Monica Martino had filmed tornadoes in the Midwest, ship collisions in the Antarctic and crab fishermen in Alaska's Bering Sea. But those experiences didn't prepare her for a terrifying nighttime boat ride in the Amazon jungle.
In February, the 41-year-old co-executive producer was thrown into a murky river after getting footage for "Bamazon," a series for the History cable channel about out-of-work Alabama construction workers mining for gold in the rain forest of Guyana.
Martino says the captain was blind in one eye and sailing too fast without a proper light. He lost control of the boat while making a hard turn, sending the crew into the river, where Martino was knocked out by the impact of hitting the water at high speed.
Pulled back into the boat, Martino regained consciousness. But on the journey back to base camp, the vessel struck a tree, slamming Martino into the deck. Although she sustained a concussion, bruised ribs and a badly torn shoulder, Martino said, she had to wait 19 hours to receive medical care at a clinic in Venezuela because the production company had no viable medical evacuation plan for the crew.
History and the production company, Red Line Films, declined to comment.
"It was a whole cascade of negligence," said Martino, who lives in Santa Monica. "We were put in a situation far beyond what any production crew should be expected to handle."
As reality TV has boomed over the last decade, action-adventure shows have become a lucrative nichein a medium hungry for high ratings. But the growth has also stirred concerns that some reality TV programs are cutting corners on safety, exposing cast and crew members to hazardous conditions.
A combination of tight budgets, lack of trained safety personnel and pressure to capture dramatic footage has caused serious and in some cases fatal incidents, according to interviews with television producers, safety consultantsand labor advocates.
Even the companies that provide insurance to Hollywood films and TV shows are reluctant to write policies for some of the edgier programs.
"These reality shows are getting riskier to get more ratings,'' said Wendy Diaz, senior underwriting director for the entertainment division of Fireman's Fund Insurance, one of the leading insurance carriers that serve the entertainment industry.
Records from OSHA and the state Division of Occupational Safety and Health show fewer than a dozen citations and accidents involving reality TV sets in the last five years, including a fatality that occurred this summer in Colorado during production of a proposed Discovery Channel series. But union officials, safety consultants and producers say those numbers don't begin to reveal the true extent of the problem.
PHOTOS: Where the last seasons left off
Many incidents go unreported because crew members sign non-disclosure agreements and fear being blacklisted if they file lawsuits. Record-keeping is further muddled by the fact that many of the shows are nonunion, and workers are often classified as independent contractors. OSHA typically tracks only serious accidents involving employees and has no jurisdiction if the incident occurs in a foreign country such as Guyana.
"Reality has a lot of near-misses and things that happen that you never hear about," said Vanessa Holtgrewe, an industry veteran and former camera operator on "The Biggest Loser" and "The X Factor" who now works as an organizer for the International Alliance of Theatrical Stage Employees. "On a lot of these shows, you're completely on your own. There is no one you can call if … you feel you're in a dangerous situation."
State and federal OSHA officials declined to comment specifically on incidents involving the reality TV sector.
Fireman's Fund estimated that it would underwrite 160 action-adventure reality shows in 2012, a 25% increase over the previous year. But itpassed on about 50 other reality TV programs because they were deemed too risky, Diaz said.
"We had people who wanted to go to Mexico to follow the drug cartels around," Diaz said. "We had one show where they were going to blow up a mine. We told them we wouldn't insure the show."
Reality series — which cover everything from "Survivor" to "Keeping Up With the Kardashians" — have provided a huge revenue stream for cable and broadcast networks. The shows have lower production costs than scripted entertainment and tend to attract the younger viewers favored by advertisers.
CRITIC'S NOTEBOOK: Try to believe in the new TV season
Author’s note: Most people don’t realize that we knew in the 1920s that leaded gasoline was extremely dangerous. And in light of a Mother Jones story this week that looks at the connection between leaded gasoline and crime rates in the United States, I thought it might be worth reviewing that history. The following is an updated version of an earlier post based on information from my book about early 10th century toxicology, The Poisoner’s Handbook.
