Monday, July 7th, 2008

Time	Event
6:51a	Facebook Obama The Facebooker Who Friended Obama By BRIAN STELTER Last November, Mark Penn, then the chief strategist for Hillary Rodham Clinton, derisively said Barack Obama’s supporters “look like Facebook.” Chris Hughes takes that as a compliment. Mr. Hughes, 24, was one of four founders of Facebook. In early 2007, he left the company to work in Chicago on Senator Obama’s new-media campaign. Leaving behind his company at such a critical time would appear to require some cognitive dissonance: political campaigns, after all, are built on handshakes and persuasion, not computer servers, and Mr. Hughes has watched, sometimes ruefully, as Facebook has marketed new products that he helped develop. “It was overwhelming for the first two months,” he recalled. “It took a while to get my bearings.” But in fact, working on the Obama campaign may have moved Mr. Hughes closer to the center of the social networking phenomenon, not farther away. The campaign’s new-media strategy, inspired by popular social networks like MySpace and Facebook, has revolutionized the use of the Web as a political tool, helping the candidate raise more than two million donations of less than $200 each and swiftly mobilize hundreds of thousands of supporters before various primaries. The centerpiece of it all is My.BarackObama.com, where supporters can join local groups, create events, sign up for updates and set up personal fund-raising pages. “If we did not have online organizing tools, it would be much harder to be where we are now,” Mr. Hughes said. Mr. Obama, now the presumptive Democratic nominee, credits the Internet’s social networking tools with a “big part” of his primary season success. “One of my fundamental beliefs from my days as a community organizer is that real change comes from the bottom up,” Mr. Obama said in a statement. “And there’s no more powerful tool for grass-roots organizing than the Internet.” Now Mr. Hughes and other campaign aides are applying the same social networking tools to try to win the general election. This time, however, they must reach beyond their base of young, Internet-savvy supporters. By early April, Mr. Obama’s new-media team was already planning for the election by expanding its online phone-calling technology. In mid-May, to keep volunteers busy as the primaries played out, the campaign started a nationwide voter registration drive. And in late June, after Senator Clinton bowed out of the race, the millions of people on the Obama campaign’s e-mail lists were asked to rally her supporters as well as undecided voters by hosting “Unite for Change” house parties across the country. Nearly 4,000 parties were held. The campaign’s successful new-media strategy is already being studied as a playbook for other candidates, including the presumptive Republican nominee, Senator John McCain. “Their use of social networks will guide the way for future campaigns,” Peter Daou, Mrs. Clinton’s Internet director, said at a recent political technology conference. Mr. Daou called Mr. Obama’s online outreach “amazing.” The heart of the campaign’s online strategy is a teeming corner of Mr. Obama’s headquarters two blocks from the Chicago River, a crowded space that looks more like an Internet start-up company than a campaign war room. During a visit in late May, a bottle of whiskey sat, almost empty, atop a refrigerator (there had been plenty of victories to celebrate lately, a staff member explained). Sitting amid a cluster of cubicles, Mr. Hughes, whose title is “online organizing guru,” handles the My.BarackObama.com site, which is known within the campaign as MyBo. Other staff members maintain Mr. Obama’s presence on Facebook (where he has one million supporters), purchase online advertising, respond to text messages from curious voters, produce videos and e-mail millions of supporters. Before helping build Facebook, the social network of choice for 70 million Americans, the fresh-faced and sandy-haired Mr. Hughes, who grew up in Hickory, N.C., went to boarding school at Andover, where he joined the Democratic Club and the student government. In the fall of 2002, he went to Harvard, where he majored in history and literature. He and a roommate, Mark Zuckerberg — now the chief executive of Facebook — shared a room that was “just about as small as my cubby at work is these days,” Mr. Hughes said. Mr. Zuckerberg and another Facebook co-founder dropped out in 2004 to work on the site full time, but Mr. Hughes graduated in 2006 before venturing to Silicon Valley. In February 2007, after showing interest in Mr. Obama’s candidacy and being reassured that the campaign’s new-media operation would be more than “just a couple Internet guys in a corner,” he left Facebook, where he has stock options that are potentially worth tens of millions of dollars, and moved to Chicago, where he lives — and dresses — like any other recent college graduate. “Cabs are a luxury,” he said. As supporters