Seeking a fix for California's gasoline market problems

California will always be at risk of gasoline price spikes caused by disruptions at refineries because it is a “fuel island,” stranded by time and distance from quick delivery of gasoline from outside the state. Without interstate pipelines, California relies primarily on maritime tankers for oil and gasoline imports, which cannot move fast enough to make up for a sudden drop in supply.

Spikes in California gasoline prices experienced in 2012 were in large part due to significant, unplanned outages at three major oil refineries. When the most recent outage occurred, in Torrance on October 1, the wholesale price for gasoline followed a pattern typical of such price spikes – rising, peaking and starting to decline within a week, fewer days than it would take a gasoline shipment to arrive at a California port.

Although the state’s clean-air requirements add to the price of gasoline, the health benefits are substantial, and studies show their value exceeds the additional cost at the pump. Furthermore, the requirements are not the primary driver of price spikes, nor do they prohibit importing gasoline from elsewhere.

In fact, refiners outside California can, and sometimes do, make gasoline that meets the state’s specifications. That said, in the wake of the recent price spike, the state eased summer-blend fuel requirements, which benefited motorists by allowing in-state refiners to immediately boost gasoline production by 3% to 5%.

But there is a larger lesson here: It’s time to think beyond the gas tank.

Instead of running on fossil fuels and driving toward empty, California needs to diversify its array of transportation fuels to include more electricity, biofuels, natural gas, propane and hydrogen.

The California Energy Commission is working to do just that as it helps the state meet ambitious climate change goals. The commission supports the development and use of new vehicle technology and alternative and renewable fuels through competitive awards of AB 118 funds — made available through legislation adopted in 2007 and funded by a small surcharge on vehicle and boat registrations and smog-check and license plate fees.

The commission has awarded more than $250 million to more than 120 clean transportation projects across the state. These awards have leveraged more than $500 million in private and public investment.

These investments support a wide range of projects, including the installation of about 6,000 electric vehicle charging stations and the rollout of hundreds of alternative fuel vehicles on the road. These investments also support the innovative development of biofuels made from algae and restaurant and agricultural waste.

The efforts are already paying off: They are reducing gasoline dependency, creating more than 5,000 long-term jobs, bolstering energy security and economic competitiveness, and reducing the risk of lung cancer and asthma for all Californians by cleaning up the air.

In the longer term, these crucial investments will lead to more options for consumers and smooth out the road to a clean transportation future for California.

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Small union is causing big problems for ports

The small band of strikers that has effectively shut down the nation's busiest shipping complex forced two huge cargo ships to head for other ports Thursday and kept at least three others away, hobbling an economic powerhouse in Southern California.

The disruption is costing an estimated $1 billion a day at the ports of Los Angeles and Long Beach, on which some 600,000 truckers, dockworkers, trading companies and others depend for their livelihoods.

"The longer it goes, the more the impacts increase," said Paul Bingham, an economist with infrastructure consulting firm CDM Smith. "Retailers will have stock outages, lost sales for products not delivered. There will be shutdowns in factories, in manufacturing when they run out of parts."

Despite the union's size — about 800 members of a unit of the International Longshore and Warehouse Union — it has managed to flex big muscles. Unlike almost anywhere else in the nation, union loyalty is strong at the country's ports. Neither the longshoremen nor the truckers are crossing the tiny union's picket lines.

The strike started at the L.A. port's largest terminal Tuesday and spread Wednesday to 10 of the two ports' 14 cargo terminals. These resemble seaside parking lots where long metal containers are loaded and unloaded with the help of giant cranes.

The union contends that the dispute is over job security and the transfer of work from higher-paid union members to lower-paid employees in other countries. The 14-employer management group says that no jobs have been outsourced and that the union wants to continue a practice called "featherbedding," or bringing in temporary workers even when there is no work.

The two sides haven't met since negotiations broke down Monday, but they were scheduled to begin talking again Thursday night. The union has worked without a contract for 21/2 years.

