Tens of thousands of Islamists rally for Morsi in Cairo

CAIRO — Islamists in Egypt's capital rallied Saturday to support President Mohamed Morsi in what is emerging as a decisive battle with opposition forces in the country's messy political transition away from three decades of Hosni Mubarak's corrupt and undemocratic rule.

Tens of thousands of Muslim Brotherhood and ultraconservative Islamists marched in a counterdemonstration to an energized week-old protest across the Nile in Tahrir Square by opposition groups challenging Morsi's expanded powers. Islamists back the president for his religious ideology but say Morsi's central aim is to rid state institutions of the lingering influence of the Mubarak era.

"There are different segments of society here. Not everyone who supports Morsi is a radical Islamist," said Mohamed Hassanein, standing amid banners and the static of loudspeakers in front of Cairo University. "He is the president for all Egyptians. He is trying protect state institutions from remnants of the old regime."

Such have been the president's talking points since he took office in June. He and the Brotherhood explain his recent decree expanding his power and the frantic race by an Islamist-dominated assembly to finish a draft constitution as the path to parliamentary elections early next year to move the country forward. Morsi told the nation Saturday that a referendum on the constitution would be held Dec. 15.

"We hope to ascend into a new era of Egypt's history, to a bright future for our beloved people," the president said in an address to the assembly. "This is a breakthrough, the first truly representative constitution that protects the rights, freedoms and human dignity of all Egyptians."

The Brotherhood has painted many of those protesting against Morsi as Mubarak loyalists who have infiltrated a wider protest movement to disrupt Egypt's transition. That view is testament to the vast differences over how Morsi's supporters and detractors view the nation's troubled political climate, even as Cairo maneuvers to rise as a leading voice in the Arab world's changing political landscape.

Protesters in Tahrir accuse the president of overstepping his bounds, peddling conspiracies and accumulating power reminiscent of Mubarak while brushing aside court rulings to propel the Brotherhood's Islamist agenda. Morsi's supporters argue that he is a good man, if an inexperienced politician, who has been unfairly tainted by liberals and leftists in a dangerous counterrevolution.

Morsi and the Brotherhood face high stakes in coming weeks. Once an outlawed opposition movement, the Brotherhood is now the country's dominant political force. Yet it has made many missteps, reversing promises, angering opposition leaders and failing to stem economic turmoil. The march Saturday was a show of unity before the vote on the draft constitution, which, if not passed, would damage Morsi's credibility.

"I'm here to watch and see what is happening, not because I'm fully convinced of the president," said Walid Alnasr, an Egyptologist, standing in a tightening crowd of men with their ears bent toward him. "The country is suffering from years and years of corruption. Do you think these things can change in three or four or five months? The president is new. He should be given time."

As Alnasr spoke, a bearded man stood at the edge of the crowd, holding up a copy of the Koran in the sunlight. "God's law," he said, and walked away.

The rally was a mix of extremists, moderates, students, professionals, men in suits and peasants from the provinces, including one wearing a white turban who spoke of the need for sharia, or Islamic law, while others tried to hush him.

"Let somebody more educated speak," they said.

The peasant was undeterred: "We're not only here for Morsi. We're here for sharia."

Another man, Hamed Abdelhamid, said, "The people in Tahrir Square are only 1% of the population. They don't represent Egypt. Most of our population is religious and is behind the president."

But the nation's judiciary, notably the Supreme Constitutional Court dominated by Mubarak-era judges, has undercut Morsi and the Brotherhood's wider ambitions, in part by dissolving the Islamist-led parliament in June. The president's decree last month to place his office and the constitutional assembly above legal jurisdiction, a move meant to limit the court's power, drew outrage from Morsi's opponents.

The court was expected to rule Sunday to dissolve the assembly amid charges it was unrepresentative. Opposition groups say the proposed constitution is influenced by Islamic law and could set back civil rights. But with the assembly's work done, it remains uncertain what leverage the court has against a leader who has ignored its decisions.

Many of the Islamists at the rally showed contempt for the courts. A poster pictured a regal Morsi standing next to an unruly collection of caricatures depicting holdover officials from the Mubarak era, including a constitutional court judge made to look like Miss Piggy and Prosecutor-General Abdel Meguid Mahmoud, who resembled the Disney character Goofy.