started to join MyBo in early 2007, Mr. Hughes brought a growth strategy, borrowed from Facebook’s founding principles: keep it real, and keep it local. Mr. Hughes wanted Mr. Obama’s social network to mirror the off-line world the same way that Facebook seeks to, because supporters would foster more meaningful connections by attending neighborhood meetings and calling on people who were part of their daily lives. The Internet served as the connective tissue. While many candidates reach their supporters through the Web, the social networking features of MyBo allow supporters to reach one another. Mr. Hughes’s abrupt shift from Facebook pioneer to campaign aide was not easy. In the lonely months before the Iowa caucus, he grappled with the small scale of his new social network, measuring its membership by the thousands rather than the millions he was accustomed to. He had to learn mystifying political shorthand (VAN, for voter file management; N.P.G., for the donor and volunteer database) and figure out how campaigns operate. Eventually, he grew comfortable. At first, his main focus was a single state. Throughout last summer and fall, the prevailing attitude was, “What can you do for Iowa today?” Mr. Hughes recalled. Mr. Obama’s win in the Iowa caucuses drove new supporters to the MyBo site in droves. Using the campaign’s online toolkit, energized volunteers laid the groundwork for field workers. So far, MyBo has attracted 900,000 members, although aides play down the raw numbers. “The point is not to have a million people” signed up, said Joe Rospars, the campaign’s new-media director, although he does expect to have well over a million signed up on MyBo by November. “The point is to be able to chop up that million-person list into manageable chunks and organize them.” In some primary and caucus states, volunteers used the Internet to start organizing themselves months before the campaign staff arrived. In Texas on March 4, Mrs. Clinton won the popular vote, but Mr. Obama came away with a lead of five delegates, thanks to a caucus win. Caucuses are a test of organizational strength, and Mr. Obama’s team used database technology to track 100,000 Texas volunteers and put them to work. This permitted campaign staff members to “skip Steps 1, 2 and 3,” Mr. Hughes said. So maybe the Obama core does “look like Facebook.” Mr. Penn’s remark, made at the Jefferson-Jackson Dinner in Iowa and reported by The Politico, was cited by both Mr. Rospars and Mr. Hughes in separate interviews. Virtual phone banks greatly benefited Mr. Obama. During the primaries, volunteers could sign in online, receive a list of phone numbers and make calls from home. The volunteers made hundreds of thousands of calls last winter and spring. At the end of June, the Obama campaign began carefully opening up its files of voters to online supporters, making it easier to find out which Democratic-leaning neighbors to call and which registered-independent doors to knock on. One goal is to drive online energy into in-person support. From January to April, for instance, the Obama campaign spent $3 million on online advertising to steer would-be voters to their polling places with online tools that tell people where to vote. The locators “are hard to build, but once you build them, they have a very high return on investment,” Mr. Hughes said. Much of the technology in the Obama toolbox was pioneered by Howard Dean’s 2004 campaign. “We were like the Wright brothers,” said Joe Trippi, the Web mastermind of the Dean campaign. The Obama team, he added, “skipped Boeing, Mercury, Gemini — they’re Apollo 11, only four years later.” Mr. Rospars and other former Dean aides formed a consulting firm, Blue State Digital, to refine their techniques. The Obama campaign purchased the backbone of MyBo from Blue State and has set out to improve it. “It’s still TheFacebook,” Mr. Hughes said, comparing Mr. Obama’s current site to the earliest and narrowest version of Facebook. “It’s still very, very rough around the edges.” Last month, acknowledging that attacks during the general election are likely to be more vociferous, the Obama campaign tried to capitalize on its network by creating a Web page, FightTheSmears.com. Through that site, the campaign hopes that supporters will act as a truth squad working to untangle accusations, as bloggers have informally in other campaigns and as many did when CBS reported on President Bush’s National Guard service in 2004. People who have posted on the site have already taken up five rumors, including that Mr. Obama was not born in the United States (a birth certificate was displayed) and that he does not put his hand over his heart during the Pledge of Allegiance (the site links to a YouTube video of him doing so). Republican strategists say, wryly, that Senator McCain’s 2000 campaign was innovative in its use of technology. (The candidate held a groundbreaking virtual fund-raiser and enabled supporters to sign up online.) But that was back when