Tuesday, March 5, 2013

Chavez's successor in Venezuela: Nicolas Maduro

Vice President Nicolas Maduro is taking over leadership of Hugo Chavez's political movement after the socialist leader died Tuesday at age 58 following a nearly two-year bout with cancer. Maduro now faces the daunting task of rallying support in a deeply divided country while maintaining unity within his party's ranks. Maduro decidedly lacks the vibrant personality that made Chavez a one-man political phenomenon in Venezuela, but he has the advantage of being Chavez's hand-picked successor. The mustachioed 50-year-old former bus driver won Chavez's trust as a loyal spokesman who echoed the president's stances. How Maduro will lead in Chavez's absence remains to be seen, although he's widely known as both a skilled negotiator and a leader who views upholding his mentor's legacy as his personal crusade and responsibility. One of the biggest tasks Maduro will likely face is attempting to hold together a diverse movement that includes radical leftists, moderates and many current and former military officers. Analysts have speculated that differences might emerge between factions led by Maduro and Diosdado Cabello, the influential National Assembly president who is thought to wield power within the military. But thus far both men have denied such divisions and vowed to remain united. After Chavez's Dec. 11 cancer surgery, Maduro stepped up his public appearances to fill the void, providing regular updates on the president's condition, calling for unity among allies and lambasting the opposition. Maduro also showed how he could attempt to continue Chavez's socialist-inspired project. Speaking at one December rally, he vowed in vague terms to maintain policies that have angered the country's leading business federation, Fedecamaras, which was long at odds with the president. "We aren't going to give dollars to Fedecamaras. What we're going to give them is pains, headaches with this Bolivarian Revolution," Maduro shouted, his voice hoarse. "I swear to you ... we're never going to betray the people of Venezuela!" Chavez's deteriorating health led him on Dec. 8 to announce Maduro as his chosen successor. He said that if his illness prevented him from being sworn in on Jan. 10, government supporters should rally around Maduro and elect him president. Maduro is expected to keep promoting programs such as free medical clinics staffed by Cuban doctors and subsidized food stores, which have endeared the president with the country's vast numbers of poor. Maduro has vowed to block a return to past policies that he said had benefited the wealthy. "Our people will never again see the bourgeoisie plundering this country," Maduro said, adding, "Better to be dead than traitors to the people and to Chavez!" That loyalty made Maduro a logical choice, political observers said. "Maduro combines two characteristics that influenced Chavez in his decision to designate him as successor: first, his loyalty to the party leadership, and second, his positions in favor of popular measures," such as social programs for the poor, said Steve Ellner, a political scientist at Venezuela's University of Oriente. In his youth, Maduro drove a bus for the Caracas Metro transit system and later became a union leader. It's unclear when Maduro and Chavez first met. But Chavez is thought to have first gotten to know Maduro in the 1980s, when Chavez was a lieutenant colonel and began a clandestine movement of disgruntled military officers that eventually carried out a failed coup attempt in 1992. Chavez was jailed on military rebellion charges and then released in 1994 when he was pardoned. Maduro went on to become a leading member of Chavez's nascent political movement, growing closer to the budding politician and also getting to know Cilia Flores, who is now attorney general and was Chavez's defense attorney following his arrest for the 1992 coup attempt. After Chavez was elected president in 1998, Maduro was selected to join a special assembly to draft a new constitution. He was later elected to the National Assembly and then became president of the legislature. Maduro was named foreign minister in 2006 and oversaw international efforts such as consolidating the regional diplomatic blocs ALBA and Unasur, strengthening relations with countries such as Russia, Iran and China, and overseeing a rapprochement with U.S.-allied Colombia. He is thought to maintain close ties with Cuba's government. Maduro "is perceived by Chavez as a negotiator with diplomatic skills who could potentially gather the support of the different factions and keep it united in the difficult months ahead," said Diego Moya-Ocampos, an analyst with the London-based consulting firm IHS Global Insight. "Nevertheless, he is not necessarily perceived as such within all the top ranks of the ruling United Socialist Party of Venezuela and the armed forces," Moya-Ocampos added. Jennifer McCoy, a political science professor at Georgia State University, described Maduro as an easygoing man who has shown a willingness to talk with government opponents. "He's always been someone who is easy to talk to," said McCoy, director of the Americas program at the Carter Center, which helped the Organization of American States facilitate dialogue between the government and opposition after a 2002 coup that briefly ousted Chavez. Maduro was always willing "to discuss the issues, and I think that's really important going forward for Venezuela," McCoy said. Before Chavez underwent his latest operation in December, he explained why he had chosen Maduro: "He's one of the young leaders with the greatest ability to continue, if I'm unable to — God knows what he does — if I'm unable to, to continue with his firm hand, with his gaze, with his heart of a man of the people, with his gift for people, with his intelligence, with the international recognition he's earned, with his leadership, leading the presidency."

