Governors Fall Away in G.O.P. Fight Against More Medicaid

Under pressure from the health care industry and consumer advocates, seven Republican governors are cautiously moving to expand Medicaid, giving an unexpected boost to President Obama’s plan to insure some 30 million more Americans.

The Supreme Court ruled last year that expanding Medicaid to include many more low-income people was an option under the new federal health care law, not a requirement, tossing the decision to the states and touching off battles in many capitols.

The federal government will pay the entire cost of covering newly eligible beneficiaries from 2014 to 2016, and 90 percent or more later. But many Republican governors and lawmakers immediately questioned whether that commitment would last, and whether increased spending on Medicaid makes sense, given the size of the federal budget deficit. Some flatly declared they would not consider it.

In Florida, where Gov. Rick Scott reversed his position and on Wednesday announced his support for expanding Medicaid, proponents say that doing so will not only save lives, but also create jobs and stimulate the economy. Similar arguments have swayed the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who in recent months have announced their intention to expand Medicaid.

The shift has delighted supporters of the law.

“I think this means the dominoes are falling,” said Ronald F. Pollack, the executive director of Families USA, a consumer group. “The message is, ‘Even though I may not have supported and even strongly opposed the Affordable Care Act, it would be harmful to the citizens of my state if I didn’t opt into taking these very substantial federal dollars to help people who truly need it.’ ”

 Nationwide, Medicaid covers 60 million people, most of them low-income or disabled. The Congressional Budget Office has estimated that 17 million more people could be enrolled if all states took the expansion option. So far, 22 states have said they will expand the program, 17 have opted against it, and 11 have not yet decided, according to Avalere Health, a consulting firm.

Some Republican governors remain firmly opposed to the expansion of Medicaid. In her State of the State address, Gov. Nikki R. Haley said, “As long as I am governor, South Carolina will not implement the public policy disaster that is Obamacare’s Medicaid expansion.”

Gov. Rick Perry affirmed that “Texas will not expand Medicaid” and said he was proud that Texas did not follow other states “scrambling to grab every tax dollar they can.”

The change of heart for some Republican governors has come after vigorous lobbying by health industry players, particularly hospitals. Hospital associations around the country signed off on Medicaid cuts under the health care law on the assumption that their losses would be more than offset by new paying customers, including many insured by Medicaid.

Politics could also be a factor in states where Republican governors have decided to expand Medicaid. Mr. Obama won all of those states except Arizona and North Dakota in last year’s election, a fact that may have influenced several of the governors’ decisions. Some of the seven are also up for re-election next year.

Religious leaders have added a moral dimension to the campaign in some states. The Roman Catholic bishops of Salt Lake City and Little Rock, Ark., for example, have urged state officials to expand Medicaid.

The Obama administration has tried to win over skeptical state officials by offering new flexibility to manage Medicaid as they like. On the same day that he agreed to expand Medicaid in Florida, Mr. Scott got federal permission to move more Medicaid beneficiaries into private managed care plans.

Mr. Scott’s support for expanding Medicaid is particularly significant — Florida is the fourth most populous state — and surprising. A onetime hospital executive, he has been among the most strident critics of the health care law, and his opposition to it was a cornerstone of his 2010 campaign for governor.

The battle is not over, however. In Florida, as in many other states, expansion is subject to approval by the Legislature, whose Republican leaders have expressed misgivings. The legislative session begins next month, and advocates say they plan to press ahead with a lobbying campaign.

Leah Barber-Heinz, a spokeswoman for Florida Chain, a health advocacy group, said it was trying to inform lawmakers and the public about who would benefit from an expansion of Medicaid. More than one-fifth of Florida residents, roughly 4 million of 19 million people, lack health insurance.

“There are so many misperceptions about the uninsured,” Ms. Barber-Heinz said. “So we’re trying to show faces of who would be impacted: people who have been hit by the recession, people who have been laid off, educated people, people who own homes.”

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The Lede: Syrian Television's Most Outraged Bystander

Last Update, 4:47 p.m. In the aftermath of a deadly bombing in Damascus on Thursday, a man emerged from a small knot of bystanders crowded around a camera crew from Syrian state television to vent his anger at the foreign Islamist fighters he held responsible. “We the Syrian people,” he said, “place the blame on the Nusra Front, the Takfiri oppressors and armed Wahhabi terrorists from Saudi Arabia that are armed and trained in Turkey.”

A report on Thursday’s bombing in Damascus from Syrian state television’s YouTube channel.

Pointing at the ruined street near the headquarters of President Bashar al-Assad’s ruling Baath Party, the man described the location as “a civilian place — a mosque, an elementary school, the homes of local families.”

Watching a copy of the report online, Rime Allaf, a Syrian writer monitoring the conflict from Vienna, noticed that this man on the street, whose views so closely echoed those of the Syrian government, had a very familiar face. That is because, as opposition activists demonstrated last June, the same man had already appeared at least 18 times in the forefront or background of such reports since the start of the uprising.

Man who appears on #Syria TV as “innocent bystander” with every Damascus car bomb has again appeared today. http://t.co/PmPRhzUUBN

— Rime Allaf (@rallaf) 21 Feb 13

After she posted a screenshot of the man’s latest appearance, Ms. Allaf observed on Twitter that “it would be funny if there weren’t so many victims of Syria regime terrorism!”

As The Lede noted last year, the man was even featured in two reports the same day during a small pro-Assad rally in Damascus.

