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About East Oregonian : E.O. (Pendleton, OR) 1888-current | View Entire Issue (July 9, 2015)
NATION/WORLD Thursday, July 9, 2015 East Oregonian Page 7A 0HGLFDUHWRFRYHUHQGRIOLIHFRXQVHOLQJ WASHINGTON (AP) — Medi- care said Wednesday it plans to pay doctors to counsel patients about end-of-life care, the same idea that sparked accusations of “death panels” and fanned a political furor around President Barack Obama’s health care law six years ago. The policy change, to take effect Jan. 1, was tucked into a massive regulation on payments for doctors. It suggests that what many doctors regard as a common-sense option is no longer seen by the Obama administration as politically toxic. Counseling would be entirely voluntary for patients. Some doctors already have such conversations with their patients without billing extra. Certain private insurers have begun offering reimbursement. But an opening to roughly 55 million Medicare bene- ¿FLDULHV FRXOG PDNH VXFK WDONV IDU more common. About three-quar- ters of the people who die each year in the U.S. are 65 and older, making Medicare the largest insurer at the end of life, according to the Kaiser Family Foundation. “As a practicing physician, and a son, and someone who has dealt with this in his own family, I would say these are discussions ... that are critical to high-quality care,” said Patrick Conway, Medicare’s chief PHGLFDORI¿FHU³,ZRXOGZDQWDQ\ American who wanted to have this conversation with their clinician to have the opportunity to do so.” Medicare is using a relatively new term for end-of-life counseling: advance care planning. That’s meant WR UHÀHFW H[SHUW DGYLFH WKDW SHRSOH should make their wishes known about end-of-life care at different stages of their lives, as early as when they get a driver’s license. The counseling aims to discern the type of treatment patients want in their last days, with options ranging from care that’s more focused on comfort than extending life to all-out medical efforts to resuscitate a dying patient. Before former Alaska Gov. Sarah Palin ignited the “death panels” outcry, there was longstanding bipartisan consensus about helping people to better understand their end-of-life choices and decisions. A 1992 law passed under Republican President George H.W. Bush requires hospitals and nursing homes to help patients who want to prepare living wills and advance directives. Similar efforts gained resonance after the 2005 death of Terri Schiavo, the brain-damaged Florida woman whose family fought for years over whether she’d want to be kept alive in a vegetative state. Then-Florida Gov. Jeb Bush got embroiled in the family’s ordeal, ordering feeding tubes reinserted for Schiavo against her husband’s wishes. An ISIS secret to success: 6KRFNWURRSVZKR¿JKWWRWKHGHDWK By HAMZA HENDAWI, QASSIM ABDUL-ZAHRA and BASSEM MROUE Associated Press BAGHDAD — They are the Islamic State group’s elite shock troops. Fanatical and disciplined, WKH\ LQ¿OWUDWH FLWLHV RI ,UDT DQG 6\ULDXQOHDVKPD\KHPDQG¿JKWWR the death, wearing explosives belts to blow themselves up among their opponents if they face defeat. IS calls them “Inghemasiyoun,” Arabic for “those who immerse themselves,” a sort of special forces unit parallel to its regular forces that is credited with many RI WKH JURXS¶V VWXQQLQJ EDWWOH¿HOG successes. A recent online video from the group showed a unit preparing to launch an eventually successful attack on the central Syrian town of al-Sukhna. “Victory RU PDUW\UGRP´ WKH ¿JKWHUV wearing blue bandanas, scream in a circle around their commander, pledging their allegiance to God and vowing never to retreat. “They cause chaos and then their main ground offensive begins,” said Redur Khalil, spokesman for the U.S.-backed Kurdish People’s Protection Units, which have led a string of military successes against the IS in Syria. Though best known for its KRUUL¿FEUXWDOLWLHVWKH,VODPLF6WDWH group has proved to be a highly RUJDQL]HG DQG ÀH[LEOH ¿JKWLQJ force, according to senior Iraqi PLOLWDU\ DQG LQWHOOLJHQFH RI¿FLDOV and Syrian Kurdish commanders on the front lines. Its tactics are often creative, whether it’s using a sandstorm as cover for an assault or a lone sniper tying himself to the top of a palm tree to pick off troops below. Its forces switch between conventional and guerrilla warfare, using the latter to wear down their opponents EHIRUH PDVVHG ¿JKWHUV EDFNHG E\ armored vehicles, Humvees and sometimes even artillery move to WDNH RYHU WHUULWRU\ 7KH ¿JKWHUV incorporate suicide bombings as a EDWWOH¿HOG WDFWLF WR EUHDN WKURXJK lines and demoralize enemies, and they hone them to make them more