Senate bailout bill keeps growing

The Senate hopes to revive Treasury’s $700 billion financial rescue plan Wednesday night by packaging it together with more than $100 billion in popular tax breaks as well as aid to rural schools important to House Republicans.

To calm voters fearful of bank failures, the $100,000 cap on federal insurance for deposits would also be raised to $250,000—a concession backed by both parties but also aimed at community banks who can be helpful in building small town support for the larger bill.

With each permutation, the bill has steadily grown in size. Treasury’s initial plan was about three pages long. The House version, which failed, stretched to 110. The Senate substitute now runs over 450 pages. And tucked away in the tax provisions is a landmark health care provision demanding that insurance companies provide coverage for mental health treatment—such as hospitalization—on parity with physical illnesses.

Really a bill onto itself, the mental health parity measure has been a bipartisan priority for top lawmakers in both chambers but has stalled because of disagreements again over how to pay for its estimated $3.8 billion five-year cost. In the current climate, that seems to be no longer a stumbling block, and if the Treasury plan becomes law, it will also.

Both presidential candidates, Sens. John McCain and Barack Obama, are slated to return for two important roll calls Wednesday evening, and Obama appears to be playing an increased role in shoring up support among House Democrats after the bill failed Monday.

Proponents hope a strong Senate vote—with support from both candidates—will marginalize the opponents in the House, which could vote Friday on the revised package. In early trading Wednesday, the Dow was holding steady. More important perhaps in the credit markets, the London inter-bank offer rate or Libor, which influences what charge in borrowing from one another, had dropped by 3 points—after spiking Monday night in the wake of the House defeat.

When the Treasury plan went down in the House, it was clearly hurt by the public perception that it was nothing more than a costly bailout for Wall Street. And since then there has been a more concerted effort by proponents to broaden grassroots support around the nation.

The U.S. Chamber of Commerce has begun radio ads targeted at lawmakers. The Republican and Democratic chairmen of national governors associations for the two parties released a joint letter Wednesday urging Congress to act. And the courtship of community banks— by raising the insurance level for deposits –builds on a decision over the weekend to also include tax breaks for local banks which were hurt by the government takeover of the two mortgage finance giants Fannie Mae and Freddie Mac.

Senate leaders are confident that they can prevail, but the strategy is not without risks in the House given the added costs of the tax package. Congressional Budget Office estimates indicate that the net impact will be to add almost $105 billion to an already large deficit next year, and fiscal conservatives will feel they are being straight-armed by the Senate which has refused to do more to offset the costs.

The biggest single piece in the package is an extension of protections for millions of middle class families who would otherwise find themselves exposed to the higher levy under the alternative minimum tax. This alone accounts for about three quarters of the cost or $78.8 billion in 2009. Almost $14 billion more can be attributed to a variety of tax break extensions important to business, including the R&E credit worth about $8.4 billion in 2009.

The rural school aid is smaller —about $3.3 billion over the next five years— but has great importance for many Western communities and could be important then in the House.

Yet many House Democrats are already upset that Republicans and the White House had rejected their effort to require Treasury to impose a fee on Wall Street transactions in five years to help recoup any taxpayer losses. The expanded Senate package would compound this loss and puts Speaker Nancy Pelosi (D-Cal.) in an awkward spot since she has vowed to stand up for these moderates in her caucus.

“The Senate has made a decision about how to proceed and what can pass that body,” Pelosi said in a statement Tuesday night. “The Senate will vote tomorrow night and the Congress will work its will. House Democrats remain strongly committed to a comprehensive bill that stabilizes the financial markets, restores confidence, and protects taxpayers, and we hope Congress can agree on legislation in the very near future.”

House Majority Leader Steny Hoyer (D-Md.) also warned on Wednesday morning that adding tax extenders might cause Democratic votes to drop of.

Speaking on The Today Show on NBC, Hoyer said he was “not particularly pleased” that the Senate has decided to add a set of tax breaks to the bailout package.

“There’s no doubt the tax package is very controversial,” Hoyer said. Soon after the defeat in the House Monday, the administration and leadership began exploring ways to revive Treasury’s plan in the Senate, where it has enjoyed more bipartisan support. Minority Leader Mitch McConnell (R-Ky.) took the lead but he was also helped by the fact that his chief negotiator on the Treasury bill, Sen. Judd Gregg (R-N.H.) enjoys a good humored, working relationship with Majority Leader Harry Reid (D-Nev.)

