Algerian Hostage Standoff Continues; U.S. Victim Identified

Anis Belghoul/Associated Press

An Algerian military truck on a road leading to a Saharan gas field where militants still held at least 10 foreign hostages on Friday.

BAMAKO, Mali — Islamic militants in Algeria continued to hold at least 10 and possibly dozens of foreign hostages Saturday, ignoring demands that they surrender peacefully. Among the dozen captives believed to have been killed was an American man from Texas.

As the hostage situation entered its fourth day, a senior Algerian government official said there were no talks planned with the militants.

“They are being told to surrender, that’s it,” the official said on the third day of the crisis. “No negotiations. That is a doctrine with us.”

The United States said for the first time that Americans were among the remaining captives and confirmed the first known death of an American hostage, Frederick Buttaccio, 58, of Katy, Tex. Linked In, the social networking site for professionals, lists a Frederick Buttaccio as a sales operations coordinator for BP, the British energy giant that helped run the complex, but a company official said it would not comment on any employee who may have been at the facility.

France said a French citizen also was known to have been killed.

All foreign governments with citizens at risk were still scrambling for basic information about the missing as they ferried escaped hostages out of the country on military aircraft and urged Algeria to use restraint.

“This is an extremely difficult and dangerous situation,” Secretary of State Hillary Rodham Clinton told reporters in Washington. Describing a conversation she had earlier Friday with Algeria’s prime minister, Abdelmalek Sellal, Mrs. Clinton said she had emphasized to him that “the utmost care must be taken to preserve innocent life.”

Algeria’s state news agency, APS, said 12 Algerian and foreign workers had been killed since Algerian special forces began an assault against the kidnappers on Thursday. It was the highest civilian death toll Algerian officials that have provided in the aftermath of the assault, which freed captives and killed kidnappers but also left some hostages dead in one of the worst mass abductions of foreign workers in years.

Previous unofficial estimates of the foreign casualties have ranged from 4 to 35. The American who died, Mr. Buttaccio, lived in a gated community in Katy, a suburb that is about 30 miles west of downtown Houston.The Algerian news agency also said that 18 militants had been killed and that the country’s special forces were dealing with remnants of a “terrorist group” that was still holding hostages in the refinery area of the gas field in remote eastern Algeria.

It also gave a new sense of how many people may have been at the facility when the militants seized it on Wednesday, asserting that nearly 650 had managed to leave the site since then, including 573 Algerians and nearly half of the 132 foreigners it said had been abducted. But that still left many people unaccounted for.

The senior Algerian official, who spoke on condition of anonymity, said he believed there were about 10 hostages, under the control of possibly 13 to 15 militants, but he emphasized that “nothing is certain” about the numbers, which have varied wildly since the crisis began. He also said that there were other workers on the site “who are still in hiding” but that the Algerian military had secured the residential part of the gas-field complex.

“What remains are a few terrorists, holding a few hostages, who have taken refuge in the gas factory,” he said. “It’s a site that’s very tricky to handle.”

The official also challenged the criticism made in some foreign capitals that the Algerian military had acted hastily and with excessive force. On the contrary, he said, Algerian forces had returned fire only as the militants sought to escape the complex with their captives.

“There was a reaction by the army,” he said. “They tried to flee and they were stopped,” the official said of the militants. “They came absolutely to blow the whole site up. These are bitter-enders.”

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With Graph Search, Facebook Bets on More Sharing

SAN FRANCISCO — Facebook’s greatest triumph has been to persuade a seventh of the world’s population to share their personal lives online.

Now the social network is taking on its archrival, Google, with a search tool to mine that personal information, just as people are growing more cautious about sharing on the Internet and even occasionally removing what they have already put up.

Whether Facebook’s more than one billion users will continue to divulge even more private details will determine whether so-called social search is the next step in how we navigate the online world. It will also determine whether Facebook has found a business model that will make it a lot of money.

“There’s a big potential upside for both Facebook and users, but getting people to change their behaviors in relation to what they share will not be easy,” said Andrew T. Stephen, who teaches marketing at the University of Pittsburgh and studies consumer behavior on online social networks.

This week, Facebook unveiled its search tool, which it calls graph search, a reference to the network of friends its users have created. The company’s algorithms will filter search results for each person, ranking the friends and brands that it thinks a user would trust the most. At first, it will mine users’ interests, photos, check-ins and “likes,” but later it will search through other information, including status updates.

“While the usefulness of graph search increases as people share more about their favorite restaurants, music and other interests, the product doesn’t hinge on this,” a Facebook spokesman, Jonathan Thaw, said.