"Morsi will save the nation," said Ayman Alshahat, a teacher waving a banner. "He will continue the revolution to take back state institutions.... This is for all Egyptian people. This is an invitation to negotiations that will move the country forward."

The opposition and the Islamists are far from compromise. The rally to support Morsi had been planned for Tahrir, but the Brotherhood switched venues to Cairo University to avoid clashes with antigovernment protesters. Brotherhood offices in several cities have been attacked and set ablaze, and officials fear more violence if tension is not eased.

There was no rancor at the Morsi rally, which with flapping flags and practiced chants was a model of sameness. Brotherhood security guards stood at barricades, checking bags and asking for identification cards. Police stayed far to the edges. Images of Morsi — thin graying beard, smile, face bordered by glasses — bobbed in the sunlight. A child with a microphone recited poetry.

"We need Morsi's decree at this critical time because remnants of the old regime are back in Tahrir Square," said Fatima Ibrahim, a black veil covering all but her eyes. "The square used to be for revolutionaries, but it is not anymore. It has been taken over by others. But we'll move forward as long as we stay behind the president."

As she spoke, Islamists chanted: "Bread. Freedom. Islamic sharia."

Across the river in Tahrir Square the chant was: "Bread. Freedom. Social Justice."

jeffrey.fleishman@latimes.com

Special correspondent Reem Abdellatif contributed to this report.

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App of the Week: Hooked

App Name: Hooked

Price: Free

Available Platforms: Android

What does this app do? Words with Friends, Angry Birds, Mahjong Connect – these are just a few of the popular apps in the Google Play Store for Android devices. For game app lovers, wading through the possibilities can be daunting.

Hooked, a game recommendation app developed by Hooked Media Group, can help.

“There are hundreds of thousands of apps out there people may really enjoy,” says Pita Uppal, CEO of the San Francisco based company.

Uppal, who recognizes people like to play with variety game apps but may have no idea what to try, likens Hooked to Netflix and Pandora rolled into one.

Once you download the app, Hooked analyses more than 40 factors, such as device type, the kinds of games a user has on his or her device, and usage statistics. By looking at what a consumer already has and how he or she is using those games, Hooked aims to offer users intelligent suggestions.

From the homescreen, select the menu button at the top and then search categories such as “Top Picks for You,” which provides a customized, star-rated list of recommendations. Press the tools key in the upper right hand corner and customize your recommendations by category, such as puzzle and racing, or by price.

Select “My Games”, and the app displays a dashboard of icons to help you understand your game activity. A folder icon, for example, shows what and how many games you have installed, and a clock icon tells you the amount of time you’ve spent playing a particular game. I spent an entire minute playing “Stupid Zombies.”

Logging in through Facebook or Google+ allows you to see what your friends and connections are playing, too.

Is it easy to set up? Yes, the 2.1MB app installs quickly. Log in with your account and go.

Should I try it? Hooked is like a personal shopper for game-loving app users, and the more you use it the more it understands what you might like. For the moment, it is only available for Android, but Uppal says the company plans to launch Hooked for iOS in the coming months.

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NBC sets premiere date for “Do No Harm” drama

LOS ANGELES (TheWrap.com) – NBC will premiere its new drama “Do No Harm” at 10 p.m. on January 31, NBC Entertainment chairman Robert Greenblatt said Friday.

The premiere date takes advantage of the one-hour series finale of “30 Rock,” which will air at 8 p.m. on that same night.

“Do No Harm” stars “Rescue Me” alum Steven Pasquale as Dr. Jason Cole, a neurosurgeon whose life is going swimmingly until his dangerous alter-ego emerges, hell-bent on creating havoc on Cole and those around him.

“January 31 will be a special night as one classic series will mark its finale with a great hour-long send-off episode while a promising new drama will make its debut on Thursdays,” Greenblatt said. “‘30 Rock’ is acclaimed as a legendary comedy and we will see a truly memorable and fitting last episode. In ‘Do No Harm,’ viewers will have a unique new dramatic storyline with an exciting new star in Steven Pasquale that takes them into dark and uncharted territory.”