Mr. McCain ran as an outsider; as the presumptive nominee, he is no longer an upstart. His social network, called McCainSpace and part of JohnMcCain.com, is “virtually impossible to use and appears largely abandoned,” said Adam Ostrow, the editor of Mashable, a blog about social networking. By all accounts, Mr. McCain is not the BlackBerry-wielding politician that Mr. Obama is. But he has given credit to what he calls Mr. Obama’s “excellent use of the Internet,” saying at a news conference last month that “we are working very hard at that as well.” The McCain campaign recently reintroduced its Web site and hired new bloggers to broaden its online presence. Patrick Ruffini, a Republican strategist who was the Webmaster for President Bush’s 2004 campaign, said that a campaign’s culture largely determines its digital strategy. The McCain campaign “could hire the best people, build the best technology, and adopt the best tactics” on the Internet. “But it would have to be in sync with the candidate and the campaign,” Mr. Ruffini said. Mr. Hughes and other Obama aides say that their candidate gravitates naturally toward social networking, so much so that he even filled out his own Facebook profile two years ago. Mr. Obama has pledged that if he is elected, he will hire a chief technology officer; Mr. Hughes’s face lights up at the thought. Other administrations have adapted to the Internet, “but they haven’t valued it,” he said. Mr. Hughes has not decided whether to return to Facebook, and the decision does hinge in part on the fate of the campaign. But the lessons he has learned in political life seem to reinforce those learned in Silicon Valley. “You can have the best technology in the world,” he said, “but if you don’t have a community who wants to use it and who are excited about it, then it has no purpose.” Copyright 2008 The New York Times Company (3 Comments | Comment on this)
6:58a	Medicare: GOP Pushes for the Real Death Tax Doctors Press Senate to Undo Medicare Cuts By ROBERT PEAR WASHINGTON — Congress returns to work this week with Medicare high on the agenda and Senate Republicans under pressure after a barrage of radio and television advertisements blamed them for a 10.6 percent cut in payments to doctors who care for millions of older Americans. The advertisements, by the American Medical Association, urge Senate Republicans to reverse themselves and help pass legislation to fend off the cut. How to pay doctors through the federal health insurance program is an issue that lawmakers are forced to confront every year because of what is widely agreed to be an outdated reimbursement formula. But the dispute, which showcases the continued potency of health care issues, has reached a new level of urgency this year. Some doctors are reassessing their participation in the program and powerful interests on all sides are in a lobbying frenzy. Just before the Fourth of July recess, the House passed a bill to prevent the Medicare pay cut by a vote of 355 to 59. In the Senate, Republicans blocked efforts to take up the bill, so the cut took effect on July 1, as required by the formula. But the Bush administration has delayed processing of new claims to give Congress time to come up with a compromise. Senator Harry Reid of Nevada, the majority leader, said he planned to force another vote this week, and Democrats pressed their case over the weekend in their national radio address. Democrats need just one more vote to pass the bill, and they hope to win over Republicans who were hit by advertisements over the recess. The advertisements assert that Republicans have been protecting “powerful insurance companies at the expense of Medicare patients’ access to doctors.” The commercials were aimed at 10 Republican senators, including seven up for election this fall. But President Bush has vowed to veto the bill, so the fight — and the uncertainty — could continue for weeks. Mr. Bush and many Republicans oppose the bill because it would finance an increase in doctors’ fees by reducing federal payments to insurance companies that offer private Medicare Advantage plans as an alternative to the traditional government-run Medicare program. Insurance companies and the White House argue that the bill would hurt beneficiaries who rely on private Medicare plans. America’s Health Insurance Plans, a trade group, ran television advertisements last week, urging Congress to “stop cuts to Medicare Advantage.” Medicare is just one issue on which Congress is stalled. The Senate has yet to finish work on a bipartisan bill to help homeowners facing foreclosure. Lawmakers are also struggling with legislation to regulate electronic surveillance and deal with soaring gasoline prices. But the Medicare issue has been a sticking point for years. The question is how to rein in the rapidly rising cost of the federal health program. Members of both parties say they want to change the formula, which defines a “sustainable growth rate” for spending on