Nevertheless, the company engineers who created the tool — former Google employees — say that the project will not reach its full potential if Facebook data is “sparse,” as they call it. But the company is confident people will share more data, be it the movies they watch, the dentists they trust or the meals that make their mouths water.

The things people declare on Facebook will be useful, when someone searches for those interests, Tom Stocky, one of the creators of Facebook search, said in an interview this week. Conversely, by liking more things, he said, people will become more useful in the eyes of their friends.

“You might be inclined to ‘like’ what you like so when your friends search, they’ll find it,” he said. “I probably would never have liked my dentist on Facebook before, but now I do because it’s a way of letting my friends know.”

Mr. Stocky offered these examples of how more information may be desirable: A single man may want to be discovered when a friend of a friend is searching for eligible bachelors in San Francisco or a restaurant that stays open late may want to be found by a night owl.

“People have shared all this great stuff on Facebook,” Mr. Stocky said. “It’s latent value. We wanted a way to unlock that.”

Independent studies suggest that Facebook users are becoming more careful about how much they reveal online, especially since educators and employers typically scour Facebook profiles.

A Northwestern University survey of 500 young adults in the summer of 2012 found that the majority avoided posting status updates because they were concerned about who would see them. The study also found that many had deleted or blocked contacts from seeing their profiles and nearly two-thirds had untagged themselves from a photo, post or check-in.

“These behavioral patterns seem to suggest that many young adults are less keen on sharing at least certain details about their lives rather than more,” said Eszter Hargittai, an associate professor of communication studies at Northwestern, who led the yet unpublished study among men and women aged 21 and 22.

Also last year, the Pew Internet Center found that social network users, including those on Facebook, were more aggressively pruning their profiles — untagging photos, removing friends and deleting comments.

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Business Briefing | Medicine: F.D.A. Clears Botox to Help Bladder Control

Botox, the wrinkle treatment made by Allergan, has been approved to treat adults with overactive bladders who cannot tolerate or were not helped by other drugs, the Food and Drug Administration said on Friday. Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity. “Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” Dr. Hylton V. Joffe, director of the F.D.A.’s reproductive and urologic products division, said in a statement. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.”

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Business Briefing | Medicine: F.D.A. Clears Botox to Help Bladder Control

Botox, the wrinkle treatment made by Allergan, has been approved to treat adults with overactive bladders who cannot tolerate or were not helped by other drugs, the Food and Drug Administration said on Friday. Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity. “Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” Dr. Hylton V. Joffe, director of the F.D.A.’s reproductive and urologic products division, said in a statement. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.”

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Analysis: Amid Tears Lance Armstrong Leaves Unanswered Questions in Oprah Winfrey Interview

In an extensive interview with Oprah Winfrey that was shown over two nights, Lance Armstrong admitted publicly for the first time that he doped throughout his cycling career. He revealed that all seven of his Tour de France victories were fueled by doping, that he never felt bad about cheating, and that he had covered up a positive drug test at the 1999 Tour with a backdated doctor’s prescription for banned cortisone.

Armstrong, the once defiant cyclist, also became choked up when he discussed how he told his oldest child that the rumors about Armstrong’s doping were true.

Even with all that, the interview will most likely be remembered for what it was missing.

Armstrong had not subjected himself to questioning from anyone in the news media since United States antidoping officials laid out their case against him in October. He chose not to appeal their ruling, leaving him with a lifetime ban from Olympic sports.

He personally chose Winfrey for his big reveal, and it went predictably. Winfrey allowed him to share his thoughts and elicited emotions from him, but she consistently failed to ask critical follow-up questions that would have addressed the most vexing aspects of Armstrong’s deception.

She did not press him on who helped him dope or cover up his drug use for more than a decade. Nor did she ask him why he chose to take banned performance-enhancing substances even after cancer had threatened his life.

Winfrey also did not push him to answer whether he had admitted to doctors in an Indianapolis hospital in 1996 that he had used performance-enhancing drugs, a confession a former teammate and his wife claimed they overheard that day. To get to the bottom of his deceit, antidoping officials said, Armstrong has to be willing to provide more details.

“He spoke to a talk-show host,” David Howman, the director general of the World Anti-Doping Agency, said from Montreal on Friday. “I don’t think any of it amounted to assistance to the antidoping community, let alone substantial assistance. You bundle it all up and say, ‘So what?’

Jeffrey M. Tillotson, the lawyer for an insurance company that unsuccessfully withheld a $5 million bonus from Armstrong on the basis that he had cheated to win the Tour de France in 2004, said his client would make a decision over the weekend about whether to sue Armstrong. If it proceeds, the company, SCA Promotions, will seek $12 million, the total it paid Armstrong in bonuses and legal fees.

