Analysis: Amid Tears Lance Armstrong Leaves Unanswered Questions in Oprah Winfrey Interview

In an extensive interview with Oprah Winfrey that was shown over two nights, Lance Armstrong admitted publicly for the first time that he doped throughout his cycling career. He revealed that all seven of his Tour de France victories were fueled by doping, that he never felt bad about cheating, and that he had covered up a positive drug test at the 1999 Tour with a backdated doctor’s prescription for banned cortisone.

Armstrong, the once defiant cyclist, also became choked up when he discussed how he told his oldest child that the rumors about Armstrong’s doping were true.

Even with all that, the interview will most likely be remembered for what it was missing.

Armstrong had not subjected himself to questioning from anyone in the news media since United States antidoping officials laid out their case against him in October. He chose not to appeal their ruling, leaving him with a lifetime ban from Olympic sports.

He personally chose Winfrey for his big reveal, and it went predictably. Winfrey allowed him to share his thoughts and elicited emotions from him, but she consistently failed to ask critical follow-up questions that would have addressed the most vexing aspects of Armstrong’s deception.

She did not press him on who helped him dope or cover up his drug use for more than a decade. Nor did she ask him why he chose to take banned performance-enhancing substances even after cancer had threatened his life.

Winfrey also did not push him to answer whether he had admitted to doctors in an Indianapolis hospital in 1996 that he had used performance-enhancing drugs, a confession a former teammate and his wife claimed they overheard that day. To get to the bottom of his deceit, antidoping officials said, Armstrong has to be willing to provide more details.

“He spoke to a talk-show host,” David Howman, the director general of the World Anti-Doping Agency, said from Montreal on Friday. “I don’t think any of it amounted to assistance to the antidoping community, let alone substantial assistance. You bundle it all up and say, ‘So what?’

Jeffrey M. Tillotson, the lawyer for an insurance company that unsuccessfully withheld a $5 million bonus from Armstrong on the basis that he had cheated to win the Tour de France in 2004, said his client would make a decision over the weekend about whether to sue Armstrong. If it proceeds, the company, SCA Promotions, will seek $12 million, the total it paid Armstrong in bonuses and legal fees.

“It seemed to us that he was more sorry that he had been caught than for what he had done,” Tillotson said. “If he’s serious about rehabbing himself, he needs to start making amends to the people he bullied and vilified, and he needs to start paying money back.”

Armstrong, who said he once believed himself to be invincible, explained in the portion of the interview broadcast Friday night that he started to take steps toward redemption last month. Then, after dozens of questions had already been lobbed his way, he became emotional when he described how he told his 13-year-old son, Luke, that yes, his father had cheated by doping. That talk happened last month over the holidays, Armstrong said as he fought back tears.

“I said, listen, there’s been a lot of questions about your dad, my career, whether I doped or did not dope, and I’ve always denied, I’ve always been ruthless and defiant about that, which is probably why you trusted me, which makes it even sicker,” Armstrong said he told his son, the oldest of his five children. “I want you to know it’s true.”

At times, Winfrey’s interview seemed more like a therapy session than an inquisition, with Armstrong admitting that he was narcissistic and had been in therapy — and that he should be in therapy regularly because his life was so complicated.

In the end, the interview most likely accomplished what Armstrong had hoped: it was the vehicle through which he admitted to the public that he had cheated by doping, which he had lied about for more than a decade. But his answers were just the first step to clawing back his once stellar reputation.

On Friday, Armstrong appeared more contrite than he had during the part of the interview that was shown Thursday, yet he still insisted that he was clean when he made his comeback to cycling in 2009 after a brief retirement, an assertion the United States Anti-Doping Agency said was untrue. He also implied that his lifetime ban from all Olympic sports was unfair because some of his former teammates who testified about their doping and the doping on Armstrong’s teams received only six-month bans.

Richard Pound, the founding chairman of WADA and a member of the International Olympic Committee, said he was unmoved by Armstrong’s televised mea culpa.

“If what he’s looking for is some kind of reconstruction of his image, instead of providing entertainment with Oprah Winfrey, he’s got a long way to go,” Pound said Friday from his Montreal office.

Armstrong acknowledged to Winfrey during Friday’s broadcast that he has a long way to go before winning back the public’s trust. He said he understood why people recently turned on him because they felt angry and betrayed.

“I lied to you and I’m sorry,” he said before acknowledging that he might have lost many of his supporters for good. “I am committed to spending as long as I have to to make amends, knowing full well that I won’t get very many back.”

Armstrong also said that the scandal has cost him $75 million in lost sponsors, all of whom abandoned him last fall after Usada made public 1,000 pages of evidence that Armstrong had doped.

“In a way, I just assumed we would get to that point,” he said of his sponsors’ leaving. “The story was getting out of control.”

