U.S. News

Feds to Publicize Drug and Device Company Payments to Doctors Next Year

by Charles Ornstein and Tracy Weber--ProPublica

After years of anticipation, all of the nation's drug and medical device makers must soon begin publicly reporting payments they make to U.S. physicians, according to final regulations announced this afternoon by the federal government.

The release of payments data in September 2014 would mark a milestone in the push to bring transparency to medicine. Once posted, patients will be able to see if their physicians receive money from any of the companies whose products they prescribe. Studies have shown that such payments, however small, bias physicians towards companies and their products.

Until now, ProPublica's Dollars for Docs tool has been the only freely available source for the public to search and analyze the payments made since 2009 by a dozen drug companies. ProPublica gathered the information from the companies' websites into one searchable, sortable database.

Most of these companies were required to post the information on their websites as part of settlements with the federal government over allegations of improper marketing. Companies have paid billions of dollars to settle the lawsuits.

ProPublica is working on an update of Dollars for Docs and in the coming weeks will expand the database to include payments from 15 companies through the end of 2012.

Drug companies, lawmakers and consumer advocates have grown increasingly frustrated by the time it has taken the U.S. Centers for Medicare and Medicaid Services (CMS) to release final rules for collecting and publishing the data under the Physician Payments Sunshine Act, which was a part of the 2010 health reform law.

The payments were supposed to become public beginning this year under provisions of the law. But federal health officials instead released proposed regulations in December 2011 and since then have been gathering and analyzing comments.

The data to be released in September 2014 will include payments made from August to December of this year, giving companies enough time to gather and report the information. The companies must turn the data over to the government by March 2014; doctors will then have 45 days to review the information for accuracy before it becomes public.

Companies will have to report the information annually afterward.

"You should know when your doctor has a financial relationship with the companies that manufacture or supply the medicines or medical devices you may need," Dr. Peter Budetti, the CMS deputy administrator for program integrity, said in a written statement. "Disclosure of these relationships allows patients to have more informed discussions with their doctors."

Sen. Chuck Grassley, R-Iowa, co-authored the Sunshine Act, which arose from his investigations of drug company payments to doctors. "Disclosure brings about accountability, and accountability will strengthen the credibility of medical research, the marketing of ideas and, ultimately, the practice of medicine," he said in a statement. "I will stay vigilant about how this law is implemented, especially after the delays seen already."

The drug companies that currently post payment information do so in different ways, using different time periods and different definitions that make analysis or aggregation of the data very difficult. The Physician Payments Sunshine Act requires every company to report the same information in the same way.

Drug, device and medical supply companies must report all payments over $10 to U.S. physicians and teaching hospitals. The data must include date of payment, a description of the service provided, the amount paid and which of a company's products the payment involved.

The types of payments to be reported include speaking fees, consulting payments, research, gifts, food, entertainment, honoraria, research grants, royalties and license fees, among others.

Companies that fail to properly report payments can be fined between $1,000 and $10,000 for each payment not reported, but the fine cannot exceed $150,000. A deliberate failure to report can lead to a fine of up to $1 million.

The trade group representing major pharmaceutical companies said it is reviewing the regulations. It had raised a number of concerns to the government. The Pharmaceutical Research and Manufacturers of America "remains committed to the principles of the Sunshine Act" and wants the information to be "usable, transparent, and understandable," Matthew Bennett, the group's senior vice president, said in a statement.

ProPublica's analysis of the payments released so far shows that many physicians receive money from several companies for promotional speaking or consulting on behalf of their products. In some cases, these payments totaled hundreds of thousands of dollars.

One Los Angeles-area doctor, for example, received more than $300,000 in speaking fees in 2009 and 2010 alone just from the companies in our database. Those firms account for only about 40 percent of U.S. pharmaceutical sales.

ProPublica also found that more than 250 physicians chosen to be drug company speakers and consultants had been disciplined by their state medical boards or other regulatory agencies.

Ed Koch, Mayor Who Became a Symbol of NYC, Dies

Edward I. Koch, the outspoken three-term New York mayor who led the biggest U.S. city from the brink of bankruptcy in the late 1970s and boosted the spirits of crime-weary residents, has died. He was 88.

