Arizona declines to set up state-based health insurance exchange












PHOENIX (Reuters) – Arizona Governor Jan Brewer said on Wednesday she was rejecting a major provision of President Barack Obama‘s healthcare reform law that calls for creating state-based health insurance markets where consumers can purchase private, federally subsidized coverage.


Citing lingering questions about the plan and operating costs she said would be passed on to families and small businesses, Brewer, a Republican, said Arizona would join at least 16 other states in opting instead for a federally run health insurance exchange.












Such networks are designed to function as online insurance markets where the uninsured can shop for private health plans offered at federally subsidized rates, and are an integral provision of the Affordable Care Act, a centerpiece of Obama’s first term in office.


Brewer, along with many other Republicans, has been an outspoken critic of Obama’s healthcare overhaul initiative, calling it an “overreaching and unaffordable assault on states’ rights and individual liberty.”


Under a newly extended deadline, states have until December 14 to notify the U.S. Health and Human Services Department whether they intend to comply with the insurance exchange mandate or leave it to the federal government to set up and operate exchanges for them.


Seventeen states plus the District of Columbia have told the Obama administration they intend to move ahead with their own exchanges, while Arizona became the latest of 17 states to reject the plan outright in favor of a federally based exchange, according to the Kaiser Family Foundation, which has closely tracked the issue.


Most of those opting out are states in the Midwest or South. Six more states have sought to join with HHS in setting up a hybrid federal-state network, and 10 states remain undecided, the foundation said.


CALLS OPPOSITION ‘UNWAVERING’


“My opposition to the Affordable Care Act is unwavering, as is my belief that it should be repealed and replaced,” Brewer said in a statement announcing her decision. Republican Mitt Romney, who lost to Obama in the November 6 presidential election, had vowed to repeal the law if elected.


Acknowledging that the law had been upheld as constitutional by the U.S. Supreme Court, and despite her advocacy of greater local control, Brewer said her state would be better off ceding management of a system she said would be dominated by the federal government in any case.


“I have come to the conclusion that the state of Arizona would wield little actual authority over its ‘state’ exchange,” she said.


Although startup costs of exchanges are to be borne by the federal government, Brewer said Arizona stood to incur $ 27 million to $ 40 million in operating expenses starting in 2015, and that those costs would be passed along in the form of higher premiums to policy holders.


Brewer, who has clashed sharply with the Obama administration on a number of issues, especially immigration policy, made her intentions known in a one-page letter to HHS on Wednesday.


The state, which also has a Republican-controlled Legislature, had spent millions of dollars in federal grant money over the past several months laying the groundwork for the possible creation of a healthcare exchange.


Brewer faced heavy lobbying from some conservative Republicans who opposed setting up a state-run exchange, while a number of business groups and healthcare organizations favored creating one. State Democrats also strongly support a state-run exchange.


One top Democratic lawmaker criticized Brewer for “an irresponsible decision” that wasted millions of dollars already spent preparing for a state-run exchange.


“The governor is going to throw that all away so she can push an extremist agenda,” state House of Representatives Minority Leader Chad Campbell said. “We’ve come to expect political grandstanding from her, but this is a whole new level.”


Campbell said in a statement the state exchange that Brewer rejected would be a plus for consumers, giving them more of a say over their healthcare decisions.


“The governor just signed over a lot of power to the federal government,” he added.


(Reporting by David Schwartz; Writing by Steve Gorman; Editing by Cynthia Johnston and Peter Cooney)


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Report: Economy boosted entrepreneurship in 2011












NEW YORK (AP) — The slow improvement in the economy gave a huge boost to entrepreneurship in the U.S. last year, according to a study released Thursday.


More than 29 million people were starting or running new businesses in 2011, the study by Babson College in Wellesley, Mass., and Baruch College in New York shows. That was a 60 percent gain from 2010, when entrepreneurship was hurt by uncertainty about the economy.












The gain also matched the increase in entrepreneurship recorded in 2005, when the economy and small businesses were booming.


A pickup in entrepreneurship indicates that people were getting more confident about the economy and were therefore willing to take a chance on starting a business. However, it also reflects a still-weak job market: Many people chose to start companies because they couldn’t find jobs or were tired of looking.


