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  • Lessons learned in Iraq

    As the U.S. enters its fourth year in Iraq, two American generals look back at the conflict so far. What lessons were learned on the battlefield? And what's next for this nation under the threat of civil war? Our special series, "The War in Iraq: Three Years Later" continues.


  • Jerry Rice? No, Condoleezza Rice!

    Secretary of State Condoleezza Rice has long said her dream job is to be comissioner of the NFL, so the announcement today that Paul Tagliabue will retire this summer led to the inevitable question at today's State Department briefing about whether she might consider abandoning her post as the United States' top diplomat.

    Her spokesman said she was "enjoying being Secretary of State." But as the transcript shows, he didn't rule it out!   

    QUESTION:  Are you worried that you might lose the secretary of state to the NFL?

    SEAN MCCORMACK:  Well, at this point, certainly I have seen the news reports about Commissioner Tagliabue retiring. I haven't been able to confirm those reports. At the moment, the secretary is enjoying being secretary of state.


  • What we're watching this Monday

    Brian is taking a break this week and I will be keeping the chair warm and blogging in his absence. He is back next Monday.

    By now you likely know that today marks the start of the fourth year of war in Iraq. Here at home a major public relations offensive is underway... the normally camera-abhorrent Vice President Cheney appeared yesterday on one of the Sunday shows to defend the U.S. strategy... Defense Secretary Donald Rumsfeld made the case for staying the course in an op-ed... and today, President Bush traveled to Cleveland for a big speech urging Americans to look beyond the violence and see signs of progress. The question though, is whether the public is even open to hearing these arguments anymore. One recent poll found more than 75 percent of Americans think that Iraq is heading toward civil war. And further undermining the administration's case... Iraq's former Prime Minister Ayad Allawi said this weekend that a civil war in Iraq is already underway. In fairness, there has been progress on the political front and there are many who do still believe in the mission, but after three years of continuous violence it is important to reflect on how we got to this point and where we go from here. That is our focus tonight.


    Richard Engel has been in Baghdad since before the start of the war and tonight will give us a reality check on where things stand from Iraqis' perspective. He'll look at how they live their lives, their constant fear of attack and whether they are able to see the future with any optimism. Kelly O'Donnell reports on the president's speech as he tries to convince Americans to stay with the mission. Worth noting: in his remarks today the president sounded far more realistic about the situation on the ground in Iraq than the vice president did in his comments yesterday. An interesting contrast. Also, Lisa Myers, our senior investigative correspondent, has an exclusive report tonight that is going to raise new questions about WMD in Iraq. This is one you are not going to want to miss.

    Also tonight... Rehema Ellis tells us about FEMA's effort to get back federal aid that was distributed improperly. She reports that more than 50,000 households received assistance that wasn't needed. Some cases do involve fraud, but a GAO investigation found that much of the blame does rest with FEMA and its accounting practices.

    Finally, we will have a wrap-up of the rough weather around the country on this the first day of Spring. And do you know the words to "The Star Spangled Banner?" Are you sure?

    See you tonight.

  • FBI "careerism" cited at Moussaoui trial

    The FBI agent who arrested Zacarias Moussaoui told government investigators that the failure of FBI headquarters to approve searches of Moussaoui's possessions, bank accounts, and phone calls amounted to "criminal negligence" and was the result of "careerism" -- supervisors more concerned with protecting their own opportunities for advancement than in getting to the bottom of a potential terrorism case. 

    The agent, Harry Samit of the FBI's Minneapolis office, concluded by mid-August 2001 that Moussaoui was an Islamic extremist working on some kind of plan to board an airplane, incapacitate the crew by using knives to seize control, and crash the plane into some target. In memos to his superiors at FBI headquarters, he stressed "the urgency of this matter," though he said it was "unknown how far advanced the plan is or how many co-conspirators exist."


    Agent Samit wrote dozens of memos to FBI offices overseas and to other U.S. intelligence agencies to bolster his request for a search. And his Minneapolis supervisor told officials at FBI headquarters in Washington that he was "trying to keep Zacarias Moussaoui from flying a plane into a building," Samit testified today. But the officials in Washington kept turning him down, which he described as a "calculated risk that lost us the opportunity to try to stop the attacks" of 9/11. Headquarters officials also blocked him from sending a summary of his suspicions about Moussaoui to the Federal Aviation Administration, Samit testified.