In closing her interview, Winfrey asked Armstrong a question that left him perplexed.

“Will you rise again?” she said.

Armstrong said: “I don’t know. I don’t know. I don’t know what’s out there.”

Then, as the interview drew to a close, Armstrong said: “The ultimate crime is the betrayal of these people that supported me and believed in me.”

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Business Briefing | Medicine: F.D.A. Clears Botox to Help Bladder Control

Botox, the wrinkle treatment made by Allergan, has been approved to treat adults with overactive bladders who cannot tolerate or were not helped by other drugs, the Food and Drug Administration said on Friday. Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity. “Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” Dr. Hylton V. Joffe, director of the F.D.A.’s reproductive and urologic products division, said in a statement. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.”

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Business Briefing | Medicine: F.D.A. Clears Botox to Help Bladder Control

Botox, the wrinkle treatment made by Allergan, has been approved to treat adults with overactive bladders who cannot tolerate or were not helped by other drugs, the Food and Drug Administration said on Friday. Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity. “Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” Dr. Hylton V. Joffe, director of the F.D.A.’s reproductive and urologic products division, said in a statement. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.”

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British Leader, David Cameron, Sees Wider Threat in Algeria Attack

Oli Scarff/Getty Images

Prime Minister David Cameron en route to Parliament to deliver a statement on the Algeria hostage crisis.

LONDON — With more than 60 hostages still missing and many feared dead, Prime Minister David Cameron told Parliament on Friday that the Qaeda-linked attack on a remote Algerian gas installation demonstrated the need for Britain and its western allies, including the United States, to direct more of their diplomatic, military and intelligence resources to the intensifying threat emanating from “the ungoverned space” of the North African desert, treating it with as much concern as the terrorist challenge in Pakistan and Afghanistan.

Mr. Cameron offered little new information about the showdown at the In Amenas plant, 1,000 miles from Algiers in the oil-and-gas-rich emptiness of the Sahara, saying the information reaching London about what he described as a “continuing situation” remained sketchy. He added that Britain had learned overnight that its fears for British citizens caught up in the hostage-taking and the subsequent shootout now focused on “significantly” fewer than the 30 people feared on Thursday. As part of the effort to learn more, he said, a special plane had been assigned to carry Britain’s ambassador in Algiers and other British diplomats to the area of the gas plant on Friday.

But in an hourlong session in the House of Commons, Mr. Cameron pointed to the somber implications of underestimating recent events in Mali and Algeria as a regional problem for North Africa rather than an increasingly fertile arena for Islamic militants and their hostility to the West. He said he had discussed his concerns in a telephone conversation with President Obama on Thursday night.

The British leader said the growth of Islamic terrorist networks in the countries of the Sahel, the broad area of North Africa that runs more than 3,000 miles from Mauritania in the west to Sudan and Somalia in the east, should be a renewed focus of western counterterrorist concerns and resources. At one point, he cited the need for military assistance to the affected countries to be part of NATO military planning, though he again emphatically ruled out any British combat role in support of France’s campaign against militants in Mali.

Pointing to the leading role played in the Algerian attack by Mokhtar Belmohtar, a terrorist ringleader and smuggler with links to North Africa’s main Islamic terrorist group, Al Qaeda in the Islamic Maghreb, Mr. Cameron warned that the Algerian attack was symptomatic of a far broader threat.

“What we know is that the terrorist threat in the Sahel comes from Al Qaeda in the Islamic Maghreb, which aspires to establish Islamic law across the Sahel and northern Africa, and to attack Western interests in the region and frankly, wherever it can,” Mr. Cameron said. “Just as we have reduced the scale of the Al Qaeda threat in other parts of the world, including in Pakistan and Afghanistan, so it has grown in other parts of the world. We need to be equally concerned about that, and equally focused on it.”

To some British commentators, Mr. Cameron’s remarks sounded as though they may have been crafted as part of a British effort to prompt a deeper involvement in North African security matters by the United States. In last year’s Libyan conflict, the United States stepped back from the lead role it has traditionally taken in NATO military operations and left Britain, France and Italy to conduct the bulk of the bombing in support of the Libyan rebels’ successful campaign to topple Col. Muammar el-Qaddafi.

Since then, high-ranking British officials have voiced concerns that the Obama administration was stepping back from European political and security issues and turning its attentions increasingly to the nations of the Pacific.

With the approach of Mr. Obama’s second inauguration on Sunday, The Spectator, a London-based weekly that is influential in Mr. Cameron’s Conservative Party, devoted its cover this week to an article headlined “The Pacific President,” and an illustration showing Mr. Obama in a brightly colored Hawaiian shirt and shorts surfing off a palm-lined beach. “As Barack Obama is sworn in again as president, his allies in the West will ask themselves the same nervous question they posed four years ago: how much does he care about us,” the accompanying article asked.

