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INTERNATIONAL EDITION

MONDAY, APRIL 30, 2012

109TH YEAR I ©2012 THE MIAMI HERALD

Health spending flattening out in U.S. BY ANNIE LOWREY

New York Times Service

The combination of the squeeze on state budgets, high rates of unemployment and the conservative movement’s revived energy provided an opening for Republican efforts, often business-backed, to promote tough-on-labor legislation in key states. Those efforts have succeeded in rolling back gains made by unions over decades, prompting vows from labor to fight back with newly engaged members shaken from selfdescribed complacency. “The steelworkers will be working harder this year than in

WASHINGTON — The growth of health spending has slowed substantially in the last few years, surprising experts and offering some fuel for optimism about the U.S. government’s long-term fiscal performance. Much of the slowdown is because of the recession, and thus not unexpected, health experts say. But some of it seems to be due to changing behavior by consumers and providers of healthcare — meaning that the lower rates of growth might persist even as the economy picks up. Because Medicare and Medicaid are two of the largest contributors to the country’s long-term debts, slower growth in health costs could reduce the pressure for enormous spending cuts or tax increases. In 2009 and 2010, total nationwide healthcare spending grew at less than 4 percent per year, the slowest annual pace in more than five decades, according to the latest numbers from the Centers for Medicaid and Medicare Services. After years of taking up a growing share of economic activity, health spending held steady in 2010, at 17.9 percent of the gross domestic product. The growth rate mostly slowed as millions of U.S. citizens lost insurance coverage along with their jobs. Worried about job security, others may have feared taking time off work for doctor’s visits or surgical procedures, or skipped nonurgent care when money was tight. Still, the slowdown was sharper than health economists expected, and a broad, bipartisan range of academics, hospital administrators and

• TURN TO UNIONS, 2A

• TURN TO HEALTH, 2A

NARAYAN WALKER/NEW YORK TIMES SERVICE

Volunteers work at a union phone bank in Madison, Wis.

Wis. vote first shot in wider union war BY JIM RUTENBERG AND STEVEN GREENHOUSE New York Times Service

GREEN BAY, Wis. — “Recall Walker” bumper stickers dotted the workers’ parking lot at the Georgia Pacific paper mill on Day Street here one recent afternoon, proof of their union’s role in the effort to oust Gov. Scott Walker from office early for his legislation limiting public employees’ bargaining rights. But among the largest donors to Walker and his cause are the plant’s owners, the billionaire industrialists Charles G. and David H. Koch, the latter of whom has said of the recall election to

be held in June, “If the unions win the recall, there will be no stopping union power.” The recall vote here has been billed as a critical test of labor muscle versus corporate money. But it is only a warm-up for a confrontation that will play out during the presidential election, which both sides view as the biggest political showdown in at least 30 years between pro- and anti-union forces. The same national groups flooding the streets and the airwaves in Wisconsin — the Kochsupported group Americans for Prosperity on the right, the AFLCIO, teachers unions and the

United Steelworkers on the left — are emerging as important outside supporters of President Barack Obama and Mitt Romney, each side empowered by the Supreme Court’s Citizens United decision. That ruling is not only giving wealthy donors like the Kochs greater options for pouring tens of millions of dollars into the presidential election. It is also giving unions — many of them representing workers in some of the major donors’ own factories — the ability for the first time ever to spend money from union treasuries for campaigning among nonunion voters.

Leaders misleading public on Iran, former Israeli security chief says BY KARIN BRULLIARD

Washington Post Service

JERUSALEM — The former chief of Israel’s domestic intelligence agency has described Prime Minister Benjamin Netanyahu and Defense Minister Ehud Barak as men driven by “messianic feelings” and said he had “no faith” in them to lead a potential strike on Iran’s nuclear facilities. The scathing comments by Yuval Diskin, who had kept a low profile since retiring last year, added to the sense of a divide between Israel’s security establishment and its political leadership over the Iran issue. Earlier last week, the current military chief voiced confidence that sanctions and the threat of military action would deter Iran from building nuclear bombs, an analysis that contrasted with Netanyahu’s and Barak’s grimmer assessments. Diskin, who headed the Shin Bet security agency for six years, was far more harsh. Speaking at a community meeting Friday, he said a preemptive Israeli attack on Iranian nuclear sites would probably accelerate, not end, Iran’s nuclear ambitions. “They are misleading the public on the Iran issue,” Diskin said of the prime minister and the defense minister, according to an account in the daily newspaper Haaretz. He added: “Believe me, I have observed them from up close . . . They are not people who I, on a personal level, trust to lead Israel to an event on that scale and carry it off. These are not people who