Venezuela's Chavez dies, officials call for unity

Some in anguish, some in fear, Venezuelans raced for home and stocked up on food and water Tuesday after the government announced the death of President Hugo Chavez, the larger-than-life firebrand socialist who led the nation for 14 years. Vice President Nicolas Maduro's voice broke and tears ran down his face as he appeared on national television to announce that Chavez died at 4:25 p.m. local time (3:55 p.m. EST, 1755 GMT) "after battling hard against an illness over nearly two years." He did not say what exactly killed Chavez, although the government had announced the previous night that a severe new respiratory infection had severely weakened him. A few hours later, Foreign Minister Elias Jaua affirmed one of Chavez's final wishes: Maduro would be interim president and then be the ruling party's candidate to carry on Chavez's populist "revolution" in elections to be called within 30 days. It was a day fraught with mixed signals, some foreboding and some violent. Just a few hours before announcing Chavez's death, Maduro made a virulent speech against enemies he claimed were trying to undermine Venezuelan democracy. And he said two U.S. military attaches had been expelled for trying to destabilize the nation. In announcing the death of the former army paratrooper who wielded Venezuela's oil wealth to benefit the poor and win friends regionally, Maduro shifted tone. He called on Venezuelans to be "dignified heirs of the giant man" Chavez was. "Let there be no weakness, no violence. Let there be no hate. In our hearts there should only be one sentiment: Love. Love, peace and discipline." The government declared 7 days of mourning and closed all schools and universities until next Monday. All across downtown Caracas, shops and restaurants began to close and Venezuelans hustled for home, some even breaking into a run. Many people looked incredulous or anguished. "I feel a sorrow so big I can't speak," said Yamilina Barrios, a 39-year-old clerk who works in the Industry Ministry, her face covered in tears. "He was the best this country had." "I hope the country calms down and continues the work that he left us, continues in unity and the progress continues," Barrios said. Among the nervous was Maria Elena Lovera, a 45-year-old housewife. "I want to go home. People are crazy and are way too upset." There were several incidents of political violence. In one, a group of masked, helmeted men on motorcycles, some brandishing revolvers, attacked about 40 students who had been protesting for more than a week near the Supreme Court building to demand the government give more information about Chavez's health. The attackers, who didn't wear clothing identifying any political allegiance, burned the students' tents and scattered their food just minutes after the death was announced. "They burned everything we had," said student leader Gaby Arellano. She said she saw four of the attackers with pistols but none fired a shot. Outside the military hospital where Chavez's remains were visited by loved ones and confederates, an angry crowd attacked a Colombian TV reporter. "They beat us with helmets, with sticks, men, women, adults," Carmen Andrea Rengifo said on RCN TV. Video images showed her bleeding above the forehead but she was not seriously injured. Maduro and other government officials have recently railed against international media for allegedly reporting rumors about Chavez's health, though RCN was not among those stations criticized. After nightfall, several hundred people gathered at Bolivar Square, a symbolic place for Chavistas because it has a huge nine-meter-tall (30-foot-tall) statue of Simon Bolivar, the 19th century independence hero who Chavez claimed as his inspiration. Some arrived singing Venezuela's national anthem and holding up posters of Chavez. Many chanted "I am Chavez," which had been a campaign slogan of the president. One man began shouting through a megaphone a warning to the opposition: "They won't return." The crowd then joined in, chanting: "They won't return." Maduro, who had urged people to meet at the square, called on the opposition to respect "the people's pain." "Those who never supported the comandante Hugo Chavez, respect the pain of the people. This is the moment to think of our families, of our country." Chavez leaves behind a political movement firmly in control of the nation, but with some doubt about how a new leadership will be formed. Chavez's illness prevented him from taking the oath of office after he was re-elected to a new term on Oct. 7 and the constitution says the speaker of the National Assembly, Diosdado Cabello, should take over as interim president under such circumstances. But Jaua said Maduro would assume the rule as that was Chavez's will. The man Chavez defeated in October, the youthful Miranda state Gov. Henrique Capriles, is widely expected to represent the opposition. Venezuela's defense minister appeared on television to announce that the military will remain loyal to the constitution in the wake of Chavez's death. Adm. Diego Molero appealed for "unity, tranquility and understanding" among Venezuelans. The announcement of Chavez's death stunned Venezuelans, if it did not surprise them. Earlier in the day, Maduro was more belligerent in tone as he announced the government had expelled two U.S. diplomats from the country and said "we have no doubt" that Chavez's cancer, which was first diagnosed in June 2011, was induced by "the historical enemies of our homeland." He compared the situation to the death of the Palestinian leader Yasser Arafat, claiming Arafat was "inoculated with an illness." Chavez's inner circle has long claimed the United States was behind a failed 2002 attempt to overthrow him, and he has frequently played the anti-American card to stir up support. Venezuela has been without a U.S. ambassador since July 2010 and expelled another U.S. military officer in 2006. U.S. State Department spokesman Patrick Ventrell rejected the assertion that the U.S. was trying to destabilize Venezuela and said it "leads us to conclude that, unfortunately, the current Venezuelan government is not interested in and improved relationship." Maduro has been taking on a larger role since Chavez urged Venezuelans to(continuous)

