CMYK
Nxxx,2013-10-13,A,001,Bs-BK,E3
Late Edition
Today, variably cloudy, patches of
rain, high 69. Tonight, mostly
cloudy, patchy drizzle, low 56. Tomorrow, morning drizzle, high 67.
Details on SportsSunday, Page 12.
VOL. CLXIII . . No. 56,288
© 2013 The New York Times
NEW YORK, SUNDAY, OCTOBER 13, 2013
$150
AT HEALTH PORTAL
Impasse and Infighting
May Affect ’14 Races MANY DEADLINES MISSED
100
Brand
By JEREMY W. PETERS
50
Generic
Average price
‘95
‘00
$5.00
G.O.P.’s Hopes FROM THE START,
To Take Senate SIGNS OF TROUBLE
Are Dimming
Prescription
Prices
The cost of both
brand and
generic
prescription
drugs is rising.
$6 beyond the greater New York metropolitan area.
‘04
‘10
Source: Census
Bureau
THE NEW YORK TIMES
Hannah Hayes, 13,
uses an inhaler and
other medicines to
control her asthma.
MAX WHITTAKER FOR THE NEW YORK TIMES
The Soaring Cost of a Simple Breath
Competition Is Supposed to Moderate Prescription Prices. It’s Not Working.
By ELISABETH ROSENTHAL
OAKLAND, Calif. — The kitchen counter
in the home of the Hayes family is scattered with the inhalers, sprays and bottles
of pills that have allowed Hannah, 13, and
her sister, Abby, 10, to excel at dance and
gymnastics despite a horrific pollen season that has set off asthma attacks, leaving
the girls struggling to breathe.
Asthma — the most common chronic
disease that affects Americans of all ages,
about 40 million people — can usually be
well controlled with drugs. But being able
to afford prescription medications in the
United States often requires top-notch insurance or plenty of disposable income,
and time to hunt for deals and bargains.
The arsenal of medicines in the Hayeses’ kitchen helps explain why. Pulmicort, a
steroid inhaler, generally retails for over
$175 in the United States, while pharmacists in Britain buy the identical product
for about $20 and dispense it free of charge
to asthma patients. Albuterol, one of the
oldest asthma medicines, typically costs
$50 to $100 per inhaler in the United States,
but it was less than $15 a decade ago, before it was repatented.
“The one that really blew my mind was
the nasal spray,” said Robin Levi, Hannah
and Abby’s mother, referring to her $80 copayment for Rhinocort Aqua, a prescription drug that was selling for more than
$250 a month in Oakland pharmacies last
year but costs under $7 in Europe, where it
PAYING TILL IT HURTS
No Room to Negotiate
is available over the counter.
The Centers for Disease Control and
Prevention puts the annual cost of asthma
in the United States at more than $56 billion, including millions of potentially
avoidable hospital visits and more than
3,300 deaths, many involving patients who
skimped on medicines or did without.
“The thing is that asthma is so fixable,”
said Dr. Elaine Davenport, who works in
Oakland’s Breathmobile, a mobile asthma
clinic whose patients often cannot afford
high prescription costs. “All people need is
medicine and education.”
With its high prescription prices, the
United States spends far more per capita
on medicines than other developed countries. Drugs account for 10 percent of the
country’s $2.7 trillion annual health bill,
even though the average American takes
fewer prescription medicines than people
in France or Canada, said Gerard Anderson, who studies medical pricing at the
Bloomberg School of Public Health at
Johns Hopkins University.
Americans also use more generic medications than patients in any other developed country. The growth of generics has
led to cheap pharmacy specials — under
$7 a month — for some treatments for high
cholesterol and high blood pressure, as
well as the popular sleeping pill Ambien.
But many generics are still expensive,
even if insurers are paying the bulk of the
bill. Generic Augmentin, one of the most
common antibiotics, retails for $80 to $120
for a 10-day prescription ($400 for the
brand-name version). Generic Concerta, a
Continued on Page 18
WASHINGTON — Next year
was supposed to be a prime opportunity for Republicans to retake the Senate. And for a while,
everything seemed to be breaking their way: a wave of Democratic retirements, a fluke in the
electoral map that put a large
number of races in states that
President Obama lost, a strong
farm team of conservative Senate hopefuls from the House.