White House officials said on Thursday that Mr. Obama had used his telephone conversation with Mr. Cameron to underscore American concerns that Britain remain a robust force within the 27-nation European Union, a hot-button issue for Mr. Cameron. The prime minister had planned — then canceled, amid the Algerian crisis — a landmark speech in Amsterdam on Friday in which he was to have outlined his plan to negotiate a much sparer role for Britain in the European bloc.

In his remarks to lawmakers on Friday, Mr. Cameron offered what could have been construed as an oblique riposte to Mr. Obama, or at least to officials in the Obama administration who have urged that Europe take greater responsibility for confronting terrorist and other security threats in its own region.  He may also have been addressing domestic critics in Britain, or other NATO countries that have been less active than Britain in counterterrorism efforts aimed at confronting the spread of Islamic militant groups.

“There is a great need for not just Britain but other countries to give a priority to understanding better, and working better, with the countries in this region,” he said. “Those who believe that there is a terrorist, extremist Al Qaeda problem in parts of North Africa, but that it is a problem for those places and we can somehow back off and ignore it, are profoundly wrong. That is a problem for those places, and for us.”

Mr. Cameron noted that Britain had been “the first country in the world” to offer France military assistance in its campaign in Mali, deploying one of the largest military transport aircraft it has, an American-made C-17 Globemaster, to ferry French troops and military equipment to Bamako, the Malian capital. He said it was time for Britain and France to move beyond their spheres of influence in Africa dating back to the colonial era, “and recognize that is in our interest to boost the capacity of all African states” confronted by the terrorist threat.

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DealBook: Michael Dell’s Empire in a Buyout Spotlight

The computer empire of Michael S. Dell spreads across a campus of low-slung buildings in Round Rock, Tex.

But his financial empire — estimated at $16 billion — occupies the 21st floor of a dark glass skyscraper on Fifth Avenue in Manhattan.

It is there that MSD Capital, started by Mr. Dell 15 years ago to manage his fortune, has quietly built a reputation as one of the smartest investors on Wall Street. By amassing a prodigious portfolio of stocks, companies, real estate and timberland, Mr. Dell has reduced his exposure to the volatile technology sector and branched out into businesses as diverse as dentistry and landscaping.

Now, Mr. Dell is on the verge of making one of the biggest investments of his life. The 47-year-old billionaire and his private equity backers are locked in talks to acquire Dell, the company he started with $1,000 as a teenager three decades ago, in a leveraged buyout worth more than $20 billion. MSD could play a role in the Dell takeover, according to people briefed on the deal.

The private equity firm Silver Lake has been in negotiations to join with Mr. Dell on a transaction, along with other potential partners like wealthy Asian investors or foreign funds. Mr. Dell would be expected to roll his nearly 16 percent ownership of the company into the buyout, a stake valued at about $3.5 billion. He could also contribute additional personal money as part of the buyout.

That money is managed by MSD, among the more prominent so-called family offices that are set up to handle the personal investments of the wealthy. Others with large family offices include Bill Gates, whose Microsoft wealth financed the firm Cascade Investment, and New York’s mayor, Michael R. Bloomberg, who set up his firm, Willett Advisors, in 2010 to manage his personal and philanthropic assets.

“Some of these family offices are among the world’s most sophisticated investors and have the capital and talent to compete with the largest private equity firms and hedge funds,” said John P. Rompon, managing partner of McNally Capital, which helps structure private equity deals for family offices.

A spokesman for MSD declined to comment for this article. The buyout talks could still fall apart.

In 1998, Mr. Dell, then just 33 years old — and his company’s stock worth three times what it is today — decided to diversify his wealth and set up MSD. He staked the firm with $400 million of his own money, effectively starting his own personal money-management business.

To head the operation, Mr. Dell hired Glenn R. Fuhrman, a managing director at Goldman Sachs, and John C. Phelan, a principal at ESL Investments, the hedge fund run by Edward S. Lampert. He knew both men from his previous dealings with Wall Street. Mr. Fuhrman led a group at Goldman that marketed specialized investments like private equity and real estate to wealthy families like the Dells. And Mr. Dell was an early investor in Mr. Lampert’s fund.

Mr. Fuhrman and Mr. Phelan still run MSD and preside over a staff of more than 100 overseeing Mr. Dell’s billions and the assets in his family foundation. MSD investments include a stock portfolio, with positions in the apparel company PVH, owner of the Calvin Klein and Tommy Hilfiger brands, and DineEquity, the parent of IHOP and Applebee’s.

Among its real estate holdings are the Four Seasons Resort Maui in Hawaii and a stake in the New York-based developer Related Companies.

