The New Old Age Blog: Training Needed for Home Care Is Lacking

“H” from Chicago, I heard you when you joined a lively discussion over hospice at home here a couple of weeks ago and asked, “where can family members get the training to do all the nursing tasks?”

In the comments section, many readers wrote in to say that caring for relatives at the end of their lives was a duty and a privilege. Others said they were unprepared for the physical and emotional burdens of doing so.

Your question stood out because of its practical character. Do caregivers have to figure out how to handle all these complicated medical issues on their own? Or is some help out there?

For an answer, I called two of the authors of “Home Alone: Family Caregivers Providing Complex Chronic Care,” put out by the United Hospital Fund and the AARP Public Policy Institute. That study recently made headlines by reporting that 46 percent of the nation’s 42 million caregivers handle medical and nursing tasks such as giving injections, caring for wounds or administering I.V.s.

Susan Reinhard, senior vice president and director of the AARP Public Policy Institute, sighed when I reached her, and said “this is a huge gap,” referring to a notable absence of available training in demanding caregiving tasks.

To the extent training exists through local agencies on aging, disease-specific organizations or social service groups, it deals mostly with so-called “activities of daily living” — helping someone bath, dress, eat, or use the bathroom — not the demands of nursing-style care, Ms. Reinhard observed.

Really, this kind of training should be the responsibility of health care providers, but doctors and nurses often give only cursory, unsatisfactory explanations of complex tasks that fall to caregivers, said Carole Levine, director of the Families and Health Care Project of the United Hospital Fund.

That leaves the burden on caregivers to be assertive and ask for help, these experts agreed. If someone is hospitalized and ready to return home, they suggest asking a nurse or another provider “show me what you are doing so I can learn how to do it,” and then asking “now, watch me do it and tell me if I am doing it wrong or right.”

Don’t give up after the first time if you feel awkward or uncomfortable. Ask to do the task again, and ask again for feedback.

No videos or written manuals, can substitute for this one-on-one, hands-on instruction. If you don’t get it to your satisfaction before a loved-one is ready to go home, don’t sign the form that says you have been given instructions on what to do, Ms. Reinhard advised. The hospital is legally obligated to ensure that discharges are safe, and this operates in your favor.

The same goes for the pharmacy: don’t sign that sheet that the pharmacist hands you indicating that you have been adequately informed about the medications you are purchasing. If you are concerned about the number of prescriptions, what they are for, their possible side effects and whether all are necessary, ask the pharmacist to sit down with you and go over all this information. Again, don’t leave until you are satisfied.

Often, caregiving tasks will change as someone with a chronic condition like Parkinson’s disease or heart failure becomes more frail. Should this happen, consider calling a home care agency and asking for a nurse to come out and teach you how to administer oxygen or help transfer someone safely from a bed to a wheelchair, Ms. Reinhard said.

You may want to videotape the session so you can view it several times; most of us don’t pick these skills up right away and need repeat practice, Ms. Levine said.

Be as specific in your request for help as possible. Rather than complaining that you are overwhelmed, say something along the lines of, “I want to make sure I know how to clean this wound and prevent an infection” or “I need to know what texture the food should be so I can feed mom without having her choke,” Ms. Levine suggested.

Her organization has prepared comprehensive materials for caregivers called “Next Step in Care.” While the focus isn’t on nursing-style caregiving tasks, three might be useful: a self-assessment tool for family caregivers, a medication management guide, and a guide to hospice and palliative care.

Other helpful materials are few and far between. Ms. Levine’s staff identified a $24.95 American Red Cross training manual for family caregivers that has a DVD explaining the mechanics of transfers and a few other complicated tasks. Also, some videos are available for free at www.mmlearn.org, a Web site that says its mission is to provide caregivers with online training and education.

Asked about model programs, Ms. Reinhard said she knew of only one: the Schmieding Home Caregiver Training Program in Arkansas, operated by the Donald W. Reynolds Institute on Aging of the University of Arkansas for Medical Sciences. The Schmieding program trains family caregivers as well as professional caregivers who work in people’s homes or nursing homes.