Two pro-Assad television channels in Syria interviewed the same man on the street at a rally in July 2012.

Mocking the dark comedy of government-run channels recycling the same die-hard Assad supporter in so many reports, activists put together several video compilations of his appearances in the state media. The most comprehensive, posted online last June, featured excerpts from 18 reports.

A compilation of Syrian state media reports featuring the same Assad supporter again and again.

Another highlight reel, uploaded to YouTube 13 months ago by a government critic, showed that after the man had spoken at least five times on state-run television, he appeared in the background of a BBC report wearing a military uniform.

A man who is frequently interviewed on Syrian state television in civilian dress appeared in the background of a BBC report wearing a military uniform.

As longtime readers of The Lede may recall, during the dispute over Iran’s 2009 presidential election, opposition bloggers noticed that one particularly die-hard supporter of Mahmoud Ahmadinejad also appeared again and again and again in photographs of pro-government rallies.

While there is no way to determine just who is responsible for Syrian television’s frequent interviews with this same man on the street, there is some evidence that Iran has advised Syria on how to report bombings on state television.

Last year, when The Guardian published a trove of hacked e-mails taken from the in-boxes of Syrian officials, one message forwarded to the president appeared to include advice from Iranian state television’s bureau chief in Damascus on what his Syrian counterparts should report after bombings. That e-mail, from Hussein Mortada, a Lebanese journalist who runs coverage of Syria for the Iranian government’s satellite news channels, complained that the government was not heeding directions he had received “from Iran and Hezbollah,” the Lebanese militant group, about who Syria should blame for bomb attacks. “It is not in our interest to say that Al Qaeda is behind” every bombing, Mr. Mortada wrote, “because such statements clear the U.S. administration and the Syrian opposition of any responsibility.”

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A 1-2 knockout: McIlroy, Woods lose in Match Play

MARANA, Ariz. (AP) — Rory McIlroy and Tiger Woods knocked out in the first round of the Match Play Championship? Not many would have given that a snowball's chance in the desert.

Almost as surprising as the freakish snowstorm on Dove Mountain was the sight of golf's two biggest stars heading to the airport, only the second time in the 15-year history of this wild tournament that No. 1 and No. 2 didn't last more than a day.

Shane Lowry of Ireland chipped in twice and drilled a fairway metal to 3 feet to seize control, and then knocked out McIlroy with a bunker shot to 4 feet to save par on the final hole. Just as the shock was wearing off, Charles Howell III came up with kind of shots he's used to seeing Woods make in the clutch — a wedge that stopped inches from the cup on the 15th hole, and a 25-foot birdie on the 16th that carried him to a 2-and-1 victory.

"It's definitely a day I'm going to remember," said Lowry, the third player in the last four years to eliminate the No. 1 seed in the opening round.

"I had nothing to lose," Howell said.

The biggest loser Thursday might have been NBC Sports, which lost the two biggest draws.

Not even Phil Mickelson can save the day. He's not playing this year.

Howell had not faced Woods in match play since he was 17 and lost to him in the third round of the 1996 U.S. Amateur. He said he had never beaten him even in the dozens of casual games they played over the years at Isleworth before Woods moved away to south Florida.

What a time to change that losing streak.

Howell, who qualified for this World Golf Championship for the first time in five years, played a fabulous round in cold conditions. They matched scores 10 times in 14 holes before Howell came through with back-to-back birdies.

"In this format, match play is crazy," Howell said. "He's Tiger Woods. I was lucky to hang in there."

The final matches were played in near darkness, and they could have stopped after 15 holes. Woods wanted to play on, even though Howell had the momentum. Woods was 2 under for the day, and neither of them made a bogey.

"We both played well," Woods said. "He made a couple of more birdies than I did. He played well, and he's advancing."

McIlroy, the No. 1 player in the world, built a 2-up lead early in the match until Lowry rallied and grabbed the momentum by chipping in for birdie on the par-5 11th to avoid falling behind, chipping in from behind the 12th green for birdie and then ripping a fairway metal to within a few feet for a conceded eagle on the 13th to go 2 up.

Lowry missed a short par putt on the 14th, only for McIlroy to give away the next hole with a tee shot into the desert and a bunker shot that flew over the 15th green and into a cactus. But the two-time major champion hung tough, coming up with a clutch birdie on the 16th to stay in the game.

McIlroy nearly holed his bunker on the 18th, and Lowry followed with a steady shot out to 4 feet and calmly sank the putt.

"Deep down, I knew I could beat him," Lowry said. "There's a reason I'm here, and this is match play."

For McIlroy, more questions are sure to follow him to Florida for his road to the Masters. He now has played only 54 holes in the first two months of the season, missing the cut in Abu Dhabi and losing in the first round at Dove Mountain.

"You want to try and get as far as you can, but I guess that's match play," McIlroy said. "I probably would have lost by more if I had played someone else in the field. It wasn't a great quality match. But it would have been nice to get through and just get another day here and another competitive round under my belt."

The only other time the top two seeds lost in the opening round was in 2002, when Woods and Phil Mickelson lost at La Costa.

Luke Donald nearly made it the top three seeds except for a clutch performance. He holed a 10-foot birdie putt to halve the 17th hole and stay tied with Marcel Siem of Germany. Donald then birdied the 18th from 7 feet to win the match.

