Treasury Will Not Mint $1 Trillion Coin to Raise Debt Ceiling

WASHINGTON — The Treasury Department said Saturday that it will not mint a trillion-dollar platinum coin to head off an imminent battle with Congress over raising the government’s borrowing limit.

“Neither the Treasury Department nor the Federal Reserve believes that the law can or should be used to facilitate the production of platinum coins for the purpose of avoiding an increase in the debt limit,” Anthony Coley, a Treasury spokesman, said in a written statement.

The Obama administration has indicated that the only way for the country to avoid a cash-management crisis as soon as next month is for Congress to raise the “debt ceiling,” which is the statutory limit on government borrowing. The cap is $16.4 trillion.

“There are only two options to deal with the debt limit: Congress can pay its bills, or it can fail to act and put the nation into default,” Jay Carney, the White House press secretary, said in a statement. “Congress needs to do its job.”

In recent weeks, some Republicans have indicated that they would not agree to raise the debt limit unless Democrats agreed to make cuts to entitlement programs like Social Security.

The White House has said it would not negotiate spending cuts in exchange for Congressional authority to borrow more, and it has insisted that Congress raise the ceiling as a matter of course, to cover expenses already authorized by Congress. In broader fiscal negotiations, it has said it would not agree to spending cuts without commensurate tax increases.

The idea of minting a trillion-dollar coin drew wide if puzzling attention recently after some bloggers and economic commentators had suggested it as an alternative to involving Congress.

By virtue of an obscure law meant to apply to commemorative coins, the Treasury secretary could order the production of a high-denomination platinum coin and deposit it at the Federal Reserve, where it would count as a government asset and give the country more breathing room under its debt ceiling. Once Congress raised the debt ceiling, the Treasury secretary could then order the coin destroyed.

Mr. Carney, the press secretary, fielded questions about the theoretical tactic at a news conference last week. But the idea is now formally off the table.

The White House has also rejected the idea that it could mount a challenge to the debt ceiling itself, on the strength of the Fourteenth Amendment to the Constitution, which holds that the “validity of the public debt” of the United States “shall not be questioned.”

The Washington Post earlier published a report that the Obama administration had rejected the platinum-coin idea.

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Syrian rebels say they've seized strategic Taftanaz air base

BEIRUT – After weeks of fighting, Syrian rebels said Friday that they had seized a strategic air base in northwestern Idlib province, depriving the government of its ability to carry out helicopter airstrikes in the area.

The Taftanaz air base has been used by the government to stage helicopter attacks on rebels in the province, adjacent to the Turkish border. The campaign to seize it had been spearheaded by hard-line Islamic fighting groups, such as Al Nusra Front, which is affiliated with Al Qaeda.

"It was fully liberated, today in the morning. There are no elements from the regime at all, and now the FSA [Free Syrian Army] has complete control," a rebel said Friday in an interview by Skype. He called himself Ismaili Taftanazi, after the name of the air base.

The government of Syrian President Bashar Assad had no comment on the status of Taftanaz, but if the rebels' claim is confirmed, it will amount to a major strategic victory for the Islamist fighters, who have concentrated on peeling off air bases. If they can deprive the government of its bases, it will be harder for Assad's forces to resupply, move troops and unleash the punishing aerial strikes that have become a trademark of the nearly 22-month war.

A rebel victory would also solidify control of rebel-held territories in Idlib. The base is the province's biggest airstrip for attack helicopters. Finally, it would provide a morale boost to Islamic fighters carrying out a similar campaign against the three major air bases in Aleppo province. Many Syrians remain wary of the fighters, alarmed by the role of hard-line Islamist groups such as Al Nusra Front.

The rebels, though apparently winning the battle, were not on the verge of seizing the entire province, where the government still holds the city of Idlib and several key military installations. Even after losing the base, the Syrian air force was still able to use MIG fighter jets to shell it, Taftanazi said.

The current round of fighting lasted 10 days, according to another rebel, who gave his name as Hazem al Shami. "This is the biggest attack against the regime from the beginning of the revolution until now," Shami said in a phone interview that may have reflected more bravado than sober analysis. The rebels had tried to seize Taftanaz for months.

