Clinton suffers clot behind right ear, full recovery seen

1 of 2. U.S. Secretary of State Hillary Clinton delivers a speech ''Frontlines and Frontiers: Making Human Rights a Human Reality'' at Dublin City University in Ireland in this file photo from December 6, 2012.

Credit: Reuters/Kevin Lamarque

By Arshad Mohammed and Jilian Mincer

WASHINGTON/NEW YORK | Mon Dec 31, 2012 8:39pm EST

WASHINGTON/NEW YORK (Reuters) - U.S. Secretary of State Hillary Clinton suffered a blood clot in a vein between her brain and skull behind her right ear but is expected to make a full recovery, her doctors said on Monday in a statement released by the State Department.

Clinton did not suffer a stroke or neurological damage as a result of the clot, the doctors said, adding that "she is in good spirits, engaging with her doctors, her family and her staff."

The U.S. secretary of state, who has not been seen in public since December 7, was revealed on Sunday evening to be in a New York hospital under treatment for a blood clot that stemmed from a concussion she suffered in mid-December.

The concussion was itself the result of an earlier illness, described by the State Department as a stomach virus she had picked up during a trip to Europe that led to dehydration and a fainting spell after she returned to the United States.

"In the course of a routine follow-up MRI on Sunday, the scan revealed that a right transverse sinus venous thrombosis had formed. This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear," Clinton's doctors, Drs. Lisa Bardack and Gigi El-Bayoumi said in the statement released by the State Department.

"To help dissolve this clot, her medical team began treating the Secretary with blood thinners. She will be released once the medication dose has been established," the doctors said. "In all other aspects of her recovery, the Secretary is making excellent progress and we are confident she will make a full recovery."

MAY RAISE QUESTIONS ABOUT ANY WHITE HOUSE RUN

Clinton's illness may raise questions about her fitness to be president should she make a new run for the White House in 2016. Barack Obama defeated her in the 2008 Democratic primary and then, upon his election as president, took the unusual step of tapping her for the most important post in his Cabinet.

Clinton earlier this month played down the notion that she would run again for the White House in 2016, telling a TV interviewer: "I've said I really don't believe that that's something I will do again. I am so grateful I had the experience of doing it before.

The former first lady turned U.S. senator from New York turned diplomat has played down talk of possibly making another White House run. She is expected to step down when her replacement as secretary of state, Senator John Kerry, is confirmed by the Senate.

Clinton has kept up a punishing schedule as the top U.S. diplomat, flying more than 950,000 miles to visit 112 countries and spending more than a quarter of her tenure - 401 days - on the road, according to the State Department.

Her health setbacks have forced her to cancel an overseas trip and postpone testimony to Congress regarding a report on the deadly attack on the U.S. diplomatic post in Benghazi, Libya. Her two deputies testified instead.

Clinton has said she intends to appear before Congress to discuss the attack - in which four Americans, including the U.S. ambassador to Libya, died - but it is unclear when she will be back at work.

The doctors gave no estimate of when she may go home from the hospital.

On Sunday, a State Department spokesman said Clinton was "being treated with anti-coagulants and is at New York-Presbyterian Hospital so that they can monitor the medication over the next 48 hours."

'PIPES' DRAIN BLOOD FROM THE BRAIN

Clinton's condition is unusual, but by no means unheard-of.

"This condition is not very common, but it certainly happens," said Dr. Raj Narayan, chair of neurosurgery at North Shore University Hospital and Long Island Jewish Medical Center in New York. It probably happens more often than we realize, he said, because it must be diagnosed with an MRI, as Clinton's was.

Narayan, who is not treating Clinton, said it likely was caused by her dehydration and the concussion that occurred from her fall. Head trauma can cause blood clots, Narayan said, because the injury triggers the production of thromboplastin, a blood protein that causes the blood to clot.

The severity depends in part on how someone is built, he said.

People normally have two of the veins where Clinton suffered the clot. Some people, however, have only one, while others have two but one is much larger than the other. The prognosis is typically better if you have two normal veins because the blood could flow through the other vein if one is blocked.