Still, researchers at the colleges say the report’s findings are a positive sign for the economy. They found that nearly 40 percent of the entrepreneurs they counted expected to create more than five new jobs each in the next five years. Many economists have said the economy can’t gain momentum unless small businesses pick up the pace of their hiring.


The economy has been showing signs of a slow but steady recovery, led by an improving housing market and greater consumer confidence. Next week will bring several new reports, including the government’s look at the job market in November.


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Rapper PSY wants Tom Cruise to go ‘Gangnam Style’












BANGKOK (AP) — The South Korean rapper behind YouTube’s most-viewed video ever has set what might be a “Mission: Impossible” for himself.


Asked which celebrity he would like to see go “Gangnam Style,” the singer PSY told The Associated Press: “Tom Cruise!”












Surrounded by screaming fans, he then chuckled at the idea of the American movie star doing his now famous horse-riding dance.


PSY’s comments Wednesday in Bangkok were his first public remarks since his viral smash video — with 838 million views — surpassed Justin Bieber‘s “Baby,” which until Saturday held the record with 803 million views.


“It’s amazing,” PSY told a news conference, saying he never set out to become an international star. “I made this video just for Korea, actually. And when I released this song — wow.”


The video has spawned hundreds of parodies and tribute videos and earned him a spotlight alongside a variety of superstars.


Earlier this month, Madonna invited PSY onstage and they danced to his song at one of her New York City concerts. MC Hammer introduced the Korean star at the American Music Awards as, “My Homeboy PSY!”


Even President Barack Obama is talking about him. Asked on Election Day if he could do the dance, Obama replied: “I think I can do that move,” but then concluded he might “do it privately for Michelle,” the first lady.


PSY was in Thailand to give a free concert Wednesday night organized as a tribute to the country’s revered King Bhumibol Adulyadej, who turns 85 next month. He paid respects to the king at a Bangkok shopping mall, signing his name in an autograph book placed beside a giant poster of the king. He then gave an outdoor press conference, as screaming fans nearby performed the pop star’s dance.


Determined not to be a one-hit wonder, PSY said he plans to release a worldwide album in March with dance moves that he thinks his international fans will like.


“I think I have plenty of dance moves left,” he said, in his trademark sunglasses and dark suit. “But I’m really concerned about the (next) music video.”


“How can I beat ‘Gangnam Style’?” he asked, smiling. “How can I beat 850 million views?”


___


Associated Press writer Thanyarat Doksone contributed to this report.


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Cyber Monday sales best ever, for Amazon’s Kindle too












(Reuters) – Internet sales jumped more than 30 percent on Cyber Monday, making it the biggest online shopping day ever, according to data released on Tuesday.


Walmart.com, the online division of Walmart U.S., had its best sales day in history, a spokeswoman said.












Cyber Monday also was a record day for sales of Amazon.com Inc’s Kindle devices, the online retailer said, without specifying the number sold.


Still, eBay Inc, operator of one of the largest online marketplaces, outperformed its arch rival Amazon.com over the crucial first five days of the holiday shopping season, according to one closely watched measure.


Cyber Monday has been the biggest online shopping day in recent years, as workers return to offices and make holiday purchases on their computers. This year, the boom in smart phone and tablet adoption has added extra fuel to online shopping.


Cyber Monday sales online jumped 30.3 percent from the same day last year, according to International Business Machines Corp, which analyzes transactions from 500 U.S. retailers.


Mobile devices accounted for 18 percent of visits to retailer websites and 13 percent of sales on Cyber Monday. That was up 70 percent and 96 percent, respectively, compared with the same day last year, IBM reported.


To that end, Walmart.com said Cyber Monday online traffic from Walmart’s mobile apps jumped 280 percent versus a year ago.


On Monday, when retailers offered big Cyber Monday online deals, web shopping peaked at 11:25 a.m. EST (1625 GMT), IBM said. That timing suggests shoppers continue to check out online offers while still at work, even though more people have high-speed Internet access at home than in previous years.


AMAZON’S KINDLE DEAL


Amazon.com cut the price of its 7-inch Kindle Fire tablet by $ 30 to $ 129 on Monday, and it was the company’s most successful Cyber Monday deal ever, the retailer said.