In the assault Friday, the rebels said, they pounded the base with a few tanks, artillery, mortars and heavy machine guns.

"Taftanaz is an important victory," said Jeffrey White, a defense fellow at the Washington Institute for Near East Policy. "The rebels showed their ability to take positions even if it takes a long time.... [And] it shows a paralysis in the regime command. They can't figure out how to deal with these situations. You have to wonder what effect it has inside the regime. What tales are being told in the inner circle about the air force's effectiveness."

White said the victory could free more rebel fighters to help take at least two more crucial bases in Idlib.

The rebels captured 15 to 20 MI-8/17 helicopters that were damaged and at least two T-72 tanks and one rocket, according to rebels and to White, who surveyed video posted on YouTube. Videos displayed the rebels showing off their captured spoils. One showed five or six rebels riding on the top of a tank, waving their hands in celebration.

Still, a military or diplomatic solution to Syria's conflict remains elusive. Last weekend, Assad unveiled a peace plan that amounted to a declaration that he alone would determine the war's end, not the United Nations or any other power. Special U.N. and Arab League envoy Lakhdar Brahimi angered the Syrian government by criticizing Assad's initiative.

Brahimi met in Geneva with U.S. Deputy Secretary of State William J. Burns and Russian Deputy Foreign Minister Mikhail Bogdanov in an effort to find common ground on Syria. Both countries say they agree on a peace initiative for Syria from last summer, but Russia refuses to back Washington's demand that Assad step down from power for a transitional government.

With Syria lambasting Brahimi publicly, it was unclear how much further the diplomat could push his peace plan. The meeting concluded without any major announcement.

"If you are asking me whether a solution is around the corner, I am not sure that is the case," Brahimi told reporters. "What I am certain of is that there is an absolute necessity for people to continue to work for such a peaceful solution."

ned.parker@latimes.com

Bulos is a special correspondent.

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Student Appeals Suspension for Refusing to Wear RFID Tracker

A Texas high school student on Friday asked a federal appeals court to overturn a lower court’s order upholding her school suspension for refusing to wear around her neck an RFID-chip student ID she claims is the “Mark of the Beast.”

The Northside Independent School District in San Antonio began issuing the RFID-laden student-body cards when the semester began in the fall. The ID badge has a bar code associated with a student’s Social Security number. The chip monitors pupils’ movements on campus, from when they arrive until when they leave.

Sophomore Andrea Hernandez was notified in November by the Northside Independent School District in San Antonio that she would not be able to continue attending John Jay High unless she wears the badge around her neck like all students. The district said the girl, who objects largely on religious grounds, would have to attend another high school that does not employ the RFID tags.

The devout Christian sued, and on Tuesday a Texas federal judge concluded the 15-year-old’s right of religion was not breached. That’s because the district, the court ruled, eventually agreed to accommodate the girl and allow her to remove the RFID chip while still demanding that she wear the identification like the other students.

U.S. District Judge Orlando Garcia’s ruling gave the girl and her family until Jan. 18 to decide whether to go to a different school or comport. She appealed Friday, arguing that adorning herself with the ID card, even one without an RFID chip, amounted to discriminating against her “sincerely held beliefs.”

“To Andrea, this ‘accommodation’ is similar to allowing a religious adherent who must eat a pork-free diet to have his pork-free diet, but to require him to wear a shirt advocating pork,” the girl’s attorney, Jerry Lynn Ward of the Rutherford Institute, wrote the New Orleans-based appeals court. (.pdf) The lower court’s decision, Ward added, “unquestionably constitutes a substantial burden upon her free exercise of religion.”

David Kravets is a senior staff writer for Wired.com and founder of the fake news site TheYellowDailyNews.com. He's a dad of two boys and has been a reporter since the manual typewriter days.

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Follow @dmkravets and @ThreatLevel on Twitter.

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Flu Deaths Reach Epidemic Level, but May Be at Peak

Deaths in the current flu season have officially crossed the line into “epidemic” territory, federal health officials said Friday, adding that, on the bright side, there were also early signs that the caseloads could be peaking.

