By Jenny Hontz     

      The IRS has ruled that a woman medically incapable of breast-feeding after a double mastectomy may not set aside the cost of infant formula as a pretax medical expense, NEWSWEEK has learned exclusively.

      “To explicitly deny women this deduction is a shameful interpretation of their regulations, especially when they’re interpreting them to accommodate footpads and condoms and Viagra,” says Dan Harrison, 39, of Los Angeles, who asked for the IRS to rule on the issue. “I think women should be pissed off.”

      Harrison’s wife, Libby, 39, had both breasts surgically removed in 2006, two years before the birth of her second daughter, Hannah. While Libby breast-fed her first child, she had no choice but to purchase infant formula for Hannah, which cost about $1,000 over the course of a year.

       Dan Harrison, an executive at NBC Universal, was looking through a list of approved medical expenses under his flexible spending account provided by Ceridian, the company that manages his employee benefits. Flexible spending accounts allow taxpayers to set aside up to $5,000 per year as pretax income for medical expenses not covered by insurance.

       Dr. Scholl’s footpads, sunscreen, birth control, and prescription sunglasses all qualify as medical care for the “diagnosis, cure, mitigation, treatment or prevention of disease,” according to the IRS. People with hearing impairments are allowed to include the cost of equipment to help them watch TV, and anyone who has lost a limb can count the cost of modifying a car as pretax income. Hypnosis, yoga, colon cleansing, massage, and even dancing lessons are also considered medical costs with a doctor’s note. However, infant formula for women medically unable to breast-feed because of breast cancer or HIV is nowhere on the list.

      Harrison wrote to the IRS asking for clarification, and he received a letter last September confirming his suspicions that formula under no circumstances is considered a medical expense. “Food, including infant formula, that satisfies your nutritional requirements is a personal expenditure,” the letter said.  Harrison saw a double standard at work. Breast-milk supplements are considered a medical expense with a doctor’s note, as are breast pumps and hot and cold packs to ease breast-feeding pain. Patients allergic to wheat may also count as a medical expense the difference between the cost of wheat-free and regular foods.

      “This special food is deductible with a doctor’s certification,” Harrison says. “How is infant formula any different?”

      The IRS had never considered a case of a woman who had to purchase formula because of a double mastectomy, and Harrison believed a principle of fairness was at stake. He challenged the IRS by requesting a formal ruling and traveling to Washington to make his case last November.

      Former California governor Gray Davis, a family friend, put Harrison in touch with Rep. Henry Waxman, who wrote a letter to the IRS supporting the Harrisons. The breast-cancer survivor organization Susan G. Komen for the Cure, also urged the IRS to reconsider, and the law firm Kirkland & Ellis took the case pro bono, putting one of its top tax attorneys, Todd Maynes, on the job. Despite having such heavy hitters in his corner, the IRS ruled July 1 against the Harrisons, saying infant formula is food, and because it’s for the baby, it doesn’t mitigate the disease of the mother. The Harrisons received the decision in the mail this week.

      “It’s food for a healthy infant,” IRS branch chief Christopher Kane told Newsweek.com. “The mother is the one with the medical problem. It’s the same expense a [healthy] woman who chooses not to breast-feed incurs,” Kane said.

      That argument doesn’t sit well with Harrison. Buying infant formula was not a choice for his family. Without it, his child could not have survived.

       “There’s no doubt, if you don’t have breast tissue, you can’t breast-feed,” he says. “There is no alternate product to give the baby. It’s not like the baby can eat a granola bar and get developmental nutrition from a prescription product, which would be deductible. It’s breast milk or formula or the kid dies.”

      Harrison also takes issue with the idea that formula is merely food. “Infant formula is so highly regulated, in my mind, it’s closer to a medicine,” he sasys. “They tell you what ingredients must be in infant formula [and in what amounts]. There’s a real care that goes into the manufacture and oversight that you don’t have in the traditional food chain.”

       To Kane’s assertion that formula doesn’t mitigate the mother’s disease because it’s for her child, Harrison points out that the health of mothers and young infants is intertwined. “This has a lot of support in medical literature and even in government hospital regulations,” he says. “It is called the mother-child dyad.”

