Month: July 2006











  • Today’s Papers


    Deadly Day
    By Eric Umansky
    Posted Thursday, July 27, 2006, at 3:24 AM ET


    The Los Angeles Times, New York Times, and Washington Post all lead with the heavy fighting in the Mideast: Eight Israeli soldiers died in an ambush as they were trying to take the strategic town of Bint Jbail near Lebanon’s southern border. Another Israeli soldier was killed in a village Israel said it took a few days ago. Hezbollah also fired about 130 rockets into Israel, wounding 10 people. Two dozen Palestinians were killed by Israeli strikes in Gaza. About half of the dead were civilians. Only the LAT datelines from Gaza City, where the paper’s reporter watched gunmen prepare for Israel’s arrival. The Post describes “pitched battles” as about 30 tanks moved into one town. USA Today reefers the Mideast and leads with airfares up about 10 percent since last year.


    As expected, little happened at the yesterday’s brief diplomatic confab in Rome, where Secretary of State Rice put the kibosh on the “entreaties of nearly all of her European and Arab counterparts” to push for an immediate cease-fire. The Post notes that U.N. chief Kofi Annan proposed an alternative platform calling for a “pause” in the fighting, but the measure was “blocked by intense U.S. pressure.”


    Hezbollah’s ground attack included mortars, RPGs, and laser-guided anti-tank missiles. It was so heavy and such a surprise that it took Israeli soldiersmost of whom were from the famed Golani Brigadean hour to shoot back. The eight soldiers killed reportedly died in the first few minutes of fighting. Israeli sources gave varying estimates on the number of guerrillas killed, and as usual Hezbollah didn’t release any numbers.


    It was hell on earth,” one Israel soldier told Haaretz. “People risked their lives not only for the wounded but also for the dead bodies.” A few days ago, an Israeli general had said Israel controlled the town.


    A front-page Post piece explores Hezbollah’s resilience so far. “These may be the best Arab troops we’ve ever faced,” said one Israeli intel expert. Hezbollah’s force in the south operates nearly autonomously, and most of the fighters are part-time militiamen who live in the area. “The command and control system is this,” said the intel expert, as he held up a cell phone.


    As the NYT explains, Israel’s seemingly limited successes are why “the country’s goals have so quickly changed from fully dismantling Hezbollah to securing a narrow strip” along the border.


    Everybody has more details on the Israeli strike that killed four U.N. soldiers. According to U.N. officials, their outpost was targeted by 21 strikes that went on for hours including after rescuers arrived. U.N. commanders said they made 10 calls to Israeli military officers, who promised to end the bombardment. Israeli Prime Minister Olmert said there will be an investigation and said it was “inconceivable” the compound was purposely hit.


    The NYT teases a poll that the paper says show a “strong isolationist streak” in the U.S. Nearly 60 percent of respondents said the U.S. doesn’t “have a responsibility try to resolve the conflict” between Israel and others. About the same percentage said the U.S. should set a timetable for withdrawal from Iraq.


    The Wall Street Journal goes high with a poll showing 45 percent of respondents support the president’s response to the Mideast crisis. The poll also has 60 percent saying the country is heading in the wrong directionabout the same as it’s been for months.


    The Post off-leads a preview of a bipartisan congressional report concluding that the Homeland Security Department’s contracting process is FUBAR. Investigators said the department doesn’t have near enough contract specialists, and the number of no-bid contracts has, as the WP puts it, “exploded.” Since DHS was created in 2003, there have been “significant overcharges, wasteful spending or mismanagement” on contracts worth a total of $34 billion.


    Everybody goes inside with Iraqi Prime Minister al-Maliki speaking to Congress and, apart from offering darn familiar rhetoric, all but begging for more reconstruction aid.


    After hanging with one U.S. unit in Baghdad for a few days, a Post reporter gets the impression that morale isn’t all that high. “Honestly,” said one named soldier, “it just feels like we’re driving around waiting to get blown up.”


    The Associated Press has an interesting analysis suggesting the new security push in Baghdad will increase the probability of a confrontation with radical cleric Moqtada Sadr. The reason: Sadr’s gunmen control chunks of the city and are causing havoc.


    The LAT fronts an interview with the U.S.’s top ground commander in Iraq, who said the push in Baghdad will include about $100 million in reconstruction projects. “I am not downplaying the importance of security, but the key thing here is getting the people believing their life is going to get better,” he said. Then he added, “Quite frankly, in 33 years in the United States Army, I never trained to stop a sectarian fight. This is something new.”