On the family side, it offers eight hours of instruction in “physical needs” associated with caregiving — managing incontinence, skin care, turning someone regularly in bed, using adaptive equipment, transfers from a bed to a wheelchair, helping patients remain mobile, and more. Classes are offered at five sites and four more are planned in the next several years, said Robin McAtee, associate director of the Reynolds Institute on Aging. If people, churches or senior centers want the instruction, which is free, Schmieding nurses will take the program to them. One-on-one instruction for tasks is also available on request.

A separate eight-hour program is available for caregivers dealing with dementia, who have additional concerns.

At a Web site called Elder Stay at Home, Schmieding sells a package of materials (three DVDs and a booklet, for $99) summarizing the content of its family caregiver training program. Separately, it has begun selling its curriculum for paid caregivers, and programs in California, Hawaii and Texas are among the first buyers. The University of Arkansas for Medical Sciences also has received a $3.7 million innovation grant from the government to expand the caregiver training program more broadly and develop online training materials.

Ms. Reinhard said AARP would like to see Schmieding-style programs rolled out across the country and begin to offer structured, reliable support to caregivers now providing nursing-style care in homes with little or no assistance.

What else am I missing here? Do you know of resources or other organizations providing intensive caregiver training along the lines of what I’ve been discussing? Where would you suggest people turn for this kind of help?

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Euro Watch: Italian Political Turmoil Weighs on Markets

ROME — Italian bond yields were sharply higher Monday, and Italian stocks led major European indexes lower, after a weekend of political turmoil in Italy gave rise to fears that the country was headed for renewed instability.

Former Prime Minister Silvio Berlusconi said he would again seek Italy’s highest office after pulling his party’s support from Mario Monti, the unelected official who currently holds the office. Mr. Monti decided over the weekend to step down.

Mr. Monti has restored Italy’s credibility with investors, giving the country a break on its borrowing costs. But those gains have come at the cost of painful austerity measures that have worsened the country’s economic situation, and given Mr. Berlusconi an opening to attack.

Mr. Monti will leave after Parliament passes a budget this month and may contest national elections against Mr. Berlusconi, with the vote — previously scheduled for April — now possible as early as February or March.

Mr. Berlusconi, a four time prime minister, left office a year ago as markets pushed Italy to the brink of financial collapse.

The Milan benchmark MIB index was down 3.6 percent in the early European afternoon, with trading halted in the shares of two banks, Monte Paschi and Banca Popolare di Milano, after they fell by their maximum daily limit.

The yield gap, or spread, between Italian 10-year sovereign bonds and equivalent German securities, the European benchmark for safety, grew to 3.61 percentage points Monday from 3.25 points late Friday, suggesting that investors were growing more wary of holding Italian debt.

A barometer of euro zone blue-chip stocks, the Euro Stoxx 50 index, fell 1.1 percent. The euro was little changed from its levels in New York Friday, at $1.2907.

“It’s as if a tank moved through” the market, said Mario Sechi, editor in chief of the Rome daily Il Tempo, speaking on Radio 24 on Monday morning. Like many Italian commentators, Mr. Sechi expressed reservations about Mr. Berlusconi’s decision to return to politics.

A dismal economic report Monday served as a reminder that despite Mr. Monti’s success with investors, the real economy continues to suffer. Italian industrial production fell a seasonally adjusted 1.1 percent in October from September, and by 6.2 percent from a year earlier, the national Istat statistics agency reported from Rome.

The coming Italian election “remains high on our list of tail risks for 2013,” Holger Schmieding, an economist in London with Berenberg Bank, wrote in a research note. “A Berlusconi campaign against ‘German austerity’ could potentially unsettle markets,” he noted, and possibly push Spain or Italy into a bailout and additional bond purchases by the European Central Bank to hold down borrowing costs.

Spanish bonds also came under renewed pressure following Mr. Monti’s announcement, with the risk premium demanded by investors for holding Spanish 10-year bonds rather than equivalent German bonds rising to 4.38 percentage points on Monday morning, from 4.16 points on Friday.

