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Medicare paid billions to sub-par nursing homes: HHS

SAN FRANCISCO Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and costs are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to The Associated Press. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall, nursing home operators are well regulated and follow federal guidelines, but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, N.Y. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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Arias Prosecutor Too Combative, Experts Say

He has barked, yelled, been sarcastic and demanded answers from accused murderer Jodi Arias this week.

And in doing so, prosecutor Juan Martinez and his aggressive antics may be turning off the jury he is hoping to convince that Arias killed her ex-boyfriend Travis Alexander in June 2008, experts told ABCNews.com today.

"Martinez is his own worst enemy," Mel McDonald, a prominent Phoenix defense attorney and former judge, told ABC News. "He takes it to the point where it's ad nauseam. You have difficulty recognizing when he's driving the point home because he's always angry and pushy and pacing around the courtroom. He loses the effectiveness, rather than build it up."

"He's like a rabid dog and believes you've got to go to everybody's throat," he said.

"If they convict her and give her death, they do it in spite of Juan, not because of him," McDonald added.

Martinez's needling style was on display again today as he pestered Arias to admit that she willingly participated in kinky sex with Alexander, though she previously testified that she only succumbed to his erotic fantasies to please him.

Arias, now 32, and Alexander, who was 27 at the time of his death, dated for a year and continued to sleep together for another year following their break-up.

Arias drove to his house in Mesa, Ariz., in June 2008, had sex with him, they took nude photos together and she killed him in his shower. She claims it was in self-defense. If convicted, Arias could face the death penalty.

Jodi Arias, Prosecutor Butt Heads in Cross-Examination Watch Video

Jodi Arias Maintains She 'Felt Like a Prostitute' Watch Video

Jodi Arias Admits to Killing Man, Lying to Police Watch Video

Martinez also attempted to point out inconsistencies in her story of the killing, bickering with her over details about her journey from Yreka, Calif., to Mesa, Ariz., including why she borrowed gas cans from an ex-boyfriend, when she allegedly took naps and got lost while driving, and why she spontaneously decided to visit Alexander at his home in Mesa for a sexual liaison.

"I want to know what you're talking about," Arias said to Martinez at one point.

"No, I'm asking you," he yelled.

Later, he bellowed, "Am I asking you if you're telling the truth?"

"I don't know," Arias said, firing back at him. "Are you?"

During three days of cross examining Arias this week, Martinez has spent hours going back and forth with the defendant over word choice, her memory, and her answers to his questions.

"Everyone who takes witness stand for defense is an enemy," McDonald said. "He prides himself on being able to work by rarely referring to his notes, but what he's giving up in that is that there's so much time he wastes on stupid comments. A lot of what I've heard is utterly objectionable."

Martinez's behavior has spurred frequent objections of "witness badgering" from Arias' attorney Kirk Nurmi, who at one point Tuesday stood up in court and appealed to the judge to have a conference with all of the attorneys before questioning continued. Judge Sherry Stephens at one point admonished Martinez and Arias for speaking over one another.

Andy Hill, a former spokesperson for the Phoenix police department, and Steven Pitt, a forensic psychiatrist who has testified as an expert witness at many trials in the Phoenix area, both said that despite his aggressive style, Martinez would likely succeed in obtaining a guilty verdict.

"When it comes to cross examination, one size does not fit all," said Pitt. "But if you set aside the incessant sparring, what the prosecutor I believe is effectively doing is pointing out the various inconsistencies in the defendant's version of events."

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Yahoo CEO right to cut remote work

STORY HIGHLIGHTS

• Raymond Fisman: Marissa Mayer needs to revive Yahoo, and face time at the office is key


• Fisman: Granted, this goes against Utopian vision of everyone working from cafes


• Fisman: In-person work means innovations, avoids misunderstood directives


• He says more jobs will get done and it'll encourage those who work in a half-empty office

Editor's note: Raymond Fisman is the Lambert Family professor of social enterprise at the Columbia Business School. He is the co-author, with Tim Sullivan, of "The Org: The Underlying Logic of the Office."

