First Person: Unemployed, Disabled and Hungry for Work












Five million Americans are among the long-term unemployed–those without a job for 27 weeks or longer–according to the Bureau of Labor Statistics. Another 7.3 million are looking for work, while the unemployment rate sits at 7.9 percent. Numbers aside, individual stories illustrate how America is affected. To see how joblessness hits home, Yahoo News asked unemployed workers to share their job-hunting stories. Here’s one.


FIRST PERSON | I am 40 and live in Racine, Wis. I have been unemployed since I was 33. I try to find work, but I’ve been disabled since 27, and I do not collect Social Security or other income. On job applications, when I am asked if I have any disabilities, I answer yes.












I have even tried to travel to different states for employment. I am seeking employment where I can. I have tried Lowe’s, Home Depot and other similar stores. All I get are letters saying I do not qualify for employment.


By trade, I am a tattoo artist, a job I have been very good at until I became disabled. I have shoulder impingement syndrome, which consists of some of the following: torn ligaments, torn tendons, bone spurs, bursitis and arthritis.


And constant pain. I feel the weather. I hardly sleep. I wish I could be somewhere else, as it is hard on my mind to deal with on a daily basis.


Still, I try to find work where I can in this tough economy, and I am on several lists to be called and never have been called to date.


I am too proud to try to get Social Security. I cannot even afford insurance to get my condition fixed. I even have applied for local state insurance to get the problem resolved so I can work again, always with no luck. So I have remained unemployed now for over 10 years and going.


I injured myself, and I am not able to lift more than 10 pounds at a time or stand or sit for long periods of time.


I just want a job so I can try to cover the medical expenses myself since I cannot get help. Surgery costs are around $ 18,000, which sounds pretty reasonable to me.


I am no stranger to hard work. Since 12, I cut grass, shoveled snow, painted houses and fences, swept chimneys, worked in heat treatment plants with dirt and oil, worked in the casting of hot metals, laid brick, made bathroom sinks, swept floors in factories, did drill-press work, sanding work, and worked at fast food places.


I do not lie to get jobs or hid my injury. I do want to work, but I worry now that my disability will mean I won’t be hired by companies because they’re afraid it will come back on them and their company.


I cannot afford private insurance as I do not have steady income. Now I find whatever I can do to reach my goal of paying for my own surgery.


It is a sad world when you live in pain, day in and day out, and you want and need to find work.


Health News Headlines – Yahoo! News


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Germany rejects Swiss tax deal













Germany’s upper house of parliament has rejected a deal with Switzerland to tax German assets held in Swiss bank accounts.












The deal would have allowed Germans with undeclared assets in Switzerland to avoid punishment by making a one-off payment of between 21% and 41% of the value of their assets.


The deal had been negotiated in April and was due to take effect in January.


But it needed to be ratified by both parliaments.


The rejection by the German upper house, the Bundesrat, prolongs the dispute between the two countries over how to deal with the estimated 180-200bn euros (£145-160bn) of German assets hidden in Switzerland.


German Finance Minister Wolfgang Schaeuble had called for support for the deal, saying: “The agreement tries to find a better solution for a situation which is unsatisfactory.”


But Norbert Walter-Borjans, of the main opposition Social Democrats, told the Bundesrat it was a deal which made “honest taxpayers feel like fools”.


Swiss Finance Minister Eveline Widmer-Schlumpf said her government remained “committed to a successful ratification”.


And the Swiss Bankers Association said in a statement: “The German upper house has missed a major opportunity to reach a fair, optimum and sustainable solution for all parties to definitively settle the bilateral tax issues.”


BBC News – Business


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Egypt reformist warns of turmoil from Morsi decree












CAIRO (AP) — Prominent Egyptian democracy advocate Mohammed ElBaradei warned Saturday of increasing turmoil that could potentially lead to the military stepping in unless the Islamist president rescinds his new, near absolute powers, as the country’s long fragmented opposition sought to unite and rally new protests.


Egypt‘s liberal and secular forces — long divided, weakened and uncertain amid the rise of Islamist parties to power — are seeking to rally themselves in response to the decrees issued this week by President Mohammed Morsi. The president granted himself sweeping powers to “protect the revolution” and made himself immune to judicial oversight.