The clerical workers are a vital link in the supply chain. They handle the immense flow of information that accompanies each cargo ship as well as every item in the freight. One shipload of shoes, toys and other products is enough to fill five warehouses.

Logistics clerk Trinie Thompson, 41, normally spends her days working with railroad lines and trucking companies to ensure that the right containers are sent along to their proper destinations. On Thursday, she was walking the picket lines at the docks.

"We will be setting up trains to Houston, trains to Dallas, to Chicago, to the Pacific Northwest," said Thompson, who has worked for 10 years for Eagle Marine Services terminal, which is affiliated with the giant APL shipping line.

"For a typical container ship, we will have to set up multiple trains. We might be sending 200 to 300 containers to Chicago alone, and there will be paperwork for all of them."

The strike comes at a time of simmering labor unrest at other U.S. ports, underscoring the unusual power labor holds in maritime trade.

On the East Coast and Gulf Coast, another group of shipping lines and terminal operators called the United States Maritime Alliance has repeatedly failed to reach agreement on a new labor contract with the International Longshoremen's Assn. A strike that might have involved dozens of ports was avoided only after both sides agreed to extend negotiations past the September end of their current contract.

A strike also was narrowly avoided at Portland, Ore., only a few days ago in a dispute between grain shippers and union workers.

Operations at Oakland International Airport and at the Port of Oakland, the third-largest port in the state behind Los Angeles and Long Beach, were affected by a brief strike this month.

Maritime unions "have successfully organized one of the most vital links in the supply chain, and it's a tradition they nurture with all of their younger workers," said Nelson Lichtenstein, a UC Santa Barbara history professor and workplace expert. "They have a very strong ideological sense of who they are, and for now they are strong."

In Los Angeles and Long Beach, the 800 clerical workers have been able to shut down most of the ports because the 10,000-member dockworkers union is honoring the picket lines. Work continues at only four cargo terminals, where the office clerical unit has no workers.

"Longshoremen stand up when other workers need our help," said Ray Ortiz Jr., a member of the International Longshore and Warehouse Union's Coast Committee. "Sure, it's a sacrifice to give up a paycheck when you refuse to cross the picket line, but we believe it's in the long-term interest of the Los Angeles-Long Beach harbor area to retain these good local jobs."

Stephen Berry, lead negotiator for the shipping lines and cargo terminals, said the clerical workers have been offered a deal that includes "absolute job security," a raise that would take average annual pay to $195,000 from $165,000, 11 weeks' paid vacation and a generous pension increase.

At a news conference Thursday, Berry denounced the tactics by the clerical workers, calling them "irresponsible."

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MacFarlane surprises UCLA class, announces contest

LOS ANGELES (AP) — Oscar host Seth MacFarlane is inviting college students to join him on stage at the Academy Awards.

The "Family Guy" creator made a surprise appearance at UCLA to announce a contest sponsored by the Academy of Motion Picture Arts and Sciences and MTV that will allow winning college students to appear on the Feb. 24 Oscar telecast.

The contest invites students to submit videos on the academy's Facebook page describing how they'll contribute to the future of film. At least six winners will serve as trophy carriers on the Oscar show, replacing the leggy models who usually perform the duties.

MacFarlane spent 40 minutes leading the undergraduate film and television class at UCLA's Westwood campus on Wednesday as part of MTV's "Stand In" series, which brings celebrities to colleges as guest lecturers.

"In re-imagining what we want the Oscar show to be, we wanted everyone appearing on that stage to feel a deep commitment to film and its legacy, and most importantly, its future," said Oscar telecast producers Craig Zadan and Neil Meron in a statement. "That was the impetus in creating this special honor for young film students who will inspire a new generation to create the films that will be honored in the future."