In the fall of 1924, five bodies from New Jersey were delivered to the New York City Medical Examiner’s Office. You might not expect those out-of-state corpses to cause the chief medical examiner to worry about the dirt blowing in Manhattan streets. But they did.
To understand why you need to know the story of those five dead men, or at least the story of their exposure to a then mysterious industrial poison.
The five men worked at the Standard Oil Refinery in Bayway, New Jersey. All of them spent their days in what plant employees nicknamed “the loony gas building”, a tidy brick structure where workers seemed to sicken as they handled a new gasoline additive. The additive’s technical name was tetraethyl lead or, in industrial shorthand, TEL. It was developed by researchers at General Motors as an anti-knock formula, with the assurance that it was entirely safe to handle.
But, as I wrote in a previous post, men working at the plant quickly gave it the “loony gas” tag because anyone who spent much time handling the additive showed stunning signs of mental deterioration, from memory loss to a stumbling loss of coordination to sudden twitchy bursts of rage. And then in October of 1924, workers in the TEL building began collapsing, going into convulsions, babbling deliriously. By the end of September, 32 of the 49 TEL workers were in the hospital; five of them were dead.
The problem, at that point, was that no one knew exactly why. Oh, they knew – or should have known – that tetraethyl lead was dangerous. As Charles Norris, chief medical examiner for New York City pointed out, the compound had been banned in Europe for years due to its toxic nature. But while U.S. corporations hurried TEL into production in the 1920s, they did not hurry to understand its medical or environmental effects.
In 1922, the U.S. Public Health Service had asked Thomas Midgley, Jr. – the developer of the leaded gasoline process – for copies of all his research into the health consequences of tetraethyl lead (TEL).
Midgley, a scientist at General Motors, replied that no such research existed. And two years later, even with bodies starting to pile up, he had still not looked into the question. Although GM and Standard Oil had formed a joint company to manufacture leaded gasoline – the Ethyl Gasoline Corporation - its research had focused solely on improving the TEL formulas. The companies disliked and frankly avoided the lead issue. They’d deliberately left the word out of their new company name to avoid its negative image.
In response to the worker health crisis at the Bayway plant, Standard Oil suggested that the problem might simply be overwork. Unimpressed, the state of New Jersey ordered a halt to TEL production. And because the compound was so poorly understood, state health officials asked the New York City Medical Examiner’s Office to find out what had happened.
In 1924, New York had the best forensic toxicology department in the country; in fact,, it had one of the few such programs period. The chief chemist was a dark, cigar-smoking, perfectionist named Alexander Gettler, a famously dogged researcher who would sit up late at night designing both experiments and apparatus as needed.
It took Gettler three obsessively focused weeks to figure out how much tetraethyl lead the Standard Oil workers had absorbed before they became ill, went crazy, or died. “This is one of the most difficult of many difficult investigations of the kind which have been carried on at this laboratory,” Norris said, when releasing the results. “This was the first work of its kind, as far as I know. Dr. Gettler had not only to do the work but to invent a considerable part of the method of doing it.”
Working with the first four bodies, then checking his results against the body of the last worker killed, who had died screaming in a straitjacket, Gettler discovered that TEL and its lead byproducts formed a recognizable distribution, concentrated in the lungs, the brain, and the bones. The highest levels were in the lungs suggesting that most of the poison had been inhaled; later tests showed that the types of masks used by Standard Oil did not filter out the lead in TEL vapors.
Rubber gloves did protect the hands but if TEL splattered onto unprotected skin, it absorbed alarmingly quickly. The result was intense poisoning with lead, a potent neurotoxin. The loony gas symptoms were, in fact, classic indicators of heavy lead toxicity.
After Norris released his office’s report on tetraethyl lead, New York City banned its sale, and the sale of “any preparation containing lead or other deleterious substances” as an additive to gasoline. So did New Jersey. So did the city of Philadelphia. It was a moment in which health officials in large urban areas were realizing that with increased use of automobiles, it was likely that residents would be increasingly exposed to dangerous lead residues and they moved quickly to protect them.
