AP Enterprise: GOP not always against entitlements (AP)

By RICARDO ALONSO-ZALDIVAR, Associated Press Ricardo Alonso-zaldivar, Associated Press – 1?hr?39?mins?ago

WASHINGTON – It's a massive health care entitlement with unfunded future costs over $7 trillion. Many conservatives are still upset at the way it was rammed through Congress.

But when the Republican presidential candidates were asked last week asked if they would repeal the Medicare drug benefit, they said no way. After all, Republicans created it.

Republicans want to pull the plug on the health care overhaul they call "Obamacare," but that law is arguably less a deficit driver than the Medicare drug plan they are defending.

Debt and deficit are the focus of the Republican Party as the 2012 presidential campaign moves through the nominating process and looks ahead to the general election. Yet the reluctance of GOP candidates to renounce a costly entitlement program that voters like shows how politics can come into play when critiquing the federal ledger.

Passed by a GOP-led Congress in 2003 under President George W. Bush, the prescription program is immensely popular with older people, faithful voters who lately have been trending Republican.

Medicare recipients pay only one-fourth of the cost of the drug benefit. Because there's no dedicated tax to support the program, the other three-fourths comes from the government's general fund. That's the same leaky pot used for defense, law enforcement, education and other priorities. It's regularly refilled with borrowed dollars that balloon the deficit.

Although the health care law costs far more than the drug benefit, it's paid for, at least on paper. It includes unpopular Medicare cuts as well as tax increases on insurers, drug and medical device companies, upper-income people, and even indoor tanning devotees.

Asked last week at the Tea Party debate if they would repeal the prescription program, GOP candidates would hear nothing of it.

Texas Gov. Rick Perry said he would not, even though he said he's concerned about its cost. Cracking down on waste and fraud might be the answer, he suggested.

"I wouldn't repeal it," said former Massachusetts Gov. Mitt Romney. He said he would restructure Medicare, but not for those now in the program or nearing retirement. The re-engineering supported by House Republicans this year and praised by Romney at the time would give future retirees a voucher-like payment to buy insurance from a range of private plans.

Texas Rep. Ron Paul noted that he'd voted against the prescription benefit, but said repeal "sure wouldn't be on my high list. I would find a lot of cuts (in) a lot of other places."

Budget hawks scoff.

"I'm an equal opportunity critic here," said David Walker, a former head of the congressional watchdog agency. "I think the Republicans were irresponsible for passing the Medicare prescription program in 2003 and I think the Democrats were irresponsible for passing" Obama's health overhaul.

As comptroller general of the Government Accountability Office for most of the past decade, Walker used his position to call attention to the nation's long-term budget problems at a time when the debt wasn't front-page news. He now leads the Comeback America Initiative, a nonpartisan group promoting fiscal responsibility.

"There was no attempt to offset the cost of the Medicare prescription bill," Walker said. "It's fair to say that at least there was an attempt to pay" for the health law through a mix of spending cuts and tax increases.

How big is the hole left by the prescription program? Over the next 75 years, its $7.5 trillion "unfunded obligation" exceeds the $6.7 trillion gap attributable to Social Security.

"When they were designing the new health care law, the experience of the Medicare prescription bill was very much in their minds," said Robert Bixby, executive director of the Concord Coalition, a nonpartisan group advocating fiscal discipline. "They didn't want to have another unfunded expansion."

Experts can debate whether future Congresses will suspend Obama's Medicare cuts and whether the long-range cost of extending coverage to more than 30 million uninsured will outpace the revenue to pay for it.

As the reactions of the GOP candidates at the debate demonstrated, no one is seriously considering repeal of the prescription program.

Thanks to taxpayers, about 90 percent of older people now have affordable access to medications that help keep them out of the hospital. Roughly two-thirds of those are enrolled in Medicare's benefit; many others are in former employers' prescription plans.

Ironically, repealing Obama's overhaul would take away the most important improvement to the program since it was created. Obama's law gradually eliminates the dreaded coverage gap known as the doughnut hole. Millions of people will each save thousands of dollars as a result.

Republicans like to point out that the cost of the prescription program is well below original estimates. They attribute that to competition among the private insurers providing the benefit.

While competition is part of the story, experts say it's not the only reason. The shift to cheaper generic drugs among people of all ages has been a powerful contributor. That may not last forever. The trustees who oversee Medicare's finances warn in their latest report that spending on drugs will rise more rapidly in the future.

Said Walker: "Basically what's happening is we're mortgaging the future of our children and grandchildren, and borrowing the money from China."

