with painkillers over strategy cost over safety lawyers

1
U(D54G1D)y+@!;!#!#!_ When North Korea launched long-range missiles this summer, and again on Friday, demonstrat- ing its ability to strike Guam and perhaps the United States main- land, it powered the weapons with a rare, potent rocket fuel that American intelligence agencies believe initially came from China and Russia. The United States government is scrambling to determine whether those two countries are still providing the ingredients for the highly volatile fuel and, if so, whether North Korea’s supply can be interrupted, either through sanctions or sabotage. Among those who study the issue, there is a growing belief that the United States should focus on the fuel, ei- ther to halt it, if possible, or to take advantage of its volatile proper- ties to slow the North’s program. But it may well be too late. Intel- ligence officials believe that the North’s program has advanced to the point where it is no longer as reliant on outside suppliers, and that it may itself be making the deadly fuel, known as UDMH. De- spite a long record of intelligence warnings that the North was ac- quiring both forceful missile en- gines and the fuel to power them, there is no evidence that Washing- ton has ever moved with urgency to cut off Pyongyang’s access to the rare propellant. Classified memos from both the George W. Bush and Obama ad- ministrations laid out, with what turned out to be prescient clarity, Nuclear Boasts Of North Korea Hinge on a Fuel By WILLIAM J. BROAD and DAVID E. SANGER Continued on Page A9 On a muggy, late spring evening, Tuan Pham awoke to the police storming his house in Ha- noi, Vietnam. They marched him to a police station and made their demand: Hand over your Facebook pass- word. Mr. Tuan, a computer engi- neer, had recently written a poem on the social network called “Mother’s Lullaby,” which criti- cized how the communist country was run. One line read, “One century has passed, we are still poor and hun- gry, do you ask why?” Mr. Tuan’s arrest came just weeks after Facebook offered a major olive branch to Vietnam’s government. Facebook’s head of global policy management, Monika Bickert, met with a top Vietnamese official in April and pledged to remove information from the social network that vio- lated the country’s laws. While Facebook said its policies in Vietnam have not changed, and it has a consistent process for gov- ernments to report illegal content, the Vietnamese government was specific. The social network, they have said, had agreed to help cre- ate a new communications chan- nel with the government to pri- oritize Hanoi’s requests and re- move what the regime considered inaccurate posts about senior leaders. Populous, developing countries like Vietnam are where the com- pany is looking to add its next bil- lion customers — and to bolster its ad business. Facebook’s promise to Vietnam helped the social me- dia giant placate a government Facebook Is Navigating a Global Power Struggle This article is by Paul Mozur, Mark Scott and Mike Isaac. A Fracturing Internet as Nations Erect New Hurdles Continued on Page A6 KEVIN WINTER/GETTY IMAGES Elisabeth Moss, right, won best lead actress for “The Handmaid’s Tale,” named best drama. Page C1. An Emmy for a Handmaid GAMBELL, Alaska — In a modest boardinghouse on an Alaskan island just 30 miles across the sea from Russia, a handwritten order form hangs on the refrigerator. There are photos of cakes a few women in this vil- lage can make for you: rectangles of yellow cake and devil’s food en- robed in buttercream, with local nicknames piped out in pink. “Happy Birthday Bop-Bop,” one reads. Another, “Happy Birth- day Siti-Girl.” Traveling out here, where huge bones from bowhead whales litter the beach, takes a 90-minute jet ride north from Anchorage and another hour by small plane over the Bering Sea. In this vast, wild part of America, accessible only by water or air, there may not be plumbing or potable water, the lo- cal store may not carry perish- ables and people may have to rely on caribou or salmon or bearded seal meat to stay fed. But no matter where you go, you will always find a cake-mix