Nine of the top 10 best-selling products on Amazon.com have been Kindles, Kindle accessories and digital content since the company unveiled new devices on September 6, it said.


Worldwide sales of Kindle devices more than doubled during the Thanksgiving weekend from the 2011 period, Amazon said.


“Demand for Kindle Fire is stronger than expected,” said Chad Bartley, an analyst at Pacific Crest Securities. “This suggests Amazon is competing effectively against Apple and Google in the near term, and increased device ownership could drive sales of digital media and physical products over the long term.”


Bartley raised his estimate for fourth-quarter Kindle Fire unit sales to 8 million from 5.5 million and increased his forecast for Amazon’s fourth-quarter revenue to $ 22.75 billion from $ 22.25 billion.


Shares of Amazon closed down almost 0.1 percent at $ 243.40 on Nasdaq. Stock in Wal-Mart Stores Inc shed 0.6 percent to close at $ 69.50.


A FIRST FOR EBAY


Still, eBay sales may have outperformed Amazon during the early part of the holiday shopping season, according to ChannelAdvisor, which helps third-party merchants sell more via websites including eBay.com and Amazon.com.


ChannelAdvisor data excludes sales specifically by Amazon, so the data does not capture Kindle device revenue and many other transactions. About 60 percent of Amazon’s unit sales are generated by the company itself, while 40 percent come from third parties operating on its platform.


ChannelAdvisor said client sales – sales generated by third-party merchants using the company’s service – soared 55.2 percent on eBay.com on Cyber Monday from a year earlier. That was about five times faster than last year’s growth.


For the five-day period from Thanksgiving through Cyber Monday, which ChannelAdvisor calls the “Cyber Five,” client sales on eBay.com rose 38.3 percent compared with the same days in 2011.


ChannelAdvisor said client sales on Amazon.com jumped 42.4 percent on Cyber Monday compared with a year earlier. Over the “Cyber Five,” client sales on Amazon.com rose 37.7 percent, the firm said.


This is the first time since at least 2007 that client sales on eBay.com have grown faster than client sales via Amazon.com during the holiday season, according to Scot Wingo, chief executive of ChannelAdvisor. The firm started tracking this in 2007, he noted.


EBay shares lost 0.5 percent to close at $ 51.15 on Tuesday. The stock rose almost 5 percent to a new multi-year high on Monday after ChannelAdvisor released its early Cyber Monday results.


EBay’s holiday advertising campaign, which included TV commercials, likely attracted more shoppers to its online marketplace, Wingo said.


EBay was also “aggressive” with holiday promotions and gift guides, and the company’s category-specific websites focused on things like fashion and electronics, were well integrated with the broader holiday promotions, unlike last year, Wingo explained.


However, the main driver may have been mobile shopping, an area in which eBay and its payments division PayPal invested early and heavily, Wingo added.


“With less than 10 percent of commerce coming from mobile devices and far higher levels ahead, we believe this trend will carry eBay Marketplace and PayPal for the next few years,” Gil Luria, an analyst at Wedbush Securities, wrote in a note to investors on Tuesday.


(Reporting by Alistair Barr in San Francisco and Jessica Wohl in Chicago, additional reporting by Lisa Baertlein in Los Angeles; Editing by Sofina Mirza-Reid, Lisa Von Ahn, Gunna Dickson and David Gregorio)


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Flu Symptoms Drove Boston Mayor to Hospital












When Boston Mayor Thomas Menino ended his vacation in Italy short this fall and checked into a Boston hospital complaining of a respiratory infection, it led doctors to find and treat a blood clot in his leg, a fracture in his back, an infection around the fracture and type 2 diabetes.


Cold and flu symptoms from respiratory infections can be a hassle, but sometimes that fever and cough can be good for just getting people to the doctor.












“That’s why every patient needs a careful evaluation because every once in a while, what the patient thinks is the flu or reports as the flu is not,” said Dr. William Schaffner, chairman of preventative medicine at Vanderbilt University in Tennessee. “I would say 99 percent of people who present to the emergency room and doctor’s office with symptoms of influenza – that is cough, fever and the like – are certainly going to have influenza.”


Click here to read about cold- and flu-fighters.