    The FBI in Washington feared that trying and failing to get a court-approved search warrant would set back the FBI's effort to keep an intelligence-gathering operation on Moussaoui going, Agent Samit said today.

    His comments about the obstructionists worried about "careerism" were made to the Inspector General of the Justice Department and have not previously been made public. 

    According to the agent, Moussaoui said that after his training, he wanted to "see some sights," including the Statue of Liberty and Empire State Building in New York and the White House in Washington. The agent suggested that the reference to the White House be passed along to the Secret Service. But he said today that FBI headquarters blocked that, too.

    All of this information came out in response to questions from Moussaoui's lawyers. They claim that the government's lack of response, even in the face of urgent warnings from the Minnesota agent, show that it would have made no difference if Moussaoui had told the truth when he was arrested. The government claims that by lying, Moussaoui prevented further investigations that could have uncovered the actual 9/11 plot.

  • This week at the U.N.

    What to do about Iran's disputed nuclear program is the big question of the week at the United Nations, although the Security Council has a full plate of other issues as well, ranging from dealing with Darfur to mission in Afghanistan, Burundi and Liberia.

    It's almost two weeks now since the IAEA board of governors referred Iran to the Security Council and today senior diplomats from the P-5 nations plus Germany are meeting in New York, outside the U.N. framework, to try to resolve a deadlock over future strategy. All apparently agree that Iran should not develop nuclear weapons, but major differences still abound over how to achieve that goal.


    What comes out of today's meeting of political directors in New York (including U.S. Undersecretary of State Nicholas Burns) could help clear the way for a Security Council initial response to the crisis, but it seems unlikely to resolve the deep-seated reluctance by Russia and China (allies of Iran) to ramp up the pressure if Tehran does not agree to demands to stop enriching uranium. Additional discussions and talks are likely in the offing.

    On Friday, U.S. Ambassador to the U.N. John Bolton said Security Council members were closer to agreement on a possible council text that would, among other things, call for a report by the IAEA director on Iranian compliance with board demands regarding its nuclear program. The U.S., Britain and France had initially favored a 14-day time frame, but diplomats expect that could be lengthened as a concession. China's U.N. Ambassador Wang Guangya indicated his country (and possibly Russia since it is thought they are working together on this) could accept "at least 4 weeks to 6 weeks." Both nations have made it clear that they want the U.N.'s nuclear agency to play the lead in handling the Iranian crisis and the Security Council to "reinforce," but not take it over, from the IAEA. The U.S. says this is a test for the Security Council.

    Meanwhile, the clock continues to tick and that 14-day progress report proposed nearly two weeks ago by the British has now effectively turned into a month. French Ambassador Jean-Marc de La Sabliere last Thursday stressed the urgency of the council reaching an agreement soon. He said "time is running out." Interestingly, the French mission to the U.N. gave background briefings to reporters last week on the technical aspects of the nuclear process.

  • Sunday's lineup

    Hi, it's Hoda Kotb... I will be filling in for John Seigenthaler again tonight. I usually work for Dateline NBC, and I do some work for the Today Show as well. If you are looking at the spelling of my name and saying, "Whaatt?!?," you are in the majority. If you CAN pronounce it, you are in the minority. I know, I know.... I should buy a vowel.

    Anyway, back to business...we are in the process of putting together our evening newscast for this Sunday and it is chocked full of news. We just wrapped up our early conference call and mid-day meeting.
     
    Tonight marks the three year anniversary of the war in Iraq, so that is obviously the big story today. Richard Engel will give us a unique perspective on the war. He has been in Iraq for more than 3 years, he speaks the language and has covered it extensively. "Ring, ring"... he must have known I was talking about him... as I type, Richard is calling in from Baghdad. He is talking with our senior producer Pat Burkey about his spot... talking elements and soundbites. There was a religious gathering in Karbala... some renewed violence...

    Also Rosiland Jordan is covering the political side of the story from Washington, D.C. We just heard from President Bush. Rehema Ellis also phoned in. She is in New Orleans and is working a spot there.

    "Ring, Ring"... Jim Maceda just phoned in and talked to Senior Producer Steve Majors about a follow-up he will do out of Serbia. Each correspondent is letting the New York staff know what elements they have for their story... pictures, interviews, etc. In return, the senior staff is giving them guidance from this end.