cake. Elsewhere, the American appe- tite for packaged baking mixes is waning, according to the market research firm Mintel, as con- sumers move away from pack- aged foods with artificial ingredi- ents and buy more from in-store bakeries and specialty pastry shops. Yet in the small, mostly in- digenous communities that dot rural Alaska, box cake is a stal- wart staple, the star of every com- munity dessert table and a potent fund-raising tool. “Cake mixes are the center of our little universe,” said Cynthia Erickson, who owns the only gro- cery store in Tanana, an Athabas- can village of 300 along the Yukon River in central Alaska. “I have four damn shelves full.” Eating in rural Alaska is all about managing the expense and scarcity of store-bought food while trying to take advantage of seasonally abundant wild foods. Cash economies are weak, utili- ties and fuel are expensive and many families live below the fed- eral poverty line. To offset the cost of living, Alaska Natives here rely on tradi- tional practices of hunting, fishing and gathering, known as “subsist- ence.” In a good year, they fill freezers with moose, berries, car- ibou, salmon or marine mammals, depending on where they live. In a bad year, they have to buy more from the store. The offerings in village stores often resemble those in the mini- marts or bodegas of America’s ur- ban food deserts, at two and three Boxed Cake Mix Sweetens Life In Far-Flung Regions of Alaska By JULIA O’MALLEY A lemon-blueberry cake baked by Cynthia Erickson. RUTH FREMSON/THE NEW YORK TIMES Continued on Page A17 WASHINGTON — President Trump’s legal team is wrestling with how much to cooperate with the special counsel looking into Russian election interference, an internal debate that led to an an- gry confrontation last week be- tween two White House lawyers and that could shape the course of the investigation. At the heart of the clash is an is- sue that has challenged multiple presidents during high-stakes Washington investigations: how to handle the demands of investi- gators without surrendering the institutional prerogatives of the office of the presidency. Similar conflicts during the Watergate and Monica S. Lewinsky scandals resulted in court rulings that lim- ited a president’s right to confi- dentiality. The debate in Mr. Trump’s West Wing has pitted Donald F. Mc- Gahn II, the White House counsel, against Ty Cobb, a lawyer brought in to manage the response to the investigation. Mr. Cobb has ar- gued for turning over as many of the emails and documents re- quested by the special counsel as possible in hopes of quickly end- ing the investigation — or at least its focus on Mr. Trump. Mr. McGahn supports coopera- tion, but has expressed worry about setting a precedent that would weaken the White House long after Mr. Trump’s tenure is over. He is described as particu- larly concerned about whether the president will invoke execu- tive or attorney-client privilege to limit how forthcoming Mr. Mc- Gahn could be if he himself is in- terviewed by the special counsel Lawyers Clash Over Strategy By West Wing Requests From Mueller Reveal New Tensions By PETER BAKER and KENNETH P. VOGEL Continued on Page A16 At a time when the United States is in the grip of an opioid epidemic, many insurers are lim- iting access to pain medications that carry a lower risk of addiction or dependence, even as they pro- vide comparatively easy access to generic opioid medications. The reason, experts say: Opioid drugs are generally cheap while safer alternatives are often more expensive. Drugmakers, pharmaceutical distributors, pharmacies and doc- tors have come under intense scrutiny in recent years, but the role that insurers — and the phar- macy benefit managers that run their drug plans — have played in the opioid crisis has received less attention. That may be changing, however. The New York State at- torney general’s office sent letters last week to the three largest pharmacy benefit managers — CVS Caremark, Express Scripts and OptumRx — asking how they were addressing the crisis. ProPublica and The New York Times analyzed Medicare pre- scription drug plans covering 35.7 million people in the second quar- ter