National Briefing | West: California: Suit Over Pepper Spraying

The beliefs of a Catholic media network have put it at odds with the Obama administration.

Room for Debate asks: What is missing from this sprawling legislation, and what should be cut?

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Romney Duels With Santorum in Republican Debate

Outside the Mesa Arts Center, people gathered on Wednesday to watch the debate taking place inside. It was the final one on the Republican primary calendar. More Photos »

MESA, Ariz. — Mitt Romney challenged Rick Santorum’s credentials as a fiscal conservative in a fiercely combative debate on Wednesday, trying to redefine Mr. Santorum as part of the problem in Washington and regain his footing in the fight for the Republican presidential nomination.

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With the Arizona and Michigan primaries only six days away, followed quickly by a dozen more contests, Mr. Romney arrived here at a critical moment of his candidacy armed with a detailed indictment of Mr. Santorum’s record in Congress. Mr. Romney sought to dismantle his rival’s claim to be the authentic conservative in the race.

“While I was fighting to save the Olympics, you were fighting to save the ‘Bridge to Nowhere,’ ” Mr. Romney said, drawing upon a noted symbol of government excess to drive home his point against Mr. Santorum, a former Pennsylvania senator.

It was Mr. Santorum’s first time in the cross hairs as a leading candidate, an uncomfortable position that has set back other Republican challengers. He did not recoil or wither under pressure, but he was placed on the defensive again and again, with Mr. Romney and Representative Ron Paul of Texas acting as a tag team in critiquing his record in Congress.

They criticized his earmarks, his vote for a provision that financed Planned Parenthood and his support of the No Child Left Behind law, President George W. Bush’s signature education plan now out of favor with conservatives. By the end of the night, the scrutiny seemed to wear on Mr. Santorum, who was taunted with boos when he said he had voted for the education program even though “it was against the principles I believed in.”

He explained that he had done so because of its importance to Mr. Bush, saying: “Sometimes you take one for the team, for the leader.” That line provided an opening for Mr. Paul, who declared: “He calls this a team sport. He has to go along to get along, and that’s the way the team plays, but that’s what the problem is with Washington.”

The landscape of the Republican presidential campaign — reshuffled yet again since the last time the candidates debated on Jan. 26 — came into sharp view here on stage at the Mesa Arts Center. It was the final scheduled Republican debate on the calendar, but unless a presumptive nominee emerges swiftly, debates could take place throughout the spring as the party’s nominating contest becomes a drawn-out fight for delegates.

If Mr. Romney came across as a persistent prosecutor, jumping in eagerly to make his points, Mr. Santorum was defensive yet did not lose his temper as others have in the hot seat.

From the start, it appeared that Mr. Romney and Mr. Santorum had a shared goal: turning the night, and the race, into a two-man contest. But Newt Gingrich came alive yet again, not as an angry combatant but as what he described as a “cheerful” alternative, enthusiastically challenging the moderator, John King of CNN, and turning questions to his own purposes.

The candidates sat behind a table for only the second time in the long-running series of debates, rather than standing behind lecterns, which at times made them seem like squirmy schoolchildren scrunched into classroom desks.

The economy — the dominant issue to most voters — took a back seat to a host of other topics in the wide-ranging debate, which dwelled on social issues, immigration and the arcane world of Congressional voting records. Mr. Romney played up his status as the only candidate on the stage who had never served in Washington, but Mr. Santorum would not let his rival take credit for balancing the budget as governor of Massachusetts, which is required by state law.

“Don’t go around bragging about something you have to do,” Mr. Santorum said. “Michael Dukakis balanced the budget for 10 years. Does that make him qualified to be president of the United States? I don’t think so.”

Mr. Santorum parried the barbs from Mr. Paul as he has all year, often laughing and shaking his head. But the exchanges between him and Mr. Romney were sharper.

“You don’t know what you’re talking about,” Mr. Santorum told him at one point.

“Wait — wait a second. Wait a second. Wait a second. Wait a second. Wait!” Mr. Romney said, cutting in as Mr. Santorum attacked the Massachusetts health care plan that Mr. Romney signed into law.

Mr. Romney managed to bring before Republican primary voters an issue that has been a sore subject between Mr. Santorum and conservatives for years: his support in the 2004 Republican primary in Pennsylvania for Senator Arlen Specter over Pat Toomey, his conservative challenger.

Michael Barbaro contributed reporting.

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Migraines May Raise a Woman's Odds of Depression

WEDNESDAY, Feb. 22 (HealthDay News) -- As if the debilitating headaches weren't bad enough, women who get migraines or have had them in the past are at increased risk for depression, a new study suggests.