Luís de Guindos, the economy minister, warned that Italy’s political turmoil would have an impact on Spain. “When doubts emerge over the stability of a neighboring country like Italy, which is also seen as vulnerable, there’s an immediate contagion for us,” he said Monday morning on Spanish national radio.

Asked whether Spain would itself seek further European rescue funding, the minister instead said that “the help that Spain needs is that the doubts over the future of the euro be removed.”

Speaking ahead of the Nobel prize awards on Monday, the European Commission president, José Manuel Barroso, said that Italy had to “continue on the road of structural reforms.” The elections, Mr. Barroso said on Sky News, “must not be used to postpone reforms.”

David Jolly reported from Paris. Raphael Minder contributed reporting from Madrid.

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Stalled Adoption Program in Guatemala Leaves Families in Limbo

Rodrigo Cruz for The New York Times

Amy and Rob Carr in Guatemala with Geovany Archilla Rodas, whom they have been trying to adopt since 2007. More Photos »

GUATEMALA CITY — The little boy flies like an airplane through the hotel, his arms outstretched. Then he leaps like a superhero, beaming as the red lights on his new sneakers flash and flicker, while the American couple he is with dissolve in laughter.

He calls them Mamá and Papi. They call him Hijo — Son. He corrects their fledgling Spanish. They teach him English. “Awe-some,” he repeats carefully, eyeing his new shoes.

To outsiders, they look like a family. But Geovany Archilla Rodas, an impish 6-year-old boy with spiky black hair, lives in an orphanage on the outskirts of this capital city. The Americans — Amy and Rob Carr of Reno, Nev. — live a world away. They are the only parents he has ever known.

They have been visiting him every year, usually twice a year, since he was a toddler, flying into this Central American city for a few days at a time to buy him clothes and to read him stories, to wipe his tears and to tickle him until he collapses in giggles at their hotel or in the orphanage.

Yet half a decade after agreeing to adopt him, the Carrs still have no idea when — or if — they will ever take Geovany home.

“There’s this hope in you that doesn’t want to die,” said Mrs. Carr, who arrived here last month with her husband, more determined than ever to cut through the bureaucracy. “In my heart, he’s my son.”

The Carrs are among the 4,000 Americans who found themselves stuck in limbo when Guatemala shut down its international adoption program in January 2008 amid mounting evidence of corruption and child trafficking. Officials here and in Washington promised at the time to process the remaining cases expeditiously.

But officials and prospective parents say that bureaucratic delays, lengthy investigations and casework hobbled by shortages of staff and resources have left hundreds of children stranded in institutions for years. Today, 150 children — including Geovany — are still waiting in orphanages and foster homes here while the Guatemalan authorities weigh whether to approve their adoptions to families in the United States.

Stalled adoptions are not unique to Guatemala. Concerns about fraud, including allegations of kidnappings and baby selling, have held up American adoptions for months, and sometimes years, from Ethiopia, Kyrgyzstan, Vietnam and Haiti. The State Department currently refuses to approve adoptions from Cambodia and Vietnam to pressure those countries to install safeguards so that children with biological relatives who can care for them are not shipped overseas, officials say.

But the problem of delayed adoptions is particularly acute in Guatemala, a country of about 14 million people, which in 2007 ranked second only to China in the number of children sent to the United States.

As officials here have spent months, and then years, trying to distinguish legitimate adoptions from fraudulent ones, many hopeful couples who had painted nurseries, hosted baby showers and bought brand new cribs began to despair as the infants they had hoped to adopt took their first steps and spoke their first words without them.

Faced with a seemingly endless process, scores of prospective parents quietly abandoned their efforts to adopt the children they once considered their own, officials say.

Guatemalan officials said they never intended for the children to remain institutionalized for so long. They say they have had to thoroughly investigate the cases, some of which are complicated by inconsistencies, false documents and questionable stories, to ensure that the children were not bought or stolen from impoverished rural women.