      The tax code, however, treats mothers and infants as separate people, Kane says. “We’re constrained by the law. That’s our job.”

      Harrison isn’t giving up. He’s taking his case to Congress and has a receptive ear in Rep. Debbie Wasserman Schultz (D-Fla.), herself a breast-cancer survivor. "This ruling clearly shows a lack of understanding of the medical implications of breast-cancer treatment in young women," Wasserman Schultz says.  "I am exploring options that will allow women adversely affected by this ruling to utilize the money they've set aside in their FSA accounts for what is clearly a medically necessary expense."

 

(Andy Attenburger/Corbis)

Apparently, no one in this country knows what a naked woman looks like. At least, that’s what media outlets including CBS, the New York Post, and Fox News seem to think. In reporting the story of Erin Andrews, the ESPN reporter who was surreptitiously taped au naturel in her hotel room, these outlets and others found it necessary to include stills from the tape making its way around the Internet. It probably seems incredibly naive to ask why (naked ladies increase ratings, duh), but the answer may be a little more complicated—and disturbing—than that.

Perhaps unsurprisingly, the outlets showing the most Andrews’s flesh are also the ones expressing the most shock and dismay over the tape. “It is many women’s worst nightmare,” The Early Show’s Julie Chen said, introducing the tape, which then played, with parts of Andrews’s body fuzzed out, during the rest of the segment—despite the fact that ESPN has sought to block websites from showing the tape, and threatened legal action against websites posting stills from the footage. The Post also used the term "nightmare" to describe the actions of the "creepy cameraman" who taped the "sideline siren"—and accompanied its story with three stills from the video.

Other journalists have been more straightforward about the prurient aspect of the story. In the Broward-Palm Beach New Times, blogger Bob Norman calls the video “Disgusting, repulsive, absolutely offensive, and outrageous. And I'm very happy to report that the video has been taken down from the web. I know because I looked for it. For like a half an hour.” He’s being sarcastic, but his comments echo the tone of much of the coverage of the video, and many of the comments on the stories: for someone to tape Andrews is completely sick. For someone to watch that tape is, hey, just human nature.

But really, what’s so interesting about the tape? Andrews has a nice body, but so do lots of other naked women you can find on the Internet, and in much higher-resolution pictures. In the video, she appears to be getting ready to go out: brushing her hair, looking in the mirror. It's not super-racy stuff. The quality of the video is so poor, it’s hard to tell Andrews’s identity. In fact, the tape has been online for months, and generated interest only when ESPN’s lawyers confirmed Andrews’s identity as the woman in the hotel room.

Obviously, the fact that Andrews is a celebrity has a lot to do with it. The fact that we’ve seen her face before somehow makes her body more interesting. And certainly, the fascination with naked celebrities is nothing new. Playboy understood that when it put Marilyn Monroe on the cover of its inaugural issue. But it’s doubtful Andrews would have caused such a stir had she posed for the magazine. What’s really provocative about the Andrews tape, what makes it good copy for Fox et al. is not that she’s naked, but that she thinks she’s alone.

Privacy, it seems, is the new nudity. This is why, when Jennifer Aniston poses topless for the cover of GQ no one does more than shrug, but when paparazzi catch her sunbathing topless, it's tabloid fodder for weeks. Same with Britney Spears. Same with Janet Jackson. It’s not so much a desire to see nudity as it is to see candor, to see what the person looks like when she’s unaware she’s being watched. It’s the impulse behind “Stars: They’re Just Like Us” and Gawker Stalker. It’s voyeurism, pure and simple. No matter how much access a celebrity gives us—posing naked, appearing on a reality TV show, revealing her deepest secrets in an interview—we’re more interested in whatever part she wants to keep to herself, no matter how tiny or inconsequential. It’s as though in some sense we’re suffering from so much celebrity overexposure, the only time we’re truly interested in watching is when they don’t want us to look.

In statements from ESPN spokespeople, Andrews has asked the press respect her privacy. What she doesn’t understand is that’s the thing we want most.