    OK, on to lighter things... if you have a pet, I GUARANTEE you will love Dawn Frantangelo's spot. It is about a new way one hospital is caring for ailing pets. It's a feel good story. We hope to see you tonight.


  • First, this message

    Before we even talk about Friday, a word about Monday's broadcast, when we will begin the rollout of our coverage of the 3-year anniversary of the start of the Iraq war. If you haven't already read what Richard Engel posted on his return to Iraq, please do. On Monday, we will hear from him further... about the HUMAN angle in all of this: what LIFE is like in Baghdad, surrounded by the horrors and stresses of a war zone, where every day is punctuated by the non-stop small-arms fire (which can still be heard, each and every night in that city) and where every public movement an individual makes carries with it measurable dangers. Our coverage will look at where we've been and where we are headed. And forgive the long-range nature of this, but in addition to Richard's reflections this coming Monday night, we've asked him to prepare a longer "reporter's notebook" piece to air a week from tonight, that's Friday, March 24. We're proud of the scope and breadth and balance of the body of coverage we will present to you next week, under the supervision of our own veteran, M.L. Flynn, who heads up our foreign coverage.


    ABOUT TONIGHT
    Something happened since we last spoke: gas prices have spiked across the country.  The indications for the long run may not be great... UNLIKE the stock market, where another trend entirely may be coming clear this week. We'll translate the numbers into understandable news tonight... some of it troubling, some positive perhaps. Also this evening, more on last night's devastating piece on airport security, an update on the latest troubling migration of bird flu (and we'll try to answer your questions), and the unbelievable new public smoking law in Calabasas, Calif. Question: how would James Madison react to the chain of events that brought about this law? It's a good one for Constitution buffs to ponder.

    We'll close the broadcast and the week with our popular "Making a Difference" segment. We hope you will join us. Have a good weekend.

  • "Operation Swarmer" status report

    A top U.S. commander in Iraq said today U.S. and Iraqi forces have faced "very light resistance" in the military offensive dubbed "Operation Swarmer" -- aimed at rooting out insurgent strongholds in the rural areas north of Baghdad. Gen. Pete Chiarelli, briefing Pentagon reporters via tele-conference from Baghdad, said 31 individuals have been detained and numerous weapons caches have been uncovered.

    Asked whether the timing and scale of the operation was politically motivated, Chiarelli said the operation had been planned for months and was based exclusively on operational intelligence.
    Chiarelli said he expects future operations like Swarmer will continue in the coming months as U.S. forces hand over control of urban areas to Iraqi security forces and are then able to focus efforts on rural areas.

    In fact, Chiarelli said by the end of this coming summer Iraqi forces will have assumed operational control of roughly 75 percent of the land areas of Iraq. Currently, he said, Iraqi forces are in charge of less than 50 percent of the land mass of Iraq.

    Editor's note: Sunday, March 19 marks the three-year anniversary of the war in Iraq. NBC's Baghdad Correspondent Richard Engel shares his reflections of the country then, and now. For complete coverage of the anniversary, including a multimedia look back, visit MSNBC.com's special section.


  • How big is 1%?

    He's the owner of a giant clothing company, but he's changing the world by thinking small -- donating one percent of his profits to good causes. Now his big idea is catching on, with hundreds of other companies joining in. Tune in to find out how one percent is "Making a Difference."


  • Top heavy

    We have so much to talk about at the very top of the broadcast tonight -- while any number of items could take the lead position, they are all of a type and have a central theme: The Bush Presidency and the current threats (and U.S. goals) around the world. First, there is the story that has become video wallpaper on the three cable networks today (and two notes here: all the videotape on a continuous loop is from the Pentagon, and many outlets are titling their coverage using the Pentagon's given name for the operation, something that's been happening with increasing frequency since DESERT STORM, but that's for a journalism seminar someday), what's being billed as the "second largest air assault since the start of the war." We've done some interesting reporting on the operation today.

    Second, the speech by National Security Advisor Stephen Hadley on Iran and the administration worldview. Third, the state of the Bush White House politically. Using a combination of Mike Boettcher, Jim Miklaszewski and David Gregory (as capable a threesome as any in television), we will have it all covered tonight.