“These are very vulnerable people, who can be easily taken advantage of,” said Elizabeth Orrego de Llerena, president of the board of directors of the National Adoption Council, which is processing the adoption cases once they have been cleared by the child welfare investigative branch. “At times, they have not had the opportunity to make a complaint or to seek solutions.”

Ms. Orrego de Llerena said that the investigations, which typically include searches for biological relatives, were necessary to ensure that children were given up voluntarily.

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You for Sale: Company Envisions ‘Vaults’ for Personal Data

Peter DaSilva for The New York Times

Michael Fertik, the founder and chief executive of Reputation.com, at its offices in Redwood City, Calif., where he has amassed a database of information collected on millions of consumers.

“YOU are walking around naked on the Internet and you need some clothes,” says Michael Fertik. “I am going to sell you some.”

Naked? Not exactly, but close.

Mr. Fertik, 34, is the chief executive of Reputation.com, a company that helps people manage their online reputations. From his perch here in Silicon Valley, he views the digital screens in our lives, the smartphones and the tablets, the desktops and the laptops, as windows of a house. People go about their lives on the inside, he says, while dozens of marketing and analytics companies watch through the windows, sizing them up like peeping Toms.

By now many Americans are learning that they are living in a surveillance economy. “Information resellers,” also known as “data brokers,” have collected hundreds to thousands of details — what we buy, our race or ethnicity, our finances and health concerns, our Web activities and social networks — on almost every American adult. Other companies that specialize in ranking consumers use computer algorithms to covertly score Internet users, identifying some as “high-value” consumers worthy of receiving pitches for premium credit cards and other offers, while dismissing others as a waste of time and marketing money. Yet another type of company, called an ad-trading platform, profiles Internet users and auctions off online access to them to marketers in a practice called “real-time bidding.”

As these practices have come to light, several members of Congress, and federal agencies, have opened investigations.

At least for now, however, these companies typically do not permit consumers to see the records or marketing scores that have been compiled about them. And that is perfectly legal.

Now, Mr. Fertik, the loquacious, lion-maned founder of Reputation.com, says he has the free-market solution. He calls it a “data vault,” or “a bank for other people’s data.”

Here at Reputation.com’s headquarters, a vast open-plan office decorated with industrial-looking metal struts and reclaimed wood — a discreet homage to the lab where Thomas Edison invented the light bulb — his company has amassed a database on millions of consumers. Mr. Fertik plans to use it to sell people on the idea of taking control of their own marketing profiles. To succeed, he will have to persuade people that they must take charge of their digital personas.

Pointing out the potential hazards posed by data brokers and the like is part of Mr. Fertik’s M.O. Covert online profiling and scoring, he says, may unfairly exclude certain Internet users from marketing offers that could affect their financial, educational or health opportunities — a practice Mr. Fertik calls “Weblining.” He plans to market Reputation.com’s data vault, scheduled to open for business early next year, as an antidote.

“A data privacy vault,” he says, “is a way to control yourself as a person.”

Reputation.com is at the forefront of a nascent industry called “personal identity management.” The company’s business model for its vault service involves collecting data about consumers’ marketing preferences and giving them the option to share the information on a limited basis with certain companies in exchange for coupons, say, or status upgrades. In turn, participating companies will get access both to potential customers who welcome their pitches and to details about the exact products and services those people are seeking. In theory, the data vault would earn money as a kind of authorization supervisor, managing the permissions that marketers would need to access information about Reputation.com’s clients.

To some, the idea seems a bit quixotic.

Reputation.com, with $67 million in venture capital, is not making a profit. Although the company’s “privacy” products, like removing clients’ personal information from list broker and marketing databases, are popular, its reputation management techniques can be controversial. For instance, it offers services meant to make negative commentary about individual or corporate clients less visible on the Web.

And there are other hurdles, like competition. A few companies, like Personal, have already introduced vault services. Also, a number of other enterprises have tried — and quickly failed — to sell consumers on data lockers.

Even so, Mr. Fertik contends Reputation.com has the answer. The company already has several hundred thousand paying customers, he says, and patents on software that can identify consumers’ information online and score their reputations. He intends to show clients their scores and advise them on how to improve them.