MSD also has investments in several private businesses, including ValleyCrest, which bills itself as the country’s largest landscape design company, and DentalOne Partners, a collection of dental practices.

Perhaps MSD’s most prominent deal came in 2008, in the middle of the financial crisis, when it joined a consortium that acquired the assets of the collapsed mortgage lender IndyMac Bank from the federal government for about $13.9 billion and renamed it OneWest Bank.

The OneWest purchase has been wildly successful. Steven Mnuchin, a former Goldman executive who led the OneWest deal, has said that the bank is expected to consider an initial public offering this year. An I.P.O. would generate big profits for Mr. Dell and his co-investors, according to people briefed on the deal.

Another arm of MSD makes select investments in outside hedge funds. Mr. Dell invested in the first fund raised by Silver Lake, the technology-focused private equity firm that might now become his partner in taking Dell private.
MSD’s principals have already made tidy fortunes. In 2009, Mr. Fuhrman, 47, paid $26 million for the Park Avenue apartment of the former Lehman Brothers chief executive Richard S. Fuld. Mr. Phelan, 48, and his wife, Amy, a former Dallas Cowboys cheerleader, also live in a Park Avenue co-op and built a home in Aspen, Colo.

Both are influential players on the contemporary art scene, with ARTNews magazine last year naming each of them among the world’s top 200 collectors. MSD, too, has dabbled in the visual arts. In 2010, MSD bought an archive of vintage photos from Magnum, including portraits of Marilyn Monroe and Mahatma Gandhi, and has put the collection on display at the University of Texas, Mr. Dell’s alma mater.

Just as the investment firms Rockefeller & Company (the Rockefellers, diversifying their oil fortune) and Bessemer Trust (the Phippses, using the name of the steelmaking process that formed the basis of their wealth) started out as investment vehicles for a single family, MSD has recently shown signs of morphing into a traditional money management business with clients beside Mr. Dell.

Last year, for the fourth time, an MSD affiliate raised money from outside investors when it collected about $1 billion for a stock-focused hedge fund, MSD Torchlight Partners. A 2010 fund investing in distressed European assets also manages about $1 billion. The Dell family is the anchor investor in each of the funds, according to people briefed on the investments.

MSD has largely remained below the radar, though its name emerged a decade ago in the criminal trial of the technology banker Frank Quattrone on obstruction of justice charges. Prosecutors introduced an e-mail that Mr. Fuhrman sent to Mr. Quattrone during the peak of the dot-com boom in which he pleaded for a large allotment of a popular Internet initial public offering.

“We know this is a tough one, but we wanted to ask for a little help with our Corvis allocation,” Mr. Fuhrman wrote. “We are looking forward to making you our ‘go to’ banker.”

The e-mail, which was not illegal, was meant to show the quid pro quo deals that were believed to have been struck between Mr. Quattrone and corporate chieftains like Mr. Dell — the bankers would give executives hot I.P.O.’s and the executives, in exchange, would hold out the possibility of giving business to the bankers. (Mr. Quattrone’s conviction was reversed on appeal.)

The MSD team has also shown itself to be loyal to its patron in other ways.

On the MSD Web site, in the frequently asked questions section, the firm asks and answers queries like “how many employees do you have” and “what kind of investments do you make.”

In the last question on the list, MSD asks itself, “Do you use Dell computer equipment?” The answer: “Exclusively!”

Michael J. de la Merced contributed reporting.

---

This post has been revised to reflect the following correction:

Correction: January 18, 2013

An earlier version of this article misstated when an energy hedge fund raised money from outside investors. It was in 2011, not earlier this year.

A version of this article appeared in print on 01/18/2013, on page B1 of the NewYork edition with the headline: Michael Dell’s Empire In a Buyout Spotlight.

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DealBook: Michael Dell’s Empire in a Buyout Spotlight

The computer empire of Michael S. Dell spreads across a campus of low-slung buildings in Round Rock, Tex.

But his financial empire — estimated at $16 billion — occupies the 21st floor of a dark glass skyscraper on Fifth Avenue in Manhattan.

It is there that MSD Capital, started by Mr. Dell 15 years ago to manage his fortune, has quietly built a reputation as one of the smartest investors on Wall Street. By amassing a prodigious portfolio of stocks, companies, real estate and timberland, Mr. Dell has reduced his exposure to the volatile technology sector and branched out into businesses as diverse as dentistry and landscaping.

Now, Mr. Dell is on the verge of making one of the biggest investments of his life. The 47-year-old billionaire and his private equity backers are locked in talks to acquire Dell, the company he started with $1,000 as a teenager three decades ago, in a leveraged buyout worth more than $20 billion. MSD could play a role in the Dell takeover, according to people briefed on the deal.