Louis Oosthuizen, the No. 4 seed, rallied to get past Richie Ramsay of Scotland.

The opening round was halted Wednesday after 3½ hours because of a freak snowstorm that covered Dove Mountain with nearly 2 inches. It continued to snow at times overnight, and it took nearly five hours to clear snow from the golf course for the tournament to resume.

Turns out, snow wasn't the only surprise.

"I had to play extremely well to have a chance, and I still kept waiting for that Tiger moment," Howell said.

It never came.

Woods missed short birdie chances at the 10th and 11th, but the real damage came on the 15th when he went long of the green with a wedge in hand. Howell also missed a pair of short putts on the back nine, but he came up big with the putt on the 16th.

"Really, I didn't even realize I was 2 up with two to go until I got right to the tee on 17, and it actually threw me for a bit because I never maybe was really in the moment and didn't quite realize how things were," Howell said. "And as far as beating Tiger Woods, it shows you that match play is crazy. I did have to play a good round. But yeah, it's a bit hard to believe I'm sitting here today."

Howell and Lowry will have to wait until Friday to find out their opponents.

Carl Pettersson was 1 up on Rickie Fowler through 17 holes when they stopped because of darkness. The winner gets Lowry, who will be fighting some history. Of the previous three players to beat the No. 1 seed in the opening round, all of them lost in the second round.

Howell gets either Gonzalo Fernandez-Castano or Francesco Molinari, who were all square through 15 holes.

In other matches:

— Ernie Els lost in the opening round for the sixth time. He missed a 3-foot par putt on the 16th hole that would have given him the lead, and he missed a 5-foot par putt on the 18th hole to lose to Fredrik Jacobson.

— Russell Henley, two months into his rookie season, defeated the hottest player in the field when he took down Charl Schwartzel, who had won twice and finished no worse than fifth in his last six tournaments worldwide.

— Rafael Cabrera Bello beat Lee Westwood in 19 holes after Westwood missed a 6-foot par putt on the last hole.

The opening round of the Match Play is typically the best day in golf. This one took two days, and it was unlike any other.

Nearly 2 inches of snow covered Dove Mountain on Wednesday, and with more snow overnight, nothing had changed when players began arriving Thursday morning. There already was a two-hour delay when they arrived.

"There was a guy building a snowman this morning at 8, and they said they were going off at 10:30," Henley said. "I figured it was going to be awhile"

No one had an easier day than Bo Van Pelt.

Having won six straight holes to go 5 up before snow suspended play on Wednesday, Van Pelt finally got back on the golf course and struck all of two shots — an 8-iron and a 45-foot putt. He won the 13th hole with a par to complete a 6-and-5 win over John Senden of Australia.

And then there was Sergio Garcia. He was one putt away from winning when play stopped Wednesday. He three-putted from 12 feet to lose the hole, and on the 18th hole, Thongchai Jaidee made a 6-foot birdie to send the match into overtime.

On the first extra hole, Garcia removed his cap and was putting his golf ball and tees in the bag as Jaidee settled over a 10-foot birdie. The putt ran around the back edge of the cup, giving Garcia life. He made birdie on the par-5 second hole to win in 20 holes.

So instead of hitting one shot Thursday, he had to play 19 of them. Garcia's was the first match of the tournament. It took him about 30 hours to finish.

"It's weirdness, I guess," Garcia said. "I guess at the end of the day, I was pleased to get through."

That's one thing McIlroy and Woods can't say.

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Sheryl Sandberg, ‘Lean In’ Author, Hopes to Spur Movement

Before Sheryl Sandberg, the chief operating officer of Facebook, started to write “Lean In,” her book-slash-manifesto on women in the workplace, she reread Betty Friedan’s “The Feminine Mystique.” Like the homemaker turned activist who helped start a revolution 50 years ago, Ms. Sandberg wanted to do far more than sell books.

Todd Heisler/The New York Times

Sheryl Sandberg, the chief operating officer of Facebook, is trying to create her own version of consciousness-raising groups.

Ms. Sandberg, whose ideas about working women have prompted both enthusiasm and criticism, is attempting nothing less than a Friedan-like feat: a national discussion of a gender-problem-that-has-no-name, this time in the workplace, and a movement to address it.

When her book is published on March 11, accompanied by a carefully orchestrated media campaign, she hopes to create her own version of the consciousness-raising groups of yore: “Lean In Circles,” as she calls them, in which women can share experiences and follow a Sandberg-crafted curriculum for career success. (First assignment: a video on how to command more authority at work by changing how they speak and even sit.)

“I always thought I would run a social movement,” Ms. Sandberg, 43, said in an interview for “Makers,” a new documentary on feminist history.

And yet no one knows whether women will show up for Ms. Sandberg’s revolution, a top-down affair propelled by a fortune worth hundreds of millions on paper, or whether the social media executive can form a women’s network of her own. Only a single test “Lean In Circle” exists. With less than three weeks until launch — which will include a spread in Time magazine and splashy events like a book party at Mayor Michael R. Bloomberg’s home — organizers cannot say how many more groups may sprout up.

Even her advisers acknowledge the awkwardness of a woman with double Harvard degrees, dual stock riches (from Facebook and Google, where she also worked), a 9,000-square-foot house and a small army of household help urging less fortunate women to look inward and work harder. Will more earthbound women, struggling with cash flow and child care, embrace the advice of a Silicon Valley executive whose book acknowledgments include thanks to her wealth adviser and Oprah Winfrey?