    Eric Umansky (www.ericumansky.com) writes “Today’s Papers” for Slate. He can be reached at todayspapers@slate.com.



     







    Mrs. Astor’s Son Denies Claims of Neglect










    Bill Cunningham/The New York Times
    Mrs. Astor at her 100th birthday party with her grandsons, Philip Marshall, center rear, and Alec Marshall, and Philips wife, Nan Starr.

    July 28, 2006
    Mrs. Astors Son Denies Claims of Neglect
    By SERGE F. KOVALESKI

    Anthony D. Marshall, who has been accused of neglecting his 104-year-old mother, the philanthropist and socialite Brooke Astor, spoke out yesterday for the first time in his own defense, saying that he had overseen expenditures of more than $2.5 million a year for his mothers care and comfort and calling the allegations against him completely untrue.

    Mr. Marshall, in a statement, said that he loved his mother and was mystified that one of his twin sons, Philip Marshall, had brought legal action against him without sharing his concerns with him beforehand.

    I am shocked and deeply hurt by the allegations against me, Mr. Marshall said. I love my mother, and no one cares more about her than I do. Her well-being, her comfort and her dignity mean everything to me.

    The necessity for Mr. Marshall, at 82, to publicly proclaim his love for his mother and defend her care came as Mrs. Astor was being treated at Lenox Hill Hospital, where she was reported in stable condition.

    She had been taken there after the court filing by Philip Marshall, which accused his father of failing to fill her prescriptions, stripping her apartment of artwork, reducing her staff, confining her dogs, and generally darkening her final years. Mrs. Astors welfare was being looked after by Annette de la Renta, a friend of Mrs. Astors who is married to the designer Oscar de la Renta, a spokesman said.

    Last night, Anthony Marshall and his wife, Charlene, walked from their Upper East Side apartment to Lenox Hill to visit his mother, buying a bouquet of pink roses at a corner grocery on the way.

    Were going through a hard time, Mr. Marshall said as he strolled on the humid evening in a dark blue suit, pin-stripe shirt and a red-and-blue tie. Its going to be very difficult for a long time now.

    His wife offered her own staunch defense of her husbands actions, and seemed to belittle claims by her stepson that Mrs. Astor living as she does in a large Park Avenue apartment with a retinue of servants and assistants exists in near squalor.

    Not everyone has a Park Avenue apartment, not everyone has eight servants, not everyone has this man, she said, gesturing toward her husband.

    Yesterdays developments seemed to cast the legal dispute as a contest between father and son, whose relationship has been described by some friends and relatives as distant and strained by decades of divorce, remarriage and the complicated conditions of caring for a woman who has lived past the century mark.

    Little is known about what prompted Philip Marshall to file a lawsuit, replete with affidavits from David Rockefeller and Henry Kissinger. But Mr. Marshall, a 53-year-old university professor who was never very much in the news despite being a member of one of New Yorks highest-profile families, is now a pivotal character in the public drama.

    In his lawsuit, Philip Marshall accuses his father a Broadway producer and former diplomat who also worked for the C.I.A. for several years of not only mistreating Mrs. Astor, but also of enriching himself with millions of dollars. He asks that his father be removed as Mrs. Astors legal guardian and replaced by Mrs. de la Renta. The court papers were quoted extensively in The Daily News but have been sealed by a judge.

    Philip Marshall lives far from the city that his grandmother captivated for decades with her philanthropy and social activities. He lives in South Dartmouth, Mass., and is a professor of historic preservation in the school of architecture, art and historic preservation at Roger Williams University in Bristol, R.I. Reached by telephone yesterday, he declined to comment.

    Some friends of Mrs. Astor said that she hardly ever talked about her grandson. I didnt even know she had a grandson, said John Fairchild, the retired publisher of Womens Wear Daily and a friend. She never mentioned a grandson.

    But Richard Cryan, 50, Mr. Marshalls first cousin, who lives in Needham, Mass., said that Mr. Marshall was very fond of his grandmother and feels a strong responsibility for her welfare. He said any speculation or suggestion that Mr. Marshall was somehow trying to cash in on Mrs. Astors fortune was unfounded.

    Philip is not an individual motivated by greed, Mr. Cryan said. He is a college professor and not money-oriented. I accept on face value that this is motivated by his concerns about the well-being of his grandmother.