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Online:

Medicare prescription drug plan: http://tinyurl.com/24xy54j

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AP ENTERPRISE: Examining football player majors (AP)

ATLANTA – When Jay Finch arrived at Georgia Tech, he wasn't just interested in being a lineman for the Yellow Jackets football team. He wanted to study architecture, too.

Then he talked with some student advisers, who gave him a dose of reality.

"They were like, 'You can expect anywhere from 100 to 120 hours of studio time,'" Finch recalled. "I said, 'Oh, like in a month.' And they were like, 'No, in a week.' And I was like, 'On top of football?'"

With that, Finch hopped aboard the M Train.

At Georgia Tech, where the famous fight song proclaims "I'm a heck of an engineer," nearly 70 percent of the football team (43 of 62 players) has chosen to major in management, a business degree dubbed the "M Train" by those on campus who consider it an easier route to a diploma than the school's renowned engineering program.

But the Yellow Jackets are hardly the only school where players tend to congregate in the same fields of study. There are four others universities where at least half the sophomores, juniors and seniors playing football are pursuing the same degree, The Associated Press found in a survey of the 68 schools in the conferences which receive automatic bids to the Bowl Championship Series, plus Notre Dame and Big East-member-to-be TCU.

At Vanderbilt, it's human and organizational development (35 of 59). At UCLA, history is a big draw (27 of 47). At Wake Forest, there's been a gridiron run on the communications department (34 of 60). At Baylor, upset winners over TCU on the opening weekend of this season, expect to find a lot of big guys in general studies (27 of 53).

This is not mere coincidence, of course. While it's natural for a selected group of students — in this case, male athletes — to be interested in the same classroom subjects, it's also apparent many are drawn to courses that are more accommodating to their Saturday pursuit.

"I wanted to dedicate myself more toward football," conceded Finch, a sophomore center. "Yeah, I did take a little bit of the easier road. Management is still hard. You've still got to go to class.

"But," he added, "at least I'm not up 'til 3 in the morning drawing."

The trend is so prevalent it has its own name — clustering — and extends far beyond Georgia Tech, Vanderbilt, UCLA, Wake Forest and Baylor.

The AP survey, compiled from media guides, university websites and information provided by the schools, showed at least half the football players with declared majors at a dozen other universities are bunched in two fields of study. At 22 schools, 50 percent or more are pursuing a degree from a group of three majors.

That means more than half of the schools at the core of major college football — 39 of 68 teams — have some level of clustering.

At a recent summit hosted by NCAA President Mark Emmert, where a rash of rule-breaking was the main focus, university presidents quietly discussed the impact that clustering has on the academic experience for student-athletes.

While the governing body has no intention of mandating more diversity in the selection of majors, it is looking at compiling more data on what players are studying, hoping it can be used to improve athletes' academic experience.

"We're not going to say certain majors are out of bounds. We're not going to say you have to take certain majors," said Kevin Lennon, the NCAA's vice president of academic and membership affairs. "Those are personal decisions that every student-athlete has to make, just like any student."

The situation puts into focus one of the ever-present conflicts in big-time college sports: winning games, making money and keeping the boosters happy vs. providing athletes with a quality education and keeping up school standards.

Georgia Tech, for instance, receives more requests from the football team than any other for special admissions — enrollment for those who don't meet the standards applied to the overall student body. But officials at the Atlanta school point out management is one of the most rigorous business programs in the country, requiring everyone to take two calculus courses and two lab sciences.

"There's always going to be that tension," said Anderson Smith, the senior vice provost for academic affairs. "You've got to recruit who the best players are. But it's a much more heterogeneous population than what we have applying to Georgia Tech as regular students."

Vanderbilt is considered the toughest academic school in the football-crazy Southeastern Conference, which is usually cited as the reason the Commodores perennially wind up at the bottom of the league standings. And yet 35 of 59 non-freshmen were going for the same degree.

By the way, what is human and organizational development anyway?

"Leadership is one of the things that we focus on, and we have a very active and engaged student body," said Beth Shinn, who chairs the department. "My guess is any club or sorority you would look at would have an overrepresentation of HOD people."

In fact, human and organization development is the most popular major on campus among all students, including three of the last six student government presidents, according to Shinn. It's a wide-ranging field, requiring courses in calculus, economics, statistics and social sciences, as well as psychology, sociology, anthropology, political science and public policy.

"Our students are prepared for a vast variety of careers," Shinn said. "We don't do basket-weaving, thank you."

Chris Marve can attest to that. The senior linebacker is actually pursuing a double-major, combining human and organizational development with sociology. As part of his HOD curriculum, he interned over the summer at a Nashville law firm and has his sights on becoming an attorney.

"This major is definitely not just an athlete's major," Marve said. "People who come here are very intelligent and have a very high intellect, so it's not an easy major at all even though a lot of athletes do sign up for it. I think it's the most powerful major you can leave out of here with."