But fearing that such measures would spread, that they would be forced to find another anti-knock compound, as well as losing considerable money, the manufacturing companies demanded that the federal government take over the investigation and develop its own regulations. U.S. President Calvin Coolidge, a Republican and small-government conservative, moved rapidly in favor of the business interests.
The manufacturers agreed to suspend TEL production and distribution until a federal investigation was completed. In May 1925, the U.S. Surgeon General called a national tetraethyl lead conference, to be followed by the formation of an investigative task force to study the problem. That same year, Midgley published his first health analysis of TEL, which acknowledged a minor health risk at most, insisting that the use of lead compounds,”compared with other chemical industries it is neither grave nor inescapable.”
It was obvious in advance that he’d basically written the conclusion of the federal task force. That panel only included selected industry scientists like Midgely. It had no place for Alexander Gettler or Charles Norris or, in fact, anyone from any city where sales of the gas had been banned, or any agency involved in the producing that first critical analysis of tetraethyl lead.
In January 1926, the public health service released its report which concluded that there was “no danger” posed by adding TEL to gasoline…”no reason to prohibit the sale of leaded gasoline” as long as workers were well protected during the manufacturing process.
The task force did look briefly at risks associated with every day exposure by drivers, automobile attendants, gas station operators, and found that it was minimal. The researchers had indeed found lead residues in dusty corners of garages. In addition, all the drivers tested showed trace amounts of lead in their blood. But a low level of lead could be tolerated, the scientists announced. After all, none of the test subjects showed the extreme behaviors and breakdowns associated with places like the looney gas building. And the worker problem could be handled with some protective gear.
There was one cautionary note, though. The federal panel warned that exposure levels would probably rise as more people took to the roads. Perhaps, at a later point, the scientists suggested, the research should be taken up again. It was always possible that leaded gasoline might “constitute a menace to the general public after prolonged use or other conditions not foreseen at this time.”
But, of course, that would be another generation’s problem. In 1926, citing evidence from the TEL report, the federal government revoked all bans on production and sale of leaded gasoline. The reaction of industry was jubilant; one Standard Oil spokesman likened the compound to a “gift of God,” so great was its potential to improve automobile performance.
In New York City, at least, Charles Norris decided to prepare for the health and environmental problems to come. He suggested that the department scientists do a base-line measurement of lead levels in the dirt and debris blowing across city streets. People died, he pointed out to his staff; and everyone knew that heavy metals like lead tended to accumulate. The resulting comparison of street dirt in 1924 and 1934 found a 50 percent increase in lead levels – a warning, an indicator of damage to come, if anyone had been paying attention.
It was some fifty years later – in 1986 – that the United States formally banned lead as a gasoline additive. By that time, according to some estimates, so much lead had been deposited into soils, streets, building surfaces, that an estimated 68 million children would register toxic levels of lead absorption and some 5,000 American adults would die annually of lead-induced heart disease. As lead affects cognitive function, some neuroscientists also suggested that chronic lead exposure resulted in a measurable drop in IQ scores during the leaded gas era. And more recently, of course, researchers had suggested that TEL exposure and resulting nervous system damage may have contributed to violent crime rates in the 20th century.
Which is just another way of say that we never got out of the loony gas building after all.
Images: 1) Manhattan, 34th Street, 1931/NYC Municipal Archives 2) 1940s gas station, US Route 66, Illinois/Deborah Blum
MOSCOW (AP) — The day after receiving his new Russian passport from President Vladimir Putin, French actor Gerard Depardieu flew Sunday to the provincial town of Saransk, where he was greeted as a local hero and offered an apartment for free.
Depardieu had sought Russian citizenship as part of his battle against a proposed super tax on millionaires in France.
Putin granted his request last week and then welcomed the actor late Saturday to his residence in Sochi, the host city of the 2014 Winter Olympics. Russian television showed the two men embracing and then chatting over supper, discussing a soon-to-be-released film in which Depardieu plays Russian monk Grigory Rasputin.
Depardieu flew Sunday to Saransk, a town about 500 kilometers (300 miles) east of Moscow, where he was met at a snow-covered airport by the governor and a group of women in traditional costume singing folk songs. He flashed his new passport to the crowd before setting out on a tour of the town.