“The voters sent us here to respond to crises, not to ignore them,” McConnell said. “And if you fail the first time, you get back up, and you work with each other.”

Reid had been fearful that he would be drawn into prolonged negotiations about changes in the core Treasury plan. But the decision to raise the cap on insurance for savings deposits won wide support Tuesday, and as a practical matter, all sides know they must deal with the tax extenders now or risk having to come back into session after the November elections.

“This is a brilliant move by Harry, and I believe it will help pick up votes on both sides of the aisle,” said Sen. Charles Schumer (D-N.Y.)

How brilliant will rest on the House reaction. The White House itself was somewhat apprehensive Tuesday night until it has seen a better vote count. And if Pelosi starts to lose Democrats who voted for the bill Monday, that means the burden will be even greater on House Republicans to increase their numbers from the 65 who backed the plan then.

Pork, pork, pork.  And exactly how much will this cost the citizens of America?

College presidents seek debate on drinking age

College presidents from about 100 of the nation’s best-known universities, including Duke, Dartmouth and Ohio State, are calling on lawmakers to consider lowering the drinking age from 21 to 18, saying current laws actually encourage dangerous binge drinking on campus.

The movement called the Amethyst Initiative began quietly recruiting presidents more than a year ago to provoke national debate about the drinking age.

”This is a law that is routinely evaded,” said John McCardell, former president of Middlebury College in Vermont who started the organization. ”It is a law that the people at whom it is directed believe is unjust and unfair and discriminatory.”

Other prominent schools in the group include Syracuse, Tufts, Colgate, Kenyon and Morehouse.
But even before the presidents begin the public phase of their efforts, which may include publishing newspaper ads in the coming weeks, they are already facing sharp criticism.

Mothers Against Drunk Driving says lowering the drinking age would lead to more fatal car crashes. It accuses the presidents of misrepresenting science and looking for an easy way out of an inconvenient problem. MADD officials are even urging parents to think carefully about the safety of colleges whose presidents have signed on.

”It’s very clear the 21-year-old drinking age will not be enforced at those campuses,” said Laura Dean-Mooney, national president of MADD.

Both sides agree alcohol abuse by college students is a huge problem.

Research has found more than 40 percent of college students reported at least one symptom of alcohol abuse or dependance. One study has estimated more than 500,000 full-time students at four-year colleges suffer injuries each year related in some way to drinking, and about 1,700 die in such accidents.

A recent Associated Press analysis of federal records found that 157 college-age people, 18 to 23, drank themselves to death from 1999 through 2005.

Moana Jagasia, a Duke University sophomore from Singapore, where the drinking age is lower, said reducing the age in the U.S. could be helpful.

”There isn’t that much difference in maturity between 21 and 18,” she said. ”If the age is younger, you’re getting exposed to it at a younger age, and you don’t freak out when you get to campus.”
McCardell’s group takes its name from ancient Greece, where the purple gemstone amethyst was widely believed to ward off drunkenness if used in drinking vessels and jewelry. He said college students will drink no matter what, but do so more dangerously when it’s illegal.

The statement the presidents have signed avoids calling explicitly for a younger drinking age. Rather, it seeks ”an informed and dispassionate debate” over the issue and the federal highway law that made 21 the de facto national drinking age by denying money to any state that bucks the trend.

But the statement makes clear the signers think the current law isn’t working, citing a ”culture of dangerous, clandestine binge-drinking,” and noting that while adults under 21 can vote and enlist in the military, they ”are told they are not mature enough to have a beer.” Furthermore, ”by choosing to use fake IDs, students make ethical compromises that erode respect for the law.”

”I’m not sure where the dialogue will lead, but it’s an important topic to American families and it deserves a straightforward dialogue,” said William Troutt, president of Rhodes College in Memphis, Tenn., who has signed the statement.

But some other college administrators sharply disagree that lowering the drinking age would help. University of Miami President Donna Shalala, who served as secretary of health and human services under President Clinton, declined to sign.

”I remember college campuses when we had 18-year-old drinking ages, and I honestly believe we’ve made some progress,” Shalala said in a telephone interview. ”To just shift it back down to the high schools makes no sense at all.”

McCardell claims that his experiences as a president and a parent, as well as a historian studying Prohibition, have persuaded him the drinking age isn’t working.