To accommodate “Do No Harm,” “Rock Center With Brian Williams” will move to Fridays at 10 p.m., following “Dateline,” beginning February 8.

TV News Headlines – Yahoo! News

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Adderall, a Drug of Increased Focus for N.F.L. Players

The first time Anthony Becht heard about Adderall, he was in the Tampa Bay locker room in 2006. A teammate who had a prescription for the drug shook his pill bottle at Becht.

“ ‘You’ve got to get some of these,’ ” Becht recalled the player saying. “I was like, ‘What the heck is that?’ He definitely needed it. He said it just locks you in, hones you in. He said, ‘When I have to take them, my focus is just raised up to another level.’ ”

Becht said he did not give Adderall another thought until 2009, when he was playing in Arizona and his fellow tight end Ben Patrick was suspended for testing positive for amphetamines. The drug he took, Patrick said, was Adderall. Becht asked Patrick why he took it, and Patrick told Becht, and reporters, that he had needed to stay awake for a long drive.

Those two conversations gave Becht, now a free agent, an early glimpse at a problem that is confounding the N.F.L. this season. Players are taking Adderall, a medication widely prescribed to treat attention deficit hyperactivity disorder, whether they need it or not, and are failing drug tests because of it. And that is almost certainly contributing to a most-troubling result: a record-setting year for N.F.L. drug suspensions.

According to N.F.L. figures, 21 suspensions were announced this calendar year because of failed tests for performance-enhancing drugs, including amphetamines like Adderall. That is a 75 percent increase over the 12 suspensions announced in 2011 and, with a month to go in 2012, it is the most in a year since suspensions for performance-enhancing drugs began in 1989.

At least seven of the players suspended this year have been linked in news media reports to Adderall or have publicly blamed the drug, which acts as a strong stimulant in those without A.D.H.D. The most recent examples were Tampa Bay cornerback Eric Wright and New England defensive lineman Jermaine Cunningham last week.

The N.F.L. is forbidden under the terms of the drug-testing agreement with the players union from announcing what substance players have tested positive for — the urine test does not distinguish among types of amphetamines — and there is some suspicion that at least a few players may claim they took Adderall instead of admitting to steroid use, which carries a far greater stigma. But Adolpho Birch, who oversees drug testing as the N.F.L.’s senior vice president for law and labor, said last week that failed tests for amphetamines were up this year, although he did not provide any specifics. The increase in Adderall use probably accounts for a large part of the overall increase in failed tests.

“If nothing else it probably reflects an uptick in the use of amphetamine and amphetamine-related substances throughout society,” Birch said. “It’s not a secret that it’s a societal trend, and I think we’re starting to see some of the effects of that trend throughout our league.”

Amphetamines have long been used by athletes to provide a boost — think of the stories of “greenies” in baseball clubhouses decades ago. That Adderall use and abuse has made its way to the N.F.L. surprises few, because A.D.H.D. diagnoses and the use of medication to control it have sharply increased in recent years.

According to Dr. Lenard Adler, who runs the adult A.D.H.D. program at New York University Langone Medical Center, 4.4 percent of adults in the general population have the disorder, of which an estimated two-thirds are men. Birch said the number of exemptions the N.F.L. has granted for players who need treatment for A.D.H.D. is “almost certainly fewer” than 4.4 percent of those in the league.

The rates of those with the disorder fall as people get older; it is far more prevalent in children and adolescents. A report from the Centers for Disease Control and Prevention, using input from parents, found that as of 2007, about 9.5 percent or 5.4 million children from ages 4 to 17 had A.D.H.D. at some point. That was an increase of 22 percent from 2003. Boys (13.2 percent) were more likely to have the disorder than girls (5.6 percent).

Of children who currently have A.D.H.D., 66.3 percent are receiving medication, with boys 2.8 times more likely to receive medication. Those 11 to 17 years old are more likely to receive medication than younger children.

But Adderall, categorized by the Drug Enforcement Administration as a Schedule II controlled substance because it is particularly addictive, is also used by college students and even some high school students to provide extra energy and concentration for studying or as a party drug to ward off fatigue.