Officials from the Centers for Disease Control and Prevention, speaking on a telephone news conference, again urged Americans to keep getting flu shots. At the same time, they emphasized that the shots are not infallible: a preliminary study rated this year’s vaccine as 62 percent effective, even though it is a good match for the most worrisome virus circulating. That corresponds to a rating of “moderately” effective — the vaccine typically ranges from 50 percent to 70 percent effective, they said.

Even though deaths stepped — barely — into epidemic territory for the first time last Saturday, the C.D.C. officials expressed no alarm, and said it was possible that new flu infections were peaking in some parts of the country. “Most of the country is seeing a lot of flu and that may continue for weeks,” said Dr. Thomas R. Frieden, the C.D.C.’s director.

New outpatient cases — a measure based on what percentage of doctor visits were for colds or flu — dropped off slightly from the previous week, to 4 percent from 6 percent. The trend was more pronounced in the South, where this year’s season began.

Dr. Frieden cautioned that the new flu figures could be aberrations because they were gathered as the holiday season was ending. Few people schedule routine checkups then, so the percentage of visits for severe illness can be pushed artificially high for a week or two, then inevitably drop.

Deaths from pneumonia and the flu, a wavy curve that is low in summer and high in winter, typically touch the epidemic level for one or two weeks every flu season. How bad a season is depends on how high the deaths climb for how long.

So far this season, 20 children with confirmed flu tests have died, but that is presumably lower than the actual number of deaths because not all children are tested and not all such deaths are reported. How many adults die will not be estimated until after the season ends, said Dr. Joseph Bresee, the chief of prevention and epidemiology for the C.D.C.’s flu branch. Epidemiologists count how many death certificates are filed in a flu year, compare the number with normal years, and estimate what percentage were probably flu-related.

Many people are getting ill this year because the country is also having widespread outbreaks of two diseases with overlapping symptoms, norovirus and whooping cough, and the normal winter surge in common colds. Flu shots have no effect on any of those.

Spot shortages of vaccines have been reported, and there will not be enough for all Americans, since the industry has made and shipped only about 130 million doses. But officials said they would be pleased if 50 percent of Americans got shots; in a typical year, 37 percent do.

Dr. Bresee said that this year’s epidemic resembles that of 2003-4, which also began early, was dominated by an H3N2 strain and killed more Americans than usual.

Nevertheless, more Americans now routinely get flu shots than did then, and doctors are much quicker to prescribe Tamiflu and Relenza, drugs that can lessen a flu’s severity if taken early.

The C.D.C.’s vaccine effectiveness study bore out the point of view of a report released last year by the University of Minnesota’s Center for Infectious Disease Research and Policy. It said that the shot’s effectiveness had been “overpromoted and overhyped,” said Michael T. Osterholm, the center’s director.

Although the report supported getting flu shots, it said that new vaccines offering lifelong protection against all flu strains, instead of annual partial protection against a mix-and-match set, must be created.

“But there’s no appetite to fund that research,” Dr. Osterholm said in an interview Friday.

“To get a vaccine across the ‘Valley of Death’ is likely to cost $1 billion,” he added, referring to the huge clinical trials that would be needed to approve a new type of vaccine. “No government has put more than $100 million into any candidate, and the private sector has no appetite for it because there’s not enough return on investment.”

At the same time, he praised the C.D.C. for measuring vaccine effectiveness in midseason.

“We’re the only ones in the world who have data like that,” he said.

“Vaccine effectiveness” is a very different metric from vaccine-virus match, which is done in a lab. Vaccine efficacy is measured by interviewing hundreds of sick or recovering patients who had positive flu tests and asking whether and when they had received shots.

Only people sick enough to visit doctors get flu tests, said Thomas Skinner, a C.D.C. spokesman, so the metric means the shot “reduces by 62 percent your chance of getting a flu so bad that you have to go to a doctor or hospital.”

During the telephone news conference Friday, Dr. Frieden repeatedly described the vaccine as “far from perfect, but by far the best tool we have to prevent influenza.”