“It seemed to us that he was more sorry that he had been caught than for what he had done,” Tillotson said. “If he’s serious about rehabbing himself, he needs to start making amends to the people he bullied and vilified, and he needs to start paying money back.”

Armstrong, who said he once believed himself to be invincible, explained in the portion of the interview broadcast Friday night that he started to take steps toward redemption last month. Then, after dozens of questions had already been lobbed his way, he became emotional when he described how he told his 13-year-old son, Luke, that yes, his father had cheated by doping. That talk happened last month over the holidays, Armstrong said as he fought back tears.

“I said, listen, there’s been a lot of questions about your dad, my career, whether I doped or did not dope, and I’ve always denied, I’ve always been ruthless and defiant about that, which is probably why you trusted me, which makes it even sicker,” Armstrong said he told his son, the oldest of his five children. “I want you to know it’s true.”

At times, Winfrey’s interview seemed more like a therapy session than an inquisition, with Armstrong admitting that he was narcissistic and had been in therapy — and that he should be in therapy regularly because his life was so complicated.

In the end, the interview most likely accomplished what Armstrong had hoped: it was the vehicle through which he admitted to the public that he had cheated by doping, which he had lied about for more than a decade. But his answers were just the first step to clawing back his once stellar reputation.

On Friday, Armstrong appeared more contrite than he had during the part of the interview that was shown Thursday, yet he still insisted that he was clean when he made his comeback to cycling in 2009 after a brief retirement, an assertion the United States Anti-Doping Agency said was untrue. He also implied that his lifetime ban from all Olympic sports was unfair because some of his former teammates who testified about their doping and the doping on Armstrong’s teams received only six-month bans.

Richard Pound, the founding chairman of WADA and a member of the International Olympic Committee, said he was unmoved by Armstrong’s televised mea culpa.

“If what he’s looking for is some kind of reconstruction of his image, instead of providing entertainment with Oprah Winfrey, he’s got a long way to go,” Pound said Friday from his Montreal office.

Armstrong acknowledged to Winfrey during Friday’s broadcast that he has a long way to go before winning back the public’s trust. He said he understood why people recently turned on him because they felt angry and betrayed.

“I lied to you and I’m sorry,” he said before acknowledging that he might have lost many of his supporters for good. “I am committed to spending as long as I have to to make amends, knowing full well that I won’t get very many back.”

Armstrong also said that the scandal has cost him $75 million in lost sponsors, all of whom abandoned him last fall after Usada made public 1,000 pages of evidence that Armstrong had doped.

“In a way, I just assumed we would get to that point,” he said of his sponsors’ leaving. “The story was getting out of control.”

In closing her interview, Winfrey asked Armstrong a question that left him perplexed.

“Will you rise again?” she said.

Armstrong said: “I don’t know. I don’t know. I don’t know what’s out there.”

Then, as the interview drew to a close, Armstrong said: “The ultimate crime is the betrayal of these people that supported me and believed in me.”

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Algerian Raid to Free Hostages Turns Deadly

BAMAKO, Mali — Without warning other governments, Algeria mounted an assault on Thursday on the heavily armed fighters holding American and other hostages at a remote Sahara gas field facility, freeing captives and killing kidnappers but leaving some hostages dead and foreign leaders scrambling to find out the fates of their citizens.

Almost a day after the raid, there was no official word on Friday on the number of hostages who had been freed, killed or still held captive. Estimates of the foreign casualties ranged from 4 to 35, though one Algerian official said the higher figure was “exaggerated.”

In London on Friday, British officials said the Algerian authorities had not informed them that the military operation deep in the Sahara had been concluded. Until the British heard otherwise, one official said, speaking in return for anonymity, “we are working on the basis that it’s an ongoing operation.”

The official declined to comment on widespread reports that British authorities were bracing for high casualty figures among up to 20 Britons thought to have been working at the installation. French officials said on Friday that there had been “very few” French nationals at the site and at least two of them were safe.

Algeria’s reported silence about the situation on the ground seemed to deepen frustration among foreign governments with citizens who had worked at the plant, close to the Libyan border.

On Thursday, despite requests for communication and pleas to consider the safety of their abducted citizens, the United States, Britain and Japan said they had not been told in advance about the military assault, stirring frustration that the Algerians might have been overly aggressive and caused needless casualties.

But the Algerian government, which has a history of violent suppression of Islamist militancy, stood by its decision to deal forcefully with the kidnappers, who were holding Algerians and citizens of nine other countries.

“Those who think we will negotiate with terrorists are delusional,” the communications minister, Mohand Saïd Oublaïd, said in an announcement about the assault on the facility near In Amenas, in eastern Algeria, close to the Libya border. “Those who think we will surrender to their blackmail are delusional.”