Dr. Leah Lagos, a New York sports psychologist who has worked with college and professional athletes, said she had seen patients who have used Adderall. She said she believed the rise in its use by professional athletes mimicked the use by college students. Just a few years ago, she said, it was estimated that 1 in 10 college students was abusing stimulants like Adderall and Ritalin. That estimate, Lagos said, has almost doubled.

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Widows Pushed Into Foreclosure by Mortgage Fine Print

Richard Patterson for The New York Times

Maria Ginise says she has developed dizzy spells from the stress of trying to save her mobile home from foreclosure in Deerfield Beach, Fla.

Geraldine Bates lost her husband to kidney failure last year. Now, she has fallen behind on her mortgage payments and is terrified that she will lose her home in Jacksonville, Fla.

Ms. Bates, 70, is caught in a foreclosure trap that is ensnaring widows across America: she cannot get help lowering her payments until her name is added to the mortgage note, but the lender says she must be current on payments before that can happen.

“I keep praying,” said Ms. Bates, who is fighting with the bank to stay in the four-bedroom house.

Just as the housing market is recovering, a growing group of homeowners — widows over the age of 50 whose husbands alone were holders of the mortgage — are losing their homes to foreclosure because of a paperwork flaw that keeps them from obtaining loan modifications.

In the latest chapter of the foreclosure crisis, homeowners over 50 are falling into foreclosure at the fastest pace of any age group, according to nationwide data, in part because women are outliving their spouses and are unable to cope with cuts in their pensions, ballooning medical costs — and the fine print on their mortgages.

While there are no exact measures of how many widows have entered foreclosure, figures compiled by AARP show the rate of foreclosures among people over 50 increased by 23 percent from 2007 to 2011, resulting in 1.5 million foreclosures.

A few lenders have tweaked their procedures to navigate the problem, and housing advocates are petitioning the Consumer Financial Protection Bureau to devise guidelines for lenders in situations that involve surviving relatives. Banks say that while the volume of delinquent mortgages means that they need a blanket policy to cover all homeowners who are behind on their payments, they are willing to work closely with widows.

Still, interviews with elder-care advocates, housing lawyers and borrowers suggest that the problem is spreading fast, propelled by an aging population. Legal aid offices in California, Florida, Ohio and New York say it is among the top complaints from clients. Billy Howard, a consumer lawyer in Tampa, Fla., said he had more than two dozen cases involving widows, up from virtually none before 2007.

“These women are essentially invisible,” said Gladys Gerson, a lawyer for Coast to Coast Legal Aid of South Florida.

At first glance, the issue seems little more than a logistical headache. To stay in the home, the surviving spouse needs to take over the mortgage. But to do that, most banks require that the borrower assuming the mortgage be up-to-date on payments. Housing advocates say that their clients, especially if one spouse experienced a prolonged illness, often find they are already thousands of dollars behind.

“Surviving spouses are trapped without a clear way to preserve their home,” said Arabelle Malinis, a lawyer at Housing and Economic Rights Advocates in California.

The conundrum is pushing some widows into foreclosure by choking off a lifeline that could save their homes. As of 2011, 6 percent of loans held by people over 50 were delinquent, up from about 1 percent in 2007, according to a July study by AARP, an advocacy group for Americans over 50. The study, which housing lawyers say accurately describes the tide of foreclosures on seniors’ homes, analyzed mortgage data over a five-year period.

Part of the problem, according to Debra Whitman, AARP’s executive vice president for policy, is that older Americans are saving less and borrowing more. Debt for Americans ages 65 to 74 is outpacing any other group, according to the Federal Reserve.

Some help is on the way. JPMorgan Chase, for example, allows surviving relatives to complete a loan modification and mortgage assumption simultaneously. And the consumer bureau is finishing rules to provide tighter oversight of mortgage servicing companies, which collect payments from homeowners.

Housing advocates say most of their widowed clients still remain in their foreclosed homes.

The trouble for Ms. Bates, of Jacksonville, Fla., began after her husband Robert, a World War II veteran, died last February. Mr. Bates had obtained a trial loan modification but died before he could make the first payment. Determined to make good on the hard-won plan, Ms. Bates said she notified HSBC, the servicer, of her husband’s death and sent in a check for $1,125.47.