Most vaccinations given in childhood for threats like measles and diphtheria are 90 percent effective or better. But flu viruses mutate so fast that they must be remade annually. Scientists are trying to develop vaccines that target bits of the virus that appear to stay constant, like the stem of the hemagglutinin spike that lets the virus break into lung cells.

During the 2009 swine flu pandemic, many elderly Americans had natural protection, presumably from flus they caught in the 1930s or ’40s.

“Think about that,” Dr. Osterholm said. “Even though they were old, they were still protected. We’ve got to figure out how to capture that kind of immunity — which current vaccines do not.”

At Friday’s news conference, Dr. Bresee acknowledged the difficulties, saying: “If I had the perfect answer as to how to make a better flu vaccine, I’d probably get a Nobel Prize.”

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DealBook: Regulators Propose Overhaul of Benchmark Interest Rate

LONDON — European regulators called for a major overhaul of a benchmark interest rate on Friday, but stopped short of demanding direct regulatory oversight after a rate-rigging scandal.

The recommended changes to the euro interbank offered rate, or Euribor, come after a $1.5 billion settlement by the Swiss bank UBS, where some traders were found to have altered that rate as well as the London interbank offered rate, or Libor, for financial gain.

The European Banking Authority and European Securities and Markets Authority are pushing to improve the accuracy of the benchmark rate and increase oversight of how banks submit rates to Euribor, which underpins trillions of dollars of global financial products.

European authorities said the system did not require participating banks to have internal governance structures to manage potential conflicts of interest when submitting rates to Euribor. Also, the rate-setting process is not sufficiently assessed against real banking transactions, according to the report.

The recommendations include cutting in half the number of maturities included in the Euribor process, to seven rates. That would leave the focus only on benchmark rates that are supported by a large number of financial transactions.

The change is in response to a drastic reduction of lending among global financial institutions during the financial crisis that reduced the accuracy of firms’ rate submissions. The fall in actual transactions also led a number of traders and senior managers at global banks to manipulate the rate, according to regulatory filings.

On Friday, European authorities did not demand direct regulatory control over Euribor, which continues to be overseen by the European Banking Federation, a trade body. A recent review of Libor by British authorities recommended regulatory oversight of that rate, as well as criminal charges against individuals trying to alter the rate for financial gain.

Despite widespread calls for authorities to take control over global benchmark rates, the European regulatory bodies do not have the legal responsibility to recommend those changes, according to a European Securities and Markets Authority spokesman.

The European Commission is considering changes to how global benchmark rates are set, and is expected to propose legislation later this year.

Other recommendations outlined by European authorities on Friday included regular audits of the rate-setting process by the European Banking Federation, as well as increasing the independence of the board that oversees Euribor. The trade body said it welcomed many of the changes outlined by the European banking and financial market regulators, adding that it was open to regulators participating in the supervision of Euribor.

Greater scrutiny of the benchmark rate is already having an effect.

As more banks continue to be embroiled in the rate-rigging scandal, a number of financial institutions, including Rabobank Groep of the Netherlands and Raiffeisen Bank International of Austria, have left the panel that sets Euribor. Euribor-EBF, the group that oversees the rate, has said other banks could also pull out of the rate-setting process.

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Irvine City Council overhauls oversight, spending on Great Park

Capping a raucous eight-hour-plus meeting, the Irvine City Council early Wednesday voted to overhaul the oversight and spending on the beleaguered Orange County Great Park while authorizing an audit of the more than $220 million that so far has been spent on the ambitious project.

A newly elected City Council majority voted 3 to 2 to terminate contracts with two firms that had been paid a combined $1.1 million a year for consulting, lobbying, marketing and public relations. One of those firms — Forde & Mollrich public relations — has been paid $12.4 million since county voters approved the Great Park plan in 2002.

"We need to stop talking about building a Great Park and actually start building a Great Park," council member Jeff Lalloway said.

The council, by the same split vote, also changed the composition of the Great Park's board of directors, shedding four non-elected members and handing control to Irvine's five council members.

The actions mark a significant turning point in the decade-long effort to turn the former El Toro Marine base into a 1,447-acre municipal park with man-made canyons, rivers, forests and gardens that planners hoped would rival New York's Central Park.