(CNN) -- When Yahoo's relatively new CEO Marissa Mayer decreed that workers would be required to show up at the office rather than work remotely, the immediate backlash from outsiders was mostly on the side of the angry Yahoo employees who were losing the comfort and convenience of telecommuting. Inside the company, reactions were mixed.

It struck a deep chord, contrary as it was to the techno-utopian impulse that has helped define Silicon Valley: the idea that someday soon we'll all be working in coffee shops or at kitchen tables, with broadband connections replacing in-person interactions.

Mayer may have been extreme in her demands for face time at the office, but it's the right call for a leader who is working to turn around one of the Internet's laggards.

Raymond Fisman

First, let's consider what's at stake for the company and what Mayer is hoping to accomplish. Yahoo is famous for having bungled its position as a one-time Internet leader. Mayer was brought on specifically to revitalize the benighted company after the departure of Jerry Yang; the firing of Carol Bartz, and the departures of another CEO who inflated his resume and an interim director. All the while, Yahoo has been a company in search of a direction.

What does the end of telecommuting have to do with giving the company a sound footing? The reasons go well beyond the obvious issue of reining in slackers who have taken advantage of Yahoo's reportedly lax monitoring of work done from home.

Talk Back: Is Yahoo wrong to end telecommuting?

Jackie Reses, Yahoo's head of human relations, has it exactly right in the memo she wrote to employees about the policy: Personal interaction is still the most effective way of conveying a company's direction, and keeping tabs on what different parts of the organization are up to. And that's what Mayer has to do with all of Yahoo's 11,500 employees to succeed.

What do in-person meetings accomplish that e-mail can't? Part of the answer lies in time use surveys of CEOs that go back nearly 40 years.

Management scholar Henry Mintzberg was among the first to track how top managers spend their time in the early 1970s. Much to his surprise, he found that around 80% of their time was spent in face-to-face meetings; the subjects of his study had few stretches of more than 10 minutes at a time to themselves.

More recent time use studies by researchers at Harvard, the London School of Economics and Columbia have found that little has changed. Despite the IT revolution, business leaders still spend 80% of their time in face-to-face meetings.

The reason is that there's only so much that one can glean from a written report or a spreadsheet. To cut through the hidden agendas, and office politics, most of the time you need to look someone in the eye and ask them, "Really? How exactly would that work?" It is this probing and questioning that allows effective managers to gather the scraps of information needed to understand what's really going on.

Similarly, all the way down the organizational chart, person-to-person interactions are crucial to ensure that an organization's change of direction isn't misrepresented or garbled in its retelling.

The bland proclamations made in reports and e-mails are given clearer meaning through the way they're communicated in the "high fidelity" that only personal interaction will allow. In-person meetings can also help teams avoid misunderstandings: As one of our friends who runs a virtual workplace puts it, with e-mail exchanges alone, everyone starts to get a bit paranoid.

Finally, the Yahoo memo notes that it's hard to innovate via e-mail exchanges or the occasional agenda-filled meeting. New ideas spring up through chance encounters in the cafeteria line and impromptu office meetings. It's an assertion that's backed up by academic research highlighting the importance of physical proximity in driving scientific progress.

Work at home? Share productivity tips

Yet there are rarely benefits without cost. Lots of tasks are easily managed from a distance. A large number of the affected Yahoo employees are customer-service representatives who aren't going to be driving innovation at the company anyway.

In one study of telecommuting at a Chinese online travel agency, customer-service reps were both happier and more productive when working from home -- probably Yahoo service reps aren't any different from their Chinese counterparts in this regard. And every Yahoo employee surely has some aspects of their jobs that could be done just as well at the kitchen table as in an office cubicle.

But it's hard to create a norm of "physically together" if the office is always half-empty. And once it becomes that way, the half that have been showing up will be less and less inclined to bother. Finally, such a shocking and provocative directive will most certainly have the effect of imbuing the organization with the sense of urgency it needs to get the job done.