“You can’t just build a vault and wish that vendors cared enough about your data to pay for it,” Mr. Fertik says. “You have to build a business that gives you the lift to accumulate a data set and attract consumers, the science to create insights that are valuable to vendors, and the power to impose restrictions on the companies who consume your data.”

THE consumer data trade is large and largely unregulated.

Companies and organizations in the United States spend more than $2 billion a year on third-party data about individuals, according to a report last year on personal identity management from Forrester Research, a market research firm. They spend billions more on credit data, market research and customer data analytics, the report said.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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New Taxes to Take Effect to Fund Health Care Law

WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

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Arithmetic on Taxes Shows Top Rate Is Just a Starting Point

WASHINGTON — Despite hints in recent days that President Obama and House Speaker John A. Boehner might compromise on the tax rate to be paid by top earners, a host of other knotty tax questions could still derail a deal to avert a fiscal crisis in January.

The math shows why. Even if Republicans were to agree to Mr. Obama’s core demand — that the top marginal income rates return to the Clinton-era levels of 36 percent and 39.6 percent after Dec. 31, rather than stay at the Bush-era rates of 33 percent and 35 percent — the additional revenue would be only about a quarter of the $1.6 trillion that Mr. Obama wants to collect over 10 years. That would be about half of the $800 billion that Republicans have said they would be willing to raise.

That calculation alone suggests the scope of the other major tax issues to be negotiated beyond tax rates. And that is why many people in both parties remain unsure that a deal will come together before Jan. 1. Without agreement, more than $500 billion in automatic tax increases on all Americans and cuts in domestic and military programs will take hold, which could cause a recession if left in place for months, economists say.

“The question is making sure that we hit a revenue target that’s required for a truly balanced deficit-reduction plan,” said Representative Chris Van Hollen of Maryland, the senior Democrat on the House Budget Committee. “And when the president and all of us say this is a question of math, we mean it. It’s very hard to make the numbers work without the top rates going back to the full Clinton-era levels.”

The top tax rates are taking center stage right now because Mr. Obama believes he won a mandate after campaigning relentlessly on the idea of extending Mr. Bush’s tax cuts only for households with annual income below $250,000. But the two parties also have ideological differences on taxes affecting savings, investment and inheritance, which have flared in battles going back to the Reagan years. To get a deal in the coming weeks, those differences must be addressed at least in broad terms, even if the details are left to a battle over revamping the tax code next year.

The argument over rates is far from settled. Although the two sides seem close enough on the percentages for easy compromise, principle and politics loom large: Republicans oppose raising rates as a matter of ideology, saying that it kills jobs, and the president insists that he will not keep the Bush-era rates on income above roughly $250,000 after two campaigns in which he vowed to return them to the levels of the Clinton years.

“Just to be clear, I’m not going to sign any package that somehow prevents the top rate from going up for folks at the top 2 percent,” he said Thursday.

In recent days, comments from some Republicans, including Mr. Boehner, their chief negotiator, have hinted that the party — recognizing its weak hand — might be moving toward a concession on tax rates. Seldom mentioned is that Mr. Obama’s revenue total also reflects four other changes from Bush-era tax cuts: higher tax rates on investment income from capital gains and dividends, and the restoration of two other Clinton-era provisions limiting deductions and tax exemptions for affluent individuals.

Together those changes would raise $407.4 billion over a decade — nearly as much as the president’s proposal on higher rates, which would raise $441.6 billion by 2023, for a total of $849 billion. Another $119 billion would come from higher estate taxes, opposed by Republicans and some Democrats.

And both the president and Republicans are committed to raising hundreds of billions of dollars by overhauling the tax code to further limit or end the tax breaks that high-income taxpayers can claim, though they differ in how to do that.

Republicans want to raise all $800 billion from overhauling the tax code, erasing tax breaks for high-income households and using the new revenues both to reduce deficits and to lower everyone’s tax rates. But they have not proposed how to do that, and the president insists it cannot be done without hitting middle-income taxpayers.