The city hoped to finish and maintain the park for years to come with $1.4 billion in state redevelopment funds. But that money vanished last year as part of the cutbacks to deal with California's massive budget deficit.

"We've gone through $220 million, but where has it gone?" council member Christina Shea said of the project's initial funding from developers in exchange for the right to build around the site. "The fact of the matter is the money is almost gone. It can't be business as usual."

The council majority said the changes will bring accountability and efficiencies to a project that critics say has been larded with wasteful spending and no-bid contracts. For all that has been spent, only about 200 acres of the park has been developed and half of that is leased to farmers.

But council members Larry Agran and Beth Krom, who have steered the course of the project since its inception, voted against reconfiguring the Great Park's board of directors and canceling the contracts with the two firms.

Krom has called the move a "witch hunt" against her and Agran. Feuding between liberal and conservative factions on the council has long shaped Irvine politics.

"This is a power play," she said. "There's a new sheriff in town."

The council meeting stretched long into the night, with the final vote coming Wednesday at 1:34 a.m. Tensions were high in the packed chambers with cheering, clapping and heckling coming from the crowd.

At one point council member Lalloway lamented that he "couldn't hear himself think."

During public comments, newly elected Orange County Supervisor Todd Spitzer chastised the council for "fighting like schoolchildren." Earlier this week he said that if the Irvine's new council majority can't make progress on the Great Park, he would seek a ballot initiative to have the county take over.

And Spitzer angrily told Agran that his stewardship of the project had been a failure.

"You know what?" he said. "It's their vision now. You're in the minority."

mike.anton@latimes.com

rhea.mahbubani@latimes.com

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Top U.S. General Says Stopping a Syrian Chemical Attack Is 'Almost Unachievable'

If Syrian dictator Bashar Assad decides to use his chemical weapons, there won’t be a thing the U.S. military can do to stop him, America’s top military officer conceded on Thursday. Nor will the U.S. step into a “hostile” atmosphere, with or without Assad, to keep those chemicals under control.

It’s been a month since U.S. intelligence learned that Assad’s forces were mixing some of their precursor chemicals for sarin gas, as Danger Room first reported. The Syrian military even loaded aerial bombs with the deadly agent. Assad hasn’t used the weapons — yet. Should he change his mind, there’s little chance the U.S. would know it before it’s too late to stop the first chemical attack in the Mideast in over 20 years.

“The act of preventing the use of chemical weapons would be almost unachievable,” Gen. Martin Dempsey, the chairman of the Joint Chiefs of Staff, told reporters at the Pentagon. “You would have to have such clarity of intelligence, persistent surveillance, you’d have to actually see it before it happened. And that’s unlikely, to be sure.”

That explains the emphasis the Obama administration has given, from President Obama and Defense Secretary Leon Panetta on down, to publicly warning Assad that using his chemical weapons would cross a “red line.” Dempsey said that “messaging” seeks to establish a deterrent, since Assad might think it would prompt outright U.S. or international intervention leading to his downfall. But that’s different from preemption.

American officials began strategizing months ago for how it should operate in a post-Assad Syria. And that includes scoping out plans for disposing of Assad’s stockpiles of nerve and mustard agents.

Today, however, Panetta shot down a related preventive step: sending U.S. troops into the chaos of the Syrian civil war to secure the chemical stocks.

U.S. military officials have previously speculated that an intervention to take hold of an estimated 500 tons of chemical precursors would require 75,000 troops, a force larger than the one currently in Afghanistan. Panetta said the international community needs to establish a “process and procedure” for keeping the stockpiles under control — but only after Assad falls, which is an uncertain proposition. U.S. intervention to lock down the chemicals, Panetta said, would depend on the establishment of new regime willing to invite the U.S. military in — another uncertain proposition.

“We’re not working on options that involve boots on the ground,” Panetta said. If there’s a “peaceful transition,” then the U.S. might consider a request that a friendly successor government might make to secure the chemical stocks. “But in a hostile situation, we’re not planning for that.” It’s looking likely that the 400 U.S. soldiers sent to Turkey to man Patriot missile batteries could be the only uniformed troops that the Pentagon openly sends to handle the Syrian crisis.