“I don’t think anyone has ever tried to do this from anywhere even close to her perch,” said Debora L. Spar, president of Barnard College, who invited Ms. Sandberg to deliver a May 2011 commencement address about gender in the workplace that caught fire online. (Ms. Sandberg, who will grant her first book interview to the CBS program “60 Minutes,” declined to comment for this article.)

Despite decades of efforts, and some visible exceptions, the number of top women leaders in many fields remains stubbornly low: for example, 21 of the current Fortune 500 chief executives are women. In her book, to be published by Knopf, Ms. Sandberg argues that is because women face invisible, even subconscious, barriers in the workplace, and not just from bosses. In her view, women are also sabotaging themselves. “We hold ourselves back in ways both big and small, by lacking self-confidence, by not raising our hands, and by pulling back when we should be leaning in,” she writes, and the result is that “men still run the world.”

Ms. Sandberg wants to take women through a collective self-awareness exercise. In her book, she urges them to absorb the social science showing they are judged more harshly and paid less than men; resist slowing down in mere anticipation of having children; insist that their husbands split housework equally; draft short- and long-term career plans; and join a “Lean In Circle,” which is half business school and half book club.

The project has the feel of a social experiment: what if women at major corporations could review research on how to overcome gender barriers, along with instruction on skills like negotiation and communication? Will working women, already stretched thin, attend nighttime video lectures on “Unconditional Responsibility” and “Using Stories Powerfully”? The instructions for the gatherings, provided to The New York Times by an outside adviser to the project, are precise, down to membership requirements (participants can miss no more than two monthly meetings per year) and the format (15-minute check-in, 3 minutes each for personal updates, a 90-minute presentation, then discussion).

Ms. Sandberg has asked a wide array of women to contribute their success stories to her new Web site. (Jill Abramson, the executive editor of The Times, wrote an essay, and the newspaper is one of many corporations to sign on to the project.) The written requests ask for positive endings, suggesting that tales closing with missed promotions or broken marriages are unwelcome. Hoping to reach beyond an elite audience, Ms. Sandberg and her foundation joined forces with Cosmopolitan magazine, which is publishing a 40-page supplement to its April issue devoted to Ms. Sandberg’s ideas, and plan to spread her message to community colleges, according to those involved in the project.

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In Reversal, Florida to Take Health Law’s Medicaid Expansion

MIAMI — Gov. Rick Scott of Florida reversed himself on Wednesday and announced that he would expand his state’s Medicaid program to cover the poor, becoming the latest — and, perhaps, most prominent — Republican critic of President Obama’s health care law to decide to put it into effect.

It was an about-face for Mr. Scott, a former businessman who entered politics as a critic of Mr. Obama’s health care proposals. Florida was one of the states that sued to try to block the law. After the Supreme Court ruled last year that though the law was constitutional, states could choose not to expand their Medicaid programs to cover the poor, Mr. Scott said that Florida would not expand its programs.

Mr. Scott said Wednesday that he now supported a three-year expansion of Medicaid, through the period that the federal government has agreed to pay the full cost of the expansion, and before some of the costs are shifted to the states.

“While the federal government is committed to paying 100 percent of the cost, I cannot in good conscience deny Floridians that needed access to health care,” Mr. Scott said at a news conference. “We will support a three-year expansion of the Medicaid program under the new health care law as long as the federal government meets their commitment to pay 100 percent of the cost during that time.”

He said there were “no perfect options” when it came to the Medicaid expansion. “To be clear: our options are either having Floridians pay to fund this program in other states while denying health care to our citizens,” he said, “or using federal funding to help some of the poorest in our state with the Medicaid program as we explore other health care reforms.”

Mr. Scott said the state would not create its own insurance exchange to comply with another provision of the law.

His reversal sent ripples through the nation, especially given the change in tone and substance since the summer, when he said he would not create an exchange or expand Medicaid.

“Floridians are interested in jobs and economic growth, a quality education for their children, and keeping the cost of living low,” Mr. Scott said in a statement at the time. “Neither of these major provisions in Obamacare will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens.”

Mr. Scott now joins the Republican governors of Arizona, Michigan, Nevada, New Mexico, North Dakota and Ohio, who have decided to join the Medicaid expansion. Some, like Gov. Jan Brewer of Arizona, were also staunch opponents of Mr. Obama’s overall health care law.

Shortly before his announcement, the governor received word from the federal government that it planned to grant Florida the final waiver needed to privatize Medicaid, a process the state initially undertook as a pilot project. Mr. Scott, who is running for re-election next year, has heavily lobbied for the waiver, arguing that Florida could not expand Medicaid without it.

Mr. Scott’s support of Medicaid expansion is significant, but is far from the last word. The program requires approval from Florida’s Republican-dominated Legislature, which has been averse to expanding Medicaid under the health care law. The Legislature’s two top Republican leaders said that before making a decision they would consider recommendations from a select committee, which has been asked to review the state’s options.

“The Florida Legislature will make the ultimate decision,” Will Weatherford, the state House speaker, said. “I am personally skeptical that this inflexible law will improve the quality of health care in our state and ensure our long-term financial stability.”

Medicaid, which covers three million people in Florida, costs the state $21 billion a year. The expansion would extend coverage to one million more people.

Mr. Scott’s reversal is sure to anger his original conservative supporters.