Mr. Obama has proposed to keep existing tax breaks but to limit the rate of those breaks for people in higher tax brackets to 28 percent, which would raise $584 billion in a decade. He has proposed variations of that proposal for four years, only to be ignored by both parties because of opposition from charitable groups, the housing industry, insurers and others to curbing deductions for charitable giving, mortgage insurance and other purposes.

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Gadgetwise Blog: Q&A: Using iTunes Music on a Windows Phone

Can I copy my iTunes music collection from my PC to my new Windows Phone?

If the music in your iTunes library was purchased in mid-2009 and later or ripped from your own compact discs, you should be able to copy it over and play it on your Windows Phone. Music files originally purchased before April 2009 are probably still protected by digital-rights management (D.R.M.) software that restricts them from being played on non-Apple devices.

Windows 7 and Windows 8 users can sync the music between computer and phone with the Windows Phone app for the PC, which gives you the option to sync iTunes playlists and music to the phone. Third-party syncing apps may also copy files between the phone and the computer.

To get Microsoft’s Windows Phone app on Windows 7, connect the phone to the computer with its USB cable, go to the Start menu and choose Devices and Printers. Double-click on the Windows Phone icon that appears on the screen and follow the on-screen directions to download the Windows Phone app. On a Windows 8 system, you should get a message on screen that guides you to downloading the app as soon as you connect the phone to the PC.

For those still using Windows XP or Windows Vista, connect the phone to the PC with the USB cable. If you have Windows XP, go to the Start menu to All Programs, choose Accessories and then open Windows Explorer. Using Windows Explorer, drag and drop the music files from your iTunes folder to your phone. On Windows Vista, go to the Start menu, select Computer and then drag the files you want to copy to the phone from the iTunes folder.

Microsoft’s site has a syncing guide on for new Windows Phone owners, as well as more information on copying iTunes files.

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Memo From Afghanistan: YouTube Ban Is Shrugged Off in Afghanistan

KABUL, Afghanistan — When it comes to YouTube, the government of Afghanistan intends to keep its hand on the switch for now.

More than two months after the Afghan government banned YouTube to prevent the spread of an anti-Islamic video, it has yet to restore access to the popular video Web site. While officials say they hope to lift the block “as soon as possible,” they have offered only a vague sense of what must happen before that can be done.

It is a measure of some of Afghanistan’s complexities, however, that even as Afghan rights advocates have worried about censorship, a common reaction on the street to the YouTube ban has been praise, or at worst ambivalence, even among some of the younger, Internet-savvy set in Kabul.

“That video dishonored our prophet,” said Syed Hamid, 19, a recent high school graduate, in comfortable English. “If YouTube isn’t going to remove the video, then our government is right to block access to it.”

He added: “I don’t need YouTube. I can watch videos on other Web sites.”

When a trailer for the video “Innocence of Muslims,” which portrays the Prophet Muhammad as a crass thug and a womanizer, began to circulate in September, the Afghan government reacted quickly to stem potential violence as riots broke out in other countries. In a move that senior Western officials in Afghanistan praised, the Afghan authorities reached out to religious leaders across the country, urging them to preach restraint and tolerance.

More controversially, officials also decided to impose the ban on YouTube after the company refused to remove the video from its site.

The country remained mostly peaceful, to the relief of the government and Western officials here. Past demonstrations related to religious insensitivity had quickly become deadly: In February, when NATO personnel were seen burning Korans near the Bagram Air Base, Afghans took to the streets in a violent outpouring of rage that led to dozens of deaths.

While Western countries, including most of the ones involved here, recoil at the idea of restricting free speech, the lesson is less clear in Afghanistan. In this case, censorship worked, and in conjunction with the government’s broader strategy almost certainly saved lives.

Still, some are asking the question: Where does the government draw the line on filtering information to its citizens? The answer has consistently been: Anywhere Islam is insulted.

“In the Islamic world, there are certain things that are untouchable,” said Jalal Noorani, senior adviser to the minister of culture and information, who initiated the ban. “We won’t be patient with anything disrespectful to our religion.”

