. (Lam's indictment here) Generally, this is the sort of thing is handled by a terrifying discussion with some people from the DHHS's Office of Inspector General, a "please don't hurt us" plea, and the payment of several million dollars and agreement to go under a Corporate Integrity Agreement for the whole thing to go away.

Instead, Tenet and the feds went to a four month trial in 2004, centering on the obscure provisions of the anti-kickback statute and physician agreements. The jury came back hung.

The feds weren't happy about that at all, so they brought Tenet back again to court and retried the case in 2005-6. Carol Lam is a very well respected health care attorney, and she decided to try the case herself. This time the trial took seven months, the jury deliberations took four months, and again, the jury came back hung.

DHHS wasn't happy about any of this, so they sent their OIG folks to talk to Tenent, and after a terrifying discussion (they threatened to exclude the hospital from participation in Medicare and Medicaid, the death sentence), a "please don't hurt us" plea, the payment of over $900 million and an agreement to go under a Corporate Integrity Agreement, Tenent sold the hosptial and the whole thing went away. (Except for at health lawyer conferences, where we all sort of listen to the tale with our mouths gaping open and thanking whatever diety we believe in that it wasn't us.)

Anyhow, I'm wondering if Lam's zeal in this health care anti-kickback case was what did her in instead of the Randy Cunningham thing. I will say, I've heard nothing but good things about her as an attorney from both sides of the case. Obviously Tenet is still a little miffed about the whole thing, but then who wouldn't be?

wow. it sounds like she was want to prosecute cases where there was little more than a personal grudge to motivate her. and you say she didn't even get the conviction?

edit: my post is snotty, but not directed at RT.

[Replaced_Texan]

Originally posted by Hank Chinaski
wow. it sounds like she was want to prosecute cases where there was little more than a personal grudge to motivate her. and you say she didn't even get the conviction?

edit: my post is snotty, but not directed at RT.

I don't know about that. The case arose because a doc who was getting prosecuted for every day run of the mill Medicare fraud said "yeah, well, they paid me exorbitantly high bribes in the form of physician recruitment agreements. You should go after them." He became the government's star witness.

None of the other hospitals in the area were doing these agreements (mainly because they were closed system hospitals like Kaiser and Scripps, so they had direct employment agreements with docs instead). And the money that changed hands from the hospital to the docs was a lot.

It was a fairly shocking case for those of us in the health care biz, but then lately, there have been more and more criminal prosecutions when in the past CMPs and CIAs would have done.

I don't think, necessarily, that it was a bad idea to go after Tenet. But certainly a lot of people do. The government did ultimately net just short of a billion dollars out of the investigation, and certainly the OIG (an independent federal government agency) was all in favor of the AUSA's actions.

I just think that maybe the Alvarado case along with the Cunningham case had Lam on the radar in Washington.

[Hank Chinaski]

Originally posted by Replaced_Texan
I don't know about that. The case arose because a doc who was getting prosecuted for every day run of the mill Medicare fraud said "yeah, well, they paid me exorbitantly high bribes in the form of physician recruitment agreements. You should go after them." He became the government's star witness.

None of the other hospitals in the area were doing these agreements (mainly because they were closed system hospitals like Kaiser and Scripps, so they had direct employment agreements with docs instead). And the money that changed hands from the hospital to the docs was a lot.

It was a fairly shocking case for those of us in the health care biz, but then lately, there have been more and more criminal prosecutions when in the past CMPs and CIAs would have done.

I don't think, necessarily, that it was a bad idea to go after Tenet. But certainly a lot of people do. The government did ultimately net just short of a billion dollars out of the investigation, and certainly the OIG (an independent federal government agency) was all in favor of the AUSA's actions.

I just think that maybe the Alvarado case along with the Cunningham case had Lam on the radar in Washington.

not snotty Hank- what is weird about the story to me, is that docs needed to be enticed into San diego. I always thought those program were for South carolina or the Dakotas or Alaska- what was that show?

[Adder]

Originally posted by Replaced_Texan
I don't know about that. The case arose because a doc who was getting prosecuted for every day run of the mill Medicare fraud said "yeah, well, they paid me exorbitantly high bribes in the form of physician recruitment agreements. You should go after them." He became the government's star witness.

None of the other hospitals in the area were doing these agreements (mainly because they were closed system hospitals like Kaiser and Scripps, so they had direct employment agreements with docs instead). And the money that changed hands from the hospital to the docs was a lot.

It was a fairly shocking case for those of us in the health care biz, but then lately, there have been more and more criminal prosecutions when in the past CMPs and CIAs would have done.

I don't think, necessarily, that it was a bad idea to go after Tenet. But certainly a lot of people do. The government did ultimately net just short of a billion dollars out of the investigation, and certainly the OIG (an independent federal government agency) was all in favor of the AUSA's actions.

I just think that maybe the Alvarado case along with the Cunningham case had Lam on the radar in Washington.