Will Yahoo employees come around to appreciating the change? Not necessarily the ones that liked to sleep in or work on a startup on Yahoo's dime, but it may be welcomed by the ones already showing up. Will it be damaging to morale? Possibly, though it may help Yahoo employees to remember that, if they're successful, the change is likely to be temporary.

But the job of the CEO isn't to maximize worker happiness. It's to make sure they get their jobs done. And in driving change at Yahoo, Mayer thinks they need to show up at the office.

Follow @CNNOpinion on Twitter.

Join us at Facebook/CNNOpinion.

The opinions in this commentary are solely those of Raymond Fisman.

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Australian cyclone crossing Western Australian coast

SYDNEY: A tropical cyclone hit Australia's resource-rich northwest coast Wednesday, bringing winds of up to 165 kilometres (102 miles) an hour as it crossed the shore near the tiny community of Pardoo.

Severe tropical cyclone Rusty had been sitting offshore for several days, slowly intensifying as it edged towards the Pilbara coast and bringing heavy rain and gale-force winds to the iron ore region.

"It is in the process of crossing," Neil Bennett from Australia's Bureau of Meteorology told AFP just after 0700 GMT, adding it was too soon to say whether it had caused any damage.

"Wind gusts in excess of 165 kilometres an hour are in that area."

Bennett said the storm had been downgraded from a category 4 storm, just one notch short of the top category, to a category 3.

The bureau had expected Rusty to make landfall close to Port Hedland, 1,300 kilometres (800 miles) north of Perth, but Bennett said the major iron ore port appeared to have escaped the full brunt of the storm.

"It looks as if Hedland has dodged the bullet, so to speak, because the worst of the winds are away from Hedland," he said.

"Hedland though has been experiencing a constant period of gale-force winds for over 36 hours now. And that's unprecedented (for that area)."

While the storm has been downgraded, its eye has also contracted from being about 80 kilometres wide on Tuesday to about 50 kilometres by the time it crossed land.

Authorities had warned residents to move out of the storm's path or seek shelter. Resident Ian Badger said he was seeking refuge at the Pardoo Roadhouse, about 120 kilometres from Port Hedland.

"It's just a matter of hanging on," he told the Australian Broadcasting Corporation.

"The amount of water that's around is a bit worrying. The ground is very sodden, very soft. As soon as you get a get a bit of strong wind, trees start going over."

The weather bureau expects the cyclone to move slowly in a south-southeasterly direction, gradually downgrading to a category 1 storm by Thursday afternoon and a tropical low the following day.

Australia's major iron ore export ports have been shut for several days anticipating Rusty's approach. Hundreds of people have been forced to evacuate their homes in the sparsely populated but cyclone-prone area.

Global iron ore giants including BHP Billiton, Rio Tinto and Fortescue Metals Group have all shut down or scaled back operations due to the storm.

-AFP/fl

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Peru: 'Missing' U.S. couple found, but family wants proof

STORY HIGHLIGHTS

• Peru's tourism minister say Jamie Neal and Garrett Hand were found in the Amazon


• Hand's mother says she won't believe the news until she hears directly from her son


• Family and friends have not been able to reach the couple since January


• Some areas they planned to visit are out of cell phone and Internet reach

(CNN) -- An American couple that went missing on a bike trek through Peru has been spotted "safe and sound," the South American country's top tourism official said Tuesday.

Jamie Neal and Garrett Hand are heading upstream in a small boat on a jungle river, said Jose Luis Silva, Peru's minister of tourism and commerce.

"They're currently in a remote, paradise-like region of the Peruvian Amazon, which is difficult to access," he told CNN.

But even as authorities trumpeted the news, Hand's mother said in a statement that she won't believe it until she hears directly from her son.

"We have not heard from them since January 25, nor have they accessed bank accounts since that time," mother Francine Fitzgerald said. "We have only the worst to consider as to why."

The couple, who hail from the San Francisco area, left last November and began a series of social media posts chronicling the trip of their dreams -- a four-month bike adventure through South America.