"Think of it as two pipes draining all of the blood out of the brain," Narayan said. "If one is blocked and the other is open, there is no problem. But if both pipes are blocked, you are in trouble."

Dr. Geoffrey Manley, chief of neurosurgery at San Francisco General Hospital and professor of neurosurgery at the University of California San Francisco (UCSF), said the condition can be fatal if not treated but that most patients recover well.

"Left untreated, these things could be fatal. But typically, injuries to the transverse sinus, if treated appropriately, patients typically do very well," Manley said.

Manley, who is also not involved in Clinton's treatment, said it was quite possible she would be out of the hospital in a week or less and the condition was not likely to have long-term effects or to be the harbinger of more clots over time.

"One doesn't necessarily dictate another one," he said.

"This is ultimately not going to cause any long-term brain problems for her, and I think that it's a message to the public that when you fall and hit your head, you need to be evaluated by somebody that takes care of brain-injured patients," he added.

(Additional reporting by Dhanya Skariachan and by Warren Strobel; editing by Todd Eastham)

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State Department made "grievous mistake" over Benghazi: Senate report

The U.S. Consulate in Benghazi is seen in flames during a protest by an armed group said to have been protesting a film being produced in the United States September 11, 2012.

Credit: Reuters/Esam Al-Fetori

By Tabassum Zakaria and Mark Hosenball

WASHINGTON | Mon Dec 31, 2012 1:24pm EST

WASHINGTON (Reuters) - The State Department made a "grievous mistake" in keeping the U.S. mission in Benghazi open despite inadequate security and increasingly alarming threat assessments in the weeks before a deadly attack by militants, a Senate committee said on Monday.

A report from the Senate Homeland Security Committee on the September 11 attacks on the U.S. mission and a nearby CIA annex, in which the U.S. ambassador to Libya and three other Americans died, faulted intelligence agencies for not focusing tightly enough on Libyan extremists.

It also faulted the State Department for waiting for specific warnings instead of improving security.

The committee's assessment, "Flashing Red: A Special Report On The Terrorist Attack At Benghazi," follows a scathing report by an independent State Department accountability review board that resulted in a top security official resigning and three others at the department being relieved of their duties.

Joseph Lieberman, an independent senator who chairs the committee, said that in thousands of documents it reviewed, there was no indication that Secretary of State Hillary Clinton had personally denied a request for extra funding or security for the Benghazi mission. He said key decisions were made by "midlevel managers" who have since been held accountable.

Republican Senator Susan Collins said it was likely that others needed to be held accountable, but that decision was best made by the Secretary of State, who has the best understanding "of how far up the chain of command the request for additional security went."

The attacks and the death of U.S. Ambassador Christopher Stevens put diplomatic security practices at posts in risky areas under scrutiny and raised questions about whether intelligence on militant activity in the region was adequate.

The Senate report said the lack of specific intelligence of an imminent threat in Benghazi "may reflect a failure" by intelligence agencies to focus closely enough on militant groups with weak or no operational ties to al Qaeda and its affiliates.

"With Osama bin Laden dead and core al Qaeda weakened, a new collection of violent Islamist extremist organizations and cells have emerged in the last two to three years," the report said. That trend has been seen in the "Arab Spring" countries undergoing political transition or military conflict, it said.

NEED FOR BETTER INTELLIGENCE

The report recommended that U.S. intelligence agencies "broaden and deepen their focus in Libya and beyond, on nascent violent Islamist extremist groups in the region that lack strong operational ties to core al Qaeda or its main affiliate groups."

Neither the Senate report nor the unclassified accountability review board report pinned blame for the Benghazi attack on a specific militant group. The FBI is investigating who was behind the assaults.

President Barack Obama, in an interview on NBC's "Meet the Press" on Sunday, said the United States had "very good leads" about who carried out the attacks. He did not provide details.

The Senate committee said the State Department should not have waited for specific warnings before acting on improving security in Benghazi.

It also said it was widely known that the post-revolution Libyan government was "incapable of performing its duty to protect U.S. diplomatic facilities and personnel," but the State Department failed to fill the security gap.