of this year. Only one-third of the people covered, for example, had any access to Butrans, a painkilling skin patch that con- tains a less-risky opioid, buprenorphine. And every drug plan that covered lidocaine patches, which are not addictive INSURERS PUTTING COST OVER SAFETY WITH PAINKILLERS CHEAP OPIOIDS FAVORED Many Plans Limit Access to Drugs With Lower Risk of Abuse By KATIE THOMAS and CHARLES ORNSTEIN Continued on Page A17 BALUKHALI, Bangladesh — Nazir Hossain, the imam of a vil- lage in far western Myanmar, gathered the faithful around him after evening prayers last month. In a few hours, more than a dozen Arakan Rohingya Salvation Army fighters from his village would strike a nearby police post with an assortment of handmade weap- ons. The men needed their cleric’s blessing. “As imam, I encouraged them never to step back from their mis- sion,” Mr. Hossein recalled of his final words to the ethnic Rohingya militants. “I told them that if they did not fight to the death, the mili- tary would come and kill their families, their women and their children.” They fought — joining an Aug. 25 assault by thousands of the group’s fighters against Myan- mar’s security forces — and the retaliation came down anyway. Since then, Myanmar’s troops and vigilante mobs have unleashed a scorched-earth operation on Ro- hingya populations in northern Rakhine State in Myanmar, send- ing hundreds of thousands fleeing their homes in a campaign that the United Nations has called eth- nic cleansing. Fears That Crisis Could Lead Rohingya to Terror on World Stage By HANNAH BEECH Rohingya refugees crossed the Naf River into Bangladesh this month as smoke rose from a nearby burning village in Myanmar. PHOTOGRAPHS BY ADAM DEAN FOR THE NEW YORK TIMES Nazir Hossain, an imam in western Myanmar, gave his blessing to Rohingya fighters before they attacked a police post in August. Continued on Page A11 Facebook must provide more detail about the Russian ads, Jim Rutenberg says. Page B1. Russian Facebook Meddling Arrivals of migrants in Italy have plunged in recent months, but the re- versal is provoking questions. PAGE A4 INTERNATIONAL A4-12 Italy Stalls Flow of Migrants In the aftermath of Hurricane Harvey, the part-time mayor of Port Arthur has been too busy helping his neighbors to clean up his own flooded house. PAGE A13 NATIONAL A13-17 Texas Mayor Puts City First Owning a low-price retail store offers immigrants an alternative to restaurant and garment factory jobs. PAGE A18 NEW YORK A18-21 A Dollar Store and a Dream Complaints from male fans about the sound of female sports announcers’ voices may mask worries about some- thing deeper. PAGE D1 SPORTS D1-6 The Meaning of ‘Shrill’ The Holocaust Museum is at the center of a debate over the Obama administra- tion’s legacy in Syria. PAGE C1 ARTS C1-8 Backlash Over Syria Report Nikki R. Haley has cast herself as someone who can sway President Trump on foreign policy. PAGE A10 Test for Trump’s U.N. Envoy Despite affirmative action, black and Hispanic students are more underrepre- sented at top colleges nationwide, though some schools saw gains. PAGE A15 Diversity Efforts Fall Short FEMA mobilized all 28 of its search- and-rescue teams for Hurricane Har- vey, and 22 for Hurricane Irma. PAGE A14 Help From Across the U.S. Thousands turned out at St. Patrick’s Cathedral to view relics of St. Padre Pio, an Italian canonized in 2002. PAGE A18 The Faithful Honor a Saint For many Latino major leaguers, the long-running sitcom is as educational as it is entertaining. PAGE D1 They’ve Got to Have ‘Friends’ On the eve of the magazine’s 50th anni- versary, Wenner Media offers its stake to buyers. PAGE B1 BUSINESS DAY B1-7 Rolling Stone Is for Sale Shinzo Abe PAGE A23 EDITORIAL, OP-ED A22-23 At the Cornell Tech campus on Roose- velt Island, large art installations aim to spur students’ imaginations. PAGE C5 Inspiring Art at Cornell Tech Late Edition VOL. CLXVII . . . No. 57,724 © 2017 The New York Times Company NEW YORK, MONDAY, SEPTEMBER 18, 2017 Today, morning fog, humid, variably cloudy, high 79. Tonight, some clouds, fog late, low 67. Tomorrow, cloudy, some rain, windy, high 75. Weather map appears on Page B6. $2.50