But critics say McCardell has badly misrepresented the research by suggesting that the decision to raise the drinking age from 18 to 21 may not have saved lives.

In fact, MADD CEO Chuck Hurley said, nearly all peer-reviewed studies looking at the change showed raising the drinking age reduced drunk-driving deaths. A survey of research from the U.S. and other countries by the Centers for Disease Control and others reached the same conclusion.

McCardell cites the work of Alexander Wagenaar, a University of Florida epidemiologist and expert on how changes in the drinking age affect safety. But Wagenaar himself sides with MADD in the debate.
The college presidents ”see a problem of drinking on college campuses, and they don’t want to deal with it,” Wagenaar said in a telephone interview. ”It’s really unfortunate, but the science is very clear.”

Another scholar who has extensively researched college binge-drinking also criticized the presidents’ initiative.

”I understand why colleges are doing it, because it splits their students, and they like to treat them all alike rather than having to card some of them. It’s a nuisance to them,” said Henry Wechsler of the Harvard School of Public Health.

But, ”I wish these college presidents sat around and tried to work out ways to deal with the problem on their campus rather than try to eliminate the problem by defining it out of existence,” he said.
Duke faced accusations of ignoring the heavy drinking that formed the backdrop of 2006 rape allegations against three lacrosse players. The rape allegations proved to be a hoax, but the alcohol-fueled party was never disputed.

Duke senior Wey Ruepten said university officials should accept the reality that students are going to drink and give them the responsibility that comes with alcohol.

”If you treat students like children, they’re going to act like children,” he said.

Duke President Richard Brodhead declined an interview request. But he wrote in a statement on the Amethyst Initiative’s Web site that the 21-year-old drinking age ”pushes drinking into hiding, heightening its risks.” It also prevents school officials ”from addressing drinking with students as an issue of responsible choice.”

Hurley, of MADD, has a different take on the presidents.

”They’re waving the white flag,” he said.

How many of the colleges sell or have interests in alcoholic beverage vendors? That would be an interesting thing to know. These ‘leaders of education’ are so off base it’s astounding. No wonder our young are so screwed up.

Perfect Villains, Flawed Tribunal

Last week, the prosecutor of the International Criminal Court in The Hague issued an arrest warrant for Sudanese President Omar al-Bashir for genocide and crimes against humanity committed in Sudan’s Darfur region. The move sparked criticism that the indictment will reduce chances for peace in Darfur. We have seen this all before: In 1993, at the apex of the Bosnian war, the Hague-based International Criminal Tribunal for the former Yugoslavia was established with roughly the same objective — to bring justice to the victims of a war that the great powers were unable or unwilling to stop.

Let’s check the results.

What ever happened to Ratko Mladic, the Bosnian Serb general who ordered the slaughter of about 8,000 Bosnian Muslims in Srebrenica in July 1995? Or to his political master, Radovan Karadzic, who pounded Sarajevo for more than three years and drove hundreds of thousands of non-Serbs from their homes during the Bosnian war? Both men were indicted by the tribunal in 1995, and both are still at large 13 years later. What’s worse, their prospects of remaining free grow with each passing day, since the tribunal has to complete all its cases by the end of this year and review the appeals by 2010. The arrest warrants will remain in place, but as of next year, there will be no one to try either of those men.

The list of the tribunal’s underachievements doesn’t end there. In the midst of his long-running trial, Slobodan Milosevic, the Serbian dictator widely regarded as the chief culprit in the bloody breakup of Yugoslavia, died of heart failure after taking medicine known to counteract other drugs he had been taking for coronary problems. Milosevic’s death deprived his surviving victims of closure and allowed his supporters to continue to claim that he was innocent.

The trial of Jovica Stanisic, the head of Milosevic’s notorious secret police, hasn’t even begun, even though Stanisic was apprehended five years ago and might be released because of health problems. Ramush Haradinaj, the Albanian militia leader in Kosovo indicted for the murders of at least 40 civilians, was acquitted in April due to lack of evidence after key prosecution witnesses were killed or refused to testify.

Meanwhile, Vojislav Seselj, Milosevic’s political ally and, along with Stanisic, the chief organizer of the paramilitary units that wreaked havoc in Croatia and Bosnia, is currently on trial but is likely to be released for lack of evidence. He almost became Serbia’s premier when his ultranationalist party came dangerously close to winning the Serbian parliamentary elections in May, garnering nearly 30 percent of the vote.