Ms. Bates said she was devastated when the check was returned, with a letter explaining the money could not be accepted because she was not on the mortgage. Ms. Bates still owes roughly $131,000 on the original $140,000 mortgage. HSBC declined to comment on the case, but said in a statement, “HSBC has a strong commitment to home preservation and regards foreclosure as a last resort.”

Complaints from widows about botched forms, unanswered calls and the peculiar frustration of being asked repeatedly by servicers for the same documents echo the concerns that culminated in a $26 billion settlement in February over other mortgage flaws with the country’s five largest mortgage servicers.

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Student scores may be used in LAUSD teacher ratings

After months of tense negotiations, leaders of the Los Angeles Unified School District and its teachers union have tentatively agreed to use student test scores to evaluate instructors for the first time, officials announced Friday.

Under the breakthrough agreement, the nation's second-largest school district would join Chicago and a growing number of other cities in using test scores as one measure of how much teachers help their students progress academically in a year.

Alarm over low student performance, especially in impoverished and minority communities, has prompted the Obama administration and others to press school districts nationwide to craft better ways to identify struggling teachers for improvement.

The Los Angeles pact proposes to do that using a unique mix of individual and schoolwide testing data — including state standardized test scores, high school exit exams and district assessments, along with rates of attendance, graduation and suspensions.

But the tentative agreement leaves unanswered the most controversial question: how much to count student test scores in measuring teacher effectiveness. The school district and the union agreed only that the test scores would not be "sole, primary or controlling factors" in a teacher's final evaluation.

"It is crystal clear that what we're doing is historic and very positive," said L.A. Supt. John Deasy, who has fought to use student test scores in teacher performance reviews since taking the district's helm nearly two years ago. "This will help develop the skills of the teaching profession and hold us accountable for student achievement."

Members of United Teachers Los Angeles, however, still need to ratify the agreement. Many teachers have long opposed using test scores in their evaluations, saying test scores are unreliable measures of teacher ability.

The union characterized the agreement as a "limited" response to a Dec. 4 court-ordered deadline to show that test scores are being used in evaluations and said negotiations were continuing for future academic years. The deadline was imposed by Los Angeles County Superior Court Judge James C. Chalfant, who ruled this year that state law requires L.A. Unified to use test scores in teacher performance reviews.

In a statement, the teachers union also emphasized that the agreement rejected the use of the district's method of measuring student academic progress for individual instructors. That measure, called Academic Growth Over Time, uses a mathematical formula to estimate how much a teacher helps students' performance, based on state test scores and controlling for such outside factors as income and race. Under the agreement, however, schoolwide scores using this method, also known as a value-added system, will be used.

For individual teachers, the agreement proposes to use raw state standardized test score data. Warren Fletcher, teachers union president, said that data give teachers more useful information about student performance on specific skills.

Critics of using test scores in teacher reviews praised Los Angeles' proposed new system, saying it uses a wide array of data to determine a teacher's effect on student learning.

Deasy said he will be developing guidelines for administrators on how to use the mix of data in teacher reviews and has said in the past that test scores should not count for more than 25% of the final rating.

"This is a complex agreement and possibly the most sophisticated evaluation agreement that I have seen," said Diane Ravitch, an educational historian and vocal critic of the use of test scores in teacher evaluations. "It assures that test scores will not be overused, will not be assigned an arbitrary and inappropriate weight, will not be the sole or primary determinant of a teacher's evaluation."

Teacher Brent Smiley at Lawrence Middle School in Chatsworth said: "I will vote yes. I have no doubt that my union leaders negotiated the best they could, given the adverse set of circumstances they faced."

Labor-relations expert Charles Kerchner called the agreement "a shotgun wedding," but added, "I think it's unabashed good news."

He said it's notable that value-added measures and test scores have been accepted in some form by the teachers union.

"UTLA has moved beyond a strategy of just saying no to a strategy of trying to craft a useful agreement," said Kerchner, a professor at Claremont Graduate University.