effective. Recently, they beefed up armor of the vehicles used in those DWWDFNV WR SUHYHQW JXQ¿UH IURP killing the driver or detonating explosives. Those strategies are being carried into new fronts as well, appearing in Egypt in last week’s dramatic attack by an IS-linked militant group against the military in the Sinai Peninsula. Andreas Krieg, a professor at King’s College London who embedded with Iraqi Kurdish ¿JKWHUVVDLG,6ORFDOFRPPDQGHUV receive overall orders on strategy but are given freedom to operate DV WKH\ VHH ¿W WR DFKLHYH WKHP The husband ultimately prevailed in a legal battle with Schiavo’s parents, who wanted her kept alive. In 2008, a year before debate over the Affordable Care Act spiraled into tea-party protests, Congress overwhelmingly passed legislation requiring doctors to discuss issues like living wills with new Medicare enrollees. And, just months before being tapped as running mate for GOP presidential nominee John McCain, Palin herself signed a proclamation recognizing Healthcare Decision Day in Alaska, with the goal of a statewide effort of spreading the word about the importance of advance directives. Troop cuts may grow LIEXGJHW impasse persists By ROBERT BURNS AP National Security Writer Islamic State militants fire an anti-tank missile in Hassakeh, northeast Syria. That’s a sharp contrast to the rigid hierarchies of the Iraqi and Syrian PLOLWDULHVZKHUHRI¿FHUVRIWHQIHDU acting without direct approval. ,6¿JKWHUVDUHKLJKO\GLVFLSOLQHG — swift execution is the punish- ment for deserting battle or falling DVOHHSRQJXDUGGXW\,UDTLRI¿FHUV VDLG 7KH JURXS DOVR LV ÀXVK ZLWK weaponry looted from Iraqi forces. IS stands out in its ability to conduct multiple battles simultane- ously, Iraqi army Lt. Gen. Abdul- Wahab al-Saadi said. “In the Iraqi army, we can only run one big battle at a time,” said al-Saadi, who was wounded twice in the past year as he led forces that retook the key cities of Beiji and Tikrit. Even the group’s atrocities go to the Islamic State looking to die, and the Islamic State is happy to help them,” said Patrick Skinner, a former CIA RI¿FHU QRZ ZLWK 7KH Soufan Group, a private geopolitical risk assess- ment company. The group’s tactics carried it to a sweep of northern and western Iraq a year ago, capturing Mosul, Iraq’s second-big- gest city. Shortly there- after, IS leader Abu Bakr al-Baghdadi declared a “caliphate” spanning its territory in Iraq and Syria. In May, it captured Ramadi, capital of Iraq’s vast western Anbar province. In Syria, it seized the central city of Palmyra. The elite shock troops were crucial in capturing are in part a tactic to terrorize its enemies. It beheads captured Ramadi. First came a wave of more soldiers, releasing videos of the than a dozen suicide bombings that killings online. Stepping up the hammered the military’s positions, shock value, recent videos showed WKHQ WKH ¿JKWHUV PRYHG LQ GXULQJ caged captives being lowered into a a sandstorm. Iraqi troops crumbled pool to drown and the heads blown DQGÀHGDVDODUJHU,6IRUFHPDUFKHG off other captives with explosive in. Since US-led airstrikes in Iraq wire around their necks. 7KH QXPEHU RI ,6 ¿JKWHUV LQ and Syria have hampered the Iraq and Syria is estimated between group’s movements, IS has lost 30,000 to 60,000, according to the ground. Iraqi troops and Shiite ,UDTLRI¿FHUV)RUPHURI¿FHUVIURP militiamen retook some cities, the military of ousted Iraqi dictator like Saddam’s hometown of Saddam Hussein have helped the 7LNULW,Q6\ULD.XUGLVK¿JKWHUV JURXSRUJDQL]HLWV¿JKWHUV9HWHUDQ backed by heavy U.S. airstrikes jihadis with combat experience in recaptured the border town of Afghanistan, Chechnya or Somalia Kobani after weeks of devas- have brought valuable experience. tating battles. More recently, IS Foreigners who join IS often lost Tal Abyad, another Syrian end up as suicide bombers. “People border town. Baltimore police commish ¿UHGDPLGKRPLFLGHULVH %$/7,025($3²7KH%DOWLPRUHPD\RU¿UHGWKH troubled city’s police commissioner Wednesday, saying that a recent spike in homicide rates weeks after a black man died of injuries in police custody required a change in leadership. Mayor Stephanie Rawlings-Blake thanked Police Commissioner Anthony Batts for his service and announced that she was appointing Deputy Police Commissioner Kevin Davis as interim commissioner. “We need a change,” Rawlings-Blake told a news conference. “This was not an easy decision but it is one that is in the best interest of Baltimore. The people of Baltimore deserve better and we’re going to get better.” 