The governor “was elected because of his principled conservative leadership against Obamacare’s overreach,” said Slade O’Brien, state director for Americans for Prosperity, an influential conservative advocacy organization. “Hopefully our legislative leaders will not follow in Governor Scott’s footsteps, and will reject expansion.”

During his announcement on Wednesday, Mr. Scott said his mother’s recent death and her lifetime struggle to raise five children “with very little money” played a role in his decision.

“Losing someone so close to you puts everything in a new perspective, especially the big decisions,” he said.

Michael Cooper contributed reporting from New York.

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World Briefing | Africa: Nigeria: Security Service Says It Halted Group Watching Israeli and U.S. Targets

Nigeria’s State Security Service said Wednesday that it broke up what it characterized as a terrorist group, backed by “Iranian handlers,” that wanted to gather intelligence about locations frequented by Americans and Israelis. The service said it arrested three suspects, but one remained at large. A spokeswoman, Marilyn Ogar, who was reading from a statement, identified the head of the group as Abdullahi Mustaphah Berende, a leader of a local Shiite sect. “He personally took photographs of the Israeli culture center in Ikoyi, Lagos,” she said. The group also conducted surveillance on USAID and the United States Peace Corps, she said. Ms. Ogar did not take questions.

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The Trade: A Revolving Door in Washington With Spin, but Less Visibility

Obsess all you’d like about President Obama’s nomination of Mary Jo White to head the Securities and Exchange Commission. Who heads the agency is vital, but important fights in Washington are happening in quiet rooms, away from the media gaze.

After a widely praised stint as a tough United States attorney, Ms. White spent the last decade serving so many large banks and investment houses that by the time she finishes recusing herself from regulatory matters, she may be down to overseeing First Wauwatosa Securities.

Ms. White maintains she can run the S.E.C. without fear or favor. But the focus shouldn’t be limited to whether she can be effective. For lobbyists, the real targets are regulators and staff members for lawmakers.

Ms. White, at least, will have to sit for Congressional testimony, answer occasional questions from the media and fill out disclosure forms. Staff members, however, work in untroubled anonymity for the most part. So, while everyone knows there’s a revolving door — so naïve to even bring it up! — few realize just how fluidly it spins.

Take what happened late last month as Washington geared up for more fights about the taxing, spending and the deficit. The Senate majority leader, Harry Reid, Democrat of Nevada, decided to bolster his staff’s expertise on taxes.

So on Jan. 25, Mr. Reid’s office announced that he had appointed Cathy Koch as chief adviser to the majority leader for tax and economic policy. The news release lists Ms. Koch’s admirable and formidable experience in the public sector. “Prior to joining Senator Reid’s office,” the release says, “Koch served as tax chief at the Senate Finance Committee.”

It’s funny, though. The notice left something out. Because immediately before joining Mr. Reid’s office, Ms. Koch wasn’t in government. She was working for a large corporation.

Not just any corporation, but quite possibly the most influential company in America, and one that arguably stands to lose the most if there were any serious tax reform that closed corporate loopholes. Ms. Koch arrives at the senator’s office by way of General Electric.

Yes, General Electric, the company that paid almost no taxes in 2010. Just as the tax reform debate is heating up, Mr. Reid has put in place a person who is extraordinarily positioned to torpedo any tax reform that might draw a dollar out of G.E. — and, by extension, any big corporation.

Omitting her last job from the announcement must have merely been an oversight. By the way, no rules prevent Ms. Koch from meeting with G.E. or working on issues that would affect the company.

The senator’s office, which declined to make Ms. Koch available for an interview, says that she will support the majority leader in his efforts to close corporate tax loopholes. His office said in a statement that the senator considered her knowledge of the private sector to be an asset and that she complied with “all relevant Senate ethics rules and disclosures.”

In a statement, the senator’s spokesman said, “The impulse in some quarters to reflexively cast suspicion on private sector experience is part of what makes qualified individuals reluctant to enter public service.”

Over in bank regulatory land, meanwhile, January was playing out like a Beltway remake of “Freaky Friday.”

Julie Williams, chief counsel for the Office of the Comptroller of the Currency and a major friend of the banks for years, had been recently shown the door by Thomas J. Curry, the new head of the regulator. Banking reform advocates took that to be an omen that a new era might be dawning at the agency, which has often been a handmaiden to large banks.

Ms. Williams, of course, landed on her feet. She’s now at the Promontory Financial Group, a classic Washington creature that is a private sector mirror image of a regulatory body. Promontory is the Shadow O.C.C. The firm was founded by a former head of the agency, Eugene A. Ludwig, and if you were to walk down the halls swinging a copy of the Volcker Rule, you would be sure to hit a former O.C.C. official. Promontory says only about 5 percent of its employees come from the O.C.C., but concedes that more than a quarter are former regulators.

Promontory, as the firm explains on its Web site, “excels at helping financial companies grapple with and resolve critical issues, particularly those with a regulatory dimension.” But it plays for the other team, too, by helping the O.C.C. put into effect regulatory reviews. The dreary normality of this is a Washington scandal in the Michael Kinsley sense: a perfectly legal one.

Promontory, which demurred on a request to talk with Ms. Williams, has a different view. The firm doesn’t lobby or help in litigation. It argues that after banks stop fighting regulators and lobbying against rules, then they come to Promontory to figure out how to fix their problems and comply.