The private equity firm Silver Lake has been in negotiations to join with Mr. Dell on a transaction, along with other potential partners like wealthy Asian investors or foreign funds. Mr. Dell would be expected to roll his nearly 16 percent ownership of the company into the buyout, a stake valued at about $3.5 billion. He could also contribute additional personal money as part of the buyout.

That money is managed by MSD, among the more prominent so-called family offices that are set up to handle the personal investments of the wealthy. Others with large family offices include Bill Gates, whose Microsoft wealth financed the firm Cascade Investment, and New York’s mayor, Michael R. Bloomberg, who set up his firm, Willett Advisors, in 2010 to manage his personal and philanthropic assets.

“Some of these family offices are among the world’s most sophisticated investors and have the capital and talent to compete with the largest private equity firms and hedge funds,” said John P. Rompon, managing partner of McNally Capital, which helps structure private equity deals for family offices.

A spokesman for MSD declined to comment for this article. The buyout talks could still fall apart.

In 1998, Mr. Dell, then just 33 years old — and his company’s stock worth three times what it is today — decided to diversify his wealth and set up MSD. He staked the firm with $400 million of his own money, effectively starting his own personal money-management business.

To head the operation, Mr. Dell hired Glenn R. Fuhrman, a managing director at Goldman Sachs, and John C. Phelan, a principal at ESL Investments, the hedge fund run by Edward S. Lampert. He knew both men from his previous dealings with Wall Street. Mr. Fuhrman led a group at Goldman that marketed specialized investments like private equity and real estate to wealthy families like the Dells. And Mr. Dell was an early investor in Mr. Lampert’s fund.

Mr. Fuhrman and Mr. Phelan still run MSD and preside over a staff of more than 100 overseeing Mr. Dell’s billions and the assets in his family foundation. MSD investments include a stock portfolio, with positions in the apparel company PVH, owner of the Calvin Klein and Tommy Hilfiger brands, and DineEquity, the parent of IHOP and Applebee’s.

Among its real estate holdings are the Four Seasons Resort Maui in Hawaii and a stake in the New York-based developer Related Companies.

MSD also has investments in several private businesses, including ValleyCrest, which bills itself as the country’s largest landscape design company, and DentalOne Partners, a collection of dental practices.

Perhaps MSD’s most prominent deal came in 2008, in the middle of the financial crisis, when it joined a consortium that acquired the assets of the collapsed mortgage lender IndyMac Bank from the federal government for about $13.9 billion and renamed it OneWest Bank.

The OneWest purchase has been wildly successful. Steven Mnuchin, a former Goldman executive who led the OneWest deal, has said that the bank is expected to consider an initial public offering this year. An I.P.O. would generate big profits for Mr. Dell and his co-investors, according to people briefed on the deal.

Another arm of MSD makes select investments in outside hedge funds. Mr. Dell invested in the first fund raised by Silver Lake, the technology-focused private equity firm that might now become his partner in taking Dell private.
MSD’s principals have already made tidy fortunes. In 2009, Mr. Fuhrman, 47, paid $26 million for the Park Avenue apartment of the former Lehman Brothers chief executive Richard S. Fuld. Mr. Phelan, 48, and his wife, Amy, a former Dallas Cowboys cheerleader, also live in a Park Avenue co-op and built a home in Aspen, Colo.

Both are influential players on the contemporary art scene, with ARTNews magazine last year naming each of them among the world’s top 200 collectors. MSD, too, has dabbled in the visual arts. In 2010, MSD bought an archive of vintage photos from Magnum, including portraits of Marilyn Monroe and Mahatma Gandhi, and has put the collection on display at the University of Texas, Mr. Dell’s alma mater.

Just as the investment firms Rockefeller & Company (the Rockefellers, diversifying their oil fortune) and Bessemer Trust (the Phippses, using the name of the steelmaking process that formed the basis of their wealth) started out as investment vehicles for a single family, MSD has recently shown signs of morphing into a traditional money management business with clients beside Mr. Dell.

Last year, for the fourth time, an MSD affiliate raised money from outside investors when it collected about $1 billion for a stock-focused hedge fund, MSD Torchlight Partners. A 2010 fund investing in distressed European assets also manages about $1 billion. The Dell family is the anchor investor in each of the funds, according to people briefed on the investments.

MSD has largely remained below the radar, though its name emerged a decade ago in the criminal trial of the technology banker Frank Quattrone on obstruction of justice charges. Prosecutors introduced an e-mail that Mr. Fuhrman sent to Mr. Quattrone during the peak of the dot-com boom in which he pleaded for a large allotment of a popular Internet initial public offering.

“We know this is a tough one, but we wanted to ask for a little help with our Corvis allocation,” Mr. Fuhrman wrote. “We are looking forward to making you our ‘go to’ banker.”