Koch died this morning at 2 a.m. of heart failure at New York-Presbyterian Columbia Hospital, spokesman George Arzt said. Koch had been moved into intensive care yesterday afternoon. The funeral will be held on Monday at Temple Emanu-El in Manhattan.

On Jan. 28, Koch had returned to the hospital two days after being released
following a week-long stay to treat water in his lungs and legs, the Associated
Press reported. Koch also was hospitalized in December 2012 for pneumonia and flu and three months earlier for anemia.

Serving from 1978 through 1989, Koch presided over the Wall Street-fueled economic boom of the 1980s, turning a $1 billion budget deficit into a $500 million surplus in five years. He restored the city’s credit, doubled the annual budget to $26 billion and oversaw $19 billion in capital improvements. His subsidized housing plan produced more than 156,000 new and renovated units.

Koch’s in-your-face style, straight talk and catchphrase “How’m I doing?” endeared him to New Yorkers wracked by the
lingering fiscal crisis, the Son of Sam serial murders and the arson and looting that erupted after a blackout in July 1977.

Commuters walking across the Brooklyn Bridge during the first day of an 11-day transit strike in 1980 were startled to find the bald, 6-foot-1-inch mayor cheering for them. He called critics “wackos,” welfare advocates “poverty pimps,” told visiting Soviet
schoolchildren that their government was “the pits” and said a crack-smoking lawyer accused of killing his daughter should be “boiled in oil.”

It was that style and straight talk that enabled Koch to work both sides of the political aisle and get things done.

"Ed Koch was one of the giants of our generation and respected by Americans across the country who respected his
candor, humor and love of country," Christopher Ruddy, CEO of Newsmax and a friend of Koch's, said. Koch was a regular contributor and blogger to Newsmax. "He set an example for other public figures when, again and again, he was able
to rise above party labels for the public good."

‘Eccentric Uncle’

He was “some mad combination of a Lindy’s waiter, Coney Island barker, Catskills comedian, irritated school principal and eccentric uncle,” the writer Pete Hamill said in 2005 during a panel discussion at the Museum of the City of New York, which hosted an exhibition on the recovery since the 1975-76 fiscal crisis. “He seemed to be everywhere at once.”

By 1985, Koch, a Democrat, had become the most popular mayor since Fiorello LaGuardia four decades before, winning 75 percent of the vote in his bid for a third term.

Four years later, after corruption scandals rocked his administration and his criticism of civil-rights leader and presidential
candidate Jesse Jackson angered some black voters, Koch was defeated by David Dinkins in the Democratic primary. Koch maintained his loss had nothing to do with the scandals or accusations that he had become a polarizing figure.

“The real reason was longevity,” he said in a 2004 interview. “You have to know when to get off the stage.”

Bronx Born

Edward Irving Koch was born in the Bronx on Dec. 12, 1924, the second of three children of Russian-Jewish immigrants Louis and Joyce Silpe Koch. His father was in the garment business. Koch attended City College of New York from 1941 to 1943, when he was drafted into the U.S. Army during World War II. He was honorably discharged with the rank of sergeant in 1946.

After the Army, Koch entered New York University School of Law, receiving his degree
in 1948. He opened a small law practice.  Koch became active in Democratic politics, working for presidential candidate Adlai Stevenson in 1952 and 1956 and becoming a member of the Greenwich Village Independent Democrats, a dissident liberal faction of the party. Koch challenged the old-line Democratic organization that was still known as Tammany Hall.

After serving two years on the City Council, Koch in 1968 won election to the U.S. House of Representatives, a victory considered an upset against the Democratic machine.  During his nine years in Congress, he spoke out against the war in Vietnam and advocated federal aid for mass transit and health care for the elderly.

Mayoral Race

Koch entered a seven-person Democratic mayoral primary in 1977, beating chief rival and future New York Governor Mario Cuomo for the nomination. The September primary was marred by mean-spiritedness that included posters saying “Vote for Cuomo, Not the Homo,” an apparent attempt to say the unmarried Koch was a homosexual. The Cuomo campaign denied it was behind the signs.

Koch took office as mayor in January 1978 after winning the November general election against Cuomo, who ran
on the Liberal Party ticket.