The district is currently developing a new evaluation system that uses Academic Growth Over Time — along with a more rigorous classroom observation process, student and parent feedback and a teacher's contributions to the school community. The new observations were tested last year on a voluntary basis with about 450 teachers and 320 administrators; this year, every principal and one volunteer teacher at each of the district's 1,200 schools are expected to be trained.

The teachers union has filed an unfair labor charge against the district, arguing that the system is being unilaterally imposed without required negotiations.

Some teachers who have participated in the new observation process say it offers more specific guidance on how they can improve. Other educators — teachers and administrators alike — complain that it is too time-consuming.

The tentative agreement, acknowledging the extra time the new evaluations would take, would extend the time between evaluations from two to as long as five years for teachers with 10 or more years of experience.

Bill Lucia of EdVoice, the Sacramento-based educational advocacy group that brought the lawsuit, said he was "cautiously optimistic."

But he expressed dismay that the union did not reach agreement a few weeks earlier, which he said would have given L.A. Unified a shot at a $40-million federal grant. The district applied for the Race to the Top grant without the required teacher union support and was eliminated from the competition this week.

Negotiations over the tentative pact, however, nearly fell apart. Earlier this week, the union pulled away from the deal on the table, L.A. Unified officials said. And the district discussed holding a Monday emergency school-board meeting to craft a formal response to the court order in anticipation that no deal would be reached. The options included adopting an evaluation system without the union's consent.

Some members of the Board of Education, who also will need to approve the pact, praised the agreement for taking student growth and achievement into account but gauging this growth through multiple measures. Steve Zimmer said that, just as important, this milestone was achieved through negotiation.

School board President Monica Garcia praised the tentative deal as "absolutely, by all accounts, better than what we have today."

teresa.watanabe@latimes.com

howard.blume@latimes.com

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Is Facebook planning to develop its own games? Revised Zynga terms open the door

As Zynga (ZNGA) continues its free fall into irrelevancy with layoffs and its one-hit social games, the gaming company has revised its contract with Facebook (FB) to free it from being “forced to launch games exclusively on the Facebook platform” and “obligated to use Facebook Credits for Zynga game pages,” according to AllThingsD. The change of terms filed with the SEC also includes a clause that states “Facebook will no longer be prohibited from developing its own games” on March 31, 2013. Could Facebook start developing its own social games? Theoretically, yes. But would Facebook really jeopardize its relationships with game developers who already make games for its social network? Probably not.

“We’re not in the business of building games and we have no plans to do so,” a Facebook spokesman told AllThingsD. “We’re focused on being the platform where games and apps are built.”

AllThingsD’s report says the change in terms isn’t so much as a bid by Facebook to make its own games, but to shed its dependence on Zynga to supply it with hit games. The new revised terms give Facebook more leverage and other game developers such as Wooga and King.com greater incentive to create games.

At the end of the day, Facebook is a publicly traded company chasing profits, despite what CEO Mark Zuckerberg says. It might not be developing games today, but that doesn’t mean it won’t create them in the future. The new terms with Zynga now leaves that door open, should it want to make its own games one day.

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“iCarly” and “Victorious” spinoff gets greenlight from Nickelodeon

LOS ANGELES (TheWrap.com) – Tweens of the world, rejoice: “iCarly” may be relegated to the dustbin of TV-programming history, but a part of it will live on.

Nickelodeon has greenlit “Sam & Cat,” a hybrid spinoff of “iCarly” – which ended its run last week – and the Nickelodeon series “Victorious.”

The series – from “iCarly” and “Victorious” creator Dan Schneider – will star Jennette McCurdy (who played Sam Puckett on “iCarly”) and Ariana Grande (perhaps better known as Cat Valentine to “Victorious” viewers). Both will reprise theo become teen entrepreneurs by starting their own after-school babysitting business.”

The 20-episode first season of “Sam & Cat” will premiere next year; production will begin in January in Los Angeles.

“Jennette and Ariana are adored by our audience, and it’s great to unite these talented actresses in this hilarious new comedy from Dan Schneider,” Nickelodeon’s president of content development and production Russell Hicks said. “This show promises to deliver on what our audience loves most about these two favorite characters – laugh-out-loud humor and non-stop adventure, and is sure to be a compelling new chapter for our new comedic duo.”

