Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

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Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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AMR pilots union meets company CEO, still backs USAir merger: spokesman

(Reuters) - American Airlines' pilots union still supports a merger with US Airways Group, a union spokesman said on Thursday, unmoved by a pitch from AMR Chief Executive Tom Horton that the company should exit Chapter 11 as an independent carrier.

Next week, US Airways CEO Doug Parker is expected to meet with the board of the Allied Pilots Association, spokesman Dennis Tajer said.

Horton, who became CEO of American parent AMR Corp as the company filed for bankruptcy protection in November 2011, requested the meeting with the pilots union leadership and met with the board for about three hours on Thursday, Tajer said.

"The case was made for the standalone plan, and APA leadership gave the standalone plan pitch due consideration but after the meeting continued to believe that a merger is best for the longtime interest of our pilots and our airline," the spokesman added.

American Airlines met with the union to thank it for its leadership in reaching a new labor contract, "discuss the next steps in our evaluation of strategic alternatives and exchange information," according to a statement from spokesman Mike Trevino.

US Airways declined to comment.

US Air has been pushing for a merger with American all year, and its plan has the support of unions that represent American's flight attendants and ground workers, in addition to the pilots union. The two carriers combined would be on par with current No. 1 United Continental Holdings in scope.

"We anticipate that Mr. Parker will articulate his vision and plan for the new American Airlines next week," Tajer added.

American Airlines creditors want a potential merger with US Airways to be an all-stock deal rather than one that pays some claims in cash, people familiar with the matter said this week. Merger discussions among US Airways, AMR and its creditors are at an advanced stage, the sources said.

The pilots unions at both American and US Airways said this week they would join the merger talks with AMR creditors and the companies. The Allied Pilots Association last week approved a new labor accord with American that grants it a 13.5 percent equity stake in a reorganized AMR.

Keith Wilson, president of the pilots union, said in a message to members on Wednesday that Wall Street analysts suggest an American-US Airways merger is likely. "While I will refrain from speculation, we must be ready to move quickly toward a potential merger," Wilson said.

American Airlines shares rose 16.9 percent to 76 cents on Thursday, while US Airways rose 2.1 percent to $12.97.

(Reporting by Karen Jacobs; Editing by Dan Grebler)

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U.S. to Send 2 Missiles Batteries to Turkey to Deter Syria

WASHINGTON — The United States plans to send two Patriot missile batteries and about 400 military personnel to Turkey to defend against a possible Syrian missile attack, two allied officials said Thursday.

The American batteries will be part of a broader push to beef up Turkey’s defenses that will also include the deployment of four other Patriot batteries — two from Germany and two from the Netherlands.

All six batteries will be under NATO’s command and control, scheduled to be operational by the end of January.

Turkey, which has been supporting the Syrian opposition to President Bashar al-Assad, has been worried it is vulnerable to Syrian missiles, including Scuds that might be tipped with chemical weapons. Those concerns were heightened by reports of increased activity at some of Syria’s chemical sites, though Defense Secretary Leon E. Panetta said this week that intelligence about chemical weapons activity in Syria had “leveled off.”

The recent Scud missile attacks mounted by forces loyal to Mr. Assad against rebels in northern Syria have only added to Turkey’s concerns. The Scud missiles fired at the rebels were armed with conventional warheads, but the attacks showed that the Assad government is prepared to use missiles as it struggles to slow rebel gains.

NATO foreign ministers last week endorsed the decision to send Patriot batteries to Turkey. The details of how many each nation would send were not worked out until this week, officials said.

In preparation for the deployment, allied officials had conducted surveys of 10 potential sites, mostly in southeastern Turkey, that could be defended by one or more Patriot batteries.

But NATO nations do not have enough batteries to cover all of the sites. With tensions building with Iran and North Korea defying the United States and its Asian allies by launching a long-range rocket, American officials did not want to send more than a few Patriot batteries to Turkey, especially since it is not clear how long they will be needed.