The contest is also aimed at drawing younger viewers favored by advertisers to the Oscars' aging TV audience. Like UCLA student Abby Smith, who immediately pulled out her smartphone to share the moment on Facebook when MacFarlane appeared before her class.

"Seth MacFarlane is speaking to my film lecture for the next hour," Smith posted. "I'm having a panic attack."

The 39-year-old entertainer urged the aspiring filmmakers and show-runners in the class to make a "commercially viable student film" before leaving school, adding that "Family Guy" was based on his own student film.

And MacFarlane said "Family Guy" could once again become a film. He said he's already come up with a concept for a feature-length movie and promised "it will happen at some point."

MacFarlane cheekily described the Academy Awards as "a crazy little variety show" and said "all I can do is do what I think is funny and most entertaining."

"The Oscars is a tricky venue," he said. "The (hosts) who have not done well, I would classify them as a noble failure, an honorable failure, because at least they were trying something new... If I can do it without torpedoing my career and getting drummed out of the business... All I can do is my very best."

He paused a beat, and added, "Lame (expletive) answer."

___

AP Entertainment Writer Sandy Cohen is on Twitter: www.twitter.com/APSandy.

___

Online:

http://www.facebook.com/TheAcademy/app_436081253118204

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Ranbaxy, a Generic Drug Maker, Stops Making Cholesterol Pill

Ranbaxy Pharmaceuticals, the largest producer of the generic version of Lipitor, has halted production of the drug until it can figure out why glass particles may have ended up in pills that were distributed to the public, the Food and Drug Administration announced Thursday.

The agency said it had not received any reports of patients being harmed by the particles, which are about the size of a grain of sand. Earlier this month, Ranbaxy recalled more than 40 lots of the drug because of the glass contamination.

The company has declined to say where the drug was manufactured or why the problem occurred, but a spokeswoman for the F.D.A. said Thursday that the company would stop making the pill’s active ingredient, which is made in India, until the investigation is completed.

The contamination was the latest episode in a history of manufacturing lapses at Ranbaxy, which is a subsidiary of the Japanese pharmaceutical company Daiichi Sankyo. The company has been operating under a court-ordered consent decree since January, one that federal authorities have called “unprecedented in scope,” after they identified a host of manufacturing problems at the company’s plants in India and the United States, and concluded that Ranbaxy had submitted false data in drug applications to the F.D.A..

The decree prevents Ranbaxy from manufacturing drugs at its most troubled facilities until it can show it is meeting United States standards, although it was allowed to continue making products — including the generic version of Lipitor — at other plants.

The F.D.A. spokeswoman, Sarah Clark-Lynn, said the affected lots were not made at “the same facilities whose conduct gave rise to the consent decree.” Nonetheless, she said in an e-mail Monday, “the consent decree provides the F.D.A. with additional tools to address violations for other Ranbaxy facilities.”

A spokesman for Ranbaxy declined to comment beyond an informational statement on the company’s Web site.

Some drug manufacturing experts said Ranbaxy’s latest troubles highlight the disparities in oversight of plants in the United States versus those overseas. “I have pretty good faith in companies and plants that make drugs in this country because I know from my own experience that they try to do a good job,” said Prabir K. Basu, executive director of the National Institute for Pharmaceutical Technology and Education, who previously worked in manufacturing and global outsourcing for pharmaceutical companies, including Searle and Pharmacia. “But my confidence is not that high when we are getting products from outside the country.”

He pointed to studies that have shown the F.D.A. inspects foreign generic manufacturing plants about once every seven to 13 years, compared with once every two years for domestic manufacturers. A law passed over the summer will eventually require the F.D.A. to apply the same standards when inspecting all manufacturing plants, regardless of which country they’re in.

Allan Coukell, director of medical programs at the Pew Health Group and an expert on drug safety, said the new law would level what he described as an uneven playing field, but “it’s incumbent on F.D.A. to hire the staff and to make the shift to a risk-based inspection system.” Under the law, fees collected from generic manufacturers will help pay for more inspectors.