The governor invited Depardieu to settle in Saransk and offered him an apartment of his choice, according to reports on state television.
Depardieu has not said where he would take up residence in Russia, only that he did not want to live in Moscow because it is too big and he prefers a village.
The Frenchman has spent a fair bit of time in Russia in recent years, including for the filming of the French-Russian film “Rasputin,” and he expresses an admiration for Putin. But it is Russia’s flat 13 percent income tax that appears to be the biggest draw at the moment as he flees high taxes in France.
France’s new Socialist government tried to raise the tax on income above €1 million ($ 1.3 million) to 75 percent from the current 41 percent. That plan was struck down by the highest court, but Budget Minister Jerome Cahuzac said Sunday that the government is reworking the law so the superrich will still be asked to pay an elevated rate. He said the government is also considering putting the new tax in place for longer than the two years initially imagined.
“I find it a bit pathetic that for tax reasons this man — whom by the way I admire infinitely as an actor — has decided to exile himself,” Cahuzac said.
___
Sarah DiLorenzo in Paris contributed to this report.
.
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Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.
Bob Chamberlin/Los Angeles Times
Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.
Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.
In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.
In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.
The proposed increases compare with about 4 percent for families with employer-based policies.
Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.
The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.
New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.
The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.
Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.
“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.
While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.
The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.
Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.
“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.
Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.
“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.
As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.
Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.
Bob Chamberlin/Los Angeles Times
Dave Jones, the California insurance commissioner, said some insurance companies could raise rates as much as they did before the law was enacted.
Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.
In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.
In other states, like Florida and Ohio, insurers have been able to raise rates by at least 20 percent for some policy holders. The rate increases can amount to several hundred dollars a month.
The proposed increases compare with about 4 percent for families with employer-based policies.
Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site, healthcare.gov, along with regulators’ evaluations.
The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.
New York, for example, recently used its sweeping powers to hold rate increases for 2013 in the individual and small group markets to under 10 percent. California can review rate requests for technical errors but cannot deny rate increases.
The double-digit requests in some states are being made despite evidence that overall health care costs appear to have slowed in recent years, increasing in the single digits annually as many people put off treatment because of the weak economy. PricewaterhouseCoopers estimates that costs may increase just 7.5 percent next year, well below the rate increases being sought by some insurers. But the companies counter that medical costs for some policy holders are rising much faster than the average, suggesting they are in a sicker population. Federal regulators contend that premiums would be higher still without the law, which also sets limits on profits and administrative costs and provides for rebates if insurers exceed those limits.
Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.
“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.
While Mr. Jones has not yet weighed in on the insurers’ most recent requests, he is pushing for a state law that will give him that authority. Without legislative action, the state can only question the basis for the high rates, sometimes resulting in the insurer withdrawing or modifying the proposed rate increase.
The California insurers say they have no choice but to raise premiums if their underlying medical costs have increased. “We need these rates to even come reasonably close to covering the expenses of this population,” said Tom Epstein, a spokesman for Blue Shield of California. The insurer is requesting a range of increases, which average about 12 percent for 2013.
Although rates paid by employers are more closely tracked than rates for individuals and small businesses, policy experts say the law has probably kept at least some rates lower than they otherwise would have been.
“There’s no question that review of rates makes a difference, that it results in lower rates paid by consumers and small businesses,” said Larry Levitt, an executive at the Kaiser Family Foundation, which estimated in an October report that rate review was responsible for lowering premiums for one out of every five filings.
Federal officials say the law has resulted in significant savings. “The health care law includes new tools to hold insurers accountable for premium hikes and give rebates to consumers,” said Brian Cook, a spokesman for Medicare, which is helping to oversee the insurance reforms.
“Insurers have already paid $1.1 billion in rebates, and rate review programs have helped save consumers an additional $1 billion in lower premiums,” he said. If insurers collect premiums and do not spend at least 80 cents out of every dollar on care for their customers, the law requires them to refund the excess.
As a result of the review process, federal officials say, rates were reduced, on average, by nearly three percentage points, according to a report issued last September.