The “iCarly” series finale last week drew 6.4 million viewers.

TV News Headlines – Yahoo! News

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Doctors Who Work for Hospitals Face a New Bottom Line

For decades, doctors in picturesque Boise, Idaho, were part of a tight-knit community, freely referring patients to the specialists or hospitals of their choice and exchanging information about the latest medical treatments.

Joshua Roper for The New York Times

St. Luke's Health System dominates the market in Boise, Idaho, and critics say patients are paying more.

Chad Case for The New York Times

Dr. Julie A. Foote, an endocrinologist in Boise, questions whether patients are getting cost-effective care as a result of consolidation in the medical field.

But that began to change a few years ago, when the city’s largest hospital, St. Luke’s Health System, began rapidly buying physician practices all over town, from general practitioners to cardiologists to orthopedic surgeons.

Today, Boise is a medical battleground.

A little over half of the 1,400 doctors in southwestern Idaho are employed by St. Luke’s or its smaller competitor, St. Alphonsus Regional Medical Center.

Many of the independent doctors complain that both hospitals, but especially St. Luke’s, have too much power over every aspect of the medical pipeline, dictating which tests and procedures to perform, how much to charge and which patients to admit.

In interviews, they said their referrals from doctors now employed by St. Luke’s had dropped sharply, while patients, in many cases, were paying more there for the same level of treatment.

Boise’s experience reflects a growing national trend toward consolidation. Across the country, doctors who sold their practices and signed on as employees have similar criticisms. In lawsuits and interviews, they describe growing pressure to meet the financial goals of their new employers — often by performing unnecessary tests and procedures or by admitting patients who do not need a hospital stay.

In Boise, just a few weeks ago, even the hospitals were at war. St. Alphonsus went to court seeking an injunction to stop St. Luke’s from buying another physician practice group, arguing that the hospital’s dominance in the market was enabling it to drive up prices and to demand exclusive or preferential agreements with insurers. The price of a colonoscopy has quadrupled in some instances, and in other cases St. Luke’s charges nearly three times as much for laboratory work as nearby facilities, according to the St. Alphonsus complaint.

Federal and state officials have also joined the fray. In one of a handful of similar cases, the Federal Trade Commission and the Idaho attorney general are investigating whether St. Luke’s has become too powerful in Boise, using its newfound leverage to stifle competition.

Dr. David C. Pate, chief executive of St. Luke’s, denied the assertions by St. Alphonsus that the hospital’s acquisitions had limited patient choice or always resulted in higher prices. In some cases, Dr. Pate said, services that had been underpriced were raised to reflect market value. St. Luke’s, he argued, is simply embracing the new model of health care, which he predicted would lead over the long term to lower overall costs as fewer unnecessary tests and procedures were performed.

Regulators expressed some skepticism about the results, for patients, of rapid consolidation, although the trend is still too new to know for sure. “We’re seeing a lot more consolidation than we did 10 years ago,” said Jeffrey Perry, an assistant director in the F.T.C.’s Bureau of Competition. “Historically, what we’ve seen with the consolidation in the health care industry is that prices go up, but quality does not improve.”

A Drive to Consolidate

An array of new economic realities, from reduced Medicare reimbursements to higher technology costs, is driving consolidation in health care and transforming the practice of medicine in Boise and other communities large and small. In one manifestation of the trend, hospitals, private equity firms and even health insurance companies are acquiring physician practices at a rapid rate.

Today, about 39 percent of doctors nationwide are independent, down from 57 percent in 2000, according to estimates by Accenture, a consulting firm.

Many policy experts praise the shift away from independent practices as a way of making health care less fragmented and expensive. Systems that employ doctors, modeled after well-known organizations like Kaiser Permanente, are better able to coordinate patient care and to find ways to deliver improved services at lower costs, these advocates say. Indeed, consolidation is encouraged by some aspects of the Obama administration’s health care law.

“If you’re going to be paid for value, for performance, you’ve got to perform together,” said Dr. Ricardo Martinez, chief medical officer for North Highland, an Atlanta-based consultant that works with hospitals.

