Technical problems, discord plagued health care site

Although state officials have provided the public scant detail about the troubled launch of Maryland's version of Obamacare, emails and documents show that the project was beset behind the scenes for months by an array of technical issues, warring contractors and other problems.

Since Maryland's online health exchange opened Oct. 1 for people to buy insurance under the Affordable Care Act — and immediately crashed — the two main companies in charge of the website have taken their fight to court, a corporate project manager was replaced and a high-powered consulting firm was quietly brought in to restore order. Though state officials initially said the crash of the online exchange was an unexpected and fixable problem, emails and documents obtained by The Baltimore Sun through state open-records laws outline serious issues before and after the launch.

Doctors choose the more expensive drug more than half a million times every year, a choice that costs the Medicare program, the largest single customer, an extra $1 billion or more annually, the Washington Post reports. 

Spending that much may make little sense for a country burdened by ever-
rising health bills, but as is often the case in American health care, there is a certain economic logic: Doctors and drugmakers profit when more-costly treatments are adopted.

In September, Lynne Spalding checked into San Francisco General Hospital for a bladder infection. Soon after, she went missing. No one ordered a full search for Spalding until nine days after she disappeared.

In that time, Lynne Spalding Ford's family scoured the city and passed out thousands of fliers -- only to find out she was dead in a stairwell at the same hospital. Now, authorities have revealed a series of mishaps leading up to the discovery of Spalding Ford's body at San Francisco General Hospital -- 17 days after she was reported missing.

The Department of Energy says it has protected the public health, and studies about radiation harm aren’t definitive. But with the government's own records about many of the sites unclear, the Journal has compiled a database that draws on thousands of public records and other sources to trace this historic atomic development effort and its consequences.

The rate of spinal fusion surgery has risen sixfold in the United States over the past 20 years, according to federal figures, and the expensive procedure, which involves the joining of two or more vertebrae, has become even more common than hip replacement, the Washington Post reports. More than 465,000 spinal fusions were performed in the United States in 2011, according to government data, and some experts say that a portion of them — perhaps as many as half — were performed without good reason.

The rapid rise of spinal fusions in the United States, especially for diagnoses that generally don’t require the procedure, has raised questions from experts about whether, amid medical uncertainty, the financial rewards are spurring the boom.

“This yearlong investigation examines how doctors and lawyers, working at the behest of the coal industry, have defeated the benefits claims of miners sick and dying of black lung, even as disease rates are on the rise and an increasing number of miners are turning to a system that was supposed to help alleviate their suffering.”

Facing Foreclosure: Oklahoma's mortgage settlement program benefits attorneys | Tulsa World
"So far, the largest financial beneficiary of Oklahoma's mortgage settlement program is a young attorney who used a system of vouchers and possibly a family connection to acquire dozens of clients."

Shocking cost investigation: Utility middle men charge renters inflated prices | Columbus Dispatch
"A 10-month investigation by The Dispatch found that residents pay markups of 5 percent to 40 percent when their landlords enter into contracts with certain submeter companies. If the customer fails to pay, the companies sometimes resort to collection tactics that would be illegal for regulated utilities, including shutting off heat in winter and even eviction."

South Austin pastor lives lavishly while West Side project languishes | Chicago Tribune
“In a rolling investigation, Chicago Tribune reporters David Jackson and Gary Marx examine government's haphazard efforts to assist one of the city's hardest-hit neighborhoods. Tracing where the money goes, their latest installment how a politically-connected pastor lives in a lavish suburban mansion while some tenants in his apartment buildings endure substandard conditions and go without heat.”

New reports fuel debate of whether Lisa Steed arrested innocent drivers | Salt Lake Tribune
“This month, UHP provided The Tribune with more documents about Steed, including the Winward review and the internal affairs investigation undertaken before her firing last year. In the internal affairs investigation, UHP found prosecutors who had received complaints about the former trooper of the year, but some of those same prosecutors also praised Steed’s work.”

Facing lawsuits over deadly asbestos, paper giant launched secretive research program | The Center for Public Integrity
“Named in more than 60,000 legal claims, Atlanta-based Georgia-Pacific sought salvation in a secret research program it launched in hopes of exonerating its product as a carcinogen, court records obtained by the Center for Public Integrity show.”

Wisconsin Supreme Court justices tend to favor attorney donors | WisconsinWatch
“Justices have the option of recusing themselves from cases involving donor attorneys but have rarely stepped aside, remaining involved in nearly 98 percent of such cases, the Center found.”

Booming rental market makes it easier for neglectful landlords to ignore substandard living conditions | Austin American-Statesman
“A wide range of involved parties — City Council members, city Code Compliance officials, tenant advocates and real estate industry groups — agree that Austin’s real estate boom has made it possible for a subset of “bad actors” among rental property owners to ignore substandard conditions and tenants’ complaints. One indicator of the scope of the problem — code complaints and violations at rental properties — has exploded in recent years.”

$1,100 an hour? Part-time service at little agencies means big bucks and benefits for politicians | San Jose Mercury News
“Even the elected officials who benefit were surprised by the hefty hourly rates, which this newspaper calculated through an analysis of government meeting minutes and the Bay Area News Group's public salary database.”

Ivy Tech, DNR emails expose favors between officials, raunchy jokes, nude pictures | Indianapolis Star
“The emails — which featured jokes about erectile dysfunction and breast size, and pictures that compared naked women to various animals — appear to violate the spirit, if not the letter, of Ivy Tech’s sexual harassment policy. Yet they were allowed to continue for at least six months before administrators asked Walkup to cease sometime this year.”