Lance Armstrong reportedly is weighing confessing to using performance-enhancing drugs. (Thao Nguyen / Associated Press / February 15, 2011)
By Lance Pugmire
January 5, 2013, 7:11 a.m.
Lance Armstrong reportedly is weighing confessing to using banned performance-enhancing drugs and blood transfusions during his run of seven Tour de France titles.
Armstrong, who was stripped in October of his Tour titles and banned for life from competition by the U.S. Anti-Doping Agency, is pursuing the admission as a route to regain his eligibility to compete, the New York Times first reported Friday.
Armstrong’s attorney, Tim Herman, told the newspaper, “I suppose anything is possible. Right now, that’s not really on the table.”
Citing pressure from the cancer-fighting charity he helped create, Livestrong, Armstrong, 41, reportedly has held discussions with his longtime nemesis, USADA Chief Executive Travis Tygart, in an attempt to negotiate a lifting of the ban, one person told the New York Times.
Armstrong has competed in triathlons and running events since his lifetime ban took effect.
Efforts to reach Tygart and Armstrong’s representatives Friday night were not immediately successful.
The World Anti-Doping Code allows for lightened punishment for those who fully detail their doping protocol in a confession.
Armstrong lost a slew of endorsement deals after he was banned, and any confession would probably leave him in jeopardy of perjury accusations since he has given sworn statements denying he used banned substances in prior legal cases.
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Galileo false-color image of the Mare Tranquillitatis and Mare Serenitatis areas of the Moon. The picture was made from four exposures taken during Galileo's second Earth/Moon flyby.
The colors are enhanced to highlight compositional differences.
Mare Tranquillitatis at left appears blue due to titanium enrichment. Orange soil in Mare Sarenitatis at lower right indicates lower titanium. Dark purple areas at left center mark the Apollo 17 landing site, composed of explosive volcanic deposits.
Red lunar highlands indicate low iron and titanium. Mare Serenitatis is roughly 1300 km across and North is at 5:00. The 95 km diameter crater Posidonius, centered at 32 N, 30 E, is at the middle of the bottom of the frame.
CARACAS/MILAN (Reuters) – Venezuelan emergency services mounted a sea and air rescue mission on Saturday after a plane carrying fashion executive Vittorio Missoni went missing off the coast of Venezuela.
The plane carrying Missoni, 58, his wife, Maurizia Castiglioni, another couple and two Venezuelan crew members disappeared after taking off from the resort of Los Roques, an archipelago off the coast of Venezuela, Italian media said.
“It disappeared yesterday. They have been looking for it with helicopters and ships, but have not found anything yet. They are still searching for it this morning,” the Italian consul in Venezuela, Giovanni Davoli, told Reuters by phone.
Missoni is the oldest son of the founders of the fashion house famous for its exuberantly coloured knits, featuring bold stripes and zigzags. He is co-owner with siblings Luca and Angela, who handle the technical and design sides of the firm.
“The Missoni family has been informed by the Venezuelan consulate that Vittorio Missoni and his wife are missing, but we don’t know any more,” said Missoni spokeswoman Maddalena Aspes.
Other members of the Missoni family are travelling back to Italy from a holiday in France, Aspes said.
Missoni and his siblings took over managing the company from their parents Ottavio and Rosita in 1996, aiming to relaunch the brand to a larger, younger market as rivals Gucci and Burberry have done. Under Vittorio’s tenure, Missoni has opened hotels in Edinburgh and Kuwait and launched the Missoni Home collection.
By 2011, the brand’s appeal was wide enough for U.S. mass-market retailer Target to ask it to design a collection.
The brand will celebrate its 60th anniversary this year.
(Reporting by Jennifer Clark and Andrew Cawthorne; Editing by Louise Ireland)
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Hillary Rodham Clinton with Field Marshal Mohamed Hussein Tantawi in Cairo in July.
WASHINGTON — When Secretary of State Hillary Rodham Clinton fractured her right elbow after slipping in a State Department garage in June 2009, she returned to work in just a few days. Her arm in a sling, she juggled speeches and a trip to India and Thailand with physical therapy, rebuilding a joint held together with wire and pins.