The U.S. public has little appetite for throwing exhausted U.S. soldiers and marines into yet another bloody Mideastern conflict. But Panetta and Dempsey’s concession underscores the massive risks that the Syrian civil war poses for either the use or black market proliferation of chemical weapons. The revolution has  already claimed the lives of 60,000 Syrians. The longer it goes on, the greater the pressure Assad may feel to unleash his unconventional arms. Alternatively, various Syrian factions might be either unwilling or unable to secure the stocks, should they prevail, nor is there any guarantee they will give up the chemical weapons once victorious.

There is confusion about how long the sarin gas will remain usable once its precursors combine. Nerve agents are inherently unstable, but U.S. government sources have told Danger Room that Syrian sophistication with chemical weaponry may leave the combined, weaponized sarin deadly for up to a year. Dempsey and Panetta, however, believe that they’ll break down after 60 days. “That’s what the scientists tell us,” Dempsey said. “I’d still be reluctant to handle it myself.”

Disposing of (or “demilitarizing”) chemical weapons is extraordinarily difficult under any circumstances; Iraq’s former chemical bunkers are still toxic nearly  than a decade after Saddam’s overthrow, and the U.S. recently said it won’t be done disposing of its Cold War chemical weapon arsenal until 2023. Assad’s nerve agents will be no exception.

One of sarin’s main precursors – methylphosphonyl difluoride, or DF – can be turned into a somewhat non-toxic slurry, if combined properly with lye and water. The problem is that when DF reacts with water, it generates heat. And since DF has an extremely low boiling point — just 55.4 degrees Celsius — it means that the chances of accidentally releasing toxic gases are really high. “You could easily kill yourself during the demil,” one observer told Danger Room during the fall. That would explain Dempsey’s reluctance to touch it.

Naturally, this process could only begin once the DF and the rubbing alcohol (sarin’s other main precursor) was gathered up from Assad’s couple dozen storage locations. Then, they’d have to be carted far, far out into the desert — to make sure no bystanders could be hurt — along with the enormous stirred-tank reactors needed to conduct the dangerous chemistry experiments. And when it was all done, there would the result would be a whole lot of hydrofluoric acid, which is itself a poison.

It’s an operation that will take many months, many men, and many millions of dollars. No wonder the leaders of America’s overtaxed military won’t commit to the job until the Syrian civil war is done.

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Adele to join in Hollywood’s Golden Globe party

LOS ANGELES (Reuters) – Pop star Adele is set to attend the Golden Globes ceremony in Beverly Hills on Sunday in what will be her first public appearance since giving birth to a boy in October.

Golden Globe organizers said the 24-year-old British singer would be attending as a nominee, rather than a performer. Her “Skyfall” theme song for the latest James Bond movie is in the running for best original song at the Golden Globes – one of Hollywood’s biggest awards shows.

The “Someone Like You” singer gave birth to her first child in October with her partner, Simon Konecki, but has since kept out of the public eye.

She performed and co-wrote the theme song for “Skyfall,” a $ 1 billion box office hit, while her Grammy-winning heartbreak album “21″ scored the rare feat in December of topping all U.S. album sales for a second straight year.

Adele will find herself mingling with some of Hollywood’s biggest movie and TV stars on January 13, including Golden Globe presenters George Clooney, Jennifer Lopez and Meryl Streep, and nominees such as Jon Hamm, Ben Affleck, Daniel Day-Lewis, Helen Mirren, Leonardo DiCaprio, Anne Hathaway and Kevin Costner.

(Reporting By Jill Serjeant; Editing by Eric Walsh)

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F.D.A. Requires Cuts to Dosages of Ambien and Other Sleep Drugs

WASHINGTON — For two decades, millions of Americans have taken Ambien to help them sleep at night. But for years, the Food and Drug Administration has gotten complaints that people felt drowsy the morning after taking the medicine or its successors, and sometimes got into car accidents.

On Thursday, after laboratory studies and driving tests confirming the risks of drowsiness, the agency said that women should be taking half as much.

The new recommendation applies to drugs containing the active ingredient zolpidem, by far the most widely used sleep aid. Using lower doses means less of the drug will remain in the blood in the morning hours, and will reduce the risk that people who use it will be impaired while driving.