The midday assault came more than 24 hours after a militant group, which the Algerians said had ties to jihadis in the region, ambushed a bus carrying gas-field workers to a nearby airport and then seized the compound. It was one of the boldest abductions of foreign workers in years.

The abductions were meant to avenge France’s armed intervention in neighboring Mali, Mr. Oublaïd said, a conflict that has escalated since French warplanes began striking Islamist fighters who have carved out a vast haven there.

On Thursday, the United States became more deeply involved in the war, working with the French to determine how to best deploy American C-5 cargo planes to ferry French troops and equipment into Mali, according to an American military official.

The United States has long been wary about stepping more directly into the Mali conflict, worried that it could provoke precisely the kind of anti-Western attack that took place in Algeria, with deadly consequences. After the raid to free the hostages, the Algerians acknowledged a price had been paid.

“The operation resulted in the neutralization of a large number of terrorists and the liberation of a considerable number of hostages,” said Mr. Oublaïd, the communications minister. “Unfortunately, we deplore also the death of some, as well as some who were wounded.”

Algerian national radio described a scene of pandemonium and high alert at the public hospital in the town of In Amenas, where wounded hostages and those who escaped were sent. The director of the hospital, Dr. Shahir Moneir, said in the report that wounded foreign hostages were transferred to the capital, Algiers.

In a telephone interview from the hospital, an Algerian who escaped, who identified himself as Mohamed Elias, said some of the hostages had exploited the chaos created by the Algerian assault to flee. “We used the opportunity,” he said, “and we just escaped.”

Senior American military officials said that aides traveling in London with Defense Secretary Leon E. Panetta were struggling to get basic information about the raid, and that an unarmed American Predator drone was monitoring the gas-field site.

Adam Nossiter reported from Bamako, and Rick Gladstone from New York. Reporting was contributed by Alan Cowell and Scott Sayare from Paris, Elisabeth Bumiller and John F. Burns from London, Eric Schmitt and David E. Sanger from Washington, Hiroko Tabuchi from Tokyo, and Mayy El Sheikh from Cairo.

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DealBook: Michael Dell’s Empire in a Buyout Spotlight

The computer empire of Michael S. Dell spreads across a campus of low-slung buildings in Round Rock, Tex.

But his financial empire — estimated at $16 billion — occupies the 21st floor of a dark glass skyscraper on Fifth Avenue in Manhattan.

It is there that MSD Capital, started by Mr. Dell 15 years ago to manage his fortune, has quietly built a reputation as one of the smartest investors on Wall Street. By amassing a prodigious portfolio of stocks, companies, real estate and timberland, Mr. Dell has reduced his exposure to the volatile technology sector and branched out into businesses as diverse as dentistry and landscaping.

Now, Mr. Dell is on the verge of making one of the biggest investments of his life. The 47-year-old billionaire and his private equity backers are locked in talks to acquire Dell, the company he started with $1,000 as a teenager three decades ago, in a leveraged buyout worth more than $20 billion. MSD could play a role in the Dell takeover, according to people briefed on the deal.

The private equity firm Silver Lake has been in negotiations to join with Mr. Dell on a transaction, along with other potential partners like wealthy Asian investors or foreign funds. Mr. Dell would be expected to roll his nearly 16 percent ownership of the company into the buyout, a stake valued at about $3.5 billion. He could also contribute additional personal money as part of the buyout.

That money is managed by MSD, among the more prominent so-called family offices that are set up to handle the personal investments of the wealthy. Others with large family offices include Bill Gates, whose Microsoft wealth financed the firm Cascade Investment, and New York’s mayor, Michael R. Bloomberg, who set up his firm, Willett Advisors, in 2010 to manage his personal and philanthropic assets.

“Some of these family offices are among the world’s most sophisticated investors and have the capital and talent to compete with the largest private equity firms and hedge funds,” said John P. Rompon, managing partner of McNally Capital, which helps structure private equity deals for family offices.

A spokesman for MSD declined to comment for this article. The buyout talks could still fall apart.

In 1998, Mr. Dell, then just 33 years old — and his company’s stock worth three times what it is today — decided to diversify his wealth and set up MSD. He staked the firm with $400 million of his own money, effectively starting his own personal money-management business.

To head the operation, Mr. Dell hired Glenn R. Fuhrman, a managing director at Goldman Sachs, and John C. Phelan, a principal at ESL Investments, the hedge fund run by Edward S. Lampert. He knew both men from his previous dealings with Wall Street. Mr. Fuhrman led a group at Goldman that marketed specialized investments like private equity and real estate to wealthy families like the Dells. And Mr. Dell was an early investor in Mr. Lampert’s fund.