Is there a particular reason for Washington not to be happy out the Tenet prosecution?

[Mmmm, Burger (C.J.)]

Originally posted by Tyrone Slothrop
"directed"?

What about Wisconsin?

We're right back where we were: you're using an example of a case in which a jury convicted and a judge did not set aside the verdict.

[Spanky]

Fuzzy climate math

By George Will

In a campaign without peacetime precedent, the media-entertainment-environmental complex is warning about global warming. Never, other than during the two world wars, has there been such a concerted effort by opinion-forming institutions to indoctrinate Americans, 83 percent of whom now call global warming a " serious problem." Indoctrination is supposed to be a predicate for action commensurate with professions of seriousness.

For example, Democrats could demand that the president send the Kyoto Protocol to the Senate so they can embrace it. In 1997, the Senate voted95 to 0 in opposition to any agreement that would, like the protocol, require significant reduction of greenhouse gas emissions in America and some other developed nations but that would involve no "specific scheduled commitments" for 129 "developing" countries, including the second-, fourth-, 10th-, 11th-, 13th- and 15th-largest economies (China, India, Brazil, South Korea, Mexico and Indonesia). Forty-two of the senators serving in 1997 are gone. Let's find out if the new senators disagree with the 1997 vote.

Do they also disagree with Bjorn Lomborg, author of "The Skeptical Environmentalist"? He says: Compliance with Kyoto would reduce global warming by an amount too small to measure. But the cost of compliance just to the United States would be higher than the cost of providing the entire world with clean drinking water and sanitation, which would prevent 2 million deaths (from diseases such as infant diarrhea) a year and prevent half a billion people from becoming seriously ill each year.

Nature designed us as carnivores, but what does nature know about nature? Meat has been designated a menace. Among the 51 exhortations in Time magazine's " Global Warming Survival Guide" (April 9), No. 22 says a BMW is less responsible than a Big Mac for "climate change," that conveniently imprecise name for our peril. This is because the world meat industry produces 18 percent of the world's greenhouse gas emissions, more than transportation produces. Nitrous oxide in manure (warming effect: 296 times greater than that of carbon) and methane from animal flatulence (23 times greater) mean that "a 16-oz. T-bone is like a Hummer on a plate."

Ben & Jerry's ice cream might be even more sinister: A gallon of it requires electricity-guzzling refrigeration and four gallons of milk produced by cows that simultaneously produce eight gallons of manure and flatulence with eight gallons of methane. The cows do this while consuming lots of grain and hay, which are cultivated by using tractor fuel, chemical fertilizers, herbicides and insecticides, and transported by fuel-consuming trains and trucks.

Newsweek says most food travels at least 1,200 miles to get to Americans' plates, so buying local food will save fuel. Do not order halibut in Omaha.

Speaking of Hummers, perhaps it is environmentally responsible to buy one and squash a Prius with it. The Prius hybrid is, of course, fuel-efficient. There are, however, environmental costs to mining and smelting (in Canada) 1,000 tons a year of zinc for the battery-powered second motor, and the shipping of the zinc 10,000 miles — trailing a cloud of carbon dioxide — to Wales for refining and then to China for turning it into the component that is then sent to a battery factory in Japan.

Opinions differ as to whether acid rain from the Canadian mining and smelting operation is killing vegetation that once absorbed carbon dioxide. But a report from CNW Marketing Research ("Dust to Dust: The Energy Cost of New Vehicles from Concept to Disposal") concludes that in "dollars per lifetime mile," a Prius (expected life: 109,000 miles) costs $3.25, compared with $1.95 for a Hummer H3 (expected life: 207,000 miles).

The CNW report states that a hybrid makes economic and environmental sense for a purchaser living in the Los Angeles basin, where fuel costs are high and smog is worrisome. But environmental costs of the hybrid are exported from the basin.

We are urged to "think globally and act locally," as Gov. Arnold Schwarzenegger has done with proposals to reduce California's carbon dioxide emissions 25 percent by 2020. If California improbably achieves this, at a cost not yet computed, it will have reduced global greenhouse gas emissions 0.3 percent. The question is:

Suppose the costs over a decade of trying to achieve a local goal are significant. And suppose the positive impact on the globe's temperature is insignificant — and much less than, say, the negative impact of one year's increase in the number of vehicles in one country (e.g., India). If so, are people who recommend such things thinking globally but not clearly?

[Adder]

Originally posted by Spanky
Fuzzy climate math

By George Will


Opinions differ as to whether acid rain from the Canadian mining and smelting operation is killing vegetation that once absorbed carbon dioxide.

This is a bad example for your point. Environmental regulation targeting acid rain has required the capture of SO2 emissions from smelting and mining for more than two decades. The regs have not put smelters out of business nor, I believe, dramatically increased metal prices. Instead, the smelters now also sell sulfuric acid that they make out of the captured SO2.

This type of innovation, however, will never be applied to carbon emissions if we continue to decline any and all efforts to address the issue.