"Will be riding my bike in other countries and out of contact for 4 months!" Neal wrote in a November Facebook post before flying with Hand to Buenos Aires, Argentina.

But for weeks, the couple shared photos online from their trek through Argentina, Chile and Peru, showing themselves posing beside their bikes on remote mountain roads, camping out in tents and smiling at the beach.

In late January, however, their Internet postings stopped and calls to their cell phones went unanswered. Family members say no one has been able to get in touch with them since then.

Fitzgerald said both the U.S. Embassy in Peru and the country's interior ministry have called to say that Neal and Hand were spotted.

But that's not enough, she said.

"Let me reiterate, until we have PROOF OF LIFE, we cannot celebrate these rumors and sightings," she wrote on a Facebook page set up to facilitate a search for the couple. "Proof of life is my son's voice on the phone and a picture of him holding the missing poster."

Silva told CNN that the tourism ministry learned of the couple's location from police, who received a report from a clinic in the town of Angoteros after sending out a nationwide alert about the missing couple.

The ministry will send a hydroplane tomorrow to shoot video of the couple and provide proof they're doing OK, he said.

"They have no idea of the commotion they have caused in the media," he said, "because they simply can't communicate with family from where they currently are."

Neal and Hand, both 25, according to a family flyer, were last seen in Lima, the Peruvian capital. But some of the areas they planned to visit are out of cell phone and Internet reach.

The Peruvian National Police earlier told CNN that the manager of a hostel in Pucallpa, where the couple stayed, confirmed to a police investigator they reached the jungle city in early February.

The manager of Arco Iris Amazonica, a small hotel in the rain forest city of Iquitos, told police the couple stayed there on February 16 and told him they planned to travel to the town of Naplo, a 15-day trek.

Peru is known for the Inca ruins of Machu Picchu, located in the Cusco region, which attract hundreds of thousands of international travelers each year.

Two weeks ago, the U.S. Embassy in Lima issued a security message warning Americans of "a potential kidnapping threat in the Cusco area."

"The Embassy has received information that members of a criminal organization may be planning to kidnap U.S. citizen tourists in the Cusco and Machu Picchu area," the message said.

But it also clarified that "thousands of U.S. citizens routinely travel to the Cusco region without undue incident. The U.S. Embassy remains confident of the Peruvian government's efforts to ensure the safety of all tourists in the region."

Peru's tourism minister said Tuesday that he was "deeply concerned" about the negative impact of reports of the missing American couple.

The reason the couple has been out of touch for so long has nothing to do with any crime, he said.

"These two young people have fallen in love with Peru," Silva said. "They have visited off-the-beaten-path places and it seems like they're having a blast -- so much so that they have forgotten to communicate with their families."

CNN's Catherine E. Shoichet and Tom Watkins contributed to this report.

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Two cops, suspect dead in Calif. shootings

Updated 1:50 a.m. EST

SANTA CRUZ, Calif. Two police officers were shot and killed Tuesday while investigating a sexual assault, and a suspect was also fatally shot, authorities said.

Santa Cruz police Chief Kevin Vogel says Sgt. Loren Butch Baker and Detective Elizabeth Butler were gunned down in mid-afternoon Tuesday as they followed up on a sexual assault investigation. He says Baker was a 28-year veteran of the department and Butler had been with the department 10 years. Vogel says Baker was married and the father of two daughters, while Butler leaves behind two young sons.

A suspect, identified as 35-year-old Jeremy Goulet, was shot and killed a short time later while authorities were pursuing the gunman, the Santa Cruz County sheriff's office said.

Residents on the adjoining streets where the shootings occurred received an automatic police call warning them to stay locked inside. About half an hour later, more than a dozen semi-automatic shots echoed down the streets in a brief shootout that killed the suspect.

Witnesses described hearing a "multitude of gunfire" - with 20 or more shots fired during that gun battle between the suspect and law enforcement, reports CBS San Francisco station station KPIX-TV.