There is no ribbon for salivary-cancer awareness. That's probably because the disease is so rare—fewer than 1 percent of cancer cases attack the salivary glands. But after Beastie Boy Adam Yauch (MCA) revealed that he had recently been diagnosed with the disease, its profile went way up. NEWSWEEK's Matt Berman asked Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, for more information about the ailment. Excerpts below:

How common and threatening is salivary-gland cancer?
Salivary tumors are extremely rare. Using [National Cancer Institute] data from the years 2002 to 2006, malignant salivary tumors had an annualized incidence rate of 1.2 per 100,000 people. Death rates of malignant salivary tumors are 0.2 per 100,000 overall. Eighty-five percent of salivary-gland tumors are parotid [i.e., in the gland were Yauch's tumor is located].

A newly released study commissioned by the Israel Dental Association has found a link between increased cell-phone use and a rise in the incidence of salivary-gland cancer in Israel. Do you think there is anything to this?
They did not find a link, they found a time-wise association. They conclude maybe the increase is due to cell phones. They wrote, “We haven't gathered data on the use of cell phones on the part of the patients, but the rise [in cancer cases] absolutely could indicate increased exposure to cellular telephones and damage caused by radiation.” That is a very weak accusation. Many other things have changed over the past few years. I have seen other cancers flare in incidence because of changes in how a population prepares and stores food, how a population smokes, or even changes in sexual habits. While it is impossible to be definitive, it is still an open question as to whether cell phones cause parotid tumors, and it’s safe to say most epidemiologists with knowledge of the subject doubt that cell phones cause parotid tumors.
 
Are there any particular causes for the disease?
There is no known reason why people get parotid tumors. They are not associated with the typical head and neck cancer risk factors like smoking, alcohol, and HPV. The only real, established risk factor for parotid tumors is radiation therapy, which is an ionized form of radiation unlike cell-phone radiation. Ionized radiation is used to treat head and neck cancers and, ironically, parotid cancers. There were some folks who are now about 50 to 70 years of age who got radiation to the tonsils in the 1950s and 1960s who are at increased risk of radiation-induced cancer.

What are the different treatment options?
The treatment options depend on whether the cancer is benign or malignant, the stage of the cancer, the type of salivary gland the cancer is in, how the tumor looks under a microscope, and the patient’s age and general health. Some are treated with surgery, others with surgery and radiation therapy.

What are the major symptoms and long- or short-term setbacks related to the cancer?
I worry the most about dry mouth, which is a frequent side effect of surgery and radiation. 

How are these cancers discovered?
These cancers are almost always found when the patient notices a lump in the jaw or cheek. Any change on the side of the mouth or face should be reported to one's physician and checked out.

NEWSWEEK's health-care coverage has been amazing this past week, both online and in the magazine. And for those of us who are more interested in petty manners of dating etiquette than one of the most important political and social issues of our time, reading the assorted NEWSWEEK articles has been a great way to quickly feel like a health-care expert. Still unsure if you have the time or dedication to dive in? Allow me, a newly minted health-care expert, to summarize.

First, Jacob Weisberg argues that a country’s health system reflects its values, and ours is currently falling short in three key areas: moral, economic, and socioeconomic. Moral because the "random unfairness that condemns the uninsured to bad health and the risk of untimely death offends the national conscience," economic because we already spend way too much for a system that doesn't really work, and sociological because it doesn’t recognize the character of the American workforce:

America has always been a mobile society, with a labor market that grows more fluid over time. Once, the norm was to work for a single employer for one's entire career. Today, people change jobs an average of 11 times before they reach 40. Fear of losing health coverage keeps people in jobs they would otherwise leave, creating a drag on economic efficiency.

Unfortunately, Weisberg then claims, the plan the Democrats are about to usher into law is one that costs trillions while failing to address any of these concerns.