So was it all a huge mistake? Fifteen years ago, when the U.N. Security Council established the tribunal, it was met with great enthusiasm both by the war’s victims, who expected justice and closure, and by human rights activists, who saw it as a great leap forward for international law. Western political leaders, who lined up in support of the court, might have had a slightly different agenda: The war in Yugoslavia was still raging, and the public, horrified by footage of mass graves and suffering civilians, wanted something done. Setting up the tribunal seemed like a good way to deflect the pressure to intervene militarily. There were also hopes that the court’s very existence would deter future crimes and speed up reconciliation in the Balkans by individualizing the guilt for wartime atrocities.

In retrospect, these hopes were naive. Some of the worst crimes in the former Yugoslavia, such as the massacres at Srebrenica and the ethnic cleansing of Kosovo, occurred well after the tribunal became fully operational — so much for deterrence. As for reconciliation, the tribunal has accomplished even less. In fact, it has done exactly the opposite, because all the nations of the former Yugoslavia see it as a political instrument aimed at demonizing their heroes and sanitizing their enemies’ records.

Resentment of the tribunal is strongest in Serbia, which had to deliver the bulk of the suspects, but other former Yugoslav republics have been far from enthusiastic. Even now, the Croatian coast is dotted with billboards glorifying former Croatian army lieutenant general Ante Gotovina, currently on trial for launching an ethnic cleansing campaign against the Serbs in 1995. As Croatian human rights activist Zarko Puhovski recently noted: “The truth doesn’t necessarily heal and calm — more often it causes hurt, anxiety and anger.”

As for the vaunted international community, the indictments were always the easy part. Actually bringing these thugs to justice would involve real, dangerous work. Mladic and Karadzic, for example, are still at large because no one has ever seriously gone after them. The tribunal doesn’t have its own intelligence and police officers to locate and apprehend the suspects; it has to ask individual countries to lend them these resources.

The tribunal itself is hardly blameless. From the beginning, it has been hampered by all the usual flaws that bedevil any U.N. body: too much red tape, inefficiency and split loyalties. But the real responsibility lies with the great powers — the United States, Britain and France. In her book, former prosecution spokeswoman Florence Hartmann describes in detail how these three nations have blocked the tribunal’s investigations whenever its probes have collided with their perceived national interests, often to prevent certain unsavory liaisons with Balkan warlords from coming to light.

Most often, expediency has trumped justice — something nations trying to bring peace to Darfur will have to deal with now that Bashir has been indicted. In the former Yugoslavia, some of the worst war crimes suspects have retained high positions in the military, police or political structures long after the war. Karadzic and Mladic lived openly in Bosnia for several years after they were indicted in 1995, when Bosnia was essentially occupied by NATO forces. Mladic was even in charge of implementing the military part of the 1995 Dayton peace agreement, working closely with NATO officers. Milosevic, meanwhile, was indicted in 1999 but continued to serve as Serbian president until late 2000. Haradinaj was prime minister of Kosovo when he was indicted in 2005.

One of the biggest problems for the prosecution has been protecting witnesses. I have some first-hand experience in this matter. In 2002, I was the first Serbian journalist to testify against Milosevic. I received threats as a result, and nationalists at home launched a defamation campaign against me. A year ago, a hand grenade blew up outside my bedroom window. It turned out that the prosecutors had placed me on the witness list against former State Security chief Stanisic without telling me. “We forgot,” a member of the prosecutor’s team told me. I told her that they should forget about my appearing in court.

While many of the tribunal’s failures have stemmed from its own inadequacies, it was the 2005 Security Council decision to impose a “conclusion strategy” and severely limit the court’s shelf life that dealt the final blow. From that moment on, the best and the brightest among its staff started looking for new jobs, while those who replaced them have often been underqualified. Many of the judges in the ongoing trials have never spent a single day in a criminal court in their home countries — they come from universities and international law institutes.

Despite everything, the tribunal has done some good work. More than 700 bad guys have been put behind bars. Meanwhile, former Yugoslav countries have set up their own war crimes courts, although these are still too feeble and subject to political pressures to try big cases, such as those of Karadzic or Mladic.