Mr. Basu said the law, called the Generic Drug User Fee Amendments of 2012 and known as Gdufa (Gah-doofuh) was a step in the right direction, but fixing the problem would require more than simply hiring more people. “This is a very difficult and complex system, and how do we ensure the integrity of this supply chain?” he said. “I don’t know how much Gdufa will help.”

Ranbaxy has held a significant share of the market for generic Lipitor, also known as atorvastatin, since it became one of the first companies to sell it after Pfizer lost patent protection for the top-selling drug last November; another company, Watson, sold a generic version that was authorized and manufactured by Pfizer. In October, Ranbaxy’s product accounted for 43 percent of prescriptions for atorvastatin, a widely used drug to lower cholesterol levels, according to an analysis by Michael Faerm, an analyst for Credit Suisse who used prescription data from the research firm IMS Health.

In its statement on Thursday, the F.D.A. said it did not expect a shortage of atorvastatin. Erin Fox, who tracks drug shortages as director of the Drug Information Service at the University of Utah, said drugs in pill form have long shelf lives and suppliers can keep large quantities in stock. Other generic manufacturers with approval to sell the drug include Apotex, Dr. Reddy’s Labs, Mylan, Sandoz, and Teva, according to the F.D.A. Web site.

Ranbaxy has posted a list of the recalled lots on its Web site, and has warned that patients should not stop taking the drug without guidance from their doctor. The lot numbers are found on the side of Ranbaxy pill bottles and the company advised patients to check with their pharmacist if customers received pills in a container dispensed by the pharmacy.

The agency said the potential for injury because of the contamination appeared to be low and “if any adverse events are experienced, they would be temporary.”

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Stocks flat; consumer spending falls

Stocks are little changed in morning trading Friday as lawmakers seek to thrash out a budget agreement. The government also reported that consumer spending fell in October.

The Dow Jones industrial average rose six points to 13,028 as of 11:13 a.m. Eastern. The Standard and Poor's 500 was down 0.4 points to 1,415. The Nasdaq composite was down five points to 3,007.

Stocks are slightly higher for the week. The Dow is up 0.2 percent, the S&P 500 index 0.4 percent. The market has fluctuated between gains and losses in recent days as news and comments filtered out from the budget negotiations in Washington.

Investors have been closely following the talks between the White House and Congress over the “fiscal cliff,” which refers to sharp government spending cuts and tax increases scheduled to start Jan. 1 unless an agreement is reached to cut the budget deficit. Economists say that those measures, if implemented, could push the U.S. economy back into a recession.

“Right now the market is just going to be held hostage as to what happens in the next five hours, versus what's going to happen in the next five years,” said Dan Veru, chief investment officer at Palisade Capital Management, in Fort Lee, New Jersey.

Americans cut back on spending last month and saw no growth in their income, reflecting disruption from Superstorm Sandy that could hold back economic growth in the final months of the year.

The Commerce Department reported that consumer spending dropped 0.2 percent in October. That's down from an increase of 0.8 percent in September and the weakest showing since May.

Among stocks making big moves:

—Yum Brands, which owns KFC, Pizza Hut and Taco Bell, fell $6.90 to $67.58. The fast-food operator reported disappointing sales and earnings forecasts. An analyst recommended that investors sell the stock.

—Zynga, the maker of computer games including “Farmville” and “Cityville,” fell 17 cents to $2.45 after the company said late Thursday that it was loosening its relationship with Facebook.

—VerSign plunged $5.50 to $33.83 after the company announced the terms of its new contract to run the key directories that keep track of “.com” domain names. The company won't be allowed to raise prices on the registration of such names without government approval.

—Duke Energy rose $1.10 to $63.49 after the company said its CEO will step down as part of a settlement with the North Carolina utilities regulator that ends an investigation into the company's takeover of in-state rival Progress Energy.