The e-mail, which was not illegal, was meant to show the quid pro quo deals that were believed to have been struck between Mr. Quattrone and corporate chieftains like Mr. Dell — the bankers would give executives hot I.P.O.’s and the executives, in exchange, would hold out the possibility of giving business to the bankers. (Mr. Quattrone’s conviction was reversed on appeal.)

The MSD team has also shown itself to be loyal to its patron in other ways.

On the MSD Web site, in the frequently asked questions section, the firm asks and answers queries like “how many employees do you have” and “what kind of investments do you make.”

In the last question on the list, MSD asks itself, “Do you use Dell computer equipment?” The answer: “Exclusively!”

---

This post has been revised to reflect the following correction:

Correction: January 18, 2013

An earlier version of this article misstated when an MSD affiliate raised money from outside investors for a hedge fund. It was last year, not earlier this year. The article also misstated which hedge fund and its focus. It was MSD Torchlight Partners, a stock-focused hedge fund, not MSD Energy Partners, an energy-focused hedge fund.

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The Neediest Cases: Medical Bills Crush Brooklyn Man’s Hope of Retiring

Andrea Mohin/The New York Times

John Concepcion and his wife, Maria, in their home in Sheepshead Bay, Brooklyn. They are awaiting even more medical bills.

Retirement was just about a year away, or so John Concepcion thought, when a sudden health crisis put his plans in doubt.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$6,865,501

Recorded Wed.:

16,711

*Total:

$6,882,212

Last year to date:

$6,118,740

*Includes $1,511,814 contributed to the Hurricane Sandy relief efforts.

“I get paralyzed, I can’t breathe,” he said of the muscle spasms he now has regularly. “It feels like something’s going to bust out of me.”

Severe abdominal pain is not the only, or even the worst, reminder of the major surgery Mr. Concepcion, 62, of Sheepshead Bay, Brooklyn, underwent in June. He and his wife of 36 years, Maria, are now faced with medical bills that are so high, Ms. Concepcion said she felt faint when she saw them.

Mr. Concepcion, who is superintendent of the apartment building where he lives, began having back pain last January that doctors first believed was the result of gallstones. In March, an endoscopy showed that tumors had grown throughout his digestive system. The tumors were not malignant, but an operation was required to remove them, and surgeons had to essentially reroute Mr. Concepcion’s entire digestive tract. They removed his gall bladder, as well as parts of his pancreas, bile ducts, intestines and stomach, he said.

The operation was a success, but then came the bills.

“I told my friend: are you aware that if you have a major operation, you’re going to lose your house?” Ms. Concepcion said.

The couple has since received doctors’ bills of more than $250,000, which does not include the cost of his seven-day stay at Beth Israel Medical Center in Manhattan. Mr. Concepcion has worked in the apartment building since 1993 and has been insured through his union.

The couple are in an anxious holding pattern as they wait to find out just what, depending on their policy’s limits, will be covered. Even with financial assistance from Beth Israel, which approved a 70 percent discount for the Concepcions on the hospital charges, the couple has no idea how the doctors’ and surgical fees will be covered.

“My son said, boy he saved your life, Dad, but look at the bill he sent to you,” Ms.  Concepcion said in reference to the surgeon’s statements. “You’ll be dead before you pay it off.”

When the Concepcions first acquired their insurance, they were in good health, but now both have serious medical issues — Ms. Concepcion, 54, has emphysema and chronic obstructive pulmonary disease, and Mr. Concepcion has diabetes. They now spend close to $800 a month on prescriptions.

Mr. Concepcion, the family’s primary wage earner, makes $866 a week at his job. The couple had planned for Mr. Concepcion to retire sometime this year, begin collecting a pension and, after getting their finances in order, leave the superintendent’s apartment, as required by the landlord, and try to find a new home. “That’s all out of the question now,” Ms. Concepcion said. Mr. Concepcion said he now planned to continue working indefinitely.

Ms. Concepcion has organized every bill and medical statement into bulging folders, and said she had spent hours on the phone trying to negotiate with providers. She is still awaiting the rest of the bills.

On one of those bills, Ms. Concepcion said, she spotted a telephone number for people seeking help with medical costs. The number was for Community Health Advocates, a health insurance consumer assistance program and a unit of Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. The society drew $2,120 from the fund so the Concepcions could pay some of their medical bills, and the health advocates helped them obtain the discount from the hospital.

Neither one knows what the next step will be, however, and the stress has been eating at them.

“How do we get out of this?” Mr. Concepcion asked. “There is no way out. Here I am trying to save to retire. They’re going to put me in the street.”

Read More..

The Neediest Cases: Medical Bills Crush Brooklyn Man’s Hope of Retiring

Andrea Mohin/The New York Times

John Concepcion and his wife, Maria, in their home in Sheepshead Bay, Brooklyn. They are awaiting even more medical bills.