    Mr. Cryan described Anthony Marshall as a classic father of the 50s, in that he was very dedicated to his career. And the flip side to that was he was not very accessible to Philip emotionally, he said. Philip Marshalls mother, Elizabeth Cryan, Mr. Cryan continued, is very warm, engaged and nurturing. I would say the relationship between Philip and his father was more distant, rather than contentious or hostile.

    One of the peripheral players in the situation is Mrs. Astors daughter-in-law, Charlene, who turned 61 yesterday. Though the Marshalls have already been demonized in tabloid accounts, those who know them find it shocking and incomprehensible that they could be accused of ignoring Mrs. Astors health, safety and personal needs.

    Charlene has been a great daughter-in law, and takes great care of Brooke, said David Richenthal, the Marshalls theatrical producing partner for such plays as the 2003 production of Long Days Journey Into Night. There is simply no connection between the reality of how loving and caring she has been, and these allegations, he said.

    The Marshalls divide their time between homes on the Upper East Side of Manhattan and Northeast Harbor, in Maine, which they met and where friends are also perplexed by the legal allegations. Im so surprised to hear these things about them, said Nan Lincoln, the arts editor of the weekly Bar Harbor Times.

    Ms. Lincoln recalled the days when her children went to the same elementary school as those of Charlene Marshall, who as a preachers wife, was living in the rectory. Charlene was married to the Rev. Paul Gilbert, the Episcopal minister at St. Marys by the Sea in Northeast Harbor. She was a friend before she ran off and shocked us all, Ms. Lincoln said of Mrs. Marshall. It was no small scandal, when she ran off.

    That was with Mr. Marshall, in 1992. Mr. Gilbert left shortly after that, Ms. Lincoln said. It was an uncomfortable situation.

    It is perhaps this past that has heightened speculation about family tensions. Though Mrs. Marshall has been a prominent participant with Mrs. Astor in legendary celebrations, those who know Mrs. Astor have described moments when she made it publicly clear even when her daughter-in-law was present that she was no fan of Mrs. Marshalls.

    And a neighbor, speaking of St. Marys by the Sea in Maine, recalled Mrs. Astor saying, after her sons affair with the ministers wife, I cant go to the church anymore.

    Yesterday, Mrs. Astor was visited at the hospital by Mrs. de la Renta, who was once considered her protégée. They have served on many charities and boards together and raised millions of dollars for the New York Public Library and the Metropolitan Museum of Art. When the investment banker Felix Rohatyn and his wife, Elizabeth, set off debate in 1986 by criticizing the opulence of their charity balls, Mrs. Astor and Mrs. de la Renta responded that the galas were critical fund-raising events. Mrs. Rohatyn was then shut out of many prestigious events for some time.

    Annette is an incredibly smart choice to act as her guardian, said Patrick McCarthy, the editorial director of Fairchild Fashion Group, which publishes Womens Wear Daily and W magazine.

    Mrs. de la Renta, 66, in addition to her work for the Metropolitan Museum of Art, the New York Public Library, the Morgan Library and Museum, the Animal Medical Center and Rockefeller University, joins in her husbands support of orphanages in the Dominican Republic.

    She is a powerhouse, the fashion publicist Paul Wilmot said. She has opinions and she is not afraid to voice them. But she does not go out for self-publicity.

    Mrs. Astors hospitalization was first reported yesterday by The Daily News and The New York Post. The hallway where Mrs. Astor is a patient looks different from the other floors: it has mahogany walls, artwork, a carpeted floor and a meditation room. It also has a special security detail with restrictions for visitors, including hospital staff. IDs are always required.

    After visiting his mother at the hospital, Mr. Marshall spoke outside his apartment building. His wife eventually pulled him away, saying that hes been dizzy; he needs his rest.

    Mr. Marshall said: I was very touched and encouraged by the fact that my mothers present state of age has brought attention to the need for care of elderly people. My mother always liked to spearhead a problem, whether it was within the New York community or throughout the nation. Im happy she can still do what she did for years for the foundation, even if she doesnt know it.

    Reporting for this article was contributed by Glenn Collins, Kate Hammer, Ethan Wilensky-Lanford and Eric Wilson in New York, Polly Saltonstall in Maine, and Stacey Stowe in Massachusetts.


    Copyright 2006 The New York Times Company








  • Phil Marino for The New York Times
    A lunch order arrives at North Shore Diabetes in New Hyde Park, N.Y. A pharmaceutical company paid for the food.