    We have an interesting story on what has become the most valuable currency in the storm zone: house trailers from FEMA. It's our own reporting, coupled with an item that was first reported on the front page of The New York Times this morning. George Lewis will round out our coverage with a preview of what March Madness will do to productivity in offices around the country. Not ours, of course.

    Our apologies for promoting the airing of a Lisa Myers piece earlier in the day that cannot air tonight due to the news of this day. We'll bring it to you another time. We hope you can join us.


  • Air assault vs. air strike

    While this is the biggest air ASSAULT in Iraq since April 22, 2003 (when the 101st Airborne assaulted from Iskandiriya to Mosul), keep one fact in perspective: There are not a lot of air assaults in Iraq to begin with. When the U.S. Army uses the term "air assault" they are referring specifically to air TRANSPORT -- moving infantrymen into an area via aircraft. An air STRIKE is when they are flying specifically to shoot at a target or targets with missiles, machine gun fire, etc.   

    In other words, what's happening today is really equivalent to transporting 1,500 infantrymen via convoy. But since this assault involves the 101st Airborne division, they move via the air rather than the ground. There have been countless operations in Iraq that have involved 1,500 troops or more moving via convoy -- helicopters are large targets so ground transport is the more common mode of transportation.

    There have not been any reports of a single shot fired yet in this "Operation Swarmer," which occurred in broad daylight. Air strikes generally occur at night. Once the 1,500 troops are in place, Pentagon officials say the next few days will be spent primarily searching the area. So far, they have found five weapons caches, including artillery and mortar rounds, small arms munitions, medical supplies, IED-making materials and instruction manuals. There are more than 650 U.S. troops and 800 Iraqi troops involved. The assault was northwest of Samarra, in an isolated and relatively rural area.


  • How in debt is the U.S.?

    The Senate has voted to increase the nation's debt limit by $871 billion, swelling it to just under $9 trillion -- that's $9,000,000,000,000. About $30,000 for every man, woman and child in the nation.

    What's that mean? What is a debt limit? Well, it means that over the years the government has taken in $9 trillion less than it spent. And there's a federal law that says the debt can only be so much -- so as deficits mount, Congress periodically (four times in the past five years) has to vote to raise the debt ceiling.

    To whom do we owe this debt? A huge portion of it is owed to foreign governments. According to the Senate Finance Committee, 96% of last year's debt was purchased (in the form of treasury bonds) by foreign countries.  One of the leaders is China.  And that has a lot of people on Capitol Hill worried.


    But they have no choice on voting to increase the limit. If they don't, the result could be economic disaster -- the first default ever on U.S. obligations.

    So the way it works is that whichever party is in power at the time has to hold its nose and vote yes (today's 52-48 vote was almost strictly along party lines), because if they fail to pass it, and economic chaos follows, the majority party would surely get the blame.

    That gives the minority party the luxury of righteously railing against the debt increase, in this it's case Democrats blaming the Bush administration and congressional Republicans for adding $3 trillion dollars to the national debt since Bush took office.

    Of course, Republicans respond that if the big-spending Democrats were in charge things would be even worse.

    Increasing the debt limit is one of the ugly little necessities of life in Congress. And the chances of a big, high-profile White House signing ceremony? Don't bet on it.

  • Did you know?

    In an interesting twist of history, the Iraqi province in which the U.S. military is launching "Operation Swarmer" is named Salah ad-din, after the most famous Islamic military hero of all, Saladin. A Kurd who was born in Tikrit in the 12th century, Saladin is credited with uniting the Arab world after years of setbacks at the hands of the crusaders. Saladin retook Jerusalem for the Muslims in 1187 after defeating the king of Jerusalem at the Battle of Hattin near the Lake of Galilee. When his soldiers entered the city of Jerusalem, they were forbidden from killing civilians, robbing people or damaging religious structures in the city. Such mercy was rare at the time, certainly unknown to the crusaders, and he has been lionized by European and Arab historians ever since.  Saladin went on to rule from Cairo and is credited with building that city's most modern hospital, complete with private rooms and staffed with trained doctors. Saladin died in 1193 and is buried in Damascus, Syria.


  • The CIA's secret source

    He was part of Saddam Hussein's inner circle, but sources tell NBC News he also became a secret source for the U.S. government. He said the U.S. was wrong about weapons of mass destruction. So why didn't the CIA listen? We'll tell you in tonight's NBC News investigation.