Migraines are intense, throbbing headaches often accompanied by nausea and sensitivity to light or sound. They are three times more common in women than in men.

The study, by researchers at Brigham and Women's Hospital in Boston, suggests that women with any history of migraines were about 40 percent more likely to develop depression than women without a similar history.

"We believe the most important aspect of our study is that migraine patients and their physicians should keep this potential link in mind," said senior study author Dr. Tobias Kurth, a neuroepidemiologist at Brigham and Women's Hospital.

Kurth noted that doctors who treat patients who have migraines might consider asking some specific questions about depression.

The researchers analyzed data from more than 36,000 participants in the U.S. Women's Health Study who did not have depression and had answered questions about their migraine history. The women, aged 45 or older, were categorized either as having active migraine with aura (visual disturbances such as flashing lights or temporary loss of vision); active migraine without aura; prior history of migraine; or no history of migraine. The women also provided information about any depression diagnoses during the study's follow-up period.

Kurth and his colleagues found that more than 6,400 of the women had current or past migraines, and that during an average 14 years of follow-up, nearly 4,000 developed depression.

Women with any history of migraines were 36 percent more likely to develop depression than women with no history of the headaches, and there was no difference between migraines with aura and migraines without aura. The researchers also found that women with only a past history of migraine had 1.41 times the risk of developing depression.

Although the results suggest a link between migraines and depression, they do not show cause and effect.

Kurth said further research is necessary to determine why migraines might increase the risk of depression. "There is not really an easy answer," he said, adding that future studies might look at whether there is a specific common biological mechanism linking both diseases.

Dr. Richard Lipton, vice chair of neurology at Albert Einstein College of Medicine and director of the Montefiore Headache Center in New York City, applauded the research.

"This is a very strong study because of the cohort design, the large sample and the long-term follow-up," he said.

Lipton noted several study limitations, however. The results don't apply to men or to younger women, he said, and it is possible the number of women with depression was even greater, since the diagnosis was based on self-reporting.

The study is scheduled for presentation at the American Academy of Neurology annual meeting in New Orleans in April. Funding was provided by the U.S. National Heart, Lung and Blood Institute and the National Cancer Institute.

Research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

To learn more about migraines, visit the National Headache Foundation.

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It’s the Economy: Why Are Harvard Graduates in the Mailroom?

Illustration by Mattias Adolfsson In their book “Freakonomics,” Stephen J. Dubner and Steven D. Levitt explain, among other things, the odd economic behavior that guides many drug dealers. In one gang they described, the typical street-corner guy made less than minimum wage but still worked extremely hard in hopes of some day becoming one of the few wildly rich kingpins. This behavior isn’t isolated to illegal activity. There are a number of professions in which workers are paid, in part, with a figurative lottery ticket. The worker accepts a lower-paying job in exchange for a slim but real chance of a large, future payday.

Deep thoughts this week:

1. Hollywood is the most glamorous lottery-style business in the U.S. economy.

2. It’s hardly the only one.

3. But now the Plan B jobs are evaporating.

Adam Davidson translates often confusing and sometimes terrifying economic and financial news.

This more or less explains Hollywood. Yes, the Oscars may be an absurd spectacle of remarkably successful people congratulating themselves for work that barely nudges at the borders of meaningful human achievement. But it’s also a celebration of a form of meritocratic capitalism. I’m not talking about the fortunes lavished on extremely good looking people; no, I mean the economic system that compels lots of young people to work extremely hard for little pay so that it’s possible to lavish fortune on the good-looking people. That’s the spirit of meritocratic capitalism!

Hollywood is, in some ways, the model lottery industry. For most companies in the business, it doesn’t make economic sense to, as Google does, put promising young applicants through a series of tests and then hire only the small number who pass. Instead, it’s cheaper for talent agencies and studios to hire a lot of young workers and run them through a few years of low-paying drudgery. (Actors are another story altogether. Many never get steady jobs in the first place.) This occupational centrifuge allows workers to effectively sort themselves out based on skill and drive. Over time, some will lose their commitment; others will realize that they don’t have the right talent set; others will find that they’re better at something else.

When it’s time to choose who gets the top job or becomes partner, managers subsequently have a lot more information to work with. In the meantime, companies also get the benefit of several years of hard work from determined young people at below-market pay. (Warner Brothers pays its mailroom clerks $25,000 to $30,000, a little more than an apprentice plumber.) While far from perfect, this strategy has done a pretty decent job of pushing those with real promise to the top. Barry Diller and David Geffen each started his career in the William Morris mailroom.