    July 28, 2006
    Drug Makers Pay for Lunch as They Pitch
    By STEPHANIE SAUL

    Anyone who thinks there is no such thing as a free lunch has never visited 3003 New Hyde Park Road, a four-story medical building on Long Island, where they are delivered almost every day.

    On a recent Tuesday, they began arriving around noon. Steaming containers of Chinese food were destined for the 20 or so doctors and employees of Nassau Queens Pulmonary Associates. The drug maker Merck paid the $258 bill.

    A deliveryman carrying trays of gourmet sandwiches sashayed past patients at Advanced Internal Medicine. The bill showed that Takeda Pharmaceuticals was picking up the bill. The doctors in the group must have liked the sandwiches. The next day, the exact same delivery came in, paid for by Cephalon.

    Free lunches like those at the medical building in New Hyde Park, N.Y., occur regularly at doctors’ offices nationwide, where delivery people arrive with lunch for the whole office, ordered and paid for by drug makers to the tune of hundreds of millions of dollars a year.

    Like the “free” vacation that comes with a time-share pitch attached, the lunches go down along with a pitch from pharmaceutical representatives hoping to bolster prescription sales. The cost of the lunches is ultimately factored in to drug company marketing expenses, working its way into the price of prescription drugs.

    Doing business over lunch is a common practice in many fields, but drug makers have honed it to perfection, particularly since 2002, when the drug industry adopted a new code banning many other free enticements — golf outings, athletic tickets, trips and lavish dinners for doctors. The code gives approval to modest meals in the course of business. And conventional wisdom in both the pharmaceutical industry and the medical profession is that a lunch is too small to pose an ethical problem. But a growing number of critics say that even those small lunches should be banned.

    A former pharmaceutical representative, Kathleen Slattery-Moschkau, called lunch “incredibly effective” in lifting pharmaceutical sales for the companies where she worked, Bristol-Myers Squibb and Johnson & Johnson.

    “We got the numbers of what the physicians were prescribing. If I brought in lunch one week, I could see the following week if that lunch had an impact,” Ms. Slattery-Moschkau said.

    Dr. John G. Scott, assistant professor of family medicine at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School in New Brunswick, N.J., is examining the interaction between medical practices and pharmaceutical representatives.

    “We found that some offices get breakfast and lunch every day,” said Dr. Scott, who calls lunch the “currency” that buys access to doctors’ offices for drug representatives. He also noted that some doctors were hard pressed to meet payrolls and that the lunches provided an added benefit for their employees.

    “Essentially, we feel that most of what the pharmaceutical reps do works at an unconscious level,” Dr. Scott said. He said most doctors said they were not influenced by the food deliveries and other small gifts. But, he added, “They do influence prescribing.”

    The $258 Merck lunch, for example, cost the company only $10.75 a person and fell clearly within industry guidelines allowing modest meals. But it could easily return thousands of dollars for the drug maker in prescriptions for the osteoporosis medication Fosamax and the asthma treatment Singulair, the two drugs discussed during lunch with two Merck representatives.

    An official of Merck’s sales and marketing division, Patrick T. Davish, says his company views lunch meetings as appropriate and “a good time to sit around and talk about the clinical properties of your drug and the disease categories you deal with.” Spokesmen for both Takeda and Cephalon emphasize that the lunches they pay for are modest.

    Dr. Scott cited several studies that show that the lunches — plus small gifts like pens and sticky notepads, along with drug samples — can lead doctors to prescribe the more expensive brand names when cheaper generic drugs would be as effective.

    Such concerns have spurred the effort to ban lunches. The movement is making headway nationwide, as opponents of the practice cite ethics questions. The hospital at the University of Pennsylvania became the latest large institution barring industry-paid lunches, effective July 1, according to its medical director, Dr. Patrick J. Brennan.

    “It curries favor and it creates influence, and it introduces influences into decision-making processes that we think ought not to be there,” Dr. Brennan said.

    Similar rules have been adopted recently at several other academic medical centers. When the University of Michigan Health System banned industry lunches last year, officials calculated that they had been worth $2.5 million annually.

    In Madras, Ore., meanwhile, a group of internists earlier this year banned not only lunch but also visits by drug representatives. Even in Madras, a rural town of about 5,000, the group got visits from more than 30 drug representatives a month, including two or three lunches.