  • What happened to VA health care?

    We report a story tonight that is going to turn a lot of heads. The Veterans Administration Health Care System, once  famously known for horrendous medical care, now offers what many consider the best health care in the nation. I am sure we will hear from many of you who have had difficult times with care at the VA. That is understandable, because the improvement in the VA has occurred relatively recently and inevitably many people will be dissatisfied with their treatment at the hands of any medical provider.


    But here is the evidence. In a study two years ago a group of researchers from the RAND Corporation and several medical Centers found that 67 percent of patients in the VA system received "appropriate care" as defined by expert panels on medical practice. Two thirds sounds short of the mark, but in the current issue of the New England Journal of Medicine the same researchers report on a survey of the country that finds only 55 percent of Americans in general are getting appropriate health care. And that number does not vary much with the patients' level of education or income.

    In addition, a telephone survey last January from the University of Michigan found that VA patients rated their satisfaction with care at 83 out of a possible 100 points for inpatient care and 80 out of 100 for outpatient care. By comparison, the same survey found rates of 73 and 75 in the general population. Another indicator comes from the American Legion, which has been surveying its members and finding similar high levels of patient satisfaction.

    Indeed, the biggest complaint about the VA system these days is from people who want in. The VA provides unlimited care for service-related injuries and illnesses. but for other problems veterans must fall below a defined income level. As a result, patients at the VA tend to be poorer and sicker than the rest of the population, which makes the improvements all the more remarkable.

    What happened? The change began with Dr. Kenneth Kizer, who became undersecretary of health for Veterans Affairs in the Clinton administration. The change has continued during the Bush administration. VA changed its emphasis from hospital to outpatient care where possible. It also set up genuine prevention programs. As a result, people with conditions like diabetes get the simple measures that can save enormous misery and thousands of dollars in treatment costs. Every patient is assigned a personal physician and the mandate from headquarters is to treat veterans with the respect and dignity they deserve.

    The other big change was a massive shift to electronic medical records. At any VA facility in the country, a doctor or other health professional can access the records of any patient in the system, including lab tests, X-rays and chart notes that can be read easily. The electronic system challenges health providers who seem to be making mistakes, and it allows for a massive collection of data so the VA can know which treatments work and which don't.

    Could the VA system be improved? Of course. Like every government program, it must battle continually for adequate funding. And many aspects of the care could be far better. But the improvements the VA has achieved serve as an example of what government can accomplish in health care –- at a time when much of the rest of health care in America seems to be getting worse.

  • First, the broadcast

    Tonight we have raging fires in Texas, we have a new and exclusive opinion poll of attitudes toward the Bush White House and the President himself. We have Saddam in court, and a major FEMA deadline expiring. Also -- for the first time in recent memory, we have a story tonight about government and health care working WELL together -- and a good thing, too, as some of our most venerable and cherished citizens are benefiting. And tonight we will take a step back and look at how energy prices, post-Katrina, have saved our lives in ways we might not have considered. We have a full boat and things are changing in these remaining hours before air.


    NOW, THE CUSTOMERS
    I'd like to respond to some of the comments submitted in response to yesterday's post to my friend and fellow Stones fan in Cheshire, Conn.: It was a private concert at Radio City Music Hall last night, and while I've never been good at remembering set lists (and while my left ear is slowly coming back to working order as the day goes on), it was, per usual, a great show. Mick was in rare form, and since I'm a huge Keith fan, it was a great night to watch him do what he does best. My wife and I were guests of the Robin Hood Foundation -- a group here in New York that does exactly what the name implies -- they solicit huge contributions from wealthy (and not-so-wealthy) individuals and companies, and give all the money away to the less fortunate in the city. In fact, those lucky enough to be invited onto the Board are asked to pay ALL the administrative costs of the charity, so that 100% of the money raised is passed on. I have done some work for them in the past, and so last night we were lucky enough to be their guests. Watching the most durable rock & roll band on earth from a distance of a few feet was a profound experience for us, and we are indebted to Robin Hood for the fact that a dream has been achieved.