But NATO diplomats said that the goal was to show enough of a commitment to Turkey’s defense to deter a Syrian attack.

It will take three weeks to ship and deploy the two American Patriot batteries, a Defense Department official said.

One allied official said it might be possible to speed up the deployment of the German and Dutch batteries if necessary. Each of those nations will also send up to 400 troops.

The United States, Germany and the Netherlands are the only NATO members that have the advanced PAC-3 Patriot system.

The Patriot batteries in Turkey will be linked to NATO’s air-defense system. The response by the missile batteries would be nearly automatic, firing interceptor missiles to destroy the target by ramming into it, a tactic the military calls “hit to kill.”

Syria denied Thursday that it had fired Scud missiles this week. But NATO’s secretary general, Anders Fogh Rasmussen, said that the intelligence gathered by the alliance indicated that they were Scud-type missiles. “In general, I think the regime in Damascus is approaching collapse,” he said. “I think now it’s only a question of time.”

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Facebook, Google tell the government to stop granting patents for abstract ideas

Facebook (FB), Google (GOOG) and six other tech companies have petitioned the courts to begin rejecting lawsuits that are based on patents for vague concepts rather than specific applications, TechCrunch reported. The agreement, which was cosigned by Zynga (ZNGA), Dell (DELL), Intuit (INTU), Homeaway (AWAY), Rackspace (RAX), and Red Hat (RHT), notes the only thing these abstract patents do is increase legal fees and slow innovation in the industry. The companies claim that “abstract patents are a plague in the high tech sector” and force innovators into litigation that results in huge settlements or steep licensing fees for technology they have already developed on their own, which then leads to higher prices for consumers.

“Many computer-related patent claims just describe an abstract idea at a high level of generality and say to perform it on a computer or over the Internet,” the briefing reads. “Such barebones claims grant exclusive rights over the abstract idea itself, with no limit on how the idea is implemented. Granting patent protection for such claims would impair, not promote, innovation by conferring exclusive rights on those who have not meaningfully innovated, and thereby penalizing those that do later innovate by blocking or taxing their applications of the abstract idea.”

The companies conclude, “It is easy to think of abstract ideas about what a computer or website should do, but the difficult, valuable, and often groundbreaking part of online innovation comes next: designing, analyzing, building, and deploying the interface, software, and hardware to implement that idea in a way that is useful in daily life. Simply put, ideas are much easier to come by than working implementations.”

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The X Factor Reveals Season 2 Finalists

TV Watch

The X Factor

12/13/2012 at 09:10 PM EST

Carly Rose Sonenclar, Emblem3, Tate Stevens and Fifth Harmony

Ray Mickshaw/FOX (4)

Sparks will fly at the finale!

On Thursday, The X Factor revealed its top three acts, who will perform next week in the final night of competition – in hopes of taking home the $5 million recording contract.

Simon Cowell said it would take a miracle to get his girl group, Fifth Harmony, to the finale after they performed Shontelle's "Impossible" and Ellie Goulding's "Anything Could Happen" on Wednesday. Keep reading to find out if their dream came true ...

Apparently, miracles do happen! Fifth Harmony was the first act to be sent through to the finale.

They will compete against departing judge L.A. Reid's country singer, Tate Stevens, and Britney Spears's only remaining contestant, Carly Rose Sonenclar.

That means Simon's promising boy band, Emblem3, are out of the running for the big prize.

"This is the way it goes on competitions," Simon said. "I'm gutted really for them ... But it happens."

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Study: People worldwide living longer, but sicker

LONDON (AP) — Nearly everywhere around the world, people are living longer and fewer children are dying. But increasingly, people are grappling with the diseases and disabilities of modern life, according to the most expansive global look so far at life expectancy and the biggest health threats.

The last comprehensive study was in 1990 and the top health problem then was the death of children under 5 — more than 10 million each year. Since then, campaigns to vaccinate kids against diseases like polio and measles have reduced the number of children dying to about 7 million.

Malnutrition was once the main health threat for children. Now, everywhere except Africa, they are much more likely to overeat than to starve.