Sleeping pills have boomed in popularity with the increasingly frantic pace of modern American life. According to IMS, a health care information and technology company, about 60 million prescriptions were dispensed in 2011, up about 20 percent since 2006. About 40 million were for products containing zolpidem.

The agency’s announcement was focused on women because they take longer to metabolize the drug than men. An estimated 10 percent to 15 percent of women will have a level of zolpidem in their blood that could impair driving eight hours after taking the pill, while only about 3 percent of men do, said Dr. Robert Temple, an official in the agency’s Center for Drug Evaluation and Research.

Reports of aftereffects from sleeping pills have circulated for years, and some doctors questioned why the drug agency took so long to act. Mishaps with sleepy driving — and even strange acts of texting, eating or having sex in the night without any memory of it in the morning — have long been familiar to the medical community.

“In this case, the F.D.A. may be behind the 8-ball,” said Daniel Carlat, an associate clinical professor of psychiatry at Tufts University, referring to residual drowsiness. “This has been a known problem. Few doctors will be surprised hearing about this. They’ll say, ‘Oh yeah, we’ve already seen this in our patients.’ ”

He added that Thursday’s announcement “will be good for public health because it will get patients to ask their doctors about the appropriate dosage.”

Agency officials acknowledged that they had received about 700 reports of driving mishaps with people on zolpidem over the years, with a spike in 2007 after a change in labeling caused more people to call in complaints. But they said it was not easy to draw a direct connection between the reports and the drug. Patients often did not remember what time they took the pill. Sometimes they had been drinking.

It was not until the drug agency reviewed driving simulation studies from controlled trials of the drug Intermezzo, which was approved in 2011 for middle-of-the-night waking, that a more complete picture of the risks emerged. The agency linked the driving simulation information with data from manufacturers on the amount of zolpidem in patients’ blood and determined that levels above about 50 nanograms per milliliter increased the risk of crashing while driving, said Dr. Ellis Unger, an official at the agency’s Center for Drug Evaluation and Research.

Dr. Unger said that all makers of new sleeping drugs would now be asked to conduct driving trials; a spokeswoman clarified that it would not be required.

“A lot of people are wondering about the elephant in the room,” Dr. Unger said. “Why did this take so long? This is science, and our thinking evolves over time.”

The drug agency told manufacturers that the recommended dose for women should be lowered to 5 milligrams from 10 for immediate-release products like Ambien, Edluar and Zolpimist. Doses for extended-release products should be lowered to 6.25 milligrams from 12.5, the agency said. Most sleeping drugs containing zolpidem are now generic.

For men, the agency informed manufacturers that labels should recommend that health care providers should “consider” prescribing lower doses.

Patients taking the higher doses should continue them for the time being, officials said, but should consult with their doctors about lowering them. Doctors can still prescribe the higher dose if the lower one does not work. The lower doses are already commercially available, Dr. Unger said, as they are recommended for older patients.

Sanofi, the manufacturer of Ambien and Ambien CR, said in a statement that it agreed that people taking zolpidem “should always talk to their doctor about the most appropriate dose,” and that the label “provides important information” to determine what that is. The company added that it “stands behind the significant clinical data demonstrating the safety and efficacy of Ambien.”

The drug has also been known to cause sleepwalking incidents, and Dr. Unger said there was evidence that the lower dose might ease such events, though it is weaker than the evidence about next-morning-drowsiness. Dr. Carlat said one of his patients discovered that her weight gain while on the drug was from midnight trips to the kitchen she did not even remember taking.

Dr. Daniel Kripke, professor emeritus of psychiatry at the University of California, San Diego, and a leading critic of sleeping pills, welcomed the move but said the agency was still not doing enough to investigate other possible side effects.

“It’s a very small step in the right direction,” he said. He added that sleeping medications like zolpidem might increase total sleep time by 20 minutes a night, but that most studies suggest that the use of sleeping pills impairs a person’s performance the next day.

Critics of the drug agency said the label on Intermezzo, which very clearly denotes the risks for women, indicate that the agency was aware of these problems earlier.