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C M Y K Nxxx,2017-09-18,A,001,Bs-4C,E2

U(D54G1D)y+@!;!#!#!_

When North Korea launchedlong-range missiles this summer,and again on Friday, demonstrat-ing its ability to strike Guam andperhaps the United States main-land, it powered the weapons witha rare, potent rocket fuel thatAmerican intelligence agenciesbelieve initially came from Chinaand Russia.

The United States governmentis scrambling to determinewhether those two countries arestill providing the ingredients forthe highly volatile fuel and, if so,whether North Korea’s supply canbe interrupted, either throughsanctions or sabotage. Amongthose who study the issue, there isa growing belief that the UnitedStates should focus on the fuel, ei-ther to halt it, if possible, or to takeadvantage of its volatile proper-ties to slow the North’s program.

But it may well be too late. Intel-ligence officials believe that theNorth’s program has advanced tothe point where it is no longer asreliant on outside suppliers, andthat it may itself be making thedeadly fuel, known as UDMH. De-spite a long record of intelligencewarnings that the North was ac-quiring both forceful missile en-gines and the fuel to power them,there is no evidence that Washing-ton has ever moved with urgencyto cut off Pyongyang’s access tothe rare propellant.

Classified memos from both theGeorge W. Bush and Obama ad-ministrations laid out, with whatturned out to be prescient clarity,

Nuclear BoastsOf North KoreaHinge on a Fuel

By WILLIAM J. BROADand DAVID E. SANGER

Continued on Page A9

On a muggy, late springevening, Tuan Pham awoke to thepolice storming his house in Ha-noi, Vietnam.

They marched him to a policestation and made their demand:Hand over your Facebook pass-word. Mr. Tuan, a computer engi-neer, had recently written a poemon the social network called“Mother’s Lullaby,” which criti-cized how the communist countrywas run.

One line read, “One century haspassed, we are still poor and hun-gry, do you ask why?”

Mr. Tuan’s arrest came justweeks after Facebook offered amajor olive branch to Vietnam’s

government. Facebook’s head ofglobal policy management,Monika Bickert, met with a topVietnamese official in April andpledged to remove informationfrom the social network that vio-lated the country’s laws.

While Facebook said its policiesin Vietnam have not changed, andit has a consistent process for gov-ernments to report illegal content,the Vietnamese government wasspecific. The social network, they

have said, had agreed to help cre-ate a new communications chan-nel with the government to pri-oritize Hanoi’s requests and re-move what the regime consideredinaccurate posts about seniorleaders.

Populous, developing countrieslike Vietnam are where the com-pany is looking to add its next bil-lion customers — and to bolster itsad business. Facebook’s promiseto Vietnam helped the social me-dia giant placate a government

Facebook Is Navigating a Global Power StruggleThis article is by Paul Mozur,

Mark Scott and Mike Isaac.A Fracturing Internet

as Nations ErectNew Hurdles

Continued on Page A6

KEVIN WINTER/GETTY IMAGES

Elisabeth Moss, right, won best lead actress for “The Handmaid’s Tale,” named best drama. Page C1.An Emmy for a Handmaid

GAMBELL, Alaska — In amodest boardinghouse on anAlaskan island just 30 milesacross the sea from Russia, ahandwritten order form hangs onthe refrigerator. There are photosof cakes a few women in this vil-lage can make for you: rectanglesof yellow cake and devil’s food en-robed in buttercream, with localnicknames piped out in pink.

“Happy Birthday Bop-Bop,”one reads. Another, “Happy Birth-day Siti-Girl.”

Traveling out here, where huge

bones from bowhead whales litterthe beach, takes a 90-minute jetride north from Anchorage andanother hour by small plane overthe Bering Sea. In this vast, wildpart of America, accessible onlyby water or air, there may not beplumbing or potable water, the lo-cal store may not carry perish-ables and people may have to relyon caribou or salmon or beardedseal meat to stay fed.

But no matter where you go,

you will always find a cake-mixcake.

Elsewhere, the American appe-tite for packaged baking mixes iswaning, according to the marketresearch firm Mintel, as con-sumers move away from pack-aged foods with artificial ingredi-ents and buy more from in-storebakeries and specialty pastryshops. Yet in the small, mostly in-digenous communities that dotrural Alaska, box cake is a stal-wart staple, the star of every com-munity dessert table and a potentfund-raising tool.