doctors. But Congress is nowhere near agreement. The pending bill offers a short-term fix. It would reverse the 10.6 percent cut and increase Medicare payments to doctors by 1.1 percent in January. Under the current formula, doctors would still face cuts of more than 5 percent a year from 2010 to 2012. Despite the president’s veto threat, many House Republicans bolted and voted for the bill, putting added pressure on their colleagues in the Senate. As the maneuvering goes on in Washington, doctors around the country have begun to reassess their participation in Medicare. Dr. David D. Richardson, 40, an ophthalmologist in Los Angeles County, closed his practice last week to all but emergency patients and those needing surgery. “I love practicing medicine,” Dr. Richardson said, “but I would lose more money by keeping my office open than by pulling it back to a skeleton crew. Just like a physician in the emergency room, I try to reduce the hemorrhaging.” In Topeka, Kan., Dr. Kent E. Palmberg, senior vice president and chief medical officer of the Stormont-Vail HealthCare system, said its 70 primary care doctors were “no longer accepting new Medicare patients as of July 1 because of the draconian cut in Medicare reimbursement.” Dr. Gerald E. Harmon, a family doctor in Pawleys Island, S.C., said he decided last week that he would not take new Medicare patients “until further notice.” “This is not what we enjoy doing,” says a notice in his waiting room. “It is what we must do to maintain financial viability.” Dr. Harmon said that Democrats had been more helpful on Medicare legislation, but that the two parties shared responsibility for the impasse. “Rome is burning, and Nero is fiddling away, trying to get re-elected,” Dr. Harmon said. Doctors have also entered the political arena. One made a direct appeal to Mr. Bush at a fund-raiser last week in Jackson, Miss. Dr. J. Patrick Barrett, a spine surgeon and president of the Mississippi State Medical Association, said he had told Mr. Bush that the Medicare pay cut would be “extremely detrimental to the health and welfare of the elderly population.” In an interview, Dr. Barrett said: “I lose money whenever I operate on a Medicare patient. In the last week, a number of doctors have told me they will quit seeing new Medicare patients or will cut back on the amount of Medicare work they do.” The A.M.A.’s advertisements focus on Senators John Cornyn of Texas, John E. Sununu of New Hampshire and Roger Wicker of Mississippi, among others. Republicans defend their position in various ways. Mr. Cornyn said the bill provided only “a patchwork fix.” Senator Charles E. Grassley of Iowa said Democrats were playing “partisan games.” Senator Jon Kyl of Arizona, the Republican whip, said, “Nobody wants to cut physicians’ pay.” But lawmakers disagree over how to cover the cost of remedial legislation. More than 10 million of the 44 million Medicare beneficiaries are in private Medicare Advantage plans offered by companies like Humana, UnitedHealth and Coventry Health Care. Many of these plans offer extra benefits like vision and dental care. But independent studies have repeatedly found that the private plans cost the government more per person than traditional Medicare. Expecting the battle to resume this week, Coventry Health Care, in an e-mail message dated July 3, asked insurance agents across the country to call Congress and oppose the pending Medicare bill, saying that it would be “harmful to beneficiaries.” On the other side of the issue, military families have joined doctors and AARP, the advocacy group for older Americans, in lobbying for the bill. Relatives of active-duty military personnel, military retirees and their dependents receive care under a federal program known as Tricare, which uses the Medicare fee schedule to pay doctors. When Medicare reduces payments to doctors, fees under the military program are also reduced, and it becomes more difficult for military families to find doctors. Congress is “playing chicken with your health care,” the Military Officers Association of America told its members in a bulletin last week. Medicare receives 15 million claims a week for services paid under the physician fee schedule, so any change in payment rates has big implications. Michael O. Leavitt, the secretary of health and human services, said he would try to “minimize the impact” of the cut by instructing Medicare contractors to hold claims for 10 business days. Kerry N. Weems, the acting administrator of the Centers for Medicare and Medicaid Services, said doctors would not be paid at the lower rates “before July 15 at the earliest.” However, Medicare officials said, that is simply what the law requires. Under existing law, claims cannot be paid sooner than 14 days after they are received. And if claims are filed on paper, rather than electronically, they cannot be paid sooner than 29 days after they are received. (Comment on this)

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