He succeeded Abraham Beame, who in his single term as mayor struggled with the worst fiscal crisis in the city’s history. Beame’s lack of charisma -- his speeches were so bland that many people couldn’t remember what he said, according to the New York Times -- stood in stark contrast to his successor. Koch never seemed to stop talking, about anything.

Publicly Accessible

He was always approachable to reporters and members of the public. On weekends, New York residents could often find the mayor on the porch at Gracie Mansion, the mayor’s residence, chewing the fat with passers-by. He also would call impromptu news conferences.

Saul Pett, a Pulitzer Prize-winning writer for the Associated Press, summed up the mayor this way in a 1981 profile:“He’s
the freshest thing to blossom in New York since chopped liver, a mixed metaphor of a politician, the antithesis of the packaged leader, irrepressible, candid, impolitic, spontaneous, funny, feisty, independent, uncowed by voter blocs, unsexy, unhandsome, unfashionable and altogether charismatic, a man oddly at peace with himself in an unpeaceful place, a mayor who presides over the country’s largest Babel with unseemly joy.”

Playboy Interview

In 1982, Koch unsuccessfully challenged Cuomo for the Democratic New York gubernatorial nomination. Koch was hurt by an interview with Playboy magazine in which he described rural life as “a joke.” The line didn’t go over well with residents of the farming communities in upstate New York.

Koch walked out of City Hall for the last time as mayor on Dec. 29, 1989. He said New York was “far better off now” than when he took office.

As a private citizen, Koch worked as a partner in the law firm Bryan Cave LLP, as a radio commentator for Bloomberg News, as a newspaper columnist and movie reviewer and as a lecturer and talk-show guest. He took political stands that angered many Democrats, such as his support for President George W. Bush and the war in Iraq.

Koch had a pacemaker implanted in 1991 and suffered a heart attack in 1999. He underwent quadruple bypass surgery
in 2009.

Later that year Koch celebrated his 85th birthday at the St. Regis Hotel in Manhattan with guests including Cuomo, Henry Kissinger and Mayor Michael Bloomberg. Former President Bill Clinton delivered his congratulations by video. A year later, Bloomberg announced that the city’s Queensboro Bridge, celebrated in Simon and Garfunkel’s “The 59th Street Bridge Song (Feelin’ Groovy),” would be named after Koch.

Ethics Campaign

Even in his mid-80s, he refused to stop campaigning. In March 2010 he formed a group called New York Uprising, which sought to tighten ethics rules, overhaul the budget process and force disclosures of income among state politicians in Albany. He visited Buffalo, Rochester and Syracuse to make his case.

“I never said I’d solve all the problems,” Koch told reporters on his last day on the job in City Hall. “Who can? Problems are going to be there forever. It’s the nature of the city. Within the confines of what a mayor can do, I did a lot. And I think they will remember that.”

Message from Mexico: U.S. Is Polluting Water It May Someday Need to Drink

by Abraham Lustgarten--Propublica

Mexico City plans to draw drinking water from a mile-deep aquifer, according to a report in the Los Angeles Times. The Mexican effort challenges a key tenet of U.S. clean water policy: that water far underground can be intentionally polluted because it will never be used.

U.S. environmental regulators have long assumed that reservoirs located thousands of feet underground will be too expensive to tap. So even as population increases, temperatures rise, and traditional water supplies dry up, American scientists and policy-makers often exempt these deep aquifers from clean water protections and allow energy and mining companies to inject pollutants directly into them.

 

As ProPublica has reported in an ongoing investigation about America's management of its underground water, the U.S. Environmental Protection Agency has issued more than 1,500 permits for companies to pollute such aquifers in some of the driest regions. Frequently, the reason was that the water lies too deep to be worth protecting.

But Mexico City's plans to tap its newly discovered aquifer suggest that America is poisoning wells it might need in the future.

Indeed, by the standard often applied in the U.S., American regulators could have allowed companies to pump pollutants into the aquifer beneath Mexico City.

For example, in eastern Wyoming, an analysis showed that it would cost half a million dollars to construct a water well into deep, but high-quality aquifer reserves. That, plus an untested assumption that all the deep layers below it could only contain poor-quality water, led regulators to allow a uranium mine to inject more than 200,000 gallons of toxic and radioactive waste every day into the underground reservoirs.