The judiciary, which was the main target of Morsi’s edicts, pushed back Saturday. The country’s highest body of judges, the Supreme Judical Council, called his decrees an “unprecedented assault.” Courts in the Mediterranean city of Alexandria announced a work suspension until the decrees are lifted.


Outside the high court building in Cairo, several hundred demonstrators rallied against Morsi, chanting, “Leave! Leave!” echoing the slogan used against former leader Hosni Mubarak in last year’s uprising that ousted him. Police fired tear gas to disperse a crowd of young men who were shooting flares outside the court.


The edicts issued Wednesday have galvanized anger brewing against Morsi and the Muslim Brotherhood, from which he hails, ever since he took office in June as Egypt’s first freely elected president. Critics accuse the Brotherhood — which has dominated elections the past year — and other Islamists of monopolizing power and doing little to bring real reform or address Egypt’s mounting economic and security woes.


Oppositon groups have called for new nationwide rallies Tuesday — and the Muslim Brotherhood has called for rallies supporting Morsi the same day, setting the stage for new violence.


Morsi supporters counter that the edicts were necessary to prevent the courts, which already dissolved the elected lower house of parliament, from further holding up moves to stability by disbanding the assembly writing the new constitution, as judges were considering doing. Like parliament was, the assembly is dominated by Islamists. Morsi accuses Mubarak loyalists in the judiciary of seeking to thwart the revolution’s goals and barred the judiciary from disbanding the constitutional assembly or parliament’s upper house.


In an interview with a handful of journalists, including The Associated Press, Nobel Peace laureate ElBaradei raised alarm over the impact of Morsi’s rulings, saying he had become “a new pharaoh.”


“There is a good deal of anger, chaos, confusion. Violence is spreading to many places and state authority is starting to erode slowly,” he said. “We hope that we can manage to do a smooth transition without plunging the country into a cycle of violence. But I don’t see this happening without Mr. Morsi rescinding all of this.”


Speaking of Egypt’s powerful military, ElBaradei said, “I am sure they are as worried as everyone else. You cannot exclude that the army will intervene to restore law and order” if the situation gets out of hand.


But anti-Morsi factions are chronically divided, with revolutionary youth activists, new liberal political parties that have struggled to build a public base and figures from the Mubarak era, all of whom distrust each other. The judiciary is also an uncomfortable cause for some to back, since it includes many Mubarak appointees who even Morsi opponents criticize as too tied to the old regime.


Opponents say the edicts gave Morsi near dictatorial powers, neutering the judiciary when he already holds both executive and legislative powers. One of his most controversial edicts gave him the right to take any steps to stop “threats to the revolution,” vague wording that activists say harkens back to Mubarak-era emergency laws.


Tens of thousands of people took to the streets in nationwide protests on Friday, sparking clashes between anti-and pro-Morsi crowds in several cities that left more than 200 people wounded.


On Saturday, new clashed broke out in the southern city of Assiut. Morsi opponents and members of the Muslim Brotherhood swung sticks and threw stones at each other outside the offices of the Brotherhood‘s political party, leaving at least seven injured.


ElBaradei and a six other prominent liberal leaders have announced the formation of a National Salvation Front aimed at rallying all non-Islamist groups together to force Morsi to rescind his edicts.


The National Salvation Front leadership includes several who ran against Morsi in this year’s presidential race — Hamdeen Sabahi, who finished a close third, former foreign minister Amr Moussa and moderate Islamist Abdel-Moneim Aboul-Fotouh. ElBaradei says the group is also pushing for the creation of a new constitutional assembly and a unity government.


ElBaradei said it would be a long process to persuade Morsi that he “cannot get away with murder.”


“There is no middle ground, no dialogue before he rescinds this declaration. There is no room for dialogue until then.”


The grouping seems to represent a newly assertive political foray by ElBaradei, the former chief of the U.N. nuclear watchdog agency. ElBaradei returned to Egypt in the year before Mubarak’s fall, speaking out against his rule, and was influential with many of the youth groups that launched the anti-Mubarak revolution.


But since Mubarak’s fall, he has been criticized by some as too Westernized, elite and Hamlet-ish, reluctant to fully assert himself as an opposition leader.