The majors winning the popularity contest vary from school to school.

At Cincinnati, 40 players picked criminal justice as their major. At Mississippi State, 30 players have declared in kinesiology. Sports administration is the choice of 28 players at LSU. Twenty-one Iowa players are majoring in interdepartmental studies, while 20 players Clemson went with sociology.

"We used to call 'em Mickey Mouse courses. They exists at every university," said Murray Sperber, who teaches at the University of California, Berkeley, is a professor emeritus at Indiana University and author of the book, "Beer & Circus: How Big-time College Sports Is Crippling Undergraduate Education."

"As an educator, my concern is: Are they getting a meaningful education?"

Some athletes seem baffled by the whole process of sorting out a major.

The vast majority of Florida players start out in social and behavioral sciences, which is actually a broad area of study that leads to choosing a major and getting a degree.

Tight end Trey Burton, a sophomore, wants to pursue a career in business. He isn't sure why he started out in social and behavioral sciences.

"I have no clue," he said. "I guess they just give you that when you get here and that's what you start out with. I really don't even know what that is. What is it? Social and behavioral? I don't even know what that is, to be honest with you."

Sperber believes the Academic Progress Rate, a landmark program set up by the NCAA to compel schools to move student-athletes into meaningful courses and show they are moving toward a degree, has actually led to more clustering of majors.

Schools can be stripped of scholarships if not enough players are making the grade. Therefore, he said, advisers tend to steer players toward less-demanding classes.

"The whole APR stuff puts a tremendous amount of pressure on academic advisers. It puts pressure on athletes to choose their major very early. It's the law of unintended consequences," Sperber said. "You think of a good defense, and immediately the offense is thinking of ways to get around it."

The NCAA makes no apologies for the APR, saying it has led to tougher academic standards and ensured that athletes from all sports graduate at a rate that matches or exceeds the student body as a whole.

"We need to remind ourselves that before the reform effort, some students weren't getting a degree at all," Lennon said. "The APR is incredibly significant. We have more young people moving toward a degree. We have many more getting degrees. That's the most important thing."

The NCAA has also done extensive research that shows the vast majority of athletes — more than eight in 10 — are satisfied with their choice of major.

And if they aren't, Myron Rolle advises them to make it a priority to take control of their academic careers.

The former Florida State star earned a Rhodes scholarship while starting at strong safety for the Seminoles. He took a year off from football to study at Oxford and is now trying to make it in the NFL. Ultimately, he hopes to become a neurosurgeon.

"I took a very proactive approach immediately when I got to school that I wanted to be in a certain major and I needed tutors and I needed this time for my teachers after class to be able to succeed and flourish," Rolle said.

"You have a lot of young kids, 18- and 19-year-olds, who want to do exactly what the coach says to get on the field. They go to college with the dreams of winning a national championship and being the best player they can be.

"But ultimately, after you're done with your school, you want to say, What did I gain from this school? Did I gain an education?"

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AP Sports Writers Mark Long in Gainesville, Fla., and Teresa Walker in Nashville, Tenn., contributed to this report.

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Follow Paul Newberry on Twitter at http://www.twitter.com/pnewberry1963

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AP Enterprise: Army treats brain injuries in field (AP)

By KRISTIN M. HALL, Associated Press Kristin M. Hall, Associated Press – 57?mins?ago

BAGRAM AIR FIELD, Afghanistan – The traumatic brain injury that Army Staff Sgt. Isidoro Castillo suffered when a suicide bomber attacked his unit in Afghanistan could have meant the end of his deployment.

Instead, Castillo's doctors handled his injury without sending him back to the United States, part of a military effort to better treat and track brain injuries that have become a signature affliction of the war.

Castillo, originally from Fayetteville, N.C., described the bombing days later while he was recovering in a new specialized housing unit for soldiers being treated for brain injuries.

"He was in my peripheral vision. I heard a pop and I hit the ground and the explosion went off," Castillo said. Five soldiers from his 18-member mentoring team were killed during an April meeting with Afghan soldiers at an outpost in the eastern province of Nangarhar.

The Army has had to rethink the way it deals with traumatic brain injury in Afghanistan and Iraq because U.S. soldiers often are targeted by roadside or suicide bombs. Not treating the sometimes hard-to-spot injury can lead to physical and emotional problems that linger long after the soldier returns home. But sending troops out of country for treatment can leave battle units short-handed.

Medical evacuations from combat zones for traumatic brain injury have been growing, from 194 in 2008 to 303 in 2010, according to statistics provided to The Associated Press from the Armed Forces Health Surveillance Center. Last year, the military implemented a strict new policy on treating and tracking soldiers with concussions right on the front lines of war.