There are two ways to proceed from here. One is to declare the tribunal a failure and refrain from setting up similar courts in the future. The other is to learn from past mistakes.

One key lesson: Countries emerging from conflict need swift justice, not decades of tedious trials aimed at establishing comprehensive historical truth. That task should be left to historians. Instead of casting a wide net and spending years examining every single fish, future tribunals should focus on the worst cases with the strongest evidence — and process them quickly, before politics steps in. And if this raises some eyebrows among legal experts, so be it. Human justice is imperfect, but no justice is much worse.

Drug Makers Near Old Goal: A Legal Shield

For years, Johnson & Johnson obscured evidence that its popular Ortho Evra birth control patch delivered much more estrogen than standard birth control pills, potentially increasing the risk of blood clots and strokes, according to internal company documents.

But because the Food and Drug Administration approved the patch, the company is arguing in court that it cannot be sued by women who claim that they were injured by the product — even though its old label inaccurately described the amount of estrogen it released.

This legal argument is called pre-emption. After decades of being dismissed by courts, the tactic now appears to be on the verge of success, lawyers for plaintiffs and drug companies say.

The Bush administration has argued strongly in favor of the doctrine, which holds that the F.D.A. is the only agency with enough expertise to regulate drug makers and that its decisions should not be second-guessed by courts. The Supreme Court is to rule on a case next term that could make pre-emption a legal standard for drug cases. The court already ruled in February that many suits against the makers of medical devices like pacemakers are pre-empted.

More than 3,000 women and their families have sued Johnson & Johnson, asserting that users of the Ortho Evra patch suffered heart attacks, strokes and, in 40 cases, death. From 2002 to 2006, the food and drug agency received reports of at least 50 deaths associated with the drug.

Documents and e-mail messages from Johnson & Johnson, made public as part of the lawsuits against the company, show that even before the drug agency approved the product in 2001, the company’s own researchers found that the patch delivered far more estrogen each day than low-dose pills. When it reported the results publicly, the company reduced the numbers by 40 percent.

The F.D.A. did not warn the public of the potential risks until November 2005 — six years after the company’s own study showed the high estrogen releases. At that point, the product’s label was changed, and prescriptions fell 80 percent, to 187,000 by last February from 900,000 in March 2004.

Gloria Vanderham, a Johnson & Johnson spokeswoman, said the company acted responsibly.

“We have regularly disclosed data to the F.D.A., the medical community and the public in a timely manner,” Ms. Vanderham said. “Ortho Evra is a safe and effective birth control option for women when used according to the labeling.”

But Janet Abaray, a plaintiff’s lawyer from Cincinnati, said that Johnson & Johnson took advantage of an agency overwhelmed by its many responsibilities.

“Johnson & Johnson knew that F.D.A. does not have the funding or the manpower to police drug companies,” Ms. Abaray said.

A series of independent assessments have concluded that the agency is poorly organized, scientifically deficient and short of money. In February, its commissioner, Andrew C. von Eschenbach, acknowledged that the agency faces a crisis and may not be “adequate to regulate the food and drugs of the 21st century.”

The F.D.A. does not test experimental medicines but relies on drug makers to report the results of their own tests completely and honestly. Even when companies fail to follow agency rules, officials rarely seek to penalize them. “These are scientists, not cops,” said David Vladeck, a professor at Georgetown Law School.

Last month, at a trial over the schizophrenia drug Zyprexa, Dr. John Gueriguian, a scientist who worked at the F.D.A. for two decades, testified that the agency did not always ask for strong warnings even if it believed a drug was risky. Companies typically oppose warnings, and the agency knows it must compromise on its requests or face years of delay, Dr. Gueriguian said.

“We at the F.D.A. know what we can obtain and we cannot obtain,” Dr. Gueriguian said. “We have many, many problems, and we have a management system — what we can’t obtain we will not ask.”

For years, top officials at the agency acknowledged that lawsuits could aid the agency’s oversight of safety issues. In the last decade, suits over Zyprexa, the withdrawn pain pill Vioxx, the withdrawn diabetes medicine Rezulin, the withdrawn heartburn medicine Propulsid and several antidepressants have shown that companies played down the risks of their medicines and failed to disclose clinical trials to the public even as they have aggressively marketed their drugs.

But now, the agency says a proliferation of lawsuits could lead to an overlapping patchwork of rules that would burden companies and might discourage patients from taking useful medicines.