Ted Kennedy thinks otherwise, and makes his case for American health-care reform in this week's cover story. He explains the significance of the fight for him and his family, many members of which have suffered through serious medical issues. While the Kennedy clan has pretty good insurance, their assorted trips to the hospital over the years have highlighted the importance of solid coverage for all Americans. Kennedy has been in the fight since the 1960s, and writes that “incremental measures won’t suffice anymore.” He then lays out the main objectives for a successful public health-care plan: Insuring the uninsured by requiring coverage and subsidizing premiums. Cutting the cost of health care by ensuring that the federal government can negotiate rates and foster competitive pricing. Rewarding doctors for thrift and preventive care, not multiple tests and visits. Kennedy also notes that:

Social justice is often the best economics. We can help disabled Americans who want to live in their homes instead of a nursing home. Simple things can make all the difference, like having the money to install handrails or have someone stop by and help every day. It's more humane and less costly—for the government and for families—than paying for institutionalized care. That's why we should give all Americans a tax deduction to set aside a small portion of their earnings each month to provide for long-term care.

It's an impassioned, compelling argument (though dissenters will find plenty of company in the article's comments section), and a very different picture from the one being painted in advertisements by the opposition. Factcheck.org has several articles examining those ads, including one debunking claims that President Obama wants to bring Canadian-flavored (that is, Canadian-flavoured) health care to the U.S. The author provides a lengthy analysis, but let's cut to the chase: does the president embrace Canadian-style health care?

The truth of the matter is that the president has repeatedly said he doesn't. In fact, since being sworn in as president, Obama has riled advocates of such single-payer systems by largely excluding them from the health care debate.

(Factcheck.org also debunks the idea that the number of uninsured Americans is closer to half the 45 million figure that's being used by Democrats, that the uninsured are mostly young, healthy 20-somethings, and that health-care CEOs receive $119 million in bonuses.)

Of course, if opponents are really looking to derail health care, they can always go for the moral-outrage/social-issue M.A.D. route. Lead republican negotiator Sen. Charles Grassley of Iowa has been quoted as saying that when it comes to public debate, "abortion is about the only issue I know of that's not compromisable." Of course, guess what writer J. Lester Feder discovered Grassley was discussing behind closed doors?

With negotiations between Grassley and Senate Finance Committee chairman Max Baucus, the Montana Democrat, seemingly deadlocked over the fundamental structure and financing of reform, NEWSWEEK has learned that Grassley has also been pushing for the inclusion of measures that would prevent reform from leading to "taxpayer-subsidized abortion."

Yikes. But to read Howard Fineman, one might come away thinking that Obama is doing a good job derailing health care on his own, thanks to the nation's sudden apprehension about increasing the national debt and the plan's lack of real reform:

The original idea was to rethink the entire convoluted and overly complex system, and to find ways to truly change the way we think about health care to both improve care and save money. There ought to be ways to do that. But the three bills to emerge so far seem like more of an attempt to buy off existing constituencies than a real rethinking of the mess.  

Once you take the time to learn about it, the health-care debate does have a lot of the same intrigue, political high stakes, pathos, and drama of a typical prime-time Fox lineup: the issues are compelling and the arguments on both sides fascinating. But if you still can’t bring yourself to care about health care, and aren't required by the obligations of your employment to blog about it, don't feel bad. You’re not alone. Sharon Begley, as always, cuts through the nonsense to explain why we tune out when we start hearing about “single-payer options" versus … whatever the other thing is.

A threat needs to have certain properties "to ring our alarm bells," says [Daniel] Gilbert, author of the 2006 bestseller Stumbling on Happiness. One is that it needs to come with a human face—preferably an evil-looking one; extra points for beard and mustache—since evolution shaped the brain to pay attention to and leap into action at threats posed by humans. (Evolution is too slow to have shaped us to become outraged by, say, lower reimbursement for branded drugs than generics.) But the mess that is the current health-care system in the United States "hasn't been visited upon us by an evil monster," says Gilbert. "It's the fault of a faceless 'system,' and that's not something we're wired to jump up and down about." If a bin Laden or any other specific villain were behind the troubles with the current system, you can bet that the percent of people calling reform a top priority would soar. (Indeed, when an individual doctor denies some poor soul ER care or when a hospital dumps a poor patient on the street, public outrage boils over, because the victim and villain come with a face and a name.)

So, you see, it's not your fault that you're not automatically compelled by the health-care debate. It's Osama bin Laden's. But don't let the terrorists win: pick up the latest issue of NEWSWEEK and visit Newsweek.com and read up on the biggest public debate of our age.