Then the government shut
down. Now, instead of sharpening their attacks on Democrats,
Republicans on Capitol Hill are
being forced to explain why they
are not to blame and why Americans should trust them to govern
both houses of Congress when
the one they do run is in such disarray. Complicating the prospects, the grass-roots political
force that has provided so much
of the energy for conservative
victories over the last four years
— the Tea Party — is aggressively working against Republicans it
considers
not
conservative
enough.
As a result, many Republicans
are openly worrying that the fallout from the fiscal battles paralyzing the capital will hit hardest
not in the House, which seems
safely in Republican hands
thanks to carefully redrawn districts, but in the Senate. Republican infighting, they say, has given Democrats the cover they
need to deflect blame and keep
their majority.
“The Tea Party benefits when
Continued on Page 21
Last-Ditch Talks Open
Senate leaders began last-ditch
negotiations on reopening the
government and raising the debt
ceiling as talks between House
Republicans and the White
House collapsed in rancor.
Article, Page 20
Web Site Problems May
Imperil Finances of
Insurance Market
This article is by Robert Pear,
Sharon LaFraniere and Ian Austen.
WASHINGTON — In March,
Henry Chao, the chief digital architect for the Obama administration’s new online insurance
marketplace, told industry executives that he was deeply worried about the Web site’s debut.
“Let’s just make sure it’s not a
third-world experience,” he told
them.
Two weeks after the rollout,
few would say his hopes were realized.
For the past 12 days, a system
costing more than $400 million
and billed as a one-stop click-andgo hub for citizens seeking health
insurance has thwarted the efforts of millions to simply log in.
The growing national outcry has
deeply embarrassed the White
House, which has refused to say
how many people have enrolled
through the federal exchange.
Even some supporters of the
Affordable Care Act worry that
the flaws in the system, if not
quickly fixed, could threaten the
fiscal health of the insurance initiative, which depends on
throngs of customers to spread
the risk and keep prices low.
“These are not glitches,” said
an insurance executive who has
participated in many conference
calls on the federal exchange.
Like many people interviewed
for this article, the executive
spoke on the condition of anonymity, saying he did not wish to
alienate the federal officials with
whom he works. “The extent of
the problems is pretty enormous.
At the end of our calls, people say,
‘It’s awful, just awful.’”
Interviews with two dozen contractors, current and former govContinued on Page 21
Sports Legends Selling Relics? Family Man One Day, Rebel Fighter the Next After 22 Years,
A Girl Identified
Hey, That Glove Really Is Gold
By NORIMITSU ONISHI
By RICHARD SANDOMIR
There comes a time when a
sports legend must decide whether to hang on to this championship ring and that game-worn
jersey, or to cash in on the memorabilia market, which can fetch
stunning sums for rare and historic artifacts.
Bill Mazeroski, the former
Pittsburgh Pirates second baseman best known for his World Series-winning home run against
the Yankees in 1960, was the latest to choose to purge his house
of decades-old keepsakes. This
summer, as the Pirates were
heading to the playoffs for the
first time in 21 years, he received
an offer from the Hunt Auctions
company to sell the uniform and
many other items cluttering his
basement.
“My wife, Milene, goes along
with me, that we might as well
get rid of it,” he said by telephone. “One of our sons said, ‘Ah,
it’s hard to get rid of,’ and the other said, ‘O.K., get rid of it.’”
The Mazeroski auction heads
into a memorabilia market in
which Chris Chambliss recently
received a combined $121,874 for
the home run bat he swung, and
the ball he hit, to win the 1976
American League Championship
Series for the Yankees, and in
which Mike Eruzione, the captain
of the 1980 United States Olympic
hockey team, sold the “Miracle
on Ice” uniform he wore during
the defeat of the Soviet team for
$657,250.