But south of the border, worsening water shortages have forced authorities to look ever deeper for drinking water.

Today in Mexico City, the world's third-largest metropolis, the depletion of shallow reservoirs is causing the ground to sink in, iconic buildings to teeter, and underground infrastructure to crumble. The discovery of the previously unmapped deep reservoir could mean that water won't have to be rationed or piped into Mexico City from hundreds of miles away.

According to the Times report, Mexican authorities have already drilled an exploratory well into the aquifer and are working to determine the exact size of the reservoir. They are prepared to spend as much as $40 million to pump and treat the deeper water, which they say could supply some of Mexico City's 20 million people for as long as a century.

Scientists point to what's happening in Mexico City as a harbinger of a world in which people will pay more and dig deeper to tap reserves of the one natural resource human beings simply cannot survive without.

"Around the world people are increasingly doing things that 50 years ago nobody would have said they'd do," said Mike Wireman, a hydrogeologist with the EPA who also works with the World Bank on global water supply issues.

Wireman points to new research in Europe finding water reservoirs several miles beneath the surface — far deeper than even the aquifer beneath Mexico City — and says U.S. policy has been slow to adapt to this new understanding.

"Depth in and of itself does not guarantee anything — it does not guarantee you won't use it in the future, and it does not guarantee that that it is not" a source of drinking water, he said.

If Mexico City's search for water seems extreme, it is not unusual. In aquifers Denver relies on, drinking water levels have dropped more than 300 feet. Texas rationed some water use last summer in the midst of a record-breaking drought. And Nevada — realizing that the water levels in one of the nation's largest reservoirs may soon drop below the intake pipes — is building a drain hole to sap every last drop from the bottom.

"Water is limited, so they are really hustling to find other types of water," said Mark Williams, a hydrologist at the University of Colorado at Boulder. "It's kind of a grim future, there's no two ways about it."

In a parched world, Mexico City is sending a message: Deep, unknown potential sources of drinking water matter, and the U.S. pollutes them at its peril.

Revealed: America’s Arms Sales To Bahrain Amid Bloody Crackdown

by Justin Elliott-ProPublica

Despite Bahrain’s bloody crackdown on pro-democracy protesters, the U.S. has continued to provide weapons and maintenance to the small Mideast nation.

Defense Department documents released to ProPublica give the fullest picture yet of the arms sales: The list includes ammunition, combat vehicle parts, communications equipment, Blackhawk helicopters, and an unidentified missile system. (Read the documents.)

 

The documents, which were provided in response to a Freedom of Information Act request and cover a yearlong period ending in February 2012, still leave many questions unanswered. It’s not clear whether in each case the arms listed have been delivered. And some entries that only cite the names of weapons may in fact refer to maintenance or spare parts.

Defense Department spokesman Paul Ebner declined to offer any more detail. “We won’t get into specifics in any of these because of the security of Bahrain,” said Ebner.

While the U.S. has maintained it is selling Bahrain arms only for external defense, human rights advocates say the documents raise questions about items that could be used against civilian protesters.

“The U.S. government should not be providing additional military equipment that could make matters worse,” said Sunjeev Bery, Middle East advocacy director for Amnesty International USA.

There have been reports that Bahrain used American-made helicopters to fire on protesters in the most intense period of the crackdown. Time magazine reported in mid-March 2011 that Cobra helicopters had conducted "live ammunition air strikes" on protesters.

The new Defense Department list of arms sales has two entries related to “AH-1F Cobra Helicopters” in March and April 2011. Neither the exact equipment or services being sold nor the delivery timetable are specified.

The U.S. is also playing a training role: In April 2012, for example, the Army News Service reported that an American team specializing in training foreign militaries to use equipment purchased from the U.S. was in Bahrain to help with Blackhawk helicopters.

Bahrain’s ambassador to the U.S., Houda Nonoo, said the country’s military has not targeted protestors. Bahrain’s military “exists to combat external threats,” Nonoo told ProPublica. “[T]he potential for U.S. foreign arms sales to be used against protestors in the future is remote.”