    Also to Mr. Schwartz, who wrote from Philadelphia: I did indeed write the item on airlines (charging more for exit row seats and aisle seats in coach) for last night's broadcast -- because it's hard to defend what has become of air travel in this country. I do a lot of flying, I love aviation and follow the industry closely, and I think many people would agree that what once bordered on a romantic, glamorous privilege has become an awful, tedious and unpleasant chore. It doesn't have to be that way.  We have seen it done differently and we deserve better.

    Onward. Thanks to all of you for writing. Every day and on any subject. We read them all. We sure hope you will join us for tonight's broadcast.

  • More U.S. troops to Iraq

    The top U.S. commander in Iraq, Gen. George Casey, has ordered that some 700 soldiers from the Army's 1st Armored Division be redeployed from Kuwait to Iraq to enhance security during the upcoming Shiite religious pilgrimage in Iraq. U.S. military officials say the bulk of the force will be deployed in Karbala, with others in Baghdad, to assist Iraqi security forces in setting up checkpoints and security perimeters around religious activities in an effort to deter car and suicide bomb attacks.

    The 700 additional forces, which had been stationed in Kuwait as a standby force, would remain in Iraq for approximately 30 days, then, if conditions permit, sent back to Kuwait.

    In light of the recent spike in sectarian violence in Iraq, U.S. military officials also report Gen. Casey has not made a decision to resume the overall withdrawal of American troops from Iraq, even though that announcement was expected sometime this month.  The current number of American forces in Iraq is about 133,000.


  • What next in Moussaoui case?

    Justice Department officials are now deciding their next steps in the Zacarias Moussaoui death penalty trial -- whether to ask the judge to reconsider yesterday's ruling or bypass her and go directly to a federal appeals court.

    In a telephone conference call last night, prosecutors said the judge has so weakened the case that it makes no sense to keep going if they cannot get some help from an appeals court. A transcript of the phone call was made available today.

    "We don't know whether it is worth us proceeding at all, candidly, under the ruling," said prosecutor Rob Spencer. "Without some relief, frankly, I think that there's no point for us to go forward."

    The judge also indicated that there may be a hearing on this issue Thursday, but nothing has been set yet.


  • The nation's VA hospitals

    Once symbols of failure and sadness, many say VA hospitals are now models of excellence. How did they manage such a remarkable transformation? Why can't other hospitals learn to do the same? We'll go inside the VA to see what went right.


  • Fielder's choice

    As we watched the news of the day fly by from our newsroom, it was clear there was no all-consuming "natural" lead story, but several major stories to round out the first segment of our broadcast, and then some. The testimony of the oil executives on the Hill today was notable, ditto the judge's ruling in the Moussaoui case. Andrea Mitchell continues her detailed look at the exclusive reporting in the new book "Cobra II" about the Iraq War (read or watch part one here), and Robert Bazell has a rather shocking piece tonight on the cost of the top-tier (and shouldn't we ALL have access to top-tier?) cancer drugs. We'll have a report from New Orleans and a closing report tonight... on a shot across the bow of the proud state of Georgia. Also, frequent travelers will want to join us for news from the airline industry! You'll also want to see who was the President's special guest during an appearance on an airport tarmac today. It's heart-warming.

    LADIES AND GENTLEMEN...
    This has the makings of a great night. I have an appointment later with two men I admire greatly, Mick and Keith (and other friends of theirs) at the building next door to our headquarters at 30 Rock. While they're all getting on in years, they are still a lot of fun.   

    We hope you can join us.


  • America's "war anxiety"

    New House Majority Leader John Boehner, R-Ohio, says that the war is causing "anxiety" among the American people that "clouds the perception of what is happening in Washington." "The war is a big issue," said Boehner at his weekly off-camera briefing with Capitol Hill reporters. "When the country is at war, there is a certain unsettling among the American people."

    This anxiety will have an impact at the polls in November, he admits, but adds: "I'm not saying that it's a detriment to Republicans." Boehner posits that the administration and Republicans are getting "no credit" for the good economy "as a result over the fact that we are at war." Boehner adds that America is fighting in Iraq for the right reasons and that there is no other option but to stay the course and ultimately win. The war in Iraq has kept the homeland safe from terror, he says. "I truly believe that that's kept the battle off of our land."

    Finally, Boehner says that House Republicans will have some kind of announcement later this week about their legislative agenda for the balance of the year.