It was vivid evidence of Mrs. Clinton’s indomitable stamina and work ethic — as a first lady, senator, presidential candidate and, for the past four years, the most widely traveled secretary of state in American history.
But after a fall at home in December that caused a concussion, and a subsequent diagnosis of a blood clot in her head, it has taken much longer for Mrs. Clinton to bounce back. She was released from a hospital in New York on Wednesday, accompanied by her daughter, Chelsea, and her husband, former President Bill Clinton. On Thursday, she told colleagues that she hoped to be in the office next week.
Her health scare, though, has reinforced the concerns of friends and colleagues that the years of punishing work and travel have taken a heavy toll. Even among her peers at the highest levels of government, Mrs. Clinton, 65, is renowned for her grueling schedule. Over the past four years, she was on the road for 401 days and spent the equivalent of 87 full days on a plane, according to the State Department’s Web site.
In one 48-hour marathon in 2009 that her aides still talk about, she traveled from talks with Palestinian leaders in Abu Dhabi to a midnight meeting with Prime Minister Benjamin Netanyahu in Jerusalem, then boarded a plane for Morocco, staying up all night to work on other issues, before going straight to a meeting of Arab leaders the next morning.
“So many people who know her have urged me to tell her not to work so hard,” said Melanne S. Verveer, who was Mrs. Clinton’s chief of staff when she was first lady and is now the State Department’s ambassador at large for women’s issues. “Well, that’s not easy to do when you’re Hillary Clinton. She doesn’t spare herself.”
It is not just a matter of duty, Ms. Verveer and others said. Mrs. Clinton genuinely relishes the work, pursuing a brand of personal diplomacy that, she argues, requires her to travel to more places than her predecessors.
While there is no medical evidence that Mrs. Clinton’s clot was caused by her herculean work habits, her cascade of recent health problems, beginning with a stomach virus, has prompted those who know her best to say that she desperately needs a long rest. Her first order of business after leaving the State Department in the coming weeks, they say, should be to take care of herself.
Some even wonder whether this setback will — or should — temper the feverish speculation that she will make another run for the White House in 2016.
“I am amazed at the number of women who come up to me and tell me she must run for president,” said Ellen Chesler, a New York author and a friend of Mrs. Clinton’s. “But perhaps this episode will alter things a bit.”
Given Mrs. Clinton’s enduring status as a role model, Ms. Chesler said women would be watching which path she decides to take, as they plan their own transitions out of the working world.
“Do remember that women of our generation are really the first to have worked through the life cycle in large numbers,” she added. “Many seem to be approaching retirement with dread.”
For now, aides say, Mrs. Clinton’s focus is on wrapping up her work at the State Department. She would like to take part in a town hall-style meeting, thank her staff and sit for some interviews. But first she has to get clearance from her doctors, who are watching her to make sure that the blood thinners they have prescribed for her clot are working.
Speaking to a meeting of a foreign policy advisory board from her home in Chappaqua, N.Y., on Thursday, Mrs. Clinton said she was crossing her fingers and encouraging her doctors to let her return next week. “I’m trying to be a compliant patient,” she said, according to a person who was in the room. “But that does require a certain level of patience, which I’ve had to cultivate over the last three and a half weeks.”
While convalescing, Mrs. Clinton has spoken with President Obama and has held a 30-minute call with Senator John Kerry, Democrat of Massachusetts, whom Mr. Obama nominated as her successor.
WASHINGTON — With 2013 bringing tax increases on the incomes of a small sliver of the richest Americans, the country’s top earners now face a heavier tax burden than at any time since Jimmy Carter was president.
The last-minute deal struck by the departing 112th Congress raised taxes on a handful of the highest-earning Americans, with about 99.3 percent of households experiencing no change in their income taxes. But the Tax Policy Center estimates that the average family in the top 1 percent will pay a federal tax rate of more than 36 percent this year, up from 28 percent in 2008. That is the highest rate since 1979, at least.