The Obama administration has stood by Bahrain’s ruling family, who are Sunni, during nearly two years of protests by the country’s majority Shia population. Bahrain is a longtime ally and the home to a large American naval base, which is considered particularly important amid the current tensions with nearby Iran.

The itemized arms sales list does not include dollar values but a separate document says military equipment worth $51 million was delivered to Bahrain in the year starting in October 2010. (That period includes several months before the protests began.)

The U.S. has long sold weapons to Bahrain, totaling $1.4 billion since 2000, according to the State Department. The sales didn’t come under scrutiny until security forces killed at least 19 people in the early months of the crackdown in 2011. (Dozens have died since then.) 

The administration put a hold on one proposed sale of Humvees and missiles in Fall 2011 following congressional criticism. But Foreign Policy reported that other unspecified equipment was still being sold without any public notification.

The new documents offer more details on what was sold during that period — including entries related to a “Blackhawk helicopter armament” in November 2011 and a missile system in January 2012.

In May 2012, the administration announced it was releasing some unspecified items to Bahrain’s military that “are not used for crowd control” while maintaining a hold on the Humvees and TOW missiles.

State Department spokesman Noel Clay told ProPublica, “We continue to withhold the export of lethal and crowd-control items intended predominately for internal security purposes, and have resumed on a case-by-case basis items related exclusively to external defense, counter-terrorism, and the protection of U.S. forces.”

The U.S. has also sold Bahrain a helicopter fit for the royal family.

In September, Missouri-based aviation services firm Sabreliner reported that, as part of an official government arms sale, it delivered to Bahrain a fully customized UH-60 Blackhawk Helicopter for “a variety of missions including transporting heads of state.” The aircraft was outfitted with a “clam shell door” for ease of entry, a “new VIP interior,” and a “custom Royal Bahraini” paintjob.

In other recent developments in Bahrain, the country’s highest court this month upheldlengthy prison sentences for 13 high-profile activists accused of plotting to overthrow the government.

In a rare occurrence in November, a series of homemade bombs were set off in the capital of Manama, killing two and leading some observers to argue that the opposition is growing more militant. Also in November, an Amnesty International report found that despite government promises, “the reform process has been shelved and repression unleashed.”

Everything We Know So Far About Drone Strikes

by Cora Currier--ProPublica

You might have heard about the “kill list.” You’ve certainly heard about drones. But the details of the U.S. campaign against militants in Pakistan, Yemen, and Somalia -- a centerpiece of the Obama administration’s national security approach – remain shrouded in secrecy. Here’s our guide to what we know—and what we don’t know.

 

Where is the drone war? Who carries it out?

Drones have been the Obama administration’s tool of choice for taking out militants outside of Iraq and Afghanistan. Drones aren’t the exclusive weapon – traditional airstrikes and other attacks have also been reported. But by one estimate, 95 percent of targeted killings since 9/11 have been conducted by drones.  Among the benefits of drones: they don’t put American troops in harm’s way.

The first reported drone strike against Al Qaeda happened in Yemen in 2002. The CIAramped up secret drone strikes in Pakistan under President George W. Bush in 2008. Under Obama, they have expanded drastically there and in Yemen in 2011.

The CIA isn’t alone in conducting drone strikes. The military has acknowledged “direct action” in Yemen and Somalia. Strikes in those countries are reportedly carried out by the secretive, elite Joint Special Operations Command. Since 9/11, JSOC has grown more than tenfold, taking on intelligence-gathering as well as combat roles. (For example, JSOC was responsible for the operation that killed Osama Bin Laden.)  

The drone war is carried out remotely, from the U.S.  and a network of secret basesaround the world. The Washington Post got a glimpse – through examining construction contracts and showing up uninvited – at the base in the tiny African nation of Djibouti from which many of the strikes on Yemen and Somalia are carried out. Earlier this year, Wired pieced together an account of the war against Somalia’s al-Shabaab militant group and the U.S.’s expanded military presence throughout Africa.

The number of strikes in Pakistan has ebbed in recent years, from a peak of more than 100 in 2008, to an estimated 46 last year. Meanwhile, the pace in Yemen picked up, with more than 40 last year. But there have been seven strikes in Pakistan in the first ten days of 2013.