“We are known in the industry as the tough-love doctors,” said Mr. Ludwig, the chief executive of Promontory. “I am deeply committed to financial stability, and the only way to have stability is to do the right thing in both the spirit and letter of the law.”

Hmm. Remember the Independent Foreclosure Review, the program that the O.C.C. and other federal bank regulators trumpeted as the largest effort to compensate victims of big banks’ foreclosure abuses? As my colleague at ProPublica, Paul Kiel, detailed last year, that review involved consultants like Promontory essentially letting banks decide who was victimized. How well did that work? So well that the regulators had to scuttle the program because it hadn’t given one red cent to homeowners but somehow, I don’t know how, managed to send more than $1.5 billion to consultants — including Promontory.

Promontory maintains that it complied with the conditions set out by the O.C.C. And the review was replaced by a settlement, which the regulators say will compensate victims — though the average payout is small beer.

Who, exactly, makes the rules at the O.C.C.? I mentioned “Freaky Friday.” That’s because at the agency, Ms. Williams is being replaced by Amy Friend. And where is Ms. Friend coming from? Wait for it … Promontory. In March, maybe they’ll do the switcheroo back.

The O.C.C. didn’t make Ms. Friend available but said that her “talent, integrity and commitment to public service are beyond reproach” and would be subject to the rule requiring her to recuse herself for a year on matters specifically relating to her former employer.

I spoke with people who said she was a smart and dedicated public servant, an expert on the Dodd-Frank Act who can help complete the scandalously long list of unfinished rules and expedite its adoption.

“Amy Friend is absolutely rowing in the right direction,” said a Senate staff member who worked on efforts to push for stronger financial regulation.

Let’s hope so.

But people also described Ms. Friend as pragmatic. In Washington, that’s the ultimate compliment. Sadly, that has come to mean someone who seeks compromise and never pushes for an overhaul when a quarter-measure will do.

Washington today resembles something like the end of “Animal Farm.” People move from one side of the table to the other and up and down the Acela corridor with ease. An outsider looking at a negotiating table would glance from lobbyist to staff member, from colleague to former colleague, from pig to man and from man to pig and find it impossible to say which is which.

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Well: No Consensus on Plantar Fasciitis

Phys Ed

Gretchen Reynolds on the science of fitness.

There are more charismatic-sounding sports injuries than plantar fasciitis, like tennis elbow, runner’s knee and turf toe. But there aren’t many that are more common. The condition, characterized by stabbing pain in the heel or arch, sidelines up to 10 percent of all runners, as well as countless soccer, baseball, football and basketball players, golfers, walkers and others from both the recreational and professional ranks. The Lakers star Kobe Bryant, the quarterback Eli Manning, the Olympic marathon runner Ryan Hall and the presidential candidate Mitt Romney all have been stricken.

But while plantar fasciitis is democratic in its epidemiology, its underlying cause remains surprisingly enigmatic. In fact, the mysteries of plantar fasciitis underscore how little is understood, medically, about overuse sports injuries in general and why, as a result, they remain so insidiously difficult to treat.

Experts do agree that plantar fasciitis is, essentially, an irritation of the plantar fascia, a long, skinny rope of tissue that runs along the bottom of the foot, attaching the heel bone to the toes and forming your foot’s arch. When that tissue becomes irritated, you develop pain deep within the heel. The pain is usually most pronounced first thing in the morning, since the fascia tightens while you sleep.

But scientific agreement about the condition and its causes ends about there.

For many years, “most of us who treat plantar fasciitis believed that it involved chronic inflammation” of the fascia, said Dr. Terrence M. Philbin, a board-certified orthopedic surgeon at the Orthopedic Foot and Ankle Center in Westerville, Ohio, who specializes in plantar fasciitis.

It was thought that by running or otherwise repetitively pounding their heels against the ground, people strained the plantar fascia, and the body responded with a complex cascade of inflammatory biochemical processes that resulted in extra blood and fluids flowing to the injury site, as well as enhanced pain sensitivity.

But instead of lasting only a few days and then fading, as acute inflammation usually does, the process can become chronic and create its own problems, causing tissue damage and continuing pain.

This progression is also what experts believed was happening when people developed chronic Achilles tendon pain, tennis elbow or other lingering, overuse injuries.

But when scientists actually biopsied fascia tissue from people with chronic plantar fasciitis, “they did not find much if any inflammation,” Dr. Philbin said. There were virtually none of the cellular markers that characterize that condition.

“Plantar fasciitis does not involve inflammatory cells,” said Dr. Karim Khan, a professor of family practice medicine at the University of British Columbia and editor of The British Journal of Sports Medicine, who has written extensively about overuse sports injuries.

Instead, plantar fasciitis more likely is caused by degeneration or weakening of the tissue. This process probably begins with small tears that occur during activity and that, in normal circumstances, the body simply repairs, strengthening the tissue as it does. That is the point of exercise training.

But sometimes, for unknown reasons, this ongoing tissue damage overwhelms the body’s capacity to respond. The small tears don’t heal. They accumulate. The tissue begins subtly to degenerate, even to shred. It hurts.

By and large, most sports medicine experts now believe that this is how we develop other overuse injuries, like tennis elbow or Achilles tendinopathy, which used to be called tendinitis. The suffix “itis” means inflammation. But since the injury isn’t thought to involve chronic inflammation, its name has changed.

This has not yet happened with plantar fasciitis, and may not, given what a mouthful fasciopathy would be.