Medical officers in Afghanistan say the new approach, which required opening seven new rehabilitation centers called Level II clinics throughout Afghanistan, is allowing more soldiers to go back to their units rather than be evacuated for treatment. Soldiers who are sent home for treatment generally don't come back.

Castillo was treated under the new guidelines. After diagnosis in the field, he was sent to the rehabilitation clinic the 101st Airborne Division set up at Bagram Air Field for about a week before returning to his unit.

On the hot and dusty military base, Castillo had his own room in a cool, quiet housing unit near the hospital, where he could watch movies on a flat-screen TV, play video games or toss a volleyball around on the sandy court outside. Medical crews use these leisure activities combined with military fitness tests, such as running with body armor or maneuvering around obstacles, to determine whether the soldier is fit to return to duty.

The clinics are also stocked with card games and Wii video games, which help occupational therapists look for memory loss or balance issues.

Castillo and other soldier patients meet daily with doctors and have dedicated occupational therapists who monitor symptoms like concentration, balance, headaches and dizziness. The care they are receiving in Afghanistan is similar to TBI rehabilitation programs at military hospitals in the U.S.

"It makes you feel like the stress is gone," Castillo said. "You have nothing to think about but how am I going to get better, what's my next appointment. They just let you breathe."

Clinics that opened last year in eastern Afghanistan returned about 1,000 soldiers to their units, said Maj. Kevin Ridderhoff, the pharmacist for the 101st Airborne Division who oversaw the program during the division's deployment. Ridderhoff said about 97 percent of soldiers who were referred to a Level II clinic were returned to duty after an average three-day stay.

"A big thing is eight hours of uninterrupted rest. Sleep is the goal," Ridderhoff explained. "With concussion, most of these guys get better. That's a good thing."

One of the final assessments is a military performance test. The soldiers don their body armor, go on a road march or a run, maneuver around obstacles, jump in and out of vehicles — all normal activities for active duty. If a soldier is able to complete them without problems or recurring symptoms, the occupational therapist can recommend a return to their unit.

The 101st Airborne Division, which sent 24,000 soldiers to Afghanistan over the past year, has been at the forefront of the new care regimen for what's called mild traumatic brain injury, often called concussion. It trained all unit medics on symptoms and brought the occupational therapists to Fort Campbell for additional training before opening the Afghanistan clinics.

The policy says soldiers are to be given at least 24 hours rest after the first concussion, seven days of rest after the second concussion and an in-depth neurological exam after the third. The policy also directs medics to check for signs of a concussion after key events, such as if a soldier is near a blast, is in a vehicle rollover accident or has a direct blow to the head.

The soldiers recovering at Bagram are separated from their units, but they could still bond with other injured troops over their near-death experiences.

Photos get passed around of a pile of charred, twisted metal — all that's left of the armored vehicle that Pfc. Kyle Kinmartin was in when it rolled over a pressure plate armed with homemade explosives. Kinmartin said he was still having trouble sleeping because he kept thinking about the explosion and fire that could have killed him or his buddies.

"I don't feel like I got blown up, but my body feels it," he said. "I just want to get back and see the guys."

Capt. Barbara Drawbaugh, an occupational therapist who worked at the mTBI center at Forward Operating Base Fenty in Jalalabad, said they are not pushing injured soldiers back into the fight if they aren't ready. "It's not so much that we are trying to force them back out there. It's that we are providing a really good environment of care to allow them to heal," she said.

Soldiers are at risk of more severe and enduring symptoms if they are not allowed to heal after a concussion and suffer a second one too quickly, Drawbaugh said.

But not all soldiers return to their units after a brain injury if more specialized care is needed.

Spc. Matthew Wright, a military policeman, spent weeks at Bagram and watched other soldiers get better and return to their units, but his symptoms weren't improving. Wright had stepped on a hastily planted bomb and got the brunt of the force of the explosion, but the shrapnel went into the ground instead of his body.

Eventually he was medically evacuated back to Fort Knox, Ky., to get further treatment in a Warrior Transition Unit. He hopes he can return to his job soon.

"It's nice to see they are taking this brain thing seriously," he said.

Feeling a sense of obligation to the mission, Castillo returned to the base where his unit was attacked. He still deals with symptoms, like headaches and feelings of anger. But the 40-year-old non-commissioned officer who has had three previous deployments said he's learned not to ignore the real consequences of a concussion.

"Don't fake the funk. If you're not real and let it out, then you're not going to heal properly and it will cost you in the future," Castillo said.

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Kristin Hall can be reached at http://twitter.com/kmhall

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