With more children surviving, chronic illnesses and disabilities that strike later in life are taking a bigger toll, the research said. High blood pressure has become the leading health risk worldwide, followed by smoking and alcohol.

"The biggest contributor to the global health burden isn't premature (deaths), but chronic diseases, injuries, mental health conditions and all the bone and joint diseases," said one of the study leaders, Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington.

In developed countries, such conditions now account for more than half of the health problems, fueled by an aging population. While life expectancy is climbing nearly everywhere, so too are the number of years people will live with things like vision or hearing loss and mental health issues like depression.

The research appears in seven papers published online Thursday by the journal Lancet. More than 480 researchers in 50 countries gathered data up to 2010 from surveys, censuses and past studies. They used statistical modeling to fill in the gaps for countries with little information. The series was mainly paid for by the Bill & Melinda Gates Foundation.

As in 1990, Japan topped the life expectancy list in 2010, with 79 for men and 86 for women. In the U.S. that year, life expectancy for men was 76 and for women, 81.

The research found wide variations in what's killing people around the world. Some of the most striking findings highlighted by the researchers: — Homicide is the No. 3 killer of men in Latin America; it ranks 20th worldwide. In the U.S., it is the 21st cause of death in men, and in Western Europe, 57th.

— While suicide ranks globally as the 21st leading killer, it is as high as the ninth top cause of death in women across Asia's "suicide belt," from India to China. Suicide ranks 14th in North America and 15th in Western Europe.

— In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths versus 1 death per 100,000).

— Central and Southeast Asia have the highest rates of fatal stroke in young adults at about 15 cases per 100,000 deaths. In North America, the rate is about 3 per 100,000.

Globally, heart disease and stroke remain the top killers. Reflecting an older population, lung cancer moved to the 5th cause of death globally, while other cancers including those of the liver, stomach and colon are also in the top 20. AIDS jumped from the 35th cause of death in 1990 to the sixth leading cause two decades later.

While chronic diseases are killing more people nearly everywhere, the overall trend is the opposite in Africa, where illnesses like AIDS, malaria and tuberculosis are still major threats. And experts warn again shifting too much of the focus away from those ailments.

"It's the nature of infectious disease epidemics that if you turn away from them, they will crop right back up," said Jennifer Cohn, a medical coordinator at Doctors Without Borders.

Still, she acknowledged the need to address the surge of other health problems across Africa. Cohn said the agency was considering ways to treat things like heart disease and diabetes. "The way we treat HIV could be a good model for chronic care," she said.

Others said more concrete information is needed before making any big changes to public health policies.

"We have to take this data with some grains of salt," said Sandy Cairncross, an epidemiologist at the London School of Hygiene and Tropical Medicine.

He said the information in some of the Lancet research was too thin and didn't fully consider all the relevant health risk factors.

"We're getting a better picture, but it's still incomplete," he said.

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Online:

www.lancet.com

http://healthmetricsandevaluation.org

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Asian shares rise, yen falls after Fed's stimulus steps

TOKYO (Reuters) - Asian shares extended gains for a seventh day on Thursday, after the U.S. Federal Reserve took new stimulus steps to bolster the economy, pressuring the yen with expectations the Japanese central bank will follow suit with more easing next week.

While stocks gained, oil and gold fell from post-Fed rallies, as investors took profits ahead of the year-end.

Despite the Fed's fresh dose of liquidity-pumping measures, the upside for stocks was also contained by concerns about the lack of breakthrough in U.S. budget talks to avert the "fiscal cliff," some $600 billion of tax hikes and spending cuts scheduled to start in January.

Failure to reach a compromise by the end of the year risks pushing the U.S. economy into recession and has stoked fears that a fragile recovery trend emerging in China and some other countries would be stifled.

U.S. stocks ended little changed on Wednesday, giving up most of the day's gains after Fed Chairman Ben Bernanke warned of damage from the "fiscal cliff", and as U.S. House of Representatives Speaker John Boehner said "serious differences" remain with President Barack Obama.

MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> added 0.3 percent to a 16-month peak, having hit successive 16-month highs since December 5. South Korean shares <.ks11> hit a two-month high and were last up 0.5 percent.

"The Fed's easing measures met the market's expectations, while the setting of clear inflation and unemployment targets exceeded hopes and will clear uncertainty on the monetary front," said Kim Yong-goo, an analyst at Samsung Securities.

The U.S. central bank, cut its forecasts for economic growth and inflation next year, committed to monthly purchases of $45 billion in Treasuries on top of the $40 billion per month in mortgage-backed bonds it started buying in September.

But it also took the unprecedented step of indicating interest rates would remain near zero until unemployment falls to at least 6.5 percent.

YEN WEAKNESS CONTINUES

The dollar advanced to its loftiest in nearly nine months against the yen, touching a high of 83.44 yen. The yen's slump boosted Japan's Nikkei share average <.n225> up 1.6 percent and above 9,700 for the first time in eight months. <.t/>

The Bank of Japan meets December 19-20 and is widely expected to further ease monetary policy to support its weak economy.

The Fed's latest move to make the jobless rate a target for its monetary policy could have a longer-term implication on the BOJ.

"While the BOJ's ultimate goal is to pull Japan out of deflation, the Fed's latest move could prompt Japanese politicians or the government to urge the BOJ to also commit itself to growth, not just price stability," said Chotaro Morita, chief fixed income strategist at Barclays.

Morita said that market consensus is for the BOJ to expand its asset-buying and lending program, currently at 91 trillion yen ($1.1 trillion), by another 5-10 trillion yen, and put off taking bolder steps until after a new cabinet is formed.

Japan holds an election on Sunday, with opinion surveys showing conservative former Prime Minister Shinzo Abe's opposition Liberal Democratic Party and its smaller ally heading for a resounding victory.

Abe wants to step up aggressive monetary easing along with heavy public works spending, policy prescriptions dubbed "Abenomics" by the media, and while his threat to curtail the BOJ's independence has unsettled investors, investors reckon the responsibility of power will prevent Abe taking excessive risks that could lead to a bond market meltdown.

The euro was relatively less volatile compared to the dollar and the yen, steadying around $1.3066 after reaching a high of $1.3098 on Wednesday.

Greece's foreign lenders welcomed a bond buyback even though it narrowly fell short of a target to cut the country's debt, paving the way for Athens to get long-delayed aid to avoid bankruptcy.

In Italy, another debt-straddled euro zone country, Silvio Berlusconi offered to stand back and make way for Mario Monti as Italy's next leader if the outgoing technocrat premier agreed to run as the candidate for a center-right coalition. Monti's intention to resign has raised concerns that his austerity policies may not be carried out.

Oil prices retreated from overnight rises, with U.S. crude futures easing 0.3 percent to $86.48 a barrel and Brent falling 0.5 percent to $109.01.

Gold tumbled more than 1 percent on stop-loss selling, after the Fed's announcement of a fresh round of bond buying lifted prices to their highest levels in nearly two weeks. Spot gold dropped 1 percent to $1,694.16.

($1 = 82.9300 Japanese yen)

(Additional reporting by Somang Yang in Seoul; Editing by Jacqueline Wong)

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Another Editor Steps Down in News Corp. Shake-Up

News Corporation’s British newspaper unit, embroiled in the aftermath of a phone hacking scandal, lost another high-ranking executive on Wednesday when the editor of The Times of London announced he would step down.

The executive, James Harding, considered by many a golden boy of British journalism, said he would depart his post at The Times amid pressure from News Corporation’s senior leadership.

He called the corporation’s chief executive, Rupert Murdoch, early Wednesday to offer his resignation, the second in two weeks at News International, the British newspaper subsidiary of News Corporation. On Dec. 2, Tom Mockridge, chief executive of News International, announced his resignation.