The evolving medical opinions about plantar fasciitis matter, beyond nomenclature, though, because treatments depend on causes. At the moment, many physicians rely on injections of cortisone, a steroid that is both a pain reliever and anti-inflammatory, to treat plantar fasciitis. And cortisone shots do reduce the soreness. In a study published last year in BMJ, patients who received cortisone injections reported less heel pain after four months than those whose shots had contained a placebo saline solution.

But whether those benefits will last is unknown, especially if plantar fasciitis is, indeed, degenerative. In studies with people suffering from tennis elbow, another injury that is now considered degenerative, cortisone shots actually slowed tissue healing.

We need similar studies in people with plantar fasciitis, Dr. Khan said. “They have not been done.”

Thankfully, most people who develop plantar fasciitis will recover within a few months without injections or other invasive treatments, Dr. Philbin said, if they simply back off their running mileage somewhat or otherwise rest the foot and stretch the affected tissues. Stretching the plantar fascia, as well as the Achilles tendon, which also attaches to the heel bone, and the hamstring muscles seems to result in less strain on the fascia during activity, meaning less ongoing trauma and, eventually, time for the body to catch up with repairs.

To ensure that you are stretching correctly, Dr. Philbin suggests consulting a physical therapist, after, of course, visiting a sports medicine doctor for a diagnosis. Not all heel or arch pain is plantar fasciitis. And comfort yourself if you do have the condition with the knowledge that Kobe Bryant, Eli Manning and Ryan Hall have all returned to competition and Mr. Romney still runs.

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Pistorius Denies Murdering Girlfriend

Siphiwe Sibeko/Reuters

Oscar Pistorius wept at a hearing on Tuesday seeking bail.

PRETORIA, South Africa — Early on Feb. 14, Oscar Pistorius says, he heard a strange noise coming from inside his bathroom, climbed out of bed, grabbed his 9-millimeter pistol, hobbled on his stumps to the door and fired four shots.

“I fail to understand how I could be charged with murder, let alone premeditated,” Mr. Pistorius said in an affidavit read Tuesday to a packed courtroom by his defense lawyer, Barry Roux. “I had no intention to kill my girlfriend.”

Prosecutors painted a far different picture, one of a calculated killer, a world-renowned athlete who had the presence of mind and calm to strap on his prosthetic legs, walk 20 feet to the bathroom door and open fire as his girlfriend, Reeva Steenkamp, cowered inside, behind a locked door.

“The applicant shot and killed an unarmed, innocent women,” Gerrie Nel, the chief prosecutor, said in court on Tuesday. That, Mr. Nel argued, amounted to premeditated murder, a charge that could send Mr. Pistorius to prison for life.

In court, Mr. Pistorius, a Paralympic track star who competed against able-bodied athletes at the London Olympics despite having lost both his lower legs as an infant, wept uncontrollably as Mr. Roux gave the runner’s account of the fateful early morning. At one point, Magistrate Desmond Nair called a recess to allow Mr. Pistorius, who was sobbing loudly, his face contorted, to regain his composure.

“My compassion as a human being does not allow me to just sit here,” Magistrate Nair said.

As the defense and prosecution laid out their competing versions of the shooting, some details were beyond dispute.

Mr. Pistorius and Ms. Steenkamp were alone in the house, having spent the evening there. Around 3 a.m., Mr. Pistorius shot Ms. Steenkamp through the bathroom door, fatally wounding her. He broke down the door and carried her down the stairs, where she died in the foyer of his upscale home in a highly secured compound.

The young woman, a model, was cremated Tuesday on the other side of the country in her hometown, Port Elizabeth. Her family and friends mourned her and called for the authorities to deal harshly with Mr. Pistorius.

“There’s a space missing inside all the people that she knew that can’t be filled again,” her brother, Adam Steenkamp, told reporters after the memorial service.

In court, Mr. Pistorius is seeking bail on the charge of premeditated murder, but he faces an uphill battle. Magistrate Nair ruled Tuesday that the case would be treated as the most serious kind of offense, which means bail will be granted only if the defense can prove extraordinary circumstances requiring it.

The court proceedings, though they concerned only whether Mr. Pistorius would receive bail, offered the first real glimpse into what unfolded at his home on the day of the shooting.

In his affidavit, Mr. Pistorius said that he and Ms. Steenkamp had decided to stay in for the night. He canceled plans with his friends for a night on the town in Johannesburg, while she opted against movies with one of her friends. They had a quiet evening, he said. She did yoga. He watched television. About 10 p.m., they went to sleep.

In the early morning hours, he said, he woke up to move a fan from the balcony and to close the sliding doors in the bedroom.

“I heard a noise in the bathroom and realized that someone was in the bathroom,” he said. “I felt a sense of terror rushing over me.”

He had already said in the affidavit that he feared South Africa’s rampant violent crime, and later added that he was worried because there were no bars on the window to the bathroom. Construction workers had left ladders in his garden, he said.

“I believed someone had entered my house,” he said in the affidavit. “I grabbed my 9-millimeter pistol from underneath my bed. On my way to the bathroom I screamed words to the effect for him/them to get out of my house and for Reeva to phone the police. It was pitch dark in the bedroom, and I thought Reeva was in bed.”

Walking on his stumps, he heard the sound of movement inside the toilet, a small room within the bathroom.

Alan Cowell contributed reporting from London.