    “The complaints that I would get from my patients were, ‘You’re 15 minutes late to see me.’ ” said Dr. David V. Evans, a member of the group. “ ‘O.K., I was back there talking to a drug rep.’ That wasn’t such a good thing.”

    Dr. Evans added, “It’s an issue of professionalism and integrity, really.”

    The pharmaceutical industry employs about 90,000 representatives. While some patients grumble about their ubiquitous presence in medical office waiting rooms — and many are aware of lunch deliveries — others say the intrusion is worthwhile in exchange for the free drug samples.

    “The doctors I go to only see them at certain times,” said Arnold Dimond of Glen Oaks, N.Y., who was leaving the New Hyde Park building recently, carrying a plastic bag of drug samples. “The samples save you quite a bit of money, too.”

    One of the most vocal opponents of free lunch is Dr. Bob Goodman, a Manhattan internist who formed an organization called No Free Lunch.

    “I’d say that lunches are going to be one of the last things to go,” Dr. Goodman said. “The interesting thing is that it’s generally not something doctors are ashamed about. That’s why I find this thing so fascinating. They don’t think they’re doing anything wrong.”

    At 3003 New Hyde Park Road most of the doctors contacted declined to be interviewed for this article. But one, Dr. Javier Morales, said the samples that representatives bring to his office are helpful for low-income patients.

    And Scott M. Lassman, senior assistant general counsel for the Pharmaceutical Research and Manufacturers of America, said: “It’s our feeling that a modest meal is not the type of thing that is going to interfere with the independence of a health care practitioner. It’s really a recognition that these folks are extremely busy. They don’t have time to talk. Perhaps the only time they do have time to talk is over lunch or dinner. So we thought it was appropriate for the sales rep to pay for that.”

    Not every doctor’s office gets free lunches at 3003 New Hyde Park Road, though many do. The deliveries often start even before lunchtime, with representatives bringing in pastries and large containers of coffee from Starbucks or Dunkin’ Donuts.

    Ms. Slattery-Moschkau, the former pharmaceutical representative, said that nurses and staff members in some offices were quite demanding about lunch.

    “It was almost a game, and it was unbelievable the animosity they would show if you did not bring the right kind of food, or if it was the third time they had pizza that week,” said Ms. Slattery-Moschkau, who left the industry in 2002 and recently wrote and directed the documentary “Money Talks,” in which the practice of lunch is discussed.

    Midweek lunches, when all the doctors are sure to be in the office, are considered prime time.

    “Wednesdays are big,” said Larry Plompen of West Islip, N.Y., who peddles lunch and coffee out of a refrigerated truck at 3003 New Hyde Park Road. Several years ago, Mr. Plompen said, a drug company purchased lunch from his truck for the entire staff of a large practice in the building.

    Other entrepreneurs have also capitalized on the business — a segment of the restaurant industry that one national lunch-ordering company, Lunch and Earn, estimates is worth $4 million a day, or as much as $1 billion a year. A founder of that company, Amy Kristjanson, a former pharmaceutical representative, said her numbers were based on a calculation of lunch spending by representatives for the top 10 pharmaceutical companies.

    Mr. Lassman said he was not aware of any industrywide figure for the cost of such lunches. But various sales representatives, pharmaceutical companies and the lunch delivery industry supplied estimates of how much is spent for lunch. Judy Kay Moore, spokeswoman for Eli Lilly, for instance, said that company’s representatives spend $500 to $750 a month for lunches. Joseph R. Carolan, an owner of Casa Mia’s in Nottingham, Md., which does a large pharmaceutical lunch delivery business in the Baltimore area, said the average representative he deals with has a monthly lunch budget of close to $2,000.

    Mr. Carolan said his lunch business — about 30 to 40 orders a day — exploded after the new industry marketing code was adopted in 2002.

    “I got into this because the feds cracked down on the more extravagant things they were doing: the dinners, courtside N.B.A. games, flying them to the islands.” Mr. Carolan said.

    He is also on the forefront of another marketing trend: rewards programs for pharmaceutical representatives.

    One who spends $5,000 at Casa Mia’s, for example, can get a $100 gift certificate to Nordstrom, one month of tanning, or a Swedish massage with a manicure and pedicure.

    Ms. Kristjanson, the former representative who founded Lunch and Earn, said that lunch represented a fundamental shift in the business.

    “Reps used to have more freedom,” Ms. Kristjanson said. “Lunch is sort of what it’s come down to.”

    Copyright 2006 The New York Times Company