"Despite the inability of the Libyan government to fulfill its duties to secure the facility, the increasingly dangerous threat assessments, and a particularly vulnerable facility, the Department of State officials did not conclude the facility in Benghazi should be closed or temporarily shut down," the report said. "That was a grievous mistake."

The Senate panel reviewed changing comments made by the Obama administration after the attack, which led to a political firestorm in the run-up to the November presidential election and resulted in U.S. Ambassador to the United Nations Susan Rice withdrawing her name from consideration to replace Clinton, who is stepping down early next year.

Rice had said her initial comments that the attack grew out of a spontaneous protest over an anti-Islam film were based on talking points provided by intelligence agencies.

Lieberman said it was not the job of intelligence agencies to formulate unclassified talking points and they should decline such requests in the future.

The report said the original talking points included a line saying "we know" that individuals associated with al Qaeda or its affiliates participated in the attacks. But the final version had been changed to say: "There are indications that extremists participated," and the reference to al Qaeda and its affiliates was deleted.

The report said that while James Clapper, the director of national intelligence, had offered to provide the committee with a detailed chronology of how the talking points were written and evolved, this had still not been delivered to Capitol Hill because the administration had spent weeks "debating internally" whether or not it should turn over information considered "deliberative" to Congress.

(Editing by Warren Strobel and David Brunnstrom)

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Senate confirms Galante as FHA chief despite losses

By David Lawder

WASHINGTON | Sun Dec 30, 2012 5:02pm EST

WASHINGTON (Reuters) - The Senate on Sunday confirmed the head of the Federal Housing Administration in her position despite mounting losses the mortgage funding agency that some fear could eventually lead to a taxpayer bailout.

In a 69-24 vote, the Senate confirmed Carol Galante as an assistant secretary of the Department of Housing and Urban Development. Galante, a former affordable housing developer in San Francisco, had been running the FHA in an acting capacity since July 2011.

The FHA, a key source of mortgage funding for first-time home buyers and those with modest incomes, backs $1.1 trillion in U.S. home mortgages. Last month it reported a projected shortfall of $16.3 billion due to souring loans that it insured during the housing market downturn during the past several years.

An independent audit suggested that the FHA would require taxpayer funding for the first time in its 78 years, though that won't be decided until February when the Obama administration releases its next budget proposal.

In response to the shortfall, the agency raised the premiums it charges on guaranteed loans by one-tenth of a percentage point, adding, on average, about $13 to a borrower's monthly mortgage payment.

Senator Tim Johnson, the Democrat who heads the Senate Banking Committee, said Galante was "highly qualified" and attributed the FHA's problems to legacy loans that were still threatening the agency's finances.

"It is important that the FHA have a confirmed management team in place to continue oversight of these legacy loans," Johnson said prior to the vote.

Following the collapse of the private subprime mortgage market during the 2007-2009 financial crisis, FHA-backed loans took over as the sole financing source for nearly all of the lower end of the U.S. housing market, which has continued to struggle.

The deteriorated finances had caused some Senate Republicans not to support Galante, who prior to her current position ran multifamily housing programs for HUD.

She joined the agency in 2009 after serving as president of Bridge Housing Corp, the largest non-profit developer of affordable housing in California.

But Republican Senator Bob Corker, who had been one of her biggest critics, publicly dropped his opposition to her confirmation after she sent him a letter pledging to take certain steps to improve the agency's finances, including tightening lending standards for buyers with lower credit scores and limiting the amount of money that could be borrowed in the FHA's reverse-mortgage program.

(Additional reporting by Margaret Chadbourn; Editing by Eric Walsh)

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Senate approves Baer to head Justice Department's antitrust team

WASHINGTON | Sun Dec 30, 2012 9:13pm EST

WASHINGTON (Reuters) - The U.S. Senate on Sunday approved prominent antitrust attorney William Baer to head the Justice Department's Antitrust Division 10 months after he was tapped by President Barack Obama.

The Senate voted 64-26 to approve Baer's nomination, which ran into problems with some Republicans because of secret information in an FBI background report.

Baer, an antitrust and white collar criminal defense attorney with the law firm Arnold & Porter LLP, has worked in the past for the U.S. Federal Trade Commission (FTC).