By some measures, the tax code might now be the most progressive in a generation, tax economists said, while noting that every American is paying a lower burden currently than they did then. In fact, the total federal tax rate is still vastly lower for the very rich than it was at any point in the 1940s through 1970s. It has risen from historical lows, but is still closer to those lows than where it was in the postwar decades.
“We made the system more progressive by raising rates at the top and leaving them for everyone else,” said Roberton Williams of the Tax Policy Center, a research group based in Washington. “The offsetting issue is that the rich have gotten a lot richer.”
Indeed, over the last three decades the bulk of pretax income gains have gone to the wealthy — and the higher up on the income scale, the bigger the gains, with billionaires outpacing millionaires who outpaced the merely rich. Economists doubted that the tax increases would do much to reverse that trend.
With the recovery failing to improve incomes for millions of average Americans and the country running trillion-dollar deficits, President Obama made “tax fairness” a centerpiece of his re-election campaign. In the heated negotiations with House Speaker John A. Boehner, that translated into the White House’s insistence on tax increases for the top 2 percent of households and a continuation of tax breaks and cuts for a vast number of taxpayers.
Republicans resisted increasing tax rates and aimed for lower revenue targets, arguing that spending was the budget’s primary problem and that no American should see his or her taxes go up too much in such a sluggish economy. But ultimately they relented, and Congress cut a last-minute deal.
“A central promise of my campaign for president was to change the tax code that was too skewed towards the wealthy at the expense of working middle-class Americans,” Mr. Obama said after Congress reached an agreement.
That deal includes a host of tax increases on the rich. It raises the tax rate to 39.6 percent from 35 percent on income above $400,000 for individuals, and $450,000 for couples. The rate on dividends and capital gains for those same taxpayers was bumped up 5 percentage points, to 20 percent. Congress also reinstated limits on the amount households with more than $300,000 in income can deduct. On top of that, two new surcharges — a 3.8 percent tax on investment income and a 0.9 percent tax on regular income — hit those same wealthy households.
As a result of the taxes added in both the deal and the 2010 health care law, which came into effect this year, taxpayers with $1 million in income and up will pay on average $168,000 more in taxes. Millionaires’ share of the overall federal tax burden will climb to 23 percent from 20 percent.
The result is a tax code that squeezes hundreds of billions of dollars more from the very well off — about $600 billion more over 10 years — while leaving the tax burden on everyone else mostly as it was. And the changes come after 30 years of both Republican and Democratic administrations doing the converse: zeroing out federal income taxes for many poor working families while also reducing the tax burden for households on the higher end of the income scale.
“Back at the end of the Carter and beginning of the Reagan administrations, we had a pretty severe income-tax burden for people at a low level of income. It was actually kind of appalling,” said Alan D. Viard, a tax expert at the American Enterprise Institute, a right-of-center research group in Washington. “Policy makers in both parties realized that was bad policy and started whittling away at it” by expanding credits and tinkering with tax rates.
After those changes and the new law, comparing average tax rates for poor households and wealthy households, 2013 might be the most progressive tax code since 1979. But economists cautioned that measuring progressivity is tricky. “It’s not like there is some scientific measure of progressivity all economists agreed upon,” said Leonard E. Burman, a professor of public affairs at Syracuse University. “People look at different numerical measures and they’ve changed in different ways at different income levels.”
Mr. Viard said that over time the code had become markedly more progressive for the poor compared with the middle class. But it arguably did not become much more progressive for the rich compared with the middle class, or the very rich compared with the rich, in part because of the George W. Bush-era tax cuts on investment income.
An anesthesiologist who earns a $500,000 salary subject to payroll and income taxes might pay a higher tax rate than a hedge fund manager making $1 billion subject mostly to capital-gains taxes, for instance.
Economists are also divided on the ultimate effect of those tax increases on the wealthy to income growth and income inequality in the United States. The recession hit the incomes of the rich hard, but they have snapped back much more strongly than those for middle or low-income workers.
“I’d still rather be really rich, even if I’m getting taxed much more than a low-income person” would be, Mr. Williams of the Tax Policy Center added.