Hollywood is merely the most glamorous industry that puts new entrants — whether they’re in the mailroom, picking up dry cleaning for a studio head or waiting on tables between open-call auditions — through a lottery system. Even glamour-free industries offer economic-lottery systems. Young, ambitious accountants who toil away at a Big Four firm may have modest expectations of glory, but they’ll be millionaires if they make partner. The same goes at law firms, ad agencies and consulting firms. Startups explicitly use a lottery system, known as stock options, to entice young people to work for nothing. Wall Street, however, is a special case. It offers extremely high entry salaries and enormous potential earnings.

Even professions that can’t offer as much in the way of riches operate as a lottery system. Academia, nonprofit groups, book publishers and public-radio production companies also put their new recruits through various forms of low-paid hazing, holding out the promise of, well, more low pay but in a job that provides, for some, something more important than money: satisfaction. In the language of economics, these people are consuming their potential wages in happiness. (Honestly, economists talk this way.)

This system is unfair and arbitrary and often takes advantage of many people who don’t really have a shot at the big prize. But it is far preferable to the parts of our economy where there are no big prizes waiting. That mailroom clerk at Warner Brothers may make less than a post office clerk (maybe even half as much), but the latter has less chance of a significant promotion. Workers in retail sales, clerical settings, low-skill manufacturing and other fields tend to have loose, uncommitted bonds to their industries, and their employers have even looser commitments to them. These jobs don’t offer a bright future precisely because they don’t require a huge amount of skill, and therefore there’s no need to do much merit-sorting.

But part of the American post-World War II economic miracle was that most people didn’t have to choose between a high-stakes-lottery job or a lousy dead-end one. Steelworkers, midlevel corporate executives, shopkeepers and plumbers were all able to make a decent amount from the start of their careers with steady, but never spectacular, raises throughout. These two tiers actually supported each other. Strivers were able to dream bigger because they had a solid Plan B. New York City and Los Angeles are buoyed by teachers, store owners, arts administrators and others who came to town to make it big in film or music or publishing, eventually gave up on that dream and ended up doing fine in another field.

Now, many economists fear that the comfortable Plan B jobs are disappearing. Technology and cheaper goods from overseas have replaced many of the not-especially-creative professions. A tax accountant loses clients to TurboTax; many graphic designers have been replaced by Photoshop; and the small shopkeeper by Home Depot, Walmart or Duane Reade. Though a lottery economy is valuable to various industries, the thought of an entire lottery-based economy, in which a few people win big while the rest are forced to toil in an uncertain and not terribly remunerative dead-end labor pool, is unfair and politically scary. If large numbers of people believe they have no shot at a better life in the future, they will work less hard and generate fewer new ideas and businesses. The economy, as a whole, will be poorer.

It’s not clear what today’s eager 23-year-old will do in 5 or 10 years when she decides that acting (or that accounting partnership) isn’t going to work out after all. The best advice may be to accept that economic success in America will come as much from the labor lottery as from hard work and tenacity. The Oscars make clear that there is only so much room at the top. In a lottery-based economy, you need some luck, too; now, perhaps, more than ever. People should be prepared to enter a few different lotteries, because the new Plan B is just going to be another long shot in a different field. The role model of our time should be an actress who was never nominated for an Oscar. Hedy Lamarr did well enough on the screen but, just in case, she spent her free time developing something called frequency-hopping spread-spectrum. It’s a wireless-communication technique still in use in Bluetooth and Wi-Fi. Not bad for a fallback.

Adam Davidson is the co-founder of NPR’s Planet Money, a podcast, blog and radio series heard on “Morning Edition,” “All Things Considered” and “This American Life.”

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Colonoscopy Prevents Death, a Study Affirms

In patients tracked for as long as 20 years, the death rate from colorectal cancer was cut by 53 percent in those who had the test and whose doctors removed precancerous growths, known as adenomatous polyps, researchers reported on Wednesday in The New England Journal of Medicine. The test examines the inside of the intestine with a camera-tipped tube.

“For any cancer screening test, reduction of cancer-related mortality is the holy grail,” said Dr. Gina Vaccaro, a gastrointestinal oncologist at the Knight Cancer Institute at Oregon Health and Science University who was not involved in the research. “This study does show that mortality is reduced if polyps are removed, and 53 percent is a very robust reduction.”

Colorectal tumors are a major cause of cancer death in the United States and one of the few cancers that that can be prevented with screening. This year, more than 143,000 new cases and 51,000 deaths are expected. Incidence and death rates have been declining for about 20 years, probably because of increased use of screening tests and better treatments. But only about 6 in 10 adults are up to date on getting screened for colorectal cancer, according to federal estimates.