Police were going door-to-door in the neighborhood, searching homes, garages, even closets, although the sheriff said authorities didn't know if another suspect remained at large.

Police, sheriff's deputies and FBI agents filled intersections, some with guns drawn, in what is ordinarily a quiet, residential neighborhood in the community about 60 miles south of San Francisco.

A store clerk a few buildings away from the shooting said the barrage of gunfire was "terrifying."

"We ducked. We have big desks, so under the desks we went," said the clerk, who spoke on condition of anonymity and asked that her store not be identified because she feared for her safety.

She said she remained locked in her store hours after the shooting and was still scared.

Two schools were locked down during the shooting. The students were later evacuated by bus to the County Government Center about half a mile away.

As darkness fell, helicopters and light aircraft patrolled above the neighborhood, which is about a mile from downtown Santa Cruz and the Santa Cruz Beach Boardwalk. The campus of University of California, Santa Cruz, is about five miles away.

The city's mayor, Hilary Bryant, said in a statement that the city was shocked over the shootings.

"Tonight we are heartbroken at the loss of two of our finest police officers who were killed in the line of duty, protecting the community we love," the statement said. "This is an exceptionally shocking and sad day for Santa Cruz and our Police Department."

Santa Cruz has faced a recent spate of violence, and community leaders had scheduled a downtown rally Tuesday to speak out against shootings. That and a city council meeting were canceled after teary-eyed city leaders learned of the deaths.

Those shootings include the killing of Pauly Silva, a 32-year-old martial arts instructor who was shot outside a popular downtown bar and restaurant on Feb. 9.

Two days later, a UC Santa Cruz student waiting at a bus stop was shot in the head during a robbery. She is recovering from her injuries.

Then on Feb. 17, a 21-year-old woman was raped and beaten on the UC Santa Cruz campus. Four days later, a Santa Cruz couple fought off two men who came in their home before dawn and threatened them with a sword.

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Inside Organized Retail Crime Raids

We used to call it shoplifting, but these days the foot soldiers of retail crime rings are known as boosters. Police even have an acronym for these operations: ORC, which stands for Organized Retail Crime.

"It's just like a Fortune 500 company," said Sergeant Eric Lee of the Gardena Police Department in Gardena, Calif. "All of this is just organized."

Watch the full story on "Nightline" TONIGHT at 12:35 a.m. ET

Police say big retail stores, from Walgreens to J.C. Penny, are getting hit by highly sophisticated shoplifting networks that steal and resell everything from underwear to razors to milk. According to the National Retail Federation, theft can amount to annual losses as high as a $37 billion for retail businesses.

"Every store in every city has to go through this," Lee said. "They wait until no one's paying attention and they walk out."

Tide detergent is currently a hot target because it is compact, expensive and easy to sell on the streets for profit, police said. The Street name: "liquid gold."

"Sometimes we get rings that just do alcohol," Lee said. "And then we get some that do just meat and seafood."

Investigators say boosters move the loot for cents on the dollar to fencing operations -- the black market resellers of the stolen goods -- which sell the stolen merchandise in plain sight in stores. Boosters, fencers, Mr. Bigs, all of those involved in these shoplifting operations can potentially make millions a year from boosting and re-selling stolen goods.

Craigslist Crackdown: Cops Go After Thieves Watch Video

And Mike Swett is on the case. A former Riverside County sheriff's deputy in Los Angeles, Swett was badly injured in a car wreck and now works as a full-time private investigator on the ORC beat who has worked with Target, Marshalls, T.J. Maxx. Stores hire him to do his own undercover police work, catching thieves before involving local law enforcement.

"Kind of like working a narcotics case, it's like you've got low-level, mid-level and then top dog," Swett said. "We like to go after the top dog and the only way to get to the top dog is mid-level first."

At his command center -- his apartment -- Swett showed off the boxes upon boxes of tapes and photographs he has collected, the fruits of countless silent stake-out hours.