Mr. Noorani said the government had no plans to ban other Web sites, so long as they did not disrespect Islam or incite ethnic violence.

The government had shown a willingness to censor offensive broadcasts before. In 2010, for instance, it shut down Emrooz TV after the local station showed a segment on Shiite Muslims that some Afghans found offensive. And a sustained war of words with Pakistan prompted Afghan officials to ban Pakistani newspapers from eastern Afghanistan in September, claiming they were little more than “propaganda tools for the Taliban.”

While Web sites that focus on vices like gambling and pornography have been banned for years, the government had never before blocked an entire media Web site for hosting an offensive video, officials said. Civil rights groups have argued that the censorship undermines President Hamid Karzai’s promises of transparency and openness.

But for all the controversy over the ban, it hardly seemed to register with many youths here in Kabul.

On a recent afternoon, hundreds of young men gathered in a plaza off the Pul-e-Khesti market, where a de facto cellphone emporium has taken root. Men waved phones as they barked out prices across the crowd. Merchants at makeshift tables charged nominal fees to download music and videos on mobile devices.

The market is just the sort of place the government feared could be a magnet for violence if the video — or even just news of its contents — spread from phone to phone. Although most Afghans do not have computers, cellphones have become ubiquitous over the past decade, and an estimated three-quarters of Afghans have access to mobile devices that allow them to watch videos.

“As long as this anti-prophet video is on YouTube, our government should keep their Web site blocked,” said Javeed Khawrin, 21, who was shopping at the market. “If I had power, I would have destroyed the whole area where this video was taped.”

Subhanullah, 24, an Afghan Army soldier who came to the market to get his phone fixed and who, like many Afghans, uses a single name, said the video “creates more haters among our national army soldiers toward the foreign troops here.”

Attitudes were similar at the city’s Women’s Garden, a sanctuary of roses, leafy trees and swing sets financed by Western aid.

Nilab Khursihid, 18, said she welcomed the government’s decision to keep the ban in place, and suggested even extending it to all material that is hurtful or disrespectful, including cartoons that lampoon Mr. Karzai.

“This is how our community is,” she said, sitting with friends in the garden. “The Internet has misled many of the youth.”

The garden, in the Shahrara neighborhood, boasts a library, a computer lab and a gymnasium for women. Small shops selling toys, lingerie and dresses line the inner wall of the compound. Nearby, a young woman sat uneasily behind the steering wheel of a Toyota, taking a driving lesson, a freedom unknown in the rest of the city.

One shopkeeper, Mariama Ahmadi, 23, who runs a dress store, offered a counterperspective. While she, too, thinks the video should have been taken down, she said, she thinks banning the Web site was a mistake. She said she preferred self-censorship, and the freedom to decide for oneself.

“We can all have our own choices and decide what to watch,” she said, her face framed by a black hijab. “The government shouldn’t be telling people what to do.”

Sharifullah Sahak contributed reporting.

Read More..

Memo From Afghanistan: YouTube Ban Is Shrugged Off in Afghanistan

KABUL, Afghanistan — When it comes to YouTube, the government of Afghanistan intends to keep its hand on the switch for now.

More than two months after the Afghan government banned YouTube to prevent the spread of an anti-Islamic video, it has yet to restore access to the popular video Web site. While officials say they hope to lift the block “as soon as possible,” they have offered only a vague sense of what must happen before that can be done.

It is a measure of some of Afghanistan’s complexities, however, that even as Afghan rights advocates have worried about censorship, a common reaction on the street to the YouTube ban has been praise, or at worst ambivalence, even among some of the younger, Internet-savvy set in Kabul.

“That video dishonored our prophet,” said Syed Hamid, 19, a recent high school graduate, in comfortable English. “If YouTube isn’t going to remove the video, then our government is right to block access to it.”

He added: “I don’t need YouTube. I can watch videos on other Web sites.”