Mr. Fuhrman and Mr. Phelan still run MSD and preside over a staff of more than 100 overseeing Mr. Dell’s billions and the assets in his family foundation. MSD investments include a stock portfolio, with positions in the apparel company PVH, owner of the Calvin Klein and Tommy Hilfiger brands, and DineEquity, the parent of IHOP and Applebee’s.

Among its real estate holdings are the Four Seasons Resort Maui in Hawaii and a stake in the New York-based developer Related Companies.

MSD also has investments in several private businesses, including ValleyCrest, which bills itself as the country’s largest landscape design company, and DentalOne Partners, a collection of dental practices.

Perhaps MSD’s most prominent deal came in 2008, in the middle of the financial crisis, when it joined a consortium that acquired the assets of the collapsed mortgage lender IndyMac Bank from the federal government for about $13.9 billion and renamed it OneWest Bank.

The OneWest purchase has been wildly successful. Steven Mnuchin, a former Goldman executive who led the OneWest deal, has said that the bank is expected to consider an initial public offering this year. An I.P.O. would generate big profits for Mr. Dell and his co-investors, according to people briefed on the deal.

Another arm of MSD makes select investments in outside hedge funds. Mr. Dell invested in the first fund raised by Silver Lake, the technology-focused private equity firm that might now become his partner in taking Dell private.
MSD’s principals have already made tidy fortunes. In 2009, Mr. Fuhrman, 47, paid $26 million for the Park Avenue apartment of the former Lehman Brothers chief executive Richard S. Fuld. Mr. Phelan, 48, and his wife, Amy, a former Dallas Cowboys cheerleader, also live in a Park Avenue co-op and built a home in Aspen, Colo.

Both are influential players on the contemporary art scene, with ARTNews magazine last year naming each of them among the world’s top 200 collectors. MSD, too, has dabbled in the visual arts. In 2010, MSD bought an archive of vintage photos from Magnum, including portraits of Marilyn Monroe and Mahatma Gandhi, and has put the collection on display at the University of Texas, Mr. Dell’s alma mater.

Just as the investment firms Rockefeller & Company (the Rockefellers, diversifying their oil fortune) and Bessemer Trust (the Phippses, using the name of the steelmaking process that formed the basis of their wealth) started out as investment vehicles for a single family, MSD has recently shown signs of morphing into a traditional money management business with clients beside Mr. Dell.

Last year, for the fourth time, an MSD affiliate raised money from outside investors when it collected about $1 billion for a stock-focused hedge fund, MSD Torchlight Partners. A 2010 fund investing in distressed European assets also manages about $1 billion. The Dell family is the anchor investor in each of the funds, according to people briefed on the investments.

MSD has largely remained below the radar, though its name emerged a decade ago in the criminal trial of the technology banker Frank Quattrone on obstruction of justice charges. Prosecutors introduced an e-mail that Mr. Fuhrman sent to Mr. Quattrone during the peak of the dot-com boom in which he pleaded for a large allotment of a popular Internet initial public offering.

“We know this is a tough one, but we wanted to ask for a little help with our Corvis allocation,” Mr. Fuhrman wrote. “We are looking forward to making you our ‘go to’ banker.”

The e-mail, which was not illegal, was meant to show the quid pro quo deals that were believed to have been struck between Mr. Quattrone and corporate chieftains like Mr. Dell — the bankers would give executives hot I.P.O.’s and the executives, in exchange, would hold out the possibility of giving business to the bankers. (Mr. Quattrone’s conviction was reversed on appeal.)

The MSD team has also shown itself to be loyal to its patron in other ways.

On the MSD Web site, in the frequently asked questions section, the firm asks and answers queries like “how many employees do you have” and “what kind of investments do you make.”

In the last question on the list, MSD asks itself, “Do you use Dell computer equipment?” The answer: “Exclusively!”

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This post has been revised to reflect the following correction:

Correction: January 18, 2013

An earlier version of this article misstated when an MSD affiliate raised money from outside investors for a hedge fund. It was last year, not earlier this year. The article also misstated which hedge fund and its focus. It was MSD Torchlight Partners, a stock-focused hedge fund, not MSD Energy Partners, an energy-focused hedge fund.

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The Neediest Cases: Medical Bills Crush Brooklyn Man’s Hope of Retiring

Andrea Mohin/The New York Times

John Concepcion and his wife, Maria, in their home in Sheepshead Bay, Brooklyn. They are awaiting even more medical bills.

Retirement was just about a year away, or so John Concepcion thought, when a sudden health crisis put his plans in doubt.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$6,865,501

Recorded Wed.:

16,711

*Total:

$6,882,212

Last year to date:

$6,118,740

*Includes $1,511,814 contributed to the Hurricane Sandy relief efforts.