The recent trend is reminiscent of the consolidation that swept the industry in the 1990s in response to the creation of health maintenance organizations, or H.M.O.’s — but there is one major difference. Then, hospitals had difficulty managing the practices, contending that doctors did not work as hard when they were employees as they had as private operators. Now, hospitals are writing contracts more in their own favor.

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Syria Rebels Find Skype Useful, but Dangers Lurk

In a demonstration of their growing sophistication and organization, Syrian rebels responded to a nationwide shutdown of the Internet by turning to satellite technology to coordinate within the country and to communicate with outside activists.

When Syria’s Internet service disappeared Thursday, government officials first blamed rebel attacks. Activist groups blamed the government and viewed the blackout as a sign that troops would violently clamp down on rebels.

But having dealt with periodic outages for more than a year, the opposition had anticipated a full shutdown of Syria’s Internet service providers. To prepare, they have spent months smuggling communications equipment like mobile handsets and portable satellite phones into the country.

“We’re very well equipped here,” said Albaraa Abdul Rahman, 27, an activist in Saqba, a poor suburb 20 minutes outside Damascus. He said he was in touch with an expert in Homs who helped connect his office and 10 others like it in and around Damascus.

Using the connection, the activists in Saqba talked to rebel fighters on Skype and relayed to overseas activists details about clashes with government forces. A video showed the rebels’ bare-bones room, four battery backups that could power a laptop for eight hours and a generator set up on a balcony.

For months, rebels fighting to overthrow President Bashar al-Assad have used Skype, a peer-to-peer Internet communication system, to organize and talk to outside news organizations and activists. A few days ago, Jad al-Yamani, an activist in Homs, sent a message to rebel fighters that tanks were moving toward a government checkpoint.

He notified the other fighters so that they could go observe the checkpoint. “Through Skype you know how the army moves or can stop it,” Mr. Yamani said.

On Friday, Dawoud Sleiman, 39, a member of the antigovernment Ahrar al-Shamal Battalion, part of the Free Syrian Army, reached out to other members of the rebel group. They were set up at the government’s Wadi Aldaif military base in Idlib, a province near the Turkish border that has seen heavy fighting, and connected to Skype via satellite Internet service.

Mr. Sleiman, who is based in Turkey, said the Free Syrian Army stopped using cellphone networks and land lines months ago and instead relies almost entirely on Skype. “Brigade members communicate through the hand-held devices,” he said.

This week rebels posted an announcement via Skype that called for the arrest of the head of intelligence in Idlib, who is accused of killing five rebels. “A big financial prize will be offered to anyone who brings the head of this guy,” the message read. “One of our brothers abroad has donated the cash.”

If the uprisings in Tunisia and Egypt were Twitter Revolutions, then Syria is becoming the Skype Rebellion. To get around a near-nationwide Internet shutdown, rebels have armed themselves with mobile satellite phones and dial-up modems.

In many cases, relatives and supporters living outside Syria bought the equipment and had it smuggled in, mostly through Lebanon and Turkey.

That equipment has allowed the rebels to continue to communicate almost entirely via Skype with little interruption, despite the blackout. “How the government used its weapons against the revolution, that is how activists use Skype,” Mr. Abdul Rahman said.

“We haven’t seen any interruption in the way Skype is being used,” said David Clinch, an editorial director of Storyful, a group that verifies social media posts for news organizations, including The New York Times (Mr. Clinch has served as a consultant for Skype).

Mr. Assad, who once fashioned himself as a reformer and the father of Syria’s Internet, has largely left the country’s access intact during the 20-month struggle with rebels. The government appeared to abandon that strategy on Thursday, when most citizens lost access. Some Syrians could still get online using service from Turkey. On Friday, Syrian officials blamed technical problems for the cutoff.

The shutdown is only the latest tactic in the escalating technology war waged in Arab Spring countries.

But several technology experts warned that the use of the Internet by rebels in Syria, even those relying on Skype, could leave them vulnerable to government surveillance.

Liam Stack contributed reporting from New York; Hala Droubi from Dubai, United Arab Emirates; and Hwaida Saad from Beirut, Lebanon.

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