Retirement was just about a year away, or so John Concepcion thought, when a sudden health crisis put his plans in doubt.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$6,865,501

Recorded Wed.:

16,711

*Total:

$6,882,212

Last year to date:

$6,118,740

*Includes $1,511,814 contributed to the Hurricane Sandy relief efforts.

“I get paralyzed, I can’t breathe,” he said of the muscle spasms he now has regularly. “It feels like something’s going to bust out of me.”

Severe abdominal pain is not the only, or even the worst, reminder of the major surgery Mr. Concepcion, 62, of Sheepshead Bay, Brooklyn, underwent in June. He and his wife of 36 years, Maria, are now faced with medical bills that are so high, Ms. Concepcion said she felt faint when she saw them.

Mr. Concepcion, who is superintendent of the apartment building where he lives, began having back pain last January that doctors first believed was the result of gallstones. In March, an endoscopy showed that tumors had grown throughout his digestive system. The tumors were not malignant, but an operation was required to remove them, and surgeons had to essentially reroute Mr. Concepcion’s entire digestive tract. They removed his gall bladder, as well as parts of his pancreas, bile ducts, intestines and stomach, he said.

The operation was a success, but then came the bills.

“I told my friend: are you aware that if you have a major operation, you’re going to lose your house?” Ms. Concepcion said.

The couple has since received doctors’ bills of more than $250,000, which does not include the cost of his seven-day stay at Beth Israel Medical Center in Manhattan. Mr. Concepcion has worked in the apartment building since 1993 and has been insured through his union.

The couple are in an anxious holding pattern as they wait to find out just what, depending on their policy’s limits, will be covered. Even with financial assistance from Beth Israel, which approved a 70 percent discount for the Concepcions on the hospital charges, the couple has no idea how the doctors’ and surgical fees will be covered.

“My son said, boy he saved your life, Dad, but look at the bill he sent to you,” Ms.  Concepcion said in reference to the surgeon’s statements. “You’ll be dead before you pay it off.”

When the Concepcions first acquired their insurance, they were in good health, but now both have serious medical issues — Ms. Concepcion, 54, has emphysema and chronic obstructive pulmonary disease, and Mr. Concepcion has diabetes. They now spend close to $800 a month on prescriptions.

Mr. Concepcion, the family’s primary wage earner, makes $866 a week at his job. The couple had planned for Mr. Concepcion to retire sometime this year, begin collecting a pension and, after getting their finances in order, leave the superintendent’s apartment, as required by the landlord, and try to find a new home. “That’s all out of the question now,” Ms. Concepcion said. Mr. Concepcion said he now planned to continue working indefinitely.

Ms. Concepcion has organized every bill and medical statement into bulging folders, and said she had spent hours on the phone trying to negotiate with providers. She is still awaiting the rest of the bills.

On one of those bills, Ms. Concepcion said, she spotted a telephone number for people seeking help with medical costs. The number was for Community Health Advocates, a health insurance consumer assistance program and a unit of Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. The society drew $2,120 from the fund so the Concepcions could pay some of their medical bills, and the health advocates helped them obtain the discount from the hospital.

Neither one knows what the next step will be, however, and the stress has been eating at them.

“How do we get out of this?” Mr. Concepcion asked. “There is no way out. Here I am trying to save to retire. They’re going to put me in the street.”

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IHT Rendezvous: Jihadist Kingpin Suspected in Hostage Seizure

LONDON — Mokhtar Belmokhtar, the one-eyed smuggler-jihadist said to be behind the seizure of foreign hostages at a gas plant in Algeria, has been a notorious kingpin of the Sahara for more than a decade.

As a successful kidnapper, cigarette smuggler — he is nicknamed “Mr. Marlboro” — and go-between for Al Qaeda, Mr. Belmokhtar has been a wanted man in his native Algeria after returning from training with jihadists in Afghanistan in 1993.

He returned at the height of a bloody decade-long civil war between the Algerian government and Islamist insurgents, acting as a channel between Al Qaeda leaders and local jihadist groups.

Raising money through kidnappings and smuggling, he has been a main supplier of weapons and equipment to insurgent groups and “has become increasingly integrated into the fabric of the Sahara and Sahel,” according to a 2009 Jamestown Foundation study that was based in part on Mr. Belmokhtar’s own account.

His activities led to him being included in a United Nations blacklist of wanted Qaeda associates.

Security agencies in Algeria and beyond might know who “Mr. Marlboro” is. But what is his motive in the operation to seize Western hostages?

In the past, he has staged kidnappings for money, negotiating the freedom of his captives in exchange for millions of dollars in ransom.

This time, the group he leads has linked the operation to events in Mali, where the French military has intervened to prevent an advance by Islamist forces that control the north of the country.