YUVAL DISKIN I would want to have holding the wheel in such an event.” Diskin’s comments echoed those previously made by Meir Dagan, the chief of Israel’s Mossad spy agency until January 2011, who said last year that a strike on Iran would lead to “regional war” and encourage Iran to continue its nuclear program. At the time, Dagan also told Israeli journalists that he feared his retirement, as well as that of Diskin and the former military chief, Gabi Ashkenazi, had removed voices that could “block any dangerous adventure” led by Netanyahu and Barak. But Diskin, who was described upon his retirement as a highly successful Shin Bet chief, had not

publicly spoken of his reservations before Friday. The offices of Netanyahu and Barak issued no responses Saturday. But other government officials and politicians denounced Diskin’s words as politically motivated and inappropriate. “If these are his opinions, he should have stated them in the appropriate forums while he was in office,” Transportation Minister Yisrael Katz said, according to the Jerusalem Post. Another Israeli official, who spoke on the condition of anonymity, said Diskin’s leadership of the internal security agency meant he was a “peripheral player” on the topic of Iran. The official termed Diskin’s criticism of Israeli leaders “surprising and strange,” in part because Diskin had elected to serve an additional year at the Shin Bet. In recent days, Israeli officials have played down the notion of a civil-security divide on Iran. Lt. Gen. Benny Gantz, the military chief who told Haaretz earlier this week that he believed Iranian leaders were “very rational people” who would ultimately decide against building nuclear weapons, said Thursday that there was no disagreement among Israeli leadership. On Thursday night, Barak emphasized that the decision about a preemptive strike would be made by political leaders and carried out by the military, and he deemed the chance of sanctions permanently stopping Iran’s nuclear programs as “low.”

Montague and Capulet as Shiite and Sunni BY TIM ARANGO

New York Times Service

BAGHDAD — It is not poison or a dagger that takes the lives of the young lovers, but a suicide bomb. The Montagues and Capulets are divided not just by family, but also by religious sect. And the dialogue in the Iraqi adaptation of Romeo and Juliet is sprinkled with references to Blackwater, Iranians and the U.S. reconstruction effort. After a recent performance here at the National Theater, where the dramatic arts were once degraded to serve as a dictator’s propaganda, the audience filed out buzzing over the return of serious art to the Iraqi capital. Cloaked as a Shakespearean classic was a lively rendering of their own lives over the last nine years. “It was about our reality, the killing that happened between the Sunnis and Shias,” said

Senan Saadi, a university student who was in the audience. The killing, of course, still happens. The morning after the show, explosions were heard in Baghdad. By the end of the day, a string of attacks around the country had left nearly three dozen people dead. By then, the cast of the play, including veteran Iraqi actors and young up-and-comers, was preparing to leave for the World Shakespeare Festival in Stratfordupon-Avon, William Shakespeare’s birthplace. “Romeo and Juliet in Baghdad” opened Thursday at the festival and runs for 10 days as part of the cultural program linked with the coming London Olympics. Its story line of a doomed cross-sectarian love affair manages to touch on nearly every element of the • TURN TO PLAY, 2A

RUI VIEIRA/AP

MUCH FODDER FOR OBAMA AT WHITE HOUSE EVENT, 3A

PEACE PLAN IN CRISIS AS SYRIA DERIDES U.N. CHIEF, 6A

BRITISH REGULATOR GETS TOUGH ON MARKET ABUSES, BUSINESS FRONT

CARMELO ANTHONY HAS MORE TO PROVE THAN LEBRON JAMES, SPORTS FRONT

INDEX THE AMERICAS .........4A U.S. NEWS.....................5A OPINION........................7A COMICS & PUZZLES....6B

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