Swett said he has been casing two joints in L.A. for months, both alleged to be mid-level fencing operations. "Nightline" was invited to ride along with him when he sent undercover agents in for a final reconnaissance mission.

At some stores and shopping malls, clerks do little to stop shoplifters and often let them run, which has contributed to the growing fencing operations.

"[The stores] don't want their employees to get injured," Swett said. "So oftentimes they will call the police, but by the time we get there they are already in their car and they are gone."

This leaves professional investigators like Swett to put the pieces together and bust open the gangs to lead over-stretched police departments to the prey.

When raid day arrived, a motorcade of squad cars departed from the Gardena, Calif., police department and pulled up to one fencing operation. Swett said the merchandise being sold was boosted goods.

"There is Victoria's Secret, expensive Victoria's Secret, the gift sets," he said, pointing down a line of tables. "J.C. Penny, Miramax, its real stuff not counterfeit."

He spotted a bottle of Katy Perry brand perfume, which usually retails for around $90 but one seller had it priced at $59.

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Vatican 'Gay lobby'? Probably not

STORY HIGHLIGHTS

• Benedict XVI not stepping down under pressure from 'gay lobby,' Allen says


• Allen: Benedict is a man who prefers the life of the mind to the nuts and bolts of government


• However, he says, much of the pope's time has been spent putting out fires

Editor's note: John L. Allen Jr. is CNN's senior Vatican analyst and senior correspondent for the National Catholic Reporter.

(CNN) -- Suffice it to say that of all possible storylines to emerge, heading into the election of a new pope, sensational charges of a shadowy "gay lobby" (possibly linked to blackmail), whose occult influence may have been behind the resignation of Benedict XVI, would be right at the bottom of the Vatican's wish list.

Proof of the Vatican's irritation came with a blistering statement Saturday complaining of "unverified, unverifiable or completely false news stories," even suggesting the media is trying to influence the papal election.

Two basic questions have to be asked about all this. First, is there really a secret dossier about a network of people inside the Vatican who are linked by their sexual orientation, as Italian newspaper reports have alleged? Second, is this really why Benedict XVI quit?

John L. Allen Jr.

The best answers, respectively, are "maybe" and "probably not."

It's a matter of record that at the peak of last year's massive Vatican leaks crisis, Benedict XVI created a commission of three cardinals to investigate the leaks. They submitted an eyes-only report to the pope in mid-December, which has not been made public.

It's impossible to confirm whether that report looked into the possibility that people protecting secrets about their sex lives were involved with the leaks, but frankly, it would be surprising if it didn't.

There are certainly compelling reasons to consider the hypothesis. In 2007, a Vatican official was caught by an Italian TV network on hidden camera arranging a date through a gay-oriented chat room, and then taking the young man back to his Vatican apartment. In 2010, a papal ceremonial officer was caught on a wiretap arranging liaisons through a Nigerian member of a Vatican choir. Both episodes played out in full public view, and gave the Vatican a black eye.

Pope Benedict XVI

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In that context, it would be a little odd if the cardinals didn't at least consider the possibility that insiders leading a double life might be vulnerable to pressure to betray the pope's confidence. That would apply not just to sex, but also potential conflicts of other sorts too, such as financial interests.

Vatican officials have said Benedict may authorize giving the report to the 116 cardinals who will elect his successor, so they can factor it into their deliberations. The most immediate fallout is that the affair is likely to strengthen the conviction among many cardinals that the next pope has to lead a serious house-cleaning inside the Vatican's bureaucracy.

It seems a stretch, however, to suggest this is the real reason Benedict is leaving. For the most part, one should probably take the pope at his word, that old age and fatigue are the motives for his decision.

That said, it's hard not to suspect that the meltdowns and controversies that have dogged Benedict XVI for the last eight years are in the background of why he's so tired. In 2009, at the height of another frenzy surrounding the lifting of the excommunication of a Holocaust-denying traditionalist bishop, Benedict dispatched a plaintive letter to the bishops of the world, voicing hurt for the way he'd been attacked and apologizing for the Vatican's mishandling of the situation.