"Bill is a highly-skilled and well-respected antitrust lawyer who understands the importance of promoting competition in order for consumers to reap the benefits of lower prices and better quality products and services," Attorney General Eric Holder said in a statement welcoming the Senate vote.

The Justice Department's Antitrust Division, along with the FTC, reviews mergers to ensure they comply with antitrust law and prosecutes price-fixing and other antitrust violations.

Baer first joined FTC as a young attorney just out of law school and returned later to head its antitrust office.

At his confirmation hearing in July, Baer urged careful monitoring of powerful companies willing to flex their muscles to push aside rivals.

Obama nominated Baer in February to fill the post vacated by Christine Varney in mid-2011. James Wayland most recently served as acting head of the Antitrust Division, but left in November.

The Senate Judiciary Committee approved the nomination in September on a 12-5 vote, with the panel's top Republican, Mike Lee of Utah, joining the Democratic majority in support.

But Senator Charles Grassley, an Iowa Republican, said during that meeting he opposed Baer's nomination for reasons that he could not give in an open session.

Grassley and 25 other Republicans voted against Baer on Sunday while 14 Republicans voted for him.

(Reporting By Doug Palmer; Editing by Eric Walsh)

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Hours from "fiscal cliff," Washington still awaits deal

1 of 15. A man walks past the U.S. Capitol Building in Washington December 17, 2012.

Credit: Reuters/Joshua Roberts

By Fred Barbash

WASHINGTON | Mon Dec 31, 2012 1:27am EST

WASHINGTON (Reuters) - The U.S. Congress comes back on Monday without a deal to avert the "fiscal cliff" and only a few hours of actual legislative time scheduled in which to act if an agreement materializes.

Negotiations involving Vice President Joe Biden and Senate Republican leader Mitch McConnell appeared to offer the last hope for avoiding the across-the-board tax increases and draconian cuts in the federal budget that will be triggered at the start of the New Year because of a deficit-reduction law enacted in August, 2011.

A jolt from the financial markets could also prod the parties, as it has occasionally in the past.

"I believe investors will show their displeasure" at the lack of progress in Washington, said Mohannad Aama, managing director at Beam Capital Management, an investment advisory firm in New York.

Democratic and Republican leaders in the Senate had hoped to clear the way for swift action on Sunday. But with the two sides still at loggerheads in talks, Senate Democratic leader Harry Reid postponed any possible votes and the Senate adjourned until Monday.

The main sticking point between Republicans and Democrats remained whether to extend existing tax rates for everyone, as Republicans want, or just for those earning below $250,000 to $400,000, as Democrats have proposed.

Also at issue were Republican demands for larger cuts in spending than those offered by President Barack Obama.

Hopes for a "grand bargain" of deficit-reduction measures vanished weeks ago as talks stalled.

While Congress has the capacity to move swiftly when motivated, the leaders of the U.S. House of Representatives and the Senate have left themselves little time for what could be a complicated day of procedural maneuvering in the event of an agreement.

House Speaker John Boehner has insisted that the Senate act first, but that chamber does not begin legislative business until about noon Monday.

OTHER BUSINESS ALSO ON AGENDA

And the cliff is not the only business on the House agenda. Farm-state lawmakers are seeking a one-year extension of the expiring U.S. farm law to head off a possible doubling of retail milk prices to $7 or more a gallon in early 2013.

Relief for victims of Superstorm Sandy is waiting in line in the House as well, though it could still consider a Senate bill on assistance for the storm until January 2, the last day of the Congress that was elected in November 2010.

Expiring along with low tax rates at midnight Monday are a raft of other tax measures effecting tens of millions of Americans.

A payroll tax holiday Americans have enjoyed for two years looks like the most certain casualty as neither Republicans or Democrats have shown much interest in continuing it, in part because the tax funds the Social Security retirement program.

The current 4.2 percent payroll tax rate paid by about 160 million workers will revert to the previous 6.2 percent rate after December 31, and will be the most immediate hit to taxpayers.

A "patch" for the Alternative Minimum Tax that would prevent millions of middle-class Americans from being taxed as if they were rich, could go over the cliff as well. Both Republicans and Democrats support doing another patch, but have not approved one.