Sam Snead’s family sold the
Continued in SportsSunday, Page 2
HUNT AUCTIONS
The uniform Bill Mazeroski
wore as he hit a title-winning
home run will be auctioned.
RAMTHA, Jordan — The Syrian rebel leader was sitting comfortably on a cushion at his home
here recently, his wife and children filling the rooms with conversation and laughter. Then one
day he shaved off his beard and
slipped back into Syria, where he
leads a rebel brigade.
“I cried,” said his mother-inlaw, Wesal al-Aweer. “I pleaded
with him not to leave.”
“We were used to having him
around the house,” said his wife,
Montaha Zoubi, 34, “so now we
feel there is an emptiness in the
house.”
A hardware store owner in Syria before the civil war, Hussein
Zoubi, 40, took up arms against
the government almost two years
ago. Since then, like thousands of
Syrian men in Jordan, Lebanon
and Turkey, he has been leading
the life of a commuter rebel, a
fighter inside Syria and a family
man across the border.
Men have long gone to war after packing off their families to
safer places. But the war’s proximity here along the Syrian-Jordanian border has collapsed the
distances. The vast majority of
the refugees are women and children, who have sought safety
And an Arrest
By MICHAEL SCHWIRTZ
and WILLIAM K. RASHBAUM
LYNSEY ADDARIO FOR THE NEW YORK TIMES
Mohammed Askar, a Syrian rebel, at home in Ramtha, Jordan.
here, while the men slip in and
out of Syria.
Unlike the battle-hardened Islamist combatants who have
made rapid gains inside Syria in
recent months, these are ordinary men — small-business owners, plumbers, carpenters —
caught up in the war. They fight
for weeks at a time and keep in
constant touch electronically, but
then return to see their families,
nurse wounds and take care of
businesses that may have suffered in their absence.
Ramtha is the twin city to
Dara’a, the birthplace of the Syrian uprising just across the border
from here. Errant mortar shells
from Dara’a fall with regularity
inside Ramtha, and the intensity
of fighting over there can sometimes be gauged by just lowering
the television volume here. Just
as significant, Dara’a’s ability to
tap Jordan’s mobile phone network allows the divided families
to engage in a nearly constant
stream of text and instant mesContinued on Page 8
It was a cold case that had
eluded investigators for more
than two decades. A little girl
with no name had been stuffed
into a cooler and left beside a
Manhattan highway. On Saturday, however, the mystery
seemed to have been lifted with
the arrest of a cousin of the girl,
known as Baby Hope, the police
said.
And the girl’s name had finally
been restored: Anjelica Castillo,
who was born in Elmhurst Hospital Center in Queens in 1987 and
was 4 years old when she died.
The cousin, Conrado Juarez,
52, who lives on Richmond Plaza
in the Bronx, was apprehended
on Friday at the Greenwich Village restaurant where he worked,
Police Commissioner Raymond
W. Kelly said. On Saturday morning, Mr. Kelly added, Mr. Juarez
confessed to sexually abusing
and murdering the girl and, with
the help of one of his sisters,
putting the body in a picnic cooler
Continued on Page 17
INTERNATIONAL 4-12
NATIONAL 14-21
SUNDAY BUSINESS
SPORTSSUNDAY
SUNDAY REVIEW
U.S.-Afghan Troop Deal Near
College Applications Backlog
Women and Leadership
The Score in Both Games: 1-0
Nicholas D. Kristof
Secretary of State John Kerry and President Hamid Karzai said one issue was
blocking a deal to keep American troops
PAGE 4
in Afghanistan beyond 2014.
A standard online application used by
hundreds of colleges has been plagued
by malfunctions, putting admissions ofPAGE 14
fices weeks behind schedule.
Four female executives, from the president of a beauty products company to
the general counsel at Pfizer, discuss
PAGE 1
succeeding in business.
Five Detroit pitchers combined to hold
Boston to one hit and record 17 strikeouts in the A.L.C.S. opener. The Cardinals beat the Dodgers in Game 2. PAGE 1
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