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British judge urges new press regulator due to hacking scandal

LONDON – In a highly anticipated and lengthy report, a senior judge Thursday recommended that a new, independent regulatory authority be set up to monitor Britain’s raucous press and to crack down on media abuses such as phone hacking and other unethical newsgathering practices.

Justice Brian Leveson said such a regulator was necessary because the press had at times “wreaked havoc in the lives of innocent people” through its intrusions on privacy and relentless pursuit of scoops.

The new regulatory body should be backed by law, but it should not include any politicians, in order to avoid government control of the press, nor any editors, in order to maintain full independence, Leveson said.

The regulator would replace a previous press complaints commission that is widely recognized in Britain to have been a failure, particularly with regard to the phone-hacking scandal. Evidence has emerged that hundreds of high-profile figures may have had their cellphones tapped by the now-defunct News of the World tabloid.

The scandal gave rise to a months-long, government-commissioned investigation into media culture and ethics by Leveson, who heard testimony from more than 300 witnesses.

The recommendations in his 2,000-page report are likely to please some hacking victims and satisfy demands of some lawmakers who say that Britain’s media, in particular its sensation-seeking and gossip-hungry tabloids, have been allowed to run amok.

But the news organizations themselves have expressed alarm over any form of regulation that has its roots in law and that, they fear, could be the first step toward government censorship. Although they recognize the need for oversight, many news outlets have pushed for a better system of self-regulation with no legal underpinning.

Leveson was eager to emphasize his respect for a free press and denied that his recommendations represented any threat to it.

“The press operating freely and in the public interest is one of the true safeguards of our democracy. As a result, it holds a privileged and powerful place in our society,” he told reporters. “But this power and influence carries with it responsibilities to the public interest in whose name it exercises these privileges. Unfortunately, as the evidence has shown beyond doubt, on too many occasions those responsibilities … have simply been ignored.”

The report has been eagerly awaited for months. As its release date neared, politicians and high-profile individuals dug in on either side, calling for laws to regulate the media or warning against them as an unacceptable infringement on a free press.

“As parliamentarians, we believe in free speech and are opposed to the imposition of any form of statutory control,” said a letter signed by 86 lawmakers. “The solution is not new laws but a profound restructuring of the self-regulatory system.”

A recent poll, however, found a majority of Britons in favor of some kind of regulation of the media backed by the force of the law.

The witnesses who appeared before Leveson included some of Britain’s best-known public figures, such as Prime Minister David Cameron. Actor Hugh Grant and "Harry Potter" author J.K. Rowling denounced media invasions of their privacy. Media baron Rupert Murdoch and other newspaper proprietors spoke about newsgathering practices.

The inquiry was launched last year after the hacking scandal exploded in the public consciousness with the revelation that the News of the World had tapped the voicemail messages of a missing 13-year-old girl, whose body was later found dumped in the woods by her killer.

Like a fast-spreading fire, the scandal quickly engulfed key pillars of British public life, putting the heat not just on tabloid newspapers but also the politicians who cozied up to them and the police who offered scoops in hopes of flattering coverage. Within days, the head of Scotland Yard resigned, as did one of Murdoch’s closest confidants, and the 168-year-old News of the World was shut down.

Three separate police investigations – into phone hacking, computer hacking and bribery of public officials – were spawned by the affair. Dozens of people, most of them journalists at Murdoch-owned publications, have been arrested.

Only a few hours before Leveson’s report was released, the former head of Murdoch’s newspapers in Britain and a onetime senior aide to Cameron appeared in court on charges of paying public officials for information.

ALSO:

Three managers arrested after deadly Bangladesh factory fire

Outgoing Mexican President Felipe Calderon heading to Harvard

Google opposes German push for search engines to pay newspapers

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AP Newsbreak: New Suzanne Collins book in 2013

NEW YORK (AP) — "The Hunger Games" novelist Suzanne Collins has a new book coming out next year.