When a trailer for the video “Innocence of Muslims,” which portrays the Prophet Muhammad as a crass thug and a womanizer, began to circulate in September, the Afghan government reacted quickly to stem potential violence as riots broke out in other countries. In a move that senior Western officials in Afghanistan praised, the Afghan authorities reached out to religious leaders across the country, urging them to preach restraint and tolerance.

More controversially, officials also decided to impose the ban on YouTube after the company refused to remove the video from its site.

The country remained mostly peaceful, to the relief of the government and Western officials here. Past demonstrations related to religious insensitivity had quickly become deadly: In February, when NATO personnel were seen burning Korans near the Bagram Air Base, Afghans took to the streets in a violent outpouring of rage that led to dozens of deaths.

While Western countries, including most of the ones involved here, recoil at the idea of restricting free speech, the lesson is less clear in Afghanistan. In this case, censorship worked, and in conjunction with the government’s broader strategy almost certainly saved lives.

Still, some are asking the question: Where does the government draw the line on filtering information to its citizens? The answer has consistently been: Anywhere Islam is insulted.

“In the Islamic world, there are certain things that are untouchable,” said Jalal Noorani, senior adviser to the minister of culture and information, who initiated the ban. “We won’t be patient with anything disrespectful to our religion.”

Mr. Noorani said the government had no plans to ban other Web sites, so long as they did not disrespect Islam or incite ethnic violence.

The government had shown a willingness to censor offensive broadcasts before. In 2010, for instance, it shut down Emrooz TV after the local station showed a segment on Shiite Muslims that some Afghans found offensive. And a sustained war of words with Pakistan prompted Afghan officials to ban Pakistani newspapers from eastern Afghanistan in September, claiming they were little more than “propaganda tools for the Taliban.”

While Web sites that focus on vices like gambling and pornography have been banned for years, the government had never before blocked an entire media Web site for hosting an offensive video, officials said. Civil rights groups have argued that the censorship undermines President Hamid Karzai’s promises of transparency and openness.

But for all the controversy over the ban, it hardly seemed to register with many youths here in Kabul.

On a recent afternoon, hundreds of young men gathered in a plaza off the Pul-e-Khesti market, where a de facto cellphone emporium has taken root. Men waved phones as they barked out prices across the crowd. Merchants at makeshift tables charged nominal fees to download music and videos on mobile devices.

The market is just the sort of place the government feared could be a magnet for violence if the video — or even just news of its contents — spread from phone to phone. Although most Afghans do not have computers, cellphones have become ubiquitous over the past decade, and an estimated three-quarters of Afghans have access to mobile devices that allow them to watch videos.

“As long as this anti-prophet video is on YouTube, our government should keep their Web site blocked,” said Javeed Khawrin, 21, who was shopping at the market. “If I had power, I would have destroyed the whole area where this video was taped.”

Subhanullah, 24, an Afghan Army soldier who came to the market to get his phone fixed and who, like many Afghans, uses a single name, said the video “creates more haters among our national army soldiers toward the foreign troops here.”

Attitudes were similar at the city’s Women’s Garden, a sanctuary of roses, leafy trees and swing sets financed by Western aid.

Nilab Khursihid, 18, said she welcomed the government’s decision to keep the ban in place, and suggested even extending it to all material that is hurtful or disrespectful, including cartoons that lampoon Mr. Karzai.

“This is how our community is,” she said, sitting with friends in the garden. “The Internet has misled many of the youth.”

The garden, in the Shahrara neighborhood, boasts a library, a computer lab and a gymnasium for women. Small shops selling toys, lingerie and dresses line the inner wall of the compound. Nearby, a young woman sat uneasily behind the steering wheel of a Toyota, taking a driving lesson, a freedom unknown in the rest of the city.

One shopkeeper, Mariama Ahmadi, 23, who runs a dress store, offered a counterperspective. While she, too, thinks the video should have been taken down, she said, she thinks banning the Web site was a mistake. She said she preferred self-censorship, and the freedom to decide for oneself.

“We can all have our own choices and decide what to watch,” she said, her face framed by a black hijab. “The government shouldn’t be telling people what to do.”

Sharifullah Sahak contributed reporting.

Read More..