“I get paralyzed, I can’t breathe,” he said of the muscle spasms he now has regularly. “It feels like something’s going to bust out of me.”

Severe abdominal pain is not the only, or even the worst, reminder of the major surgery Mr. Concepcion, 62, of Sheepshead Bay, Brooklyn, underwent in June. He and his wife of 36 years, Maria, are now faced with medical bills that are so high, Ms. Concepcion said she felt faint when she saw them.

Mr. Concepcion, who is superintendent of the apartment building where he lives, began having back pain last January that doctors first believed was the result of gallstones. In March, an endoscopy showed that tumors had grown throughout his digestive system. The tumors were not malignant, but an operation was required to remove them, and surgeons had to essentially reroute Mr. Concepcion’s entire digestive tract. They removed his gall bladder, as well as parts of his pancreas, bile ducts, intestines and stomach, he said.

The operation was a success, but then came the bills.

“I told my friend: are you aware that if you have a major operation, you’re going to lose your house?” Ms. Concepcion said.

The couple has since received doctors’ bills of more than $250,000, which does not include the cost of his seven-day stay at Beth Israel Medical Center in Manhattan. Mr. Concepcion has worked in the apartment building since 1993 and has been insured through his union.

The couple are in an anxious holding pattern as they wait to find out just what, depending on their policy’s limits, will be covered. Even with financial assistance from Beth Israel, which approved a 70 percent discount for the Concepcions on the hospital charges, the couple has no idea how the doctors’ and surgical fees will be covered.

“My son said, boy he saved your life, Dad, but look at the bill he sent to you,” Ms.  Concepcion said in reference to the surgeon’s statements. “You’ll be dead before you pay it off.”

When the Concepcions first acquired their insurance, they were in good health, but now both have serious medical issues — Ms. Concepcion, 54, has emphysema and chronic obstructive pulmonary disease, and Mr. Concepcion has diabetes. They now spend close to $800 a month on prescriptions.

Mr. Concepcion, the family’s primary wage earner, makes $866 a week at his job. The couple had planned for Mr. Concepcion to retire sometime this year, begin collecting a pension and, after getting their finances in order, leave the superintendent’s apartment, as required by the landlord, and try to find a new home. “That’s all out of the question now,” Ms. Concepcion said. Mr. Concepcion said he now planned to continue working indefinitely.

Ms. Concepcion has organized every bill and medical statement into bulging folders, and said she had spent hours on the phone trying to negotiate with providers. She is still awaiting the rest of the bills.

On one of those bills, Ms. Concepcion said, she spotted a telephone number for people seeking help with medical costs. The number was for Community Health Advocates, a health insurance consumer assistance program and a unit of Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. The society drew $2,120 from the fund so the Concepcions could pay some of their medical bills, and the health advocates helped them obtain the discount from the hospital.

Neither one knows what the next step will be, however, and the stress has been eating at them.

“How do we get out of this?” Mr. Concepcion asked. “There is no way out. Here I am trying to save to retire. They’re going to put me in the street.”

Read More..

The Neediest Cases: Medical Bills Crush Brooklyn Man’s Hope of Retiring

Andrea Mohin/The New York Times

John Concepcion and his wife, Maria, in their home in Sheepshead Bay, Brooklyn. They are awaiting even more medical bills.

Retirement was just about a year away, or so John Concepcion thought, when a sudden health crisis put his plans in doubt.

For the past 100 years, The New York Times Neediest Cases Fund has provided direct assistance to children, families and the elderly in New York. To celebrate the 101st campaign, an article will appear daily through Jan. 25. Each profile will illustrate the difference that even a modest amount of money can make in easing the struggles of the poor.

Last year donors contributed $7,003,854, which was distributed to those in need through seven New York charities.

2012-13 Campaign

Previously recorded:

$6,865,501

Recorded Wed.:

16,711

*Total:

$6,882,212

Last year to date:

$6,118,740

*Includes $1,511,814 contributed to the Hurricane Sandy relief efforts.

“I get paralyzed, I can’t breathe,” he said of the muscle spasms he now has regularly. “It feels like something’s going to bust out of me.”

Severe abdominal pain is not the only, or even the worst, reminder of the major surgery Mr. Concepcion, 62, of Sheepshead Bay, Brooklyn, underwent in June. He and his wife of 36 years, Maria, are now faced with medical bills that are so high, Ms. Concepcion said she felt faint when she saw them.