Research stalls on dangers of military burn pits | Democrat and Chronicle
“Thousands of returning veterans and civilians are now attributing myriad symptoms — respiratory problems, neurological disorders, cancers and ALS — to exposure to the burn pits, which were located at dozens of bases throughout Iraq and Afghanistan.”

Dozens of Georgia children die despite state intervention | Atlanta Journal-Constitution
“Epic failures by Georgia’s child welfare system have given the state one of the nation’s highest rates of death by abuse and neglect, an investigation by The Atlanta Journal-Constitution shows.”

Ted Cruz Failed To Disclose Ties To Caribbean Holding Company | Time Swampland
“Texas Republican Senator Ted Cruz potentially violated ethics rules by failing to publicly disclose his financial relationship with a Caribbean-based holding company during the 2012 campaign, a review of financial disclosure and company documents by TIME shows.”

GW misrepresented admissions and financial aid policy for years | The GW Hatchet
George Washington University admitted publicly for the first time Friday that it puts hundreds of undergraduate applicants on its waitlist each year because they cannot pay GW's tuition.

“Thousands of returning veterans and civilians are now attributing myriad symptoms — respiratory problems, neurological disorders, cancers and ALS — to exposure to the burn pits, which were located at dozens of bases throughout Iraq and Afghanistan.”

Since 2005, New York taxpayers have donated $1.8 million through their income tax returns to aid the fight against prostate cancer, but researchers have yet to see a dime.

How Sunrise police make millions selling drugs | Sun Sentinel
"Police in this suburban town best known for its sprawling outlet mall have hit upon a surefire way to make millions. They sell cocaine."

How safe are Indiana day cares? | Indianapolis Star
"Indiana spends about $2.5 million inspecting and licensing more than 4,000 day cares that serve more than 150,000 children every year. Yet an Indianapolis Star investigation found that the system fails to hold many day cares accountable — even if they jeopardize the safety of children. In fact, at least 21 children have died in Indiana day cares since 2009, nine in 2012 alone, records show. And 15 of them were in unlicensed or illegal homes or centers."

Faking the Grade | Texas Tribune
A Texas Tribune investigation of a No Child Left Behind tutoring program has uncovered years of inaction by state officials while money flowed to tutoring companies, delivering few academic results.

Mugged by a Mug Shot Online | The New York Times
“Web sites are publishing arrest photos of millions of Americans and often charging fees to remove the pictures.”

Pharmaceutical firms paid to attend meetings of panel that advises FDA | The Washington Post
“A scientific panel that shaped the federal government’s policy for testing the safety and effectiveness of painkillers was funded by major pharmaceutical companies that paid hundreds of thousands of dollars for the chance to affect the thinking of the Food and Drug Administration, according to hundreds of e-mails obtained by a public records request.”

Congressional budget crisis was months in the planning | The New York Times
“The stand by conservatives that led to the current crisis was the outgrowth of a long-running effort, waged by a galaxy of well-funded groups, to undo President Obama’s health care law.”

There was time to help Paul Schmidt, but county politics got in the way | Milwaukee Journal Sentinel
“At the time, Paul Schmidt — PJ, as he was known then — was 5, an easygoing tow-headed boy who lived less than a mile from the land where the new hospital would be built. In the years to come, he would climb apple trees and play "Ghosts in the Graveyard" there with the kids down the block. It would be years before he would begin to withdraw and make plans to kill himself. There was plenty of time to build a system that could help him.”

In Minnesota, nurses in trouble get second chances | Star Tribune
“Records examined by the Star Tribune of more than 1,000 disciplinary actions by the Minnesota Board of Nursing over the past four years show that it tolerates or forgives misconduct that would end nursing careers in other states. The board actively licenses more than 260 nurses since 2010 who have records of unsafe practice, including botched care that led to patient harm or even death. Eighty-eight nurses are allowed to practice despite having been charged or convicted of crimes such as physical or sexual assault and drug thefts — some against their own patients. The board gives nurses who admit misconduct second, third and sometimes more chances to keep practicing. Getting fired for incompetence, even multiple times, rarely means Minnesota nurses lose their licenses.”

Large hospitals enjoy revenue, borrowing advantage | CentralOhio.com
“Hospitals are confronting declining revenues and continuing investment demands from their patients and the government. These twin pressures are bringing into focus the advantages that large hospital operators hold over smaller independent ones, and why the latter might want to align with the former.” 

Berkshire Hathaway subsidiaries deny, delay asbestos, hazard claims, suits, insiders allege | Scripps News
“Scripps interviewed more than 20 sources -- some confidential -- reviewed dozens of lawsuits and spoke with former insiders, who all allege the Berkshire-owned companies that handle its asbestos and pollution policies -- National Indemnity Co. and Resolute Management Inc. -- wrongfully delay or deny compensation to cancer victims and others to boost Berkshire’s profits. In multiple cases, courts and arbitrators have ruled that the Berkshire subsidiaries’ tactics have been in “bad faith” or intentional.”

Hidden cash fueled Warren campaign | Democrat & Chronicle
“Long before the term "Super PAC" entered the national lexicon of campaign finance, unauthorized committees — those acting in support of but without the expressed approval of candidates — gave donors a means to skirt limits that New York places on those donating directly to candidates.”

Drugged Driving Tough to Detect, Convict | NBC Bay Area
“An investigation into current law governing impaired driving by NBC Bay Area’s Investigative Unit discovered large holes when it comes to regulating and determining who is legally impaired due to drug use.”