Mr. Belmokhtar, 40, is thought to be based in Mali in the rebel-held town of Gao, which has been attacked by French warplanes. Some believe he is masterminding the hostage operation from there.

The hostage-takers have demanded an end to the intervention and a reversal of Algeria’s decision to allow the French military to fly over its territory on the way to Mali.

Mr. Belmokhtar might also be seeking to reassert his role as a central player in the factionalized Islamist politics of the region after a recent move by the local Qaeda affiliate to push him aside.

He was removed from a military leadership role in Al Qaeda in the Islamic Maghreb in October, according to French broadcaster RFI, after falling out with the movement’s leaders.

He then announced the creation of his own brigade as part of a rapprochement with Mujao, a jihadist group that has broken with Al Qaeda.

He is also thought to be close to leaders of Mali’s Tuareg tribesmen, possibly through one of his many marriages. The Tuareg’s seizure of northern Mali last year was rapidly taken over by jihadists.

It is as yet unclear whether the Algerian hostage-taking was a rapid response to the French intervention in Mali or whether it was preplanned for other motives.

Mr. Belmokhtar, condemned in his absence to life imprisonment by Algerian courts, was already scheduled to be tried in absentia by the Algiers criminal tribunal next Monday on charges that include supplying weapons for attacks on Algerian soil.

Planned targets were said to include pipelines and oil company installations in southern Mali.

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Bits Blog: Facebook's Other Big Disruption

Facebook just made a potentially game-changing announcement. It got less fanfare than Tuesday’s announcement that it is going into the social search business, but this other announcement may have bigger long-term implications for the technology industry.

Put simply, some of the world’s biggest computing systems just got a little cheaper, and a lot easier to configure. As a consequence, the companies that supply the hardware to these systems may have to scramble to remain as profitable. The reason is a Facebook-led open source project.

In 2011 Facebook began the Open Compute Project, an effort among technology companies to use open-source computer hardware. Tech companies similarly shared intellectual property with Linux software, which lowered costs and spurred innovation. Facebook’s project has attracted many significant participants, including Goldman Sachs, Arista Networks, Rackspace, Hewlett-Packard and Dell.

At a user summit on Wednesday Intel, another key member of the Open Compute Project, announced it would release to the group a silicon-based optical system that enables the data and computing elements in a rack of computer servers to communicate at 100 gigabits a second. That is significantly faster than conventional wire-based methods, and uses about half the power.

More important, it means that elements of memory and processing that now must be fixed closely together can be separated within a rack, and used as needed for different kinds of tasks. There is a lot of waste in data centers today simply because, when there is an upgrade in servers, lots of other associated data-processing hardware has to be changed, too.

There were other announcements, like a computer motherboard called Grouphug that allows different manufacturers’ chips to be interchanged without altering other parts of the machine. Before, they were custom made. Put together, such innovations potentially lower the cost and complexity of running big and small data centers to an extent that works for a lot of companies.

“Who wouldn’t want a cheaper, more efficient server?” said Frank Frankovsky, vice president of hardware design at Facebook, and the chairman of Open Compute. “The problem we’re solving is much larger than Facebook’s own challenges. There is a massive amount of data in the world that people expect to have processed quickly.”

To be sure, it’s in Facebook’s interest to attack expensive hardware. The company makes money from a service that requires hundreds of thousands of computer servers distributed in big centers around the world. Google and Amazon.com, which are not members of the project, maintain proprietary systems which they apparently felt gave them a competitive edge.

For Facebook, the difference seems to be more in the software. To the extent hardware costs drop, that’s great for them. Mr. Frankovsky argued that, while “this puts challenges on the incumbents” in hardware, “it also helps them. They have a finite number of engineering resources, and this way they hear from a community about whether there is an interest for a product.” Intel may hope to benefit from its open-source release, since it could see an overall rise in demand for its chips with the move toward cheaper computing.

The real test is whether Facebook can increase the number of potential buyers for Open Compute equipment. “The question is, can they extend this beyond a few Web businesses like Facebook and Rackspace, or a few financial exercises at Goldman, and bring this to industries like oil or aerospace?” said Matt Eastwood, an analyst with IDC, a technology research firm. “That will take it from 20 or 30 companies to hundreds of companies.”

The issue isn’t so much a technical one, he argues, as it is one of getting corporate information technology professionals interested in radical design changes. Mr. Frankovsky is aware of the problem. Recently he and his colleagues led a seminar in Texas for BP, Shell and other oil giants on how they could use Open Compute hardware in their data centers.

This will not change things dramatically this year, and possibly even next, but over the long haul it could remake a lot of businesses. Linux, remember, was around for several years as a minor player, but eventually undid Sun Microsystems and others.

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