How are targets chosen?

series of articles based largely on anonymous comments from administration officials have given partial picture of how the U.S. picks targets and carries out strikes. Two recent reports – from researchers at Columbia Law School and from theCouncil on Foreign Relations– also give detailed overviews of what’s known about the process.

The CIA and the military have reportedly longmaintained overlapping “kill lists.” According to news reports last spring, the military’s list was hashed out in Pentagon-run interagency meetings, with the White House approving proposed targets. Obama would authorize particularly sensitive missions himself.

This year, the process reportedly changed, to concentrate the review of individuals and targeting criteria in the White House. According to the Washington Post, the reviews now happen at regular interagency meetings at the National Counterterrorism Center. Recommendations are sent to a panel of National Security Council officials. Final revisions go through White House counterterror adviser John Brennan to the president. Several profiles have highlightedBrennan’s powerful and controversial role in shaping the trajectory of the targeted killing program. This week, Obama nominated Brennan to head the CIA.

At least some CIA strikes don’t have to get White House signoff. The director of the CIA canreportedly green-light strikes in Pakistan. In a 2011 interview, John Rizzo, previously the CIA’s top lawyer, said agency attorneys did an exhaustive review of each target.

Doesn’t the U.S. sometimes target people whose names they don’t know?

Yes.  While administration officials often have frequently framed drone strikes as going after “high-level al Qaeda leaders who are planning attacks” against the U.S., many strikes go after apparent militants whose identities the U.S. doesn’t know. The so-called “signature strikes”began under Bush in early 2008 and were expanded by Obama. Exactly what portion of strikes are signature strikes isn’t clear.

At various points the CIA’s use of signature strikes in Pakistan in particular have caused tensions with the White House and State Department. One official told the New York Times about a joke that for the CIA, “three guys doing jumping jacks,” was a terrorist training camp.

In Yemen and Somalia, there is debate about whether the militants targeted by the U.S. are in fact plotting against the U.S. or instead fighting against their own country. Micah Zenko, a fellow at the Council on Foreign Relations who has been critical of the drone program, toldProPublica that the U.S. is essentially running “a counterinsurgency air force” for allied countries. At times, strikes have relied on local intelligence that later proves faulty. The Los Angeles Times recently examined the case of a Yemeni man killed by a U.S. drone and the complex web of allegiances and politics surrounding his death.

How many people have been killed in strikes?

The precise number isn’t known, but some estimates peg the total around 3,000.

A number of groups are tracking strikes and estimating casualties:

·         The Long War Journal covers Pakistan and Yemen.

·         The New America Foundation covers Pakistan.

·         The London Bureau of Investigative Journalism covers YemenSomalia, andPakistan, as well as statistics from on drone strikes carried out in Afghanistan.

How many of those killed are have been civilians?

It’s impossible to know.

There has been considerable back-and-forth about the tally of civilian casualties. For instance, the New America Foundation estimates between 261 and 305 civilians have been killed in Pakistan; The Bureau of Investigative Journalism gives a range of 475 - 891. All of the counts are much higher than the very low numbers of deaths the administration claims. (We’ve detailed inconsistencies even within those low estimates.)  Some analyses show that civilian deaths have dropped proportionally in recent years.

The estimates are largely compiled by interpreting news reports relying on anonymous officials or accounts from local media, whose credibility may vary. (For example, the Washington Post reported last month that the Yemeni government often tries to conceal the U.S.’ role in airstrikes that kill civilians.)

The controversy has been compounded by the fact that the U.S. reportedly counts any military-age male killed in a drone strike as a militant. An administration official told ProPublica, “If a group of fighting age males are in a home where we know they are constructing explosives or plotting an attack, it's assumed that all of them are in on that effort.” It’s not clear what if any investigation occurs after the fact.

Columbia Law School conducted an in-depth analysis of what we know about the U.S.’s efforts to mitigate and calculate civilian casualties. It concluded that the drone war’s covert nature hampered accountability measures taken in traditional military actions.Another report from Stanford and NYU documented “anxiety and psychological trauma” among Pakistani villagers.

This fall, the U.N. announced an investigation into the civilian impact – in particular, allegations of “double-tap” strikes, in which a second strike targets rescuers.