Mr. Concepcion, who is superintendent of the apartment building where he lives, began having back pain last January that doctors first believed was the result of gallstones. In March, an endoscopy showed that tumors had grown throughout his digestive system. The tumors were not malignant, but an operation was required to remove them, and surgeons had to essentially reroute Mr. Concepcion’s entire digestive tract. They removed his gall bladder, as well as parts of his pancreas, bile ducts, intestines and stomach, he said.

The operation was a success, but then came the bills.

“I told my friend: are you aware that if you have a major operation, you’re going to lose your house?” Ms. Concepcion said.

The couple has since received doctors’ bills of more than $250,000, which does not include the cost of his seven-day stay at Beth Israel Medical Center in Manhattan. Mr. Concepcion has worked in the apartment building since 1993 and has been insured through his union.

The couple are in an anxious holding pattern as they wait to find out just what, depending on their policy’s limits, will be covered. Even with financial assistance from Beth Israel, which approved a 70 percent discount for the Concepcions on the hospital charges, the couple has no idea how the doctors’ and surgical fees will be covered.

“My son said, boy he saved your life, Dad, but look at the bill he sent to you,” Ms.  Concepcion said in reference to the surgeon’s statements. “You’ll be dead before you pay it off.”

When the Concepcions first acquired their insurance, they were in good health, but now both have serious medical issues — Ms. Concepcion, 54, has emphysema and chronic obstructive pulmonary disease, and Mr. Concepcion has diabetes. They now spend close to $800 a month on prescriptions.

Mr. Concepcion, the family’s primary wage earner, makes $866 a week at his job. The couple had planned for Mr. Concepcion to retire sometime this year, begin collecting a pension and, after getting their finances in order, leave the superintendent’s apartment, as required by the landlord, and try to find a new home. “That’s all out of the question now,” Ms. Concepcion said. Mr. Concepcion said he now planned to continue working indefinitely.

Ms. Concepcion has organized every bill and medical statement into bulging folders, and said she had spent hours on the phone trying to negotiate with providers. She is still awaiting the rest of the bills.

On one of those bills, Ms. Concepcion said, she spotted a telephone number for people seeking help with medical costs. The number was for Community Health Advocates, a health insurance consumer assistance program and a unit of Community Service Society, one of the organizations supported by The New York Times Neediest Cases Fund. The society drew $2,120 from the fund so the Concepcions could pay some of their medical bills, and the health advocates helped them obtain the discount from the hospital.

Neither one knows what the next step will be, however, and the stress has been eating at them.

“How do we get out of this?” Mr. Concepcion asked. “There is no way out. Here I am trying to save to retire. They’re going to put me in the street.”

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DealBook: Michael Dell’s Empire in a Buyout Spotlight

The computer empire of Michael S. Dell spreads across a campus of low-slung buildings in Round Rock, Tex.

But his financial empire — estimated at $16 billion — occupies the 21st floor of a dark glass skyscraper on Fifth Avenue in Manhattan.

It is there that MSD Capital, started by Mr. Dell 15 years ago to manage his fortune, has quietly built a reputation as one of the smartest investors on Wall Street. By amassing a prodigious portfolio of stocks, companies, real estate and timberland, Mr. Dell has reduced his exposure to the volatile technology sector and branched out into businesses as diverse as dentistry and landscaping.

Now, Mr. Dell is on the verge of making one of the biggest investments of his life. The 47-year-old billionaire and his private equity backers are locked in talks to acquire Dell, the company he started with $1,000 as a teenager three decades ago, in a leveraged buyout worth more than $20 billion. MSD could play a role in the Dell takeover, according to people briefed on the deal.

The private equity firm Silver Lake has been in negotiations to join with Mr. Dell on a transaction, along with other potential partners like wealthy Asian investors or foreign funds. Mr. Dell would be expected to roll his nearly 16 percent ownership of the company into the buyout, a stake valued at about $3.5 billion. He could also contribute additional personal money as part of the buyout.

That money is managed by MSD, among the more prominent so-called family offices that are set up to handle the personal investments of the wealthy. Others with large family offices include Bill Gates, whose Microsoft wealth financed the firm Cascade Investment, and New York’s mayor, Michael R. Bloomberg, who set up his firm, Willett Advisors, in 2010 to manage his personal and philanthropic assets.

“Some of these family offices are among the world’s most sophisticated investors and have the capital and talent to compete with the largest private equity firms and hedge funds,” said John P. Rompon, managing partner of McNally Capital, which helps structure private equity deals for family offices.

A spokesman for MSD declined to comment for this article. The buyout talks could still fall apart.

In 1998, Mr. Dell, then just 33 years old — and his company’s stock worth three times what it is today — decided to diversify his wealth and set up MSD. He staked the firm with $400 million of his own money, effectively starting his own personal money-management business.