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Pistorius: Lover caught in tragedy or killer?

PRETORIA, South Africa (AP) — Oscar Pistorius portrayed himself as a lover caught in tragedy, wielding a pistol and frightened as he stood only on his stumps, then killed his girlfriend after mistaking her for an intruder on Valentine's Day.

Prosecutors, however, said the double-amputee Olympian committed premeditated murder, planning the slaying, then firing at Reeva Steenkamp as she cowered behind his locked bathroom door with no hope of escape.

"She couldn't go anywhere," Prosecutor Gerrie Nel told a packed courtroom Tuesday. "It must have been horrific."

Weeping uncontrollably, Pistorius listened as his words were read out in court by his attorney during the opening of a two-day bail hearing, his first public account of the events surrounding the shooting death of Steenkamp, a 29-year-old model and reality TV star who had spoken out against violence against women.

"I fail to understand how I could be charged with murder, let alone premeditated murder, as I had no intention to kill my girlfriend, Reeva Steenkamp," Pistorius said in the sworn affidavit. "I deny the aforesaid allegation in the strongest terms."

It was the first time that the prosecution and Pistorius provided details of their radically divergent accounts of the killing, which has shocked South Africans and fans worldwide, who idolized the 26-year-old track star known as the Blade Runner for overcoming his disability to compete in last summer's London Olympics.

Nel said Pistorius committed premeditated murder when he rose from his bed after a fight with Steenkamp, pulled on his prosthetic legs and walked about 20 feet from his bedroom to the locked toilet door and pumped it with four bullets, three of which hit the model.

That contradicted the runner's statement, read aloud by defense attorney Barry Roux, who described how the couple spent a quiet night together in the athlete's upscale home in a gated community in the capital of Pretoria, then went to sleep around 10 p.m.

Sometime before dawn, Pistorius said he awoke, and walking only on his stumps, pulled a fan in from an open balcony and closed it. That's when he said he heard a noise and became alarmed because the bathroom window, which had no security bars, was open and workers had left ladders nearby.

"It filled me with horror and fear," Pistorius said in the statement.

"I am acutely aware of violent crime being committed by intruders entering homes," he said. "I have received death threats before. I have also been a victim of violence and of burglaries before. For that reason I kept my firearm, a 9 mm Parabellum, underneath my bed when I went to bed at night."

Too frightened to turn on a light, Pistorius said, he pulled out his pistol and headed for the bathroom, believing Steenkamp was still asleep "in the pitch dark" of the bedroom.

"As I did not have my prosthetic legs on and felt extremely vulnerable, I knew I had to protect Reeva and myself," he said, adding that he shouted to Steenkamp to call the police as he fired at the closed toilet door.

It was then, Pistorius said, that he realized Steenkamp was not in bed.

He said he pulled on his prosthetic legs and tried to kick down the toilet door before finally giving up and bashing it in with a cricket bat. Inside, he said he found Steenkamp, slumped over but still alive. He said he lifted her bloodied body and carried her downstairs to seek medical help.

But it was too late. "She died in my arms," Pistorius said.

"We were deeply in love and I could not be happier," the athlete said. "I know she felt the same way. She had given me a present for Valentine's Day but asked me only to open it the next day."

Pistorius broke down in sobs repeatedly as his account was read, prompting Chief Magistrate Desmond Nair to call a recess at one point.

"Maintain your composure," the magistrate said. "You need to apply your mind here."

"Yes, my lordship," Pistorius replied, his voice quivering.

Nair adjourned the case until Wednesday without ruling on whether Pistorius would be granted bail. However, he said the gravity of the charge — which carries a mandatory life sentence — meant the athlete's lawyers must offer "exceptional" reasons for bail to be granted, making his release unlikely.

Roux, the defense attorney, said there was no evidence to substantiate a murder charge. "We submit it is not even murder. There is no concession this is a murder," he said.

The prosecutor disagreed.

"It is our respectful argument that 'pre-planning' or premeditation do not require months of planning," Nel said. "If ... I ready myself and walk a distance with the intention to kill someone, it is premeditated."

Hundreds of miles from the Magistrate's Court, a memorial service was held for Steenkamp in the south coast city of Port Elizabeth. Six pallbearers carried her coffin, draped with a white cloth and covered in white flowers, into the church for the private service and cremation.

Relatives recalled how the model with a law degree had campaigned against domestic violence and had planned to don black for a "Black Friday" protest in honor of a 17-year-old girl who was recently gang-raped and mutilated.

What "she stood for, and the abuse against women, unfortunately it's gone right around, and I think the Lord knows that statement is more powerful now," said her uncle, Mike Steenkamp.

South Africa has some of the world's worst rates of violence against women and the highest rate in the world of women killed by an intimate partner, according to a study by the Medical Research Council, which said at least three women are killed by a partner every day in the country of 50 million.

Since the shooting, several of Pistorius' sponsors have dropped him. On Tuesday, Clarins Group, which owns Thierry Mugler Perfumes, said it would withdraw all advertising featuring the Olympian. A cologne line with the company, called A(asterisk)Men, bears his image.

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Associated Press writer Michelle Faul in Johannesburg and AP photographer Schalk van Zuydam in Port Elizabeth, South Africa, contributed to this report.

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Jon Gambrell can be reached at www.twitter.com/jongambrellAP. Gerald Imray can be reached at www.twitter.com/geraldimrayAP.

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