Why just kill? What about capture?

Administration officials have said in speeches that militants are targeted for killing when they pose an imminent threat to the U.S. and capture isn’t feasible. But killing appears to be is far more common than capture, and accounts of strikes don’t generally shed light on “imminent” or “feasible.”  Cases involving secret, overseas captures under Obama show the political and diplomatic quandaries in deciding how and where a suspect could be picked up.

This fall, the Washington Post described something called the “disposition matrix” – a process that has contingency plans for what to do with terrorists depending where they are. The Atlantic mapped out how that decision-making might happen in the case of a U.S. citizen, based on known examples. But of course, the details of the disposition matrix, like the “kill lists” it reportedly supplants, aren’t known.

What’s the legal rationale for all this?

Obama administration officials have given a series of speeches broadly outlining the legal underpinning for strikes, but they never talk about specific cases. In fact, they don’t officially acknowledge the drone war at all.   

 The White House argues that Congress’ 2001 Authorization for Use of Military Force as well as international law on nations’ right to self-defense provides sound legal basis for targeting individuals affiliated with Al Qaeda or “associated forces,” even outside Afghanistan. That can include U.S. citizens.

“Due process,” said Attorney General Eric Holder said in a speech last March, “takes into account the realities of combat.”

What form that “due process” takes hasn’t been detailed. And, as we’ve reported, the government frequently clams up when it comes to specific questions – like  civilian casualties, or the reasons specific individuals were killed.

Just last week, a federal judge ruled that the government did not have to release a secret legal memo making the case for the killing of Anwar al-Awlaki, a U.S. citizen. The judge also ruled the government did not have to respond to other requests seeking more information about targeted killing in general.  (In making the ruling, the judge acknowledged a “Catch-22,” saying that the government claimed “as perfectly lawful certain actions that seem on their face incompatible with our Constitution and laws while keeping the reasons for their conclusion a secret.”)

The U.S. has also sought to dismiss a lawsuit brought by family members over Awlaki’s death and that of his 16-year-old son – also a U.S. citizen -- who was killed in a drone strike.

When does the drone war end?

The administration has reportedly discussed scaling back the drone war, but by other accounts, it is formalizing the targeted killing program for the long haul. The U.S.estimates there Al Qaeda in the Arabian Peninsula has a “few thousand” members; but officials have also said the U.S. cannot “capture of kill every last terrorist who claims an affiliation with al Qaeda.”

The State Department’s legal counsel, Jeh Johnson, who just stepped down as general counsel for the Pentagon, gave a speech last month gave a speech last month entitled, “The Conflict Against Al Qaeda and its Affiliates: How Will It End?” He didn’t give a date.

 John Brennan has reportedly said the CIA should return to its focus on intelligence-gathering. But Brennan’s key role in running the drone war from the White House has led to debate about how much he would actually curtail the agency’s involvement if he is confirmed as CIA chief.

What about backlash abroad?

There appears to be plenty of it. Drone strikes are deeply unpopular in the countries where they occur, sparking frequent protests. Despite that, Brennan said last August that the U.S. saw,“little evidence that these actions are generating widespread anti-American sentiment or recruits.”

General Stanley McChrystal, who led the military in Afghanistan, recently contradicted that, saying, “The resentment created by American use of unmanned strikes ... is much greater than the average American appreciates. They are hated on a visceral level, even by people who've never seen one or seen the effects of one.” The New York Times recently reported that Pakistani militants have carried out a campaign of brutal reprisals against locals, accusing them of spying for the U.S.

As for international governments: Top U.S. allies have mostly kept silent. A 2010 U.N. report raised concerns about the precedent of a covert, boundary-less war. The President of Yemen, Abdu Hadi, supports the U.S. campaign, while Pakistan maintains an uneasy combination of public protest and apparent acquiescence.

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NY Giants Training Facility

A huge mural that lines one of the hallways in the 2012 Super Bowl champion New York Giants training facility also known as the Timex Performance Center. See details

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Boulders Scoreboard

The high tech scoreboard at Provident Bank Park, home of the Rockland Boulders. See details

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Mollica

The Rockland Boulder's Ryan Mollica waits to make the tag at third base. See details

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