The multimillion-selling children's author has completed an autobiographical picture story scheduled for Sept. 10, 2013, Scholastic Inc. announced Thursday. The 40-page book will be called "Year of the Jungle," based on the time in Vietnam served by Collins' father, a career Air Force officer.

"Year of the Jungle" is her first book since 2010's "Mockingjay," the last of "The Hunger Games" trilogy that made Collins an international sensation. More than 50 million copies of the "Hunger Games" books are in print and the first of four planned movies has grossed more than $600 million worldwide since coming out in March.

Collins' next project will be intended for ages 4 and up, a younger audience than those who have read, and re-read, her dystopian stories about young people forced to hunt and kill each other. But "Year of the Jungle" will continue, in a gentler way, the author's exploration of war. James Proimos, an old friend from her days as a television writer who helped persuade Collins to become a children's author, illustrated the book.

"For several years I had this little wicker basket next to my writing chair with the postcards my dad had sent me from Vietnam and photos of that year. But I could never quite find a way into the story. It has elements that can be scary for the audience and it would be easy for the art to reinforce those. It could be really beautiful art but still be off-putting to a kid, which would defeat the point of doing the book," Collins, 50, said in a statement released by Scholastic.

"Then one day I was having lunch with Jim and telling him about the idea and he said, 'That sounds fantastic.' I looked at him and I had this flash of the story through his eyes, with his art. It was like being handed a key to a locked door. So, I just blurted out, 'Do you want to do it?' Fortunately he said 'Yes.'"

"How could I refuse?" Proimos said in a statement. "The idea she laid out over burritos and ice tea during our lunch was brilliant and not quite like any picture book I had ever come across. The writing is moving and personal. What Suzanne does so well here is convey complicated emotions through the eyes of a child."

According to Scholastic, "Year of the Jungle" will tell of a little girl named Suzy and her fears after her father leaves for war. She wonders when he'll come back and "feels more and more distant" as he misses family gatherings. He does return, but he has changed and his daughter must learn that "he still loves her just the same."

Collins has said before that she wanted to write a book about her father. In a 2010 interview with The Associated Press, she explained that her father was a trained historian who made a point of discussing war with his family.

"I believe he felt a great responsibility and urgency about educating his children about war," she said. "He would take us frequently to places like battlefields and war monuments. It would start back with whatever had precipitated the war and moved up through the battlefield you were standing in and through that and after that. It was a very comprehensive tour guide experience. So throughout our lives we basically heard about war."

Scholastic also announced Thursday that "Catching Fire," the second "Hunger Games" book and originally released in 2009, is coming out in June as a paperback. The paperback edition usually comes within a year of the hardcover, but "Catching Fire" had been selling so well that Scholastic waited. "Mockingjay" has yet to be released as a paperback.

Next summer, Collins' five-volume "The Underland Chronicles," published before "The Hunger Games," will be reissued with new covers.

"'The Underland Chronicles,' with its fantasy world and 11-year old protagonist, Gregor, was designed for middle readers," Collins said in a statement. "The 'Hunger Games' trilogy features a teen narrator, Katniss Everdeen, and a stark dystopian backdrop for the YA (young adult) audience. 'Year of the Jungle' attempts to reach the picture book readers by delving into my own experience as a first grader with a father deployed in Vietnam."

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Medicare Is Faulted in Electronic Medical Records Conversion

The conversion to electronic medical records — a critical piece of the Obama administration’s plan for health care reform — is “vulnerable” to fraud and abuse because of the failure of Medicare officials to develop appropriate safeguards, according to a sharply critical report to be issued Thursday by federal investigators.

Mike Spencer/Wilmington Star-News, via Associated Press

Celeste Stephens, a nurse, leads a session on electronic records at New Hanover Regional Medical Center in Wilmington, N.C.

Centers for Medicare and Medicaid Services

Marilyn Tavenner, acting administrator for Medicare.