The Brotherhood‘s Freedom and Justice political party, once headed by Morsi, said Saturday in a statement that the president’s decision protects the revolution against former regime figures who have tried to erode elected institutions and were threatening to dissolve the constitutional assembly.


The Brotherhood warned in another statement that there were forces trying to overthrow the elected president in order to return to power. It said Morsi has a mandate to lead, having defeated one of Mubarak’s former prime ministers this summer in a closely contested election.


Morsi’s edicts also removed Abdel-Meguid Mahmoud, the prosecutor general first appointed by Mubarak, who many Egyptians accused of not prosecuting former regime figures strongly enough.


Speaking to a gathering of judges cheering support for him at the high court building in Cairo, Mahmoud warned of a “vicious campaign” against state institutions. He also said judicial authorities are looking into the legality of the decision to remove him — setting up a Catch-22 of legitimacy, since under Morsi’s decree, the courts cannot overturn any of his decisions.


“I thank you for your support of judicial independence,” he told the judges.


“Morsi will have to reverse his decision to avoid the anger of the people,” said Ahmed Badrawy, a labor ministry employee protesting at the courthouse. “We do not want to have an Iranian system here,” he added, referring to fears that hardcore Islamists may try to turn Egypt into a theocracy.


Several hundred protesters remained in Cairo’s Tahrir Square Saturday, where a number of tents have been erected in a sit-in following nearly a week of clashes with riot police.


____


Brian Rohan contributed to this report from Cairo.


Middle East News Headlines – Yahoo! News


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HP says products may have been sold to Syria by others












(Reuters) – Hewlett Packard Co said in a letter made public on Friday that its products could have been delivered to Syria through resellers or distributors, but the world’s largest PC maker affirmed it did not sell directly to the country.


The letter was a response to a request from the U.S. Securities and Exchange Commission‘s Office of Global Security Risk that asked whether HP’s products were sold in countries where they would be subject to U.S. sanctions.












“We are aware of November 2011 news reports that your equipment was installed by the Italian company, Area SpA, in Syria as part of a nationwide surveillance and tracking system designed to monitor people in that country,” the SEC wrote in its request.


“Please describe to us the nature, duration, and extent of your past, current, and anticipated contacts with Syria and Iran, whether through subsidiaries, distributors, resellers, vendors, retailers, or other direct or indirect arrangements.”


In a letter dated October 9, HP said it had not authorized the sale of products to Syria.


Instead, HP said the Italian surveillance company had likely obtained its products from an HP partner that was unaware of their ultimate destination.


In another October 9 letter to the agency, HP said it ended its contract with Area SpA in April.


Calls to HP seeking further comment were unanswered as were calls to Area SpA.


HP’s overseas subsidiaries ended sales of printers and related supplies to third-party distributors and resellers with customers in Iran in early 2009, the company wrote.


But because its products are often sold by others through indirect channels without its knowledge or consent “it is always possible that products may be diverted to Iran or Syria after being sold to channel partners, such as distributors and resellers,” HP said.


Reuters has documented how banned computer equipment from U.S. companies has made its way to Iran’s largest telecommunications company through China-based ZTE.


Networking equipment maker Cisco Systems Inc has since cut its ties to ZTE.


HP said in both letters that it would continue to work with ZTE, but it had conducted an internal investigation relating to an alleged sale of its products to MTN Irancell, Iran’s second largest mobile carrier.


The company was also asked about EDS – an IT outsourcing company that HP bought in 2008 – and any activity in Iran, Syria and Sudan.


HP said it had the same policy regarding Sudan as it did on sales to Iran or Syria.


HP is eager to avoid more negative publicity after surprising the market on Tuesday with an $ 8.8 billion write-down on its $ 11.1 billion acquisition of software group Autonomy, accusing the British company of improper accounting to inflate sales.


Autonomy has denied any wrongdoing.


(Reporting by Nicola Leske in New York. Editing by Leslie Gevirtz and Andre Grenon)


Tech News Headlines – Yahoo! News


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Secret message found with carrier pigeon may never be deciphered












 Secret message found with carrier pigeon may never be decipheredBritish man finds carrier pigeon skeleton in his fireplace with unbreakable secret code (Reuters)


Before military forces had secure cell phones and satellite communications, they used carrier pigeons. The highly trained birds delivered sensitive information