Cancer screening tests have come in for greater scrutiny recently. A government panel recommended in October that men no longer get the P.S.A. blood screening test for prostate cancer after concluding it did not save lives. The new study on colonoscopy has limitations — it is not a randomized clinical trial — but some experts say it nonetheless was well done and helps answer questions about the effectiveness of the procedure.

Earlier research had proved that removing precancerous polyps could greatly reduce the incidence of colorectal cancer. But a major question remained: Did removing the polyps really save lives? In theory, it was possible that doctors were finding growths that would not have killed the patient, or missing ones that could be fatal.

“This study puts that argument to rest,” said Dr. David A. Rothenberger, a professor and deputy chairman of surgery at the University of Minnesota Masonic Cancer Center. He was not part of the study.

Robert A. Smith, the senior director for cancer control at the American Cancer Society, said, “This is a very big deal.”

A team of researchers led by Dr. Sidney J. Winawer, a gastroenterologist at Memorial Sloan-Kettering Cancer Center in New York City, followed 2,602 patients who had adenomatous polyps removed during colonoscopies from 1980 to 1990. Doctors compared their death rate from colorectal cancer with that of the general population, where 25.4 deaths from the disease would have been expected in a group the same size. But among the polyp group, there were only 12 deaths from colorectal cancer, which translates into a 53 percent reduction in the death rate.

The new study did not compare colonoscopy with other ways of screening for colorectal cancer and so does not fully resolve a longstanding medical debate about which method is best. Tests other than colonoscopy look for blood in the stool or use different techniques to examine the intestine. All the tests are unpleasant, and people are often reluctant to have them.

Although doctors have differed about which method is best, they agree that it is important to get over the squeamishness and have some type of test, usually starting at age 50. Screening is worthwhile because colorectal cancer is one of the few types of cancer (cervical and skin cancer are others) in which premalignant growths have been identified and the disease can be prevented if those growths are detected and cut out. Research indicates that not every polyp turns into cancer, but that nearly every colorectal tumor starts out as an adenomatous polyp.

Even if intestinal cancer has already developed, it can still be cured if it is found early and treated.

“Not all adenomas become cancers, and not all cancers cause death,” said Ann Zauber, the lead author of the study and a statistician at Sloan-Kettering. But in many cases, she said, “we have gotten those that would have had the potential to go on and cause a cancer death.”

Dr. Smith, at the American Cancer Society, said the new study on colonoscopy was well done, and noted that changes in death rates can be difficult to measure because they require long-term studies like this one.

But Dr. Harold C. Sox, an emeritus professor of medicine at Dartmouth Medical School and former editor of a leading medical journal, Annals of Internal Medicine, cautioned that the new study was not the last word. He said it was not clear that the same reduction in the death rate found in the study would occur in the general population.

Nonetheless, he said, “I suspect that removing polyps does reduce colorectal cancer mortality.”

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Illinois Budget Calls for Cuts

“This budget contains truths that may not be what you want to hear,” the governor, a Democrat. told the Democratic-controlled legislature in Springfield. “But these are truths that you do need to know.”

The proposal would eliminate two prisons and close 60 state offices and facilities, resulting in more than 1,100 layoffs and saving Illinois about $88.9 million, according to budget documents.

Mr. Quinn also said he would cut his own office’s budget by 9 percent next year and asked other state offices to do the same.

“Today, our rendezvous with reality has arrived,” he said.

It has, it seems, been coming for a while, as the state’s unpaid bills have mounted and reports of its underfinanced state pension and Medicaid systems have grown ever more alarming.

But while the governor spoke about the need for cuts in the Medicaid and pension systems, some critics said his proposals did not go far enough or provide specific steps to reduce the state’s unfinanced liabilities.

Even with cuts in discretionary spending, Mr. Quinn’s $33.8 billion proposed budget is still larger than the budget passed the last fiscal year, and would require pension and Medicaid changes to ease the state’s financial woes, which grew again this year to total about $8 billion in unpaid bills.

“It’s a little disconcerting that we would spend more money than we spent the year before,” said Matt Murphy, a Republican state senator.

For years, Illinois has watched its debt climb, largely as a result of increasing pension costs, which Mr. Quinn pegged at about $5.2 billion this year — triple what they cost in 2008. In his speech, he announced that a working group would study the issue and deliver recommendations this spring.

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Room for Debate: Beyond Race in Affirmative Action

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