Menino, 69, arrived at Brigham and Women’s Hospital on Oct. 25, complaining of fatigue and a cough, and doctors described him as “extremely washed out” with some “malaise.” In addition to the respiratory infection, doctors found a blood clot that traveled from Menino’s leg to his lungs.


Respiratory illnesses, like the one that initially drove Menino to seek medical attention, can often range from mild to severe, Schaffner said.


“He was feeling poorly enough to end what was supposed to be a very pleasant vacation, and when he got here, he was very weak and very washed out,” Dr. Dale Adler, Menino’s doctor, said during a press conference in mid-November.


Doctors can usually tell whether flu-like symptoms are the result of a respiratory infection or something else soon after the patient is admitted. If not, they can perform a series of tests to find out.


Click here to read about flu fact and fiction.


(The flu can lead to other ailments, the most common of which is pneumonia, or an infection of the lungs, Schaffner said.


About 1.1 million pneumonia patients were hospitalized and discharged in 2009, according to the latest data from the Centers for Disease Control and Prevention. On average, they stayed in the hospital 5.2 days.)


Weeks later, Menino was still in the hospital. Although his illness and clot had been resolved, he was complaining of back pain, which doctors discovered was the result of a compression fracture and an infection around the fracture.


Finally, doctors discovered that Menino had underlying type 2 diabetes, which may have contributed to the infection, Menino’s doctor said during a press conference on Monday.


It’s not clear how Menino’s initial flu-like symptoms tied into his other ailments, but doctors said they are positive about his prognosis. The mayor relocated to a rehabilitation center on Monday.


“It is a run of bad luck,” Morris said of Menino. “He will rebound from this.”


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China ‘not currency manipulator’













The US has decided not to declare China as having manipulated its currency to gain an unfair trade advantage.












But the Treasury did say that China’s currency, the yuan, remains “significantly undervalued” and urged China to make further progress.


In its semi-annual report, it said Beijing did not meet the criteria to be called a currency manipulator, which could have sparked US trade sanctions.


Critics of China say it keeps the yuan low to keep its exports cheap.


“The Chinese authorities have substantially reduced the level of official intervention in exchange markets since the third quarter of 2011, and China has taken a series of steps to liberalise controls on capital movements, as part of a broader plan to move to a more flexible exchange rate regime,” the Treasury said.


But it noted there was more to do and that “further appreciation” against the US dollar and other major currencies was “warranted”.


The issue of whether China manipulates its currency is an important political issue and an ongoing source of tension between the world’s two biggest economies.


Defeated US presidential candidate Mitt Romney had said he would have branded China a currency manipulator on his first day in office.


Twice a year, the Treasury gives a report to Congress on China’s yuan policy. Previous reports have also found China keeps the yuan undervalued, but have fallen short of calling China a currency manipulator.


China has, since 2005, had a managed currency, whereby the yuan is pegged against a basket of foreign currencies. It has been slowing appreciating against the US dollar.


In its report, the Treasury said that the yuan had appreciated by 9.3% against the dollar since June 2010, while China’s trade and current account surpluses have both fallen from their peaks.


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Rugby-England add flyhalf Burns to squad for All Blacks’ test












LONDON, Nov 27 (Reuters) – England called up uncapped Gloucester flyhalf Freddie Burns on Tuesday to their squad for Saturday’s test against New Zealand in place of the injured Toby Flood.


Flood sustained ligament damage to a big toe during the 16-15 loss to South Africa at Twickenham last Saturday.












Owen Farrell, whose last start was in the first test in South Africa this year, is set to replace Flood in the starting XV against the world champions.


Lock Courtney Lawes, who missed England’s first three tests of the November series because of a knee injury, has also been included in the 23-man squad. Two other locks, Mouritz Botha and Tom Palmer, have been omitted.


After beating Fiji in their opening match, England have lost to Australia and the Springboks and now face a daunting match against the All Blacks who are unbeaten in 20 tests since the start of their victorious World Cup campaign last year.


“For those in Saturday’s squad the message is clear – last week we went toe to toe with the second best team in the world and felt we should have won,” England head coach Stuart Lancaster said in a statement.