“Cake mixes are the center ofour little universe,” said CynthiaErickson, who owns the only gro-cery store in Tanana, an Athabas-can village of 300 along the YukonRiver in central Alaska. “I havefour damn shelves full.”

Eating in rural Alaska is allabout managing the expense andscarcity of store-bought foodwhile trying to take advantage ofseasonally abundant wild foods.Cash economies are weak, utili-ties and fuel are expensive andmany families live below the fed-eral poverty line.

To offset the cost of living,Alaska Natives here rely on tradi-tional practices of hunting, fishingand gathering, known as “subsist-ence.” In a good year, they fillfreezers with moose, berries, car-ibou, salmon or marine mammals,depending on where they live. In abad year, they have to buy morefrom the store.

The offerings in village storesoften resemble those in the mini-marts or bodegas of America’s ur-ban food deserts, at two and three

Boxed Cake Mix Sweetens LifeIn Far-Flung Regions of Alaska

By JULIA O’MALLEY

A lemon-blueberry cake bakedby Cynthia Erickson.

RUTH FREMSON/THE NEW YORK TIMES

Continued on Page A17

WASHINGTON — PresidentTrump’s legal team is wrestlingwith how much to cooperate withthe special counsel looking intoRussian election interference, aninternal debate that led to an an-gry confrontation last week be-tween two White House lawyersand that could shape the course ofthe investigation.

At the heart of the clash is an is-sue that has challenged multiplepresidents during high-stakesWashington investigations: howto handle the demands of investi-gators without surrendering theinstitutional prerogatives of theoffice of the presidency. Similarconflicts during the Watergateand Monica S. Lewinsky scandalsresulted in court rulings that lim-ited a president’s right to confi-dentiality.

The debate in Mr. Trump’s WestWing has pitted Donald F. Mc-Gahn II, the White House counsel,against Ty Cobb, a lawyer broughtin to manage the response to theinvestigation. Mr. Cobb has ar-gued for turning over as many ofthe emails and documents re-quested by the special counsel aspossible in hopes of quickly end-ing the investigation — or at leastits focus on Mr. Trump.

Mr. McGahn supports coopera-tion, but has expressed worryabout setting a precedent thatwould weaken the White Houselong after Mr. Trump’s tenure isover. He is described as particu-larly concerned about whetherthe president will invoke execu-tive or attorney-client privilege tolimit how forthcoming Mr. Mc-Gahn could be if he himself is in-terviewed by the special counsel

Lawyers ClashOver StrategyBy West Wing

Requests From MuellerReveal New Tensions

By PETER BAKERand KENNETH P. VOGEL

Continued on Page A16

At a time when the UnitedStates is in the grip of an opioidepidemic, many insurers are lim-iting access to pain medicationsthat carry a lower risk of addictionor dependence, even as they pro-vide comparatively easy access togeneric opioid medications.

The reason, experts say: Opioiddrugs are generally cheap whilesafer alternatives are often moreexpensive.

Drugmakers, pharmaceuticaldistributors, pharmacies and doc-tors have come under intensescrutiny in recent years, but therole that insurers — and the phar-macy benefit managers that runtheir drug plans — have played inthe opioid crisis has received lessattention. That may be changing,however. The New York State at-torney general’s office sent letterslast week to the three largestpharmacy benefit managers —CVS Caremark, Express Scriptsand OptumRx — asking how theywere addressing the crisis.

ProPublica and The New YorkTimes analyzed Medicare pre-scription drug plans covering 35.7million people in the second quar-ter of this year. Only one-third ofthe people covered, for example,had any access to Butrans, apainkilling skin patch that con-tains a less-risky opioid,buprenorphine. And every drugplan that covered lidocainepatches, which are not addictive

INSURERS PUTTINGCOST OVER SAFETYWITH PAINKILLERS

CHEAP OPIOIDS FAVORED

Many Plans Limit Accessto Drugs With Lower

Risk of Abuse

By KATIE THOMASand CHARLES ORNSTEIN

Continued on Page A17

BALUKHALI, Bangladesh —Nazir Hossain, the imam of a vil-lage in far western Myanmar,gathered the faithful around himafter evening prayers last month.In a few hours, more than a dozenArakan Rohingya Salvation Armyfighters from his village wouldstrike a nearby police post with anassortment of handmade weap-ons.