7KH¿ULQJFRPHVPRQWKVDIWHUWKHFLW\EURNHRXW into riots following the death of Freddie Gray, who died in April of injuries he received in police custody. Six SROLFH RI¿FHUV KDYH EHHQ FULPLQDOO\ FKDUJHG LQ *UD\¶V death. After the violence, arrests in the city plummeted and the city’s homicide rate spiked. The most recent violence happened Tuesday night, when gunmen jumped out of WZR YDQV DQG ¿UHG DW D JURXS RI SHRSOH D IHZ EORFNV from an urban university campus, killing three people. A fourth person sought treatment for a gunshot wound to the buttocks and was in stable condition. Police said Wednesday that the shooting wasn’t random, but no arrests have been made. Militant website via AP WASHINGTON — In the midst of a war against the Islamic State that the Obama administra- tion says will last many years, the Army is moving ahead with big troop cuts. And they could grow even larger unless Congress and WKH:KLWH+RXVH¿QGDZD\WRVWRS further across-the-board spending reductions this fall. Army leaders were notifying members of Congress Wednesday with details of how they intend to reduce the active-duty force from 490,000 soldiers to 450,000 within two years. The size of the reduction was announced months ago, but congressional delegations have been waiting for word on how the cuts would be distributed and timed; troop reductions can LQÀLFW VLJQL¿FDQW HFRQRPLF SDLQ on communities reliant on military base populations. If a new round of automatic spending cuts, known as seques- tration, goes ahead, the Army says it will have to reduce even further, to 420,000 soldiers. Gen. Ray Odierno, the Army chief of staff, has said he can accept the planned reduction of 40,000 soldiers over the next two years, which the Army plans to implement by trimming the size of numerous units. The biggest cuts would be to an infantry unit at Fort Benning, Georgia, and an airborne infantry unit at Fort Richardson in Alaska. Each would shrink from about 4,000 soldiers to about 1,050, GHIHQVH RI¿FLDOV VDLG :HGQHVGD\ 7KRVH GHWDLOV ZHUH ¿UVW UHSRUWHG Tuesday by USA Today. The full SODQ IRU VSHFL¿F FXWV LV H[SHFWHG to be made public by the Army on Thursday. In Odierno’s view, being forced to shrink the Army is not the hardest part of coping with years- long budget wrangling between the Congress and the White House. (YHQPRUHGLI¿FXOWKHVD\VLVWKH uncertainty for military planners and the nation’s soldiers. “The thing I worry about is it has put a lot of turbulence in the Army and brought a lot of angst to our soldiers,” he told reporters May 28. As he nears the end of his tenure as Army chief, Odierno said the only thing that could push the service off its course toward modernization is more budget uncertainty. “The unpredictability is killing us,” he said. Census shows Hispanics outnumber whites in California AP file photo In this May 2007 photo, a man joins thousands rallying during a May Day event in front of Los Angeles City Hall. According to figures released by the U.S. Census Bureau, Hispanic Californians began to narrowly outnumber white Californians in 2014. LOS ANGELES (AP) — The long-expected moment when Latinos surpassed whites as California’s largest racial or ethnic group has come and gone. Hispanic Californians began to narrowly outnumber white Cali- IRUQLDQV VRPHWLPH LQ WKH ¿UVW KDOI of 2014, according to U.S. Census %XUHDX¿JXUHVUHOHDVHGLQODWH-XQH The state had some 14.99 million Latinos compared with about 14.92 million non-Hispanic whites as of July 1, 2014, the most recent data available. Together, the two groups make up nearly 80 percent of the state’s popu- lation. Demographers had expected the shift for decades as the state’s Hispanic population boomed due to immigration and birth rates. Many thought it would happen sooner than it did — the California Department of Finance had predicted 2013 — but a slight decline in popula- tion pushed it to last year. ³7KLVLVVRUWRIWKHRI¿FLDOVWDWLVWLFDO recognition of something that has been underway for almost an entire gener- ation,” Roberto Suro, director of the Tomás Rivera Policy Institute at the University of Southern California, told the Los Angeles Times on Wednesday. California joins New Mexico as the second state with a Latino plurality. Hawaii, with its large Asian popula- tion, is the third state where whites are not the largest ethnic group. California saw an immigration boom from Mexico and Central America during the 1980s, a popula- tion surge that has since moved to other states, particularly in the Midwest and South. As that happened, California’s Hispanic population has grown more rooted and settled. Some 70 percent of the state’s immigrants, the majority of those Latinos, were living in the U.S. before 2000, a higher rate than any other state, according to 2012 census data.