At best, the Internal Revenue Service has warned that as many as 100 million taxpayers could face refund delays without an AMT fix. At worst, they could face higher taxes unless Congress comes back with a retroactive fix.

After Tuesday, Congress could move for retroactive relief on any or all of the tax and spending issues. But that would require compromises that Republicans and Democrats have been unwilling to make so far.

Obama said on Sunday he plans on pushing legislation as soon as January 4 to reverse the tax hikes for all but the wealthy.

(Editing by Christopher Wilson)

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Immigration, economic revival head Obama's second-term checklist

U.S. President Barack Obama gestures while addressing his first news conference since his reelection, at the White House in Washington November 14, 2012.

Credit: Reuters/Larry Downing

By Mark Felsenthal

WASHINGTON | Sun Dec 30, 2012 4:30pm EST

WASHINGTON (Reuters) - President Barack Obama is pledging to focus in his second term on immigration reform, boosting economic growth through infrastructure repair and energy policies that nod to environmental protection.

The president is mired in a difficult fight with congressional Republicans to avoid sharp spending cuts and steep tax increases collectively referred to as the "fiscal cliff." However, he still has a longer-term to-do list for his remaining four years in office, he said in an interview on NBC's "Meet the Press" that was broadcast on Sunday.

Obama, who won re-election in November after a campaign in which he succeeded in painting himself as a strong advocate for the middle class and those aspiring to join it, also promised in the interview to make a run at passing gun control legislation in the first year of his second term.

"Fixing our broken immigration system is a top priority," he said. He renewed a pledge to introduce legislation in the first year of his second term to get it done.

Immigration reform is a sensitive subject for the president, who failed to fulfill his promise to revamp the system during his first term. Latino voters were a critical part of the coalition that helped get him re-elected, a fact that may soften political opposition from Republicans, who are eager to bolster their support with that demographic group.

Immigration reform supporters on the left believe that the 11 million undocumented foreigners in the United States should be allowed a path to work toward citizenship. But opponents believe that this approach would reward people who broke the law by coming to the United States illegally.

Republicans have sought stronger measures to keep illegal immigrants from entering the United States from Mexico. Advocates on both sides of the debate want to more effectively verify legal workers in an economy in which businesses want to hire non-U.S. workers ranging from low-paid farm hands to technology-savvy professionals.

While negotiations to avoid the fiscal cliff have hogged the spotlight in the first weeks after the election, Obama said he wants to take steps to ensure the sluggish recovery gains steam.

Many observers had believed a persistently high level of unemployment would thwart Obama's chances of winning a second term. The U.S. jobless rate peaked at 10 percent in 2009 after the harshest recession since the Great Depression but has been falling and dipped to 7.7 percent in November.

The president said rebuilding crumbling roads, bridges and schools could put people back to work and put the economy on a sounder footing. He said he would pair those steps - which would likely involve government spending - with deficit reduction measures to tame the nation's budget deficit.

The president also said energy policy would be a leading emphasis. He said he would focus on how the country can produce more energy and export energy, while also dealing with environmental challenges. He did not specify how he would do that. The president's effort to fight climate change with a broad emissions trading system failed during his first term.

When pressed, Obama added gun control to his list of priorities, reiterating his support for a ban on assault rifles and high capacity clips, as well as background checks.

(Reporting By Mark Felsenthal; Editing by Cynthia Osterman)

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Senate, House agriculture committees in deal to avert milk price spike

By Jim Wolf

WASHINGTON | Sun Dec 30, 2012 10:19pm EST

WASHINGTON (Reuters) - Farm-state lawmakers have agreed to a one-year extension of the expiring U.S. farm law that, if enacted, would head off a possible doubling of retail milk prices to $7 or more a gallon in early 2013.

The extension would end a 32-month attempt to update farm subsidies dating from the Depression era, when farmers were crushed by low prices and huge crop surpluses, to meet today's high-wire challenges of tight food supplies, high operating costs and volatile markets.

House Agriculture Committee Chairman Frank Lucas, an Oklahoma Republican, said on Sunday he hoped the legislation would be passed by Congress and signed by President Barack Obama by Tuesday to avoid higher prices for milk in grocery stores.