  • New cancer drugs

    They work wonders, but with prices as high as $100,000 per year, they're out-of-reach for all but the fortunate few. Tonight, a look at the harsh realities of life-saving medicines that only the truly wealthy can afford.


  • Lots of news about heart disease

    We have a report tonight on three important stories concerning treatments for people at high risk for heart disease and stroke. Taken together, those conditions kill more than 830,000 Americans a year  -- far more than anything else -- so it is important to know what works and what doesn't to lower the risk.

    One study is part of a trend. Scientists have been finding that lowering blood cholesterol further and further is amazingly effective at combating the disease. In this latest study, researchers managed to get 500 people who had already suffered heart disease to take high doses of one of the cholesterol lowering drugs called statins -- in this case Crestor, made by Astra Zeneca. The average level of LDL, the so called "bad cholesterol," dropped from 130 to 60 in the study, an unheard of drop. Using a technique that measures artery-clogging plague inside the blood vessels, the researchers found that after two years the amount of plaque receded by up to nine percent. In other words, the heart disease seemed to reverse.


    It is important to note that this study was not large enough or long enough to measure an actual drop in heart attacks or strokes -– and that research needs to be done. But the evidence strongly suggests that when the plaque goes away, the risk for cardiovascular disease will recede. 

    It is also important to note that this study is yet another endorsement of statin drugs, which already are the best selling medications in history. Exercise and a heart healthy diet remain the major weapons against heart disease. Many people will never needs statins. But very few Americans who do need them can get their cholesterol down to the levels that are now recommended without these drugs, and they can be very expensive. But remember, statins come in several brands and some of the older ones are now off patent and thus much cheaper. Everyone who needs a statin does not need the latest and most expensive ones. It would make sense for everyone who needs a statin to start on a older one and go to the newer more expensive brands only if they are not hitting their goals. That is a serious discussion to have with your doctor, especially if you pay for all or part of your medications.

    Another point worth mentioning again: the statin used in this study is Crestor, made by Astra Zeneca.  Some consumer groups, especially Public Citizen, have said that Crestor has an unacceptably high rate of a side effect shared with all statins: a muscle weakening called rabdomyolosis. The company denies the problem and so far the FDA agrees. But, again, you do not need to take Crestor or another specific statin to get a significant drop in your bad cholesterol. 

    There are also two negative studies to report on people at high risk for heart disease. On the basis of preliminary evidence, many doctors widely prescribed Plavix, a blood thinner to be taken along with aspirin to lower the risk of heart attacks. A major advertising campaign helped push Plavix sales to $3.5 billion a year. But finally, a big study actually tested the idea and found that Plavix, which costs about $4 a day, was no better than a daily aspirin, which costs pennies.

    The other negative study showed that people taking vitamins B6, B12 and folic supplements had no less heart disease. Some scientists had hoped the supplements would reduce disease risk because they reduce the level of a natural body chemical called homcysteine. Studies of large groups of people found that those with high levels of homcysteine, like those with high levels of bad cholesterol, have more heart disease and stroke. But the vitamins did nothing to reduce the risk.

  • Playing offense

    While minutes ago under a JUST IN banner, CNN announced the President's approval rating had hit a new low, the markers of political damage have been collecting in and around 1600 Pennsylvania Avenue for some time. Today the President launched an attempt to take the offensive in the debate over the war, and David Gregory will have it for us tonight. Andrea Mitchell will continue a conversation that started yesterday on "Meet the Press": the authors of the new book on the Iraq War, Cobra II, will share exclusive details of the war plan... versus the actual performance on the ground. From what I've been able to read of the book, and having been there for a portion of the ground war, the details are fascinating -- including, but not limited to, the fact that the now-famous "Thunder Run" by an armored mechanized column (under the command of Col. Perkins) was an ad-lib by U.S. forces. Headquarters only found out about it when they noticed the blue "blips" of friendly forces on their overlay map of downtown Baghdad. It was our guys... they just weren't supposed to be there. It worked.

    Also tonight, the wild displays of nature over the weekend and today, from the tornadoes in the Midwest to the fires in Texas. My colleague Ann Curry is just back from Chad, and will report on her findings, and Robert Bazell will look at the latest medical news -- heart health, B Vitamins and other fronts as well.

    Since there is no way I can keep up with David Gregory on the blogging front today, I'll leave it at that for now. We hope you can join us.


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