The use of electronic medical records has been central to the aim of overhauling health care in America. Advocates contend that electronic records systems will improve patient care and lower costs through better coordination of medical services, and the Obama administration is spending billions of dollars to encourage doctors and hospitals to switch to electronic records to track patient care.

But the report says Medicare, which is charged with managing the incentive program that encourages the adoption of electronic records, has failed to put in place adequate safeguards to ensure that information being provided by hospitals and doctors about their electronic records systems is accurate. To qualify for the incentive payments, doctors and hospitals must demonstrate that the systems lead to better patient care, meeting a so-called meaningful use standard by, for example, checking for harmful drug interactions.

Medicare “faces obstacles” in overseeing the electronic records incentive program “that leave the program vulnerable to paying incentives to professionals and hospitals that do not fully meet the meaningful use requirements,” the investigators concluded. The report was prepared by the Office of Inspector General for the Department of Health and Human Services, which oversees Medicare.

The investigators contrasted the looser management of the incentive program with the agency’s pledge to more closely monitor Medicare payments of medical claims. Medicare officials have indicated that the agency intends to move away from a “pay and chase” model, in which it tried to get back any money it has paid in error, to one in which it focuses on trying to avoid making unjustified payments in the first place.

Late Wednesday, a Medicare spokesman said in a statement: “Protecting taxpayer dollars is our top priority and we have implemented aggressive procedures to hold providers accountable. Making a false claim is a serious offense with serious consequences and we believe the overwhelming majority of doctors and hospitals take seriously their responsibility to honestly report their performance.”

The government’s investment in electronic records was authorized under the broader stimulus package passed in 2009. Medicare expects to spend nearly $7 billion over five years as a way of inducing doctors and hospitals to adopt and use electronic records. So far, the report said, the agency has paid 74, 317 health professionals and 1,333 hospitals. By attesting that they meet the criteria established under the program, a doctor can receive as much as $44,000 for adopting electronic records, while a hospital could be paid as much as $2 million in the first year of its adoption. The inspector general’s report follows earlier concerns among regulators and others over whether doctors and hospitals are using electronic records inappropriately to charge more for services, as reported by The New York Times last September, and is likely to fuel the debate over the government’s efforts to promote electronic records. Critics say the push for electronic records may be resulting in higher Medicare spending with little in the way of improvement in patients’ health. Thursday’s report did not address patient care.

Even those within the industry say the speed with which systems are being developed and adopted by hospitals and doctors has led to a lack of clarity over how the records should be used and concerns about their overall accuracy.

“We’ve gone from the horse and buggy to the Model T, and we don’t know the rules of the road. Now we’ve had a big car pileup,” said Lynne Thomas Gordon, the chief executive of the American Health Information Management Association, a trade group in Chicago. The association, which contends more study is needed to determine whether hospitals and doctors actually are abusing electronic records to increase their payments, says it supports more clarity.

Although there is little disagreement over the potential benefits of electronic records in reducing duplicative tests and avoiding medical errors, critics increasingly argue that the federal government has not devoted enough time or resources to making certain the money it is investing is being well spent.

House Republicans echoed these concerns in early October in a letter to Kathleen Sebelius, secretary of health and human services. Citing the Times article, they called for suspending the incentive program until concerns about standardization had been resolved. “The top House policy makers on health care are concerned that H.H.S. is squandering taxpayer dollars by asking little of providers in return for incentive payments,” said a statement issued at the same time by the Republicans, who are likely to seize on the latest inspector general report as further evidence of lax oversight. Republicans have said they will continue to monitor the program.

In her letter in response, which has not been made public, Ms. Sebelius dismissed the idea of suspending the incentive program, arguing that it “would be profoundly unfair to the hospitals and eligible professionals that have invested billions of dollars and devoted countless hours of work to purchase and install systems and educate staff.” She said Medicare was trying to determine whether electronic records had been used in any fraudulent billing but she insisted that the current efforts to certify the systems and address the concerns raised by the Republicans and others were adequate.