“Now we have a chance to take on the number one side in front of a passionate Twickenham crowd, who have been fantastic throughout the Internationals, and it is a challenge we will meet head on.” (Reporting by John Mehaffey; Editing by Ken Ferris)


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Privacy groups ask Facebook to withdraw proposed policy changes












SAN FRANCISCO (Reuters) – Two privacy advocacy groups urged Facebook Inc on Monday to withdraw proposed changes to its terms of service that would allow the company to share user data with recently acquired photo-application Instagram, eliminate a user voting system and loosen email restrictions within the social network.


The changes, which Facebook unveiled on Wednesday, raise privacy risks for users and violate the company’s previous commitments to its roughly 1 billion members, according to the Electronic Privacy Information Center and the Center for Digital Democracy.












“Facebook’s proposed changes implicate the user privacy and terms of a recent settlement with the Federal Trade Commission,” the groups said in a letter to Facebook Chief Executive Mark Zuckerberg that was published on their websites on Monday.


By sharing information with Instagram, the letter said, Facebook could combine user profiles, ending its practice of keeping user information on the two services separate.


Facebook declined to comment on the letter.


In April, Facebook settled privacy charges with the U.S. Federal Trade Commission that it had deceived consumers and forced them to share more personal information than they intended. Under the settlement, Facebook is required to get user consent for certain changes to its privacy settings and is subject to 20 years of independent audits.


Facebook, Google and other online companies have faced increasing scrutiny and enforcement from privacy regulators as consumers entrust ever-increasing amounts of information about their personal lives to Web services.


Facebook unveiled a variety of proposed changes to its terms of service and data use polices on Wednesday, including a move to scrap a 4-year old process that can allow the social network’s roughly 1 billion users to vote on changes to its policies.


If proposed changes generate more than 7,000 public comments during a seven-day period, Facebook’s current terms of service automatically trigger a vote by users to approve the changes. But the vote is only binding if at least 30 percent of users take part, and two prior votes never reached that threshold.


The latest proposed changes had garnered more than 17,000 comments by late Monday.


Facebook also said last week that it wanted to eliminate a setting for users to control who can contact them on the social network’s email system. The company said it planned to replace the “Who can send you Facebook messages” setting with new filters for managing incoming messages.


That change is likely to increase the amount of unwanted “spam” messages that users receive, the privacy groups warned on Monday.


Facebook’s potential information sharing with Instagram, a photo-sharing service for smartphone users that it bought in October, flows from proposed changes that would allow the company to share information between its own service and other businesses or affiliates it owns.


The change could open the door for Facebook to build unified profiles of its users that include people’s personal data from its social network and from Instagram, similar to recent moves by Google Inc.


In January, Google said it would combine users’ personal information from its various Web services – such as search, email and the Google+ social network – to provide a more customized experience. The unified data policy raised concerns among some privacy advocates and regulators, who said it was an invasion of people’s privacy.


“As our company grows, we acquire businesses that become a legal part of our organization,” Facebook spokesman Andrew Noyes said in an emailed statement on Monday.


“Those companies sometimes operate as affiliates. We wanted to clarify that we will share information with our affiliates and vice versa, both to help improve our services and theirs, and to take advantage of storage efficiencies,” Noyes said.


(Reporting By Alexei Oreskovic; Editing by Richard Pullin)


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Man accused of stealing Tim Allen’s Chevy Impala












DENVER (AP) — A man suspected of stealing one of Tim Allen‘s custom cars says the comedian left the keys so he could drive it to Denver.


Denver police spokesman Sonny Jackson said Monday that 34-year-old Faustino Ibarra is being held without bond while awaiting extradition to California after his arrest on Saturday.












In a jailhouse interview with KDVR-TV (http://bit.ly/TpJirK ), Ibarra claimed Allen adopted him years ago. Jackson said there is no evidence of any adoption.


Ibarra said Allen had left the door to his garage open along with the keys.


Police confirmed that the customized 1996 Chevrolet Impala SS belonged to the “Home Improvement” star but said it hadn’t yet been reported stolen when it turned up in Denver.


Allen’s publicist Marleah (mar-LEE-uh) Leslie said she wouldn’t comment because it’s a police matter.


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Medications for Treating a Common Infection Are Losing Effectiveness












The misuse and overuse of antibiotics continues to be a vexing problem in the United States, particularly in the southeastern part of the country, according to a new report that tracks antibiotic resistance patterns.