But Thomas Roth, director of the sleep center at Henry Ford Hospital in Detroit who has been a consultant to sleeping pill makers, said that the drug agency had always been concerned about the potential risks with driving, “but they care about it more now.” He said he believed the lower dose would still be effective for many patients.

Agency officials say all patients are unique and doses will need to be tailored. They say the drugs should be prescribed at the lowest dose required.

Dr. Daniel J. Buysse, professor of psychiatry at the University of Pittsburgh School of Medicine, said he already prescribed the lower dose when he feels it is necessary, by telling patients to cut a tablet in half along the score.

“This just tells me, maybe be a little bit more cautious,” said Dr. Buysse, who has been a consultant for drug companies including the maker of Ambien. “But I do not think it will have a big effect on what I do.”

Andrew Pollack contributed reporting from San Francisco.

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Electronic Records Systems Have Not Reduced Health Costs, Report Says

The conversion to electronic health records has failed so far to produce the hoped-for savings in health care costs and has had mixed results, at best, in improving efficiency and patient care, according to a new analysis by the influential RAND Corporation.

Jim Wilson/The New York Times

Dr. Alvin Rajkomar tracks patient data on a Samsung Galaxy Note. A new report questions whether electronic records reduce health care costs.

Optimistic predictions by RAND in 2005 helped drive explosive growth in the electronic records industry and encouraged the federal government to give billions of dollars in financial incentives to hospitals and doctors that put the systems in place.

“We’ve not achieved the productivity and quality benefits that are unquestionably there for the taking,” said Dr. Arthur L. Kellermann, one of the authors of a reassessment by RAND that was published in this month’s edition of Health Affairs, an academic journal.

RAND’s 2005 report was paid for by a group of companies, including General Electric and Cerner Corporation, that have profited by developing and selling electronic records systems to hospitals and physician practices. Cerner’s revenue has nearly tripled since the report was released, to a projected $3 billion in 2013, from $1 billion in 2005.

The report predicted that widespread use of electronic records could save the United States health care system at least $81 billion a year, a figure RAND now says was overstated. The study was widely praised within the technology industry and helped persuade Congress and the Obama administration to authorize billions of dollars in federal stimulus money in 2009 to help hospitals and doctors pay for the installation of electronic records systems.

“RAND got a lot of attention and a lot of buzz with the original analysis,” said Dr. Kellermann, who was not involved in the 2005 study. “The industry quickly embraced it.”

But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services.

Health care spending has risen $800 billion since the first report was issued, according to federal figures. The reasons are many, from the aging of the baby boomer population, to the cost of medical advances, to higher usage of medical services over all.

Officials at RAND said their new analysis did not try to put a dollar figure on how much electronic record-keeping had helped or hurt efforts to reduce costs. But the firm’s acknowledgment that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted.

The recent analysis was sharply critical of the commercial systems now in place, many of which are hard to use and do not allow doctors and patients to share medical information across systems. “We could be getting much more if we could take the time to do a little more planning and to set more standards,” said Marc Probst, chief information officer for Intermountain Healthcare, a large health system in Salt Lake City that developed its own electronic records system and is cited by RAND as an example of how the technology can help improve care and reduce costs.

The RAND researchers pointed to a number of other reasons the expected savings had not materialized. The rate of adoption has been slow, they said, and electronic records do not address the fact that doctors and hospitals reap the benefits of high volumes of care.

Many experts say the available systems seem to be aimed more at increasing billing by providers than at improving care or saving money. Federal regulators are investigating whether electronic records make it easier for hospitals and doctors to bill for services they did not provide and whether Medicare and other federal agencies are adequately monitoring the use of electronic records.

Technology “is only a tool,” said Dr. David Blumenthal, who helped oversee the federal push for the adoption of electronic records under President Obama and is now president of the Commonwealth Fund, a nonprofit health group. “Like any tool, it can be used well or poorly.” While there is strong evidence that electronic records can contribute to better care and more efficiency, Dr. Blumenthal said, the systems in place do not always work in ways that help achieve those benefits.

Federal officials say they are drafting new rules to address many of the concerns about the current systems.

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