Even if Benedict didn't resign because of any specific crisis, including this latest one, such anguish must have taken its toll. Benedict is a teaching pope, a man who prefers the life of the mind to the nuts and bolts of government, yet an enormous share of his time and energy has been consumed trying to put out internal fires.

It's hard to know why Benedict XVI is stepping off the stage, but I doubt it is because of a "gay lobby."

Follow us on Twitter @CNNOpinion.

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The opinions expressed in this commentary are solely those of John L. Allen Jr.

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Asian markets mostly slip on Italy uncertainty

HONG KONG: Asian markets mostly fell on Tuesday, with dealers spooked by an election in Italy that left no clear winner, leading to political uncertainty and fresh fears about eurozone stability.

The dollar and euro extended the losses suffered in US trade as investors absorbed the Italian results, while there was also concern about the lack of progress in Washington to avoid spending cuts due to take effect on Friday.

Tokyo tumbled 2.26 percent, or 263.71 points, to 11,398.81, with profit-takers also moving in after the index enjoyed a big surge on Monday.

Sydney shed 1.03 percent, or 52.2 points, to 5,003.6, and Seoul lost 0.47 percent, or 9.51 points, to close at 2,000.01.

Shanghai tumbled 1.40 percent, or 32.48 points, to 2,293.34, while Hong Kong fell 1.32 percent, or 300.39 points, to 22,519.69.

Italy Tuesday looked headed for political deadlock as results from Sunday's election indicated there would be no clear winner, while the biggest gainer was a protest party run by a popular comedian.

The polls show that while the leftists won the lower house, the party run by former prime minister Silvio Berlusconi had more seats in the upper house.

Investors fear the outcome will lead to political stalemate in the country and a possible return to the dark days of the region's financial crisis if austerity measures introduced to cut Rome's huge debt pile are reversed.

The developments in Italy sent a shiver through forex markets in New York, with the euro tumbling to $1.3065 and 120.12 yen.

In Asia, the single currency sat at $1.3045 and 119.70 yen, well down from the $1.3197 and 124.24 yen in Tokyo on Monday.

The dollar fetched 91.76 yen against 91.92 yen in New York, far off the 94.77 yen high seen Monday in Asia.

The split vote in Italy wiped out the yen's Monday losses that were fuelled by reports Japan's government is likely to nominate a man to run the central bank who is in favour of more aggressive monetary easing.

On Wall Street, the Dow tumbled 1.55 percent in its biggest single-day drop since November, while the S&P 500 dived 1.83 percent and the Nasdaq sank 1.44 percent.

Traders are also keeping an eye on US lawmakers to see if they can muster an agreement to avoid the imposition of $85 billion in budget cuts -- known as the sequester -- that will come in on Friday.

Analysts have warned that if less drastic cuts are not agreed, the still-fragile economy could slip back into recession.

Oil prices fell, with New York's main contract, light sweet crude for delivery in April, dropping 85 cents to $92.26 a barrel in the afternoon and Brent North Sea crude for delivery in April shedding 85 cents to $113.59.

Gold was at $1,593.60 at 0805 GMT compared with $1,593.30 late Monday.

In other markets:

-- Taipei fell 0.84 percent, or 66.78 points, to 7,880.9.

Taiwan Semiconductor Manufacturing Co shed 1.43 percent to NT$103.5 while leading smartphone maker HTC was 0.36 percent higher at NT$276.5.

-- Manila closed 1.35 percent lower, giving up 90.66 points to 6,630.67.

SM Investments shed 1.37 percent to 1,010 pesos and Ayala Corp. fell 1.02 percent to 584 pesos, while SM Prime Holdings slid 1.60 percent to 18.50 pesos.

-- Wellington closed 0.30 percent, or 12.47 points, higher at 4,238.92.

Telecom rose 1.1 percent to NZ$2.32, Sky City added 0.5 percent to NZ$4.10 and Air New Zealand was up 4.7 percent at NZ$1.33.

- AFP/xq

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