The survey found a decline in the number of MRSA infections—methicillin-resistant staphylococcus aureus—a potentially dangerous skin infection. However, more antibiotics are becoming resistant to the bacteria that cause urinary tract infections, which is a common infection that had been fairly easy to treat until recently.












The data were released by Extending the Cure, a project of the Center for Disease Dynamics, Economics & Policy, a nonprofit think tank with offices in Washington, D.C. and New Dehli. The organization’s mission is to gather evidence on antibiotic overuse and resistance.


“People don’t realize we’ve only had antibiotics for about 70 years. That is a very, very short period of time,” Ramanan Laxminarayan, director of Extending the Cure, told Take Part. “We have these wonderful, helpful drugs that are able to do things that we’ve never done before—and now we’re about to lose them again. I don’t think people realize how much we depend on them.”


Unnecessary use makes antibiotics less effective in fighting off infections because, when repeatedly exposed to certain drugs, microbes change and become resistant. Widespread publicity about antibiotic overuse has led to some positive changes in prescribing patterns. Antibiotic prescriptions in the United States fell 17 percent from 1999 to 2012, according to the report. Far fewer pediatricians, for example, prescribe antibiotics for children’s mild respiratory symptoms and earaches.


“That is really good news,” Laxminarayan says. “There is progress at reducing antibiotic use at things where people think they should never have been prescribed in the first place. We’re not denying antibiotics when people really need it. We are denying antibiotics when we don’t need it.”


MORE: The Verdict Is in: Antibiotics in Animal Feed Create Superbugs


Moreover, the ability to treat skin infections has improved since the peak days of MRSA cases in the mid-2000s. MRSA infections have fallen by about half due to efforts to find new therapies and interventions.


However, antibiotic resistance is still a huge problem, Laxminarayan says. The report found that some of the drugs used to treat urinary tract infections are failing because bacterial resistance to those medications has increased by more than 30 percent since 1999.


Urinary tract infections, which are caused by the E. coli bacteria, account for more than 8.6 million visits to healthcare professionals each year, according to the Centers for Disease Control and Prevention. If untreated, these infections can turn into life-threatening bloodstream infections.


“Things that were commonly treatable are not as treatable anymore,” Laxminarayan says.


MORE: Study Uncovers Alarming Worldwide Rates of Drug-Resistant TB


Hospitals remain at the center of the antibiotic-resistance problem, he says. Hospital patients are typically older and sicker, and heavy antibiotic use is often necessary. But hospitals can help address antibiotic resistance by taking steps to curb the spread of infections within the hospital, he says. Five to eight percent of people develop an infection while in the hospital.


“We have sharply increased resistance around the country because it is not going down in hospitals, and hospitals are where the worse kinds of resistance are found,” he says. “We’ve advocated for having stronger hospital infection control. If you stop the infection from spreading, you don’t have to worry about resistance. We need pretty much a revolution regarding infection control in hospitals.”


The survey also found eye-opening regional differences regarding antibiotic resistance, such as higher levels of antibiotic overuse in the southeastern United States. It’s not clear why that area of the country has lagged behind, he says.


MORE: Judge to FDA on Antibiotics: Prove They’re Safe


The survey found that residents of Appalachian and Gulf Coast states, where antibiotic use rates are highest, take about twice as many antibiotics per capita as people living in Western states. In 2010, the five states with the highest rates of antibiotic use in the nation were Kentucky, West Virginia, Tennessee, Mississippi, and Louisiana. The five states with the lowest antibiotic use in the nation were Alaska, Hawaii, California, Oregon, and Washington.


Extending the Cure displays its data online via the ResistanceMap, a tool created to track changes in antibiotic drug use and resistance. People can see how the area they live in compares to other regions.


“We want people to be knowledgeable and therefore empowered about what they can do about the problem,” Laxminarayan says.


Earlier this month, the CDC, Extending the Cure and 25 other national health organizations issued a joint consensus statement on the need to preserve antibiotic effectiveness and fight over-use.


“When so many government agencies and public organizations have signed on it indicates we’re all pointing in the same direction,” Laxminarayan says.


Question: What should be done to reduce the overuse of antibiotics? Tell us what you think in the Comments.



Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.


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