Devastated, mourning Chavez supporters pour onto streets

Grieving and stunned supporters of deceased Venezuelan President Hugo Chavez took to the streets on Tuesday weeping, chanting slogans and vowing to continue their hero's revolution. Gathering in streets and squares across the South American nation of 29 million people, backers of the socialist leader shouted: "Chavez lives forever!" and "The fight continues!" "We have to show that what he did was not in vain," said Jamila Rivas, 49, crying outside the military hospital where Chavez died. Hundreds of supporters flocked there. Venezuelans have been tracking the ups-and-downs of Chavez's two-year battle against cancer, but some supporters felt a sense of disbelief that the flamboyant leader was gone. "He was our father. 'Chavismo' will not end. We are his people. We will continue to fight!" said Nancy Jotiya, 56, in Caracas' downtown Bolivar Square, named for Venezuela's independence hero and Chavez's idol, Simon Bolivar. "I admired him. He was a great man," said housewife Aleida Rodriguez, 50, who heard the news as she emerged from Caracas' underground transport system. Venezuela's opposition leader, Henrique Capriles, offered condolences and called for unity. Some opponents could not hide their happiness at the end to a rule they viewed as a cruel dictatorship. "At last!" shouted some women, coming out of their homes in one upscale neighborhood. Hatred for Chavez ran deep among the wealthier members of Venezuela's population. Some openly celebrated his death on Twitter. There were reports of isolated incidents of looting and violence, including the burning of tents belonging to students who had been protesting in a Caracas street for the last week against secrecy over Chavez's condition. Around Latin America and the Caribbean, where Chavez's oil-fueled largesse was a source of support for various leftist governments, tributes and condolences poured in. Bolivian President Evo Morales, a close personal friend, wept as he spoke of Chavez. Brazil's Congress held a minute of silence. "President Chavez has always been a friend of Brazil, regardless of his political position," said Renan Calheiros, president of the Brazilian Senate. Colombia, whose pro-U.S. conservative governments have clashed fiercely with Chavez in the past, also paid homage. "I think in the last two years ... our relations with Venezuela advanced really well, and he was also a very important support for the current peace process," Foreign Minister Maria Angela Holguin said, referring to her government's rapprochement with Chavez and ongoing peace talks with leftist rebels. "Hopefully he'll find peace." Former Canadian Prime Minister Jean Chretien told CBC television he met Chavez several times, was quite fond of him, and acted as a facilitator between Chavez and former U.S. President George W. Bush at a 2001 Summit of the Americas. "He was a great baseball fan and player and he always told me that if I were to visit him in Venezuela we would go to a baseball field and he would throw balls to me for me to hit them," he said. "And we never had the occasion to do that."