“It has been made clear to me that News Corporation would like to appoint a new editor of The Times,” Mr. Harding told his staff. “I have therefore agreed to stand down.”

The same day that Mr. Harding said he would depart, regulatory filings showed that Rebekah Brooks, a former chief executive of News International, had received a $17.6 million severance package that included “compensation for loss of office” and “various ongoing benefits.”

Ms. Brooks, who had served as editor of the News of the World and Sun tabloids, both accused of widespread phone hacking, is expected to stand trial in September over accusations of illegal payments to public officials. She has also been charged with conspiracy to intercept voice mail messages and conspiracy to pervert the course of justice. She has denied the accusations.

The settlement agreement, reached during Ms. Brooks’s departure in July 2011 at the height of the phone hacking scandal at The News of the World, stipulates that she would be required to return much of her compensation if she were found guilty.

Mr. Harding took over as editor of The Times in 2007 at 38, making him one of the youngest to hold the job in the broadsheet’s 227-year history. His counterpart at The Sunday Times, John Witherow, was widely expected to replace him. News International declined to comment.

Mr. Murdoch bought The Times in 1981, adding prestige and influence to his stable of British tabloids. In October, the paper’s weekday circulation was down 7.82 percent from the same month last year, to 403,770 readers, according to Britain’s Audit Bureau of Circulations.

Under Mr. Harding’s leadership, The Times took a relatively critical stance against its parent company’s handling of the hacking scandal, and speculation arose that the spirited coverage had led to his ouster.

“In uniquely difficult circumstances I hope we have covered the story that has swirled around us with the integrity and independence that readers of The Times expect of us,” Mr. Harding told his staff.

In a statement, Mr. Murdoch said, “James has been a distinguished editor for The Times” and helped lead the paper “through difficult times.”

News Corporation is readying itself to split off its publishing assets into a separate publicly traded entity. The new company will be led by Robert Thomson, currently the managing editor of The Wall Street Journal and editor in chief of Dow Jones.

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New Flickr iPhone app to compete with Instagram and Twitter with 16 filters

Hot on the heels of its email redesign, Yahoo (YHOO) announced on Wednesday that it has completely redesigned the Flickr iPhone app. The new app borrows heavily from Instagram and focuses on what makes Flickr special: photos and communities. Yahoo’s new Flickr app also includes 16 filters with their own fancy names to go head-on with Instagram and Twitter’s recently updated app that added eight filters. Users can now access the Flickr app with numerous accounts including Facebook (FB) and Google (GOOG) and photos can be shared to Facebook, Twitter, Tumblr or via email. The new Flickr app is available for free on iPhone but to our disappointment, there isn’t an iPad-optimized version.

Ellis Hamburger from The Verge penned an interesting editorial on how Twitter misses the mark by simply adding filters to its app without having the close community that makes Instagram so addictive. Led by CEO Marissa Mayer, Yahoo seems aware that mobile apps thrive on the communities that sprout up. The new Flickr app’s emphasis on how the images are displayed and shared in visually appealing and digestible thumbnails suggests Yahoo finally understands mobile.

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Tevin Hunte Is 'So Happy' After His Voice Elimination

TV Watch

The Voice

By Jessica Herndon and Julia Haskins

12/12/2012 at 07:45 PM EST

Team Cee Lo's Trevin Hunte was eliminated on Tuesday's episode of The Voice, but the soulful singer isn't letting the end of this journey hold him back.

"I feel like the best person on the planet Earth. I am so happy and excited to be honest," Hunte told PEOPLE after the show. I feel like a weight has been lifted. Being away from family and friends and what you're used to was definitely a hard thing for me."

Hunte is looking forward to his mom's cooking and seeing his friends back home, and he won't waste a second wondering what if he'd made it further.

"I have no regrets. I am glad that I took a leap of faith and auditioned," he said. "I auditioned for American Idol and told my family I didn't have the strength to do it again. But I am definitely happy and excited that I made it this far."

And he still has a long way to go. "I'm only 18," he said. "I'm just really excited."

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