The bill was listed among measures that could be called for a vote on Monday in the House of Representatives although action was not guaranteed.

Despite consensus on the need to extend the farm bill, lawmakers continue to discuss how long the extension should be.

Representative Tom Cole, an Oklahoma Republican, told reporters late on Sunday a nine-month farm bill extension was being considered as part of deal being crafted in the Senate to stave off the "fiscal cliff" of automatic tax hikes and spending cuts that begin kicking in on January 1.

"There's good chance that if there is a package out of the Senate, it will include something on the farm bill. The easiest thing to get done would be nine months of current law," Cole said.

A second Republican, Representative Steven LaTourette, said a nine-month extension could be part of the fiscal cliff package or could move separately if the fiscal talks fail.

House Republican leaders refused to call a vote during the fall on a full-scale, $500 billion farm bill on grounds it might fail because it did not cut spending enough.

Grain, soybean and cotton growers would get another round of the $5 billion "direct payment" subsidy that all sides agreed to kill in a new farm bill. The payments are made regardless of need. Reformers say the payments are unjustified when crop prices and farm income are at near-record levels.

DISASTER MONEY AND A NEW DAIRY PROGRAM

Also in the extension, lawmakers would revive agricultural disaster-relief programs that ran out of money a year ago and create a new dairy subsidy program. It would compensate dairy farmers whenever milk prices are low and feed prices are high. The so-called margin protection program would require farmers to limit production to avert a long run of low dairy prices.

Traditionally, the dairy program sets a minimum price for milk through government purchase of butter, cheese and dry milk. If Congress does not act, the dairy support price will revert on Tuesday to the level dictated by an outmoded 1949 law and which is roughly double the price now paid to farmers.

The potential retail milk price has been estimated at $6 to $8 a gallon versus current levels near $3.50.

Agriculture Secretary Tom Vilsack, during an interview broadcast by CNN, said higher milk prices - if it comes to that - would ripple throughout all commodities "if this thing goes on for an extended period of time."

Senator Debbie Stabenow, chairwoman of the Senate Agriculture Committee, said the "responsible short-term farm bill extension ... not only stops milk prices from spiking, but also prevents eventual damage to our entire agriculture economy."

TWO FALLBACKS IF EXTENSION FALTERS

House Republican leaders readied two alternatives, if needed, to the one-year extension. One was a one-month extension of the now-expired 2008 farm law without disaster funds or the new dairy program and the other was a one-month suspension of the dairy provisions of the 1949 law.

It was not clear which bill would be called for debate, a farm lobbyist said on Sunday. A small-farm activist said any package passed by Congress must include rural economic development funds and money for soil conservation on "working lands," the largest of USDA's conservation programs.

"If a new farm bill doesn't pass this Congress, we'll soon hold another mark-up and just keep working until one is enacted next year," said Stabenow, a Michigan Democrat.

It would be the first time on record that Congress began drafting a farm bill during a two-year session and had to carry it into the following session, congressional researchers said. Hearings on the new farm bill began April 21, 2010.

HOUSE, SENATE DISPUTE ON BIG CUTS

While dairy producers generally support the so-called margin-protection program as the answer to high feed costs, processors and foodmakers oppose it. They say it is wrong-minded in its premise of curtailing production when prices are low, and it will destroy a healthy export market for dairy products.

The rejuvenated disaster programs would cover losses from this year's widespread drought, especially for livestock producers, although tree farmers, honey bees and farm-raised fish are also covered. Maximum payment would be $100,000.

Senators passed a farm bill in June estimated to save $23 billion over 10 years, with most of the cuts in crop subsidies and conservation programs. The House Agriculture Committee approved a bill with $35 billion in cuts in July, half of it in food stamps for the poor - the biggest cut in food stamps in a generation.

Fiscally conservative House Republicans have called for larger cuts in farm subsidies and food stamps while some House Democrats opposed any food stamp cuts.

(Additional reporting by Charles Abbott, David Lawder and Richard Cowan; Editing by Ros Krasny, Maureen Bavdek, Jan Paschal and Eric Walsh)

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