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Fast-food workers walk out in N.Y. amid rising U.S. labor unrest

New York -- A week after hundreds of Wal-Mart employees walked off their jobs to demand better wages and the freedom to form a union, fast-food workers from some of the nation’s largest chains are staging a similar walkout.

Employees from McDonald's, Wendy’s, Burger King, Taco Bell and KFC are staging protests in locations around New York City today, demanding $15 an hour in pay – more than double the minimum wage some receive – and the right to form a union.

“What we’re finding is that there’s huge support among fast food workers to form a union and to fight back against the poverty wages that they’re being paid,” said Jonathan Westin, organizing director of New York Communities for Change, which is helping to organize the strike.

“Most workers are being paid minimum wage, they can’t afford rent, they can’t afford to put food on the table,” he said. “Many people rely on public assistance to subsidize their wages.”

The first walkout began at a McDonald's on Madison Avenue at 6:30 a.m., where 14 workers refused to enter the building – the majority of the morning shift, Westin said. The protests are now moving to downtown Brooklyn, the Penn Station area, and Times Square.

Darryl Young, 24, was one of the McDonald's workers to walkout. The Bronx resident says he gets paid $7.25 an hour to be a cashier, but is asked to do many more jobs -- maintenance, manning the grill, cleanup. He's the only one in his household earning an income, and said he was nervous about walking out because he has a 2-week-old daughter.

"I'm just standing up for what's right," he said.

It is often difficult to organize service workers because of the changing nature of their shifts – it’s even  more difficult to organize low-wage workers in a bad economy, because people are afraid they won’t be able to find a new job.

But Westin said his group had been talking to workers throughout the summer. Interest grew after Wal-Mart workers walked off the job last week. Workers at the ports of Los Angeles and Long Beach also walked out last week.

Those actions follow a period of relative quiet on the labor front, broken by the Chicago teacher’s strike earlier this year and a strike by employees of Hostess Brands that the company blamed for putting it out of business.

More walkouts are likely to come.

“Strikes have always run in clusters, at points that nobody anticipates,” Julius Getman, a labor expert and the author of “Restoring the Power of Unions: It Takes a Movement,” said in an interview last week.

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Obama, Romney to meet over lunch at the White House Thursday

WASHINGTON -- President Obama and former campaign rival Mitt Romney will meet for a private lunch Thursday at the White House, fulfilling an offer that Obama made after his reelection victory.

The White House announced Wednesday morning that Obama and the former Republican presidential nominee will dine at an undisclosed time in the Private Dining Room in the Executive Mansion. The event will be closed to reporters and photographers.

The duo’s meeting follows a statement from Obama on Election Night.

“In the weeks ahead, I also look forward to sitting down with Governor Romney to talk about where we can work together to move this country forward,” Obama said.

PHOTOS: 2016 presidential possibilities

Obama, in a press conference held Nov. 14, offered some hints as to what their conversation may be.

“There are certain aspects of Governor Romney’s record and his ideas that I think could be very helpful,” Obama said. “To give you one example, I do think he did a terrific job running the Olympics. And you know, that skill set of trying to figure out how do we make something work better applies to the federal government.”

“There may be ideas that he has with respect to jobs and growth that can help middle-class families that I want to hear,” Obama added. “I’m not either prejudging what he’s interested in doing, nor am I suggesting I’ve got some specific assignment.”

Romney, who lost the race by about 3.5 million votes, has avoided public appearances since shortly after the election, when he aggravated many in his own party by accusing Obama of winning through “gifts” to African-Americans, Latinos and young voters during his first term.

“The Obama campaign was following the old playbook of giving a lot of stuff to groups that they hoped they could get to vote for them and be motivated to go out to the polls,” the former Massachusetts governor said on a conference call to supporters.

PHOTOS: President Obama’s past

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