The Ortho case, however, suggests that Johnson & Johnson, like other drug makers, is not always quick to tell the F.D.A. about potential problems with its medicines.

In 1996, the company told the agency it planned to develop the Ortho Evra patch in part because it would be likely to expose women to less estrogen than pills. The company suggested that the body would not break down hormones delivered via the patch as readily as the pill, so lower doses could be used to achieve contraception. And unlike the pill, which must be taken daily, the patch is changed weekly.

High doses of estrogen are known to raise the risk for blood clots that can cause heart attacks and strokes.

But a crucial trial completed in 1999 showed that the patch delivered 30 to 38 micrograms of estrogen into the bloodstream each day, according to company documents.

Because up to half of the estrogen in pills is lost in the digestive tract before it reaches the blood, the study suggested that the patch delivered an amount of estrogen that could be as high as a pill containing 76 micrograms of estrogen. In 1988, the F.D.A. banned birth control pills with more than 50 micrograms of estrogen.

But the study’s author, Dr. Larry Abrams, who has since retired from Johnson & Johnson, decided to apply a “correction factor” to the results of the 1999 trial, according to documents. He claimed that the patch actually delivered about 40 percent less estrogen than the trial results showed — about 20 micrograms a day.

Dr. Abrams made the change, according to his deposition, to adjust for the different ways the body metabolizes hormones from pills and patches. This adjustment was never part of the study protocol, a plan filed with the F.D.A..

“The judgment was made by the pharmacokeneticists at the time that in doing the calculation, it was probably appropriate to make that correction,” Bob Tucker, a lawyer representing Johnson & Johnson, said in an interview Thursday. “Later on when people looked at it in a different time frame, they concluded that probably the correction shouldn’t be applied.” The company mentioned its decision to use the “correction factor” only once in a 435-page report filed with the F.D.A., and then only in a complex mathematical formula. When the study was published in 2002, there was no reference to the alteration.

Mr. Tucker said that the F.D.A. was aware of the “correction factor.”

Clinical trials conducted before the patch was approved raised other red flags, as patients complained of breast soreness and nausea. “The side effects seem related” to high estrogen doses, one company scientist wrote in an e-mail message.

Two other studies, one conducted in 1999 and another in 2003, confirmed that the patch released more estrogen than the pill. Still, Johnson & Johnson delayed reporting those results to the food and drug agency, according to documents that have been made public in lawsuits.

After the patch was approved, the company marketed it as releasing 20 micrograms of estrogen to the blood every 24 hours, a figure it now acknowledges was inaccurate. It also acknowledges that the patch releases more estrogen than the pill but says that the estrogen released under the two methods cannot be directly compared.

The New York Times provided the drug agency with a copy of a court brief and asked whether agency medical reviewers were aware of the “correction factor.”

Rita Chappelle, an F.D.A. spokeswoman, replied, “At present, we are reviewing the allegations and cannot comment further at this time.”

Prescriptions for the patch grew rapidly after its introduction, reaching more than 900,000 by March 2004, according to data from Wolters Kluwer, a company that tracks prescription trends. But as the use of the patch rose, so did reports of side effects.

By 2004, after the death of Zakiya Kennedy, an 18-year-old college freshman in New York, food and drug officials had become concerned.

In November 2005, the agency announced that it had placed a warning that the patch “exposes women to higher levels of estrogen than most birth control pills.”

Since then, an epidemiological study has shown that women on the patch can have as much as double the risk of blood clots than those taking pills. And prescriptions for the patch have fallen 80 percent.

Still, lawyers for Johnson & Johnson say that patients should not be allowed to sue the company because the F.D.A. approved the patch and its label.

“F.D.A. is responsible for making those decisions,” said John Winter, a lawyer for the company.

Judge David A. Katz of Federal District Court for the Northern District of Ohio is expected to rule soon on whether any of the lawsuits against Johnson & Johnson can go forward.

In the fall, the Supreme Court will hear a separate pre-emption case involving Wyeth, another drug company. Chris Seeger, a plaintiffs’ lawyer who has about 125 Ortho Evra cases, said he expected the court to rule in Wyeth’s favor.

“Our lawsuits are the ultimate check against the mistake made by the government, or fraud made by the companies against the government, or just an underfunded bureaucracy stretched thin,” he said.

I’m too angry to make any sense of this.