To head the operation, Mr. Dell hired Glenn R. Fuhrman, a managing director at Goldman Sachs, and John C. Phelan, a principal at ESL Investments, the hedge fund run by Edward S. Lampert. He knew both men from his previous dealings with Wall Street. Mr. Fuhrman led a group at Goldman that marketed specialized investments like private equity and real estate to wealthy families like the Dells. And Mr. Dell was an early investor in Mr. Lampert’s fund.

Mr. Fuhrman and Mr. Phelan still run MSD and preside over a staff of more than 100 overseeing Mr. Dell’s billions and the assets in his family foundation. MSD investments include a stock portfolio, with positions in the apparel company PVH, owner of the Calvin Klein and Tommy Hilfiger brands, and DineEquity, the parent of IHOP and Applebee’s.

Among its real estate holdings are the Four Seasons Resort Maui in Hawaii and a stake in the New York-based developer Related Companies.

MSD also has investments in several private businesses, including ValleyCrest, which bills itself as the country’s largest landscape design company, and DentalOne Partners, a collection of dental practices.

Perhaps MSD’s most prominent deal came in 2008, in the middle of the financial crisis, when it joined a consortium that acquired the assets of the collapsed mortgage lender IndyMac Bank from the federal government for about $13.9 billion and renamed it OneWest Bank.

The OneWest purchase has been wildly successful. Steven Mnuchin, a former Goldman executive who led the OneWest deal, has said that the bank is expected to consider an initial public offering this year. An I.P.O. would generate big profits for Mr. Dell and his co-investors, according to people briefed on the deal.

Another arm of MSD makes select investments in outside hedge funds. Mr. Dell invested in the first fund raised by Silver Lake, the technology-focused private equity firm that might now become his partner in taking Dell private.
MSD’s principals have already made tidy fortunes. In 2009, Mr. Fuhrman, 47, paid $26 million for the Park Avenue apartment of the former Lehman Brothers chief executive Richard S. Fuld. Mr. Phelan, 48, and his wife, Amy, a former Dallas Cowboys cheerleader, also live in a Park Avenue co-op and built a home in Aspen, Colo.

Both are influential players on the contemporary art scene, with ARTNews magazine last year naming each of them among the world’s top 200 collectors. MSD, too, has dabbled in the visual arts. In 2010, MSD bought an archive of vintage photos from Magnum, including portraits of Marilyn Monroe and Mahatma Gandhi, and has put the collection on display at the University of Texas, Mr. Dell’s alma mater.

Just as the investment firms Rockefeller & Company (the Rockefellers, diversifying their oil fortune) and Bessemer Trust (the Phippses, using the name of the steelmaking process that formed the basis of their wealth) started out as investment vehicles for a single family, MSD has recently shown signs of morphing into a traditional money management business with clients beside Mr. Dell.

Last year, for the fourth time, an MSD affiliate raised money from outside investors when it collected about $1 billion for a stock-focused hedge fund, MSD Torchlight Partners. A 2010 fund investing in distressed European assets also manages about $1 billion. The Dell family is the anchor investor in each of the funds, according to people briefed on the investments.

MSD has largely remained below the radar, though its name emerged a decade ago in the criminal trial of the technology banker Frank Quattrone on obstruction of justice charges. Prosecutors introduced an e-mail that Mr. Fuhrman sent to Mr. Quattrone during the peak of the dot-com boom in which he pleaded for a large allotment of a popular Internet initial public offering.

“We know this is a tough one, but we wanted to ask for a little help with our Corvis allocation,” Mr. Fuhrman wrote. “We are looking forward to making you our ‘go to’ banker.”

The e-mail, which was not illegal, was meant to show the quid pro quo deals that were believed to have been struck between Mr. Quattrone and corporate chieftains like Mr. Dell — the bankers would give executives hot I.P.O.’s and the executives, in exchange, would hold out the possibility of giving business to the bankers. (Mr. Quattrone’s conviction was reversed on appeal.)

The MSD team has also shown itself to be loyal to its patron in other ways.

On the MSD Web site, in the frequently asked questions section, the firm asks and answers queries like “how many employees do you have” and “what kind of investments do you make.”

In the last question on the list, MSD asks itself, “Do you use Dell computer equipment?” The answer: “Exclusively!”

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This post has been revised to reflect the following correction:

Correction: January 18, 2013

An earlier version of this article misstated when an MSD affiliate raised money from outside investors for a hedge fund. It was last year, not earlier this year. The article also misstated which hedge fund and its focus. It was MSD Torchlight Partners, a stock-focused hedge fund, not MSD Energy Partners, an energy-focused hedge fund.

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