The men needed their cleric’sblessing.

“As imam, I encouraged themnever to step back from their mis-sion,” Mr. Hossein recalled of hisfinal words to the ethnic Rohingyamilitants. “I told them that if theydid not fight to the death, the mili-

tary would come and kill theirfamilies, their women and theirchildren.”

They fought — joining an Aug.25 assault by thousands of thegroup’s fighters against Myan-mar’s security forces — and theretaliation came down anyway.Since then, Myanmar’s troops andvigilante mobs have unleashed ascorched-earth operation on Ro-hingya populations in northernRakhine State in Myanmar, send-ing hundreds of thousands fleeingtheir homes in a campaign thatthe United Nations has called eth-nic cleansing.

Fears That Crisis Could Lead Rohingya to Terror on World StageBy HANNAH BEECH

Rohingya refugees crossed the Naf River into Bangladesh this month as smoke rose from a nearby burning village in Myanmar.PHOTOGRAPHS BY ADAM DEAN FOR THE NEW YORK TIMES

Nazir Hossain, an imam in western Myanmar, gave his blessingto Rohingya fighters before they attacked a police post in August.Continued on Page A11

Facebook must provide moredetail about the Russian ads, JimRutenberg says. Page B1.

Russian Facebook Meddling

Arrivals of migrants in Italy haveplunged in recent months, but the re-versal is provoking questions. PAGE A4

INTERNATIONAL A4-12

Italy Stalls Flow of Migrants

In the aftermath of Hurricane Harvey,the part-time mayor of Port Arthur hasbeen too busy helping his neighbors toclean up his own flooded house. PAGE A13

NATIONAL A13-17

Texas Mayor Puts City First

Owning a low-price retail store offersimmigrants an alternative to restaurantand garment factory jobs. PAGE A18

NEW YORK A18-21

A Dollar Store and a Dream

Complaints from male fans about thesound of female sports announcers’voices may mask worries about some-thing deeper. PAGE D1

SPORTS D1-6

The Meaning of ‘Shrill’The Holocaust Museum is at the centerof a debate over the Obama administra-tion’s legacy in Syria. PAGE C1

ARTS C1-8

Backlash Over Syria Report

Nikki R. Haley has cast herself assomeone who can sway PresidentTrump on foreign policy. PAGE A10

Test for Trump’s U.N. Envoy

Despite affirmative action, black andHispanic students are more underrepre-sented at top colleges nationwide,though some schools saw gains. PAGE A15

Diversity Efforts Fall Short

FEMA mobilized all 28 of its search-and-rescue teams for Hurricane Har-vey, and 22 for Hurricane Irma. PAGE A14

Help From Across the U.S.Thousands turned out at St. Patrick’sCathedral to view relics of St. Padre Pio,an Italian canonized in 2002. PAGE A18

The Faithful Honor a Saint

For many Latino major leaguers, thelong-running sitcom is as educationalas it is entertaining. PAGE D1

They’ve Got to Have ‘Friends’

On the eve of the magazine’s 50th anni-versary, Wenner Media offers its staketo buyers. PAGE B1

BUSINESS DAY B1-7

Rolling Stone Is for SaleShinzo Abe PAGE A23

EDITORIAL, OP-ED A22-23

At the Cornell Tech campus on Roose-velt Island, large art installations aim tospur students’ imaginations. PAGE C5

Inspiring Art at Cornell Tech

Late Edition

VOL. CLXVII . . . No. 57,724 © 2017 The New York Times Company NEW YORK, MONDAY, SEPTEMBER 18, 2017

Today, morning fog, humid, variablycloudy, high 79. Tonight, someclouds, fog late, low 67. Tomorrow,cloudy, some rain, windy, high 75.Weather map appears on Page B6.

$2.50