Wednesday, February 27, 2013

Medicare paid $5.1B for poor nursing home care

Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found. The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions. One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated. By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being. Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul. "These findings raise concerns about what Medicare is paying for," the report said. Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects. In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare. In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said. The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities. That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review. Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose. In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes. "Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to." CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report. Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it. "Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said. Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities. "Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed." Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged. Investigators found the homes didn't always do what was needed to ensure a smooth transition. In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

Senate Dems' bill light on deficit cuts in 2013

White House-backed legislation in the Senate to replace $85 billion in across-the-board spending cuts would raise the deficit through the end of the budget year by tens of billions of dollars, officials said late Wednesday as the two parties maneuvered for public support on economic issues. The nonpartisan Congressional Budget Office said that under the Democratic measure, deficits also would rise in each of the next two years before turning downward. Democratic officials had said earlier in the day their bill would spread one year's worth of anticipated savings — $85 billion — over a decade in an attempt to avoid damaging the shaky economic recovery. The legislation would cancel across-the-board cuts due to begin on Friday. Instead, it would eliminate payments to some farmers, enact defense reductions beginning in two years and impose tax increases, mostly on millionaires. White House spokesman Jay Carney recently told reporters at the White House the administration supports the measure. The Senate is expected to vote on Thursday on rival Democratic and Republican plans to replace the spending cuts, known in Washington-speak as a "sequester." Both bills are expected to fail. In an indication that across-the-board cuts are inevitable, President Barack Obama has set a meeting with congressional leaders for the day they take effect. While the administration has warned of severe cuts in government services as a result of the reductions, few, if any, are likely to be felt for several weeks. That could give the administration and lawmakers breathing room to negotiate a replacement, although Senate Republican Leader Mitch McConnell said during the day there were limits to what could be negotiated. "We can either secure those reductions more intelligently, or we can do it the president's way with across-the board cuts. But one thing Americans simply will not accept is another tax increase to replace spending reductions we already agreed to," he said. Democrats said their proposal to replace across-the-board cuts was designed with the economy in mind. It "seeks the same amount of savings in a more responsible way" as the $85 billion in cuts that will otherwise take effect, said Adam Jentleson, a spokesman for Senate Majority Leader Harry Reid. "The impact on the economy is much better. Sequestration as constituted would hurt economic growth and destroy jobs," he added. Over a decade, the bill would cut deficits by an estimated $110 billion, half from higher taxes and half from the defense and farm program cuts. That is in keeping with Obama's call for a balanced approach that combines selected spending cuts with closing tax loopholes. Senate Democrats have been reluctant to spell out the details of their measure, although it is not clear if that results from its relatively small impact on the deficits through the end of the current budget year. Across the Capitol, though, the party's leaders have talked openly of their desire to spread the cuts in their replacement measure over a longer period. "It is entirely intentional," said Rep. Chris Van Hollen, D-Md., and the party's senior member on the House Budget Committee. "The whole idea is to achieve the equivalent deficit reduction without hurting jobs and having disruption in the economy. You do that by having targeted cuts and eliminating tax loopholes over a longer period of time," he added. He said the Democrats' approach is the same as Federal Reserve Chairman Ben Bernanke's recommendation, which is to help the recovery gain strength before beginning to make cuts. In the Senate, Republicans have yet to disclose their own sequester replacement measure. Most of the rank and file favors an alternative that lets Obama adjust the cuts to minimize any impact on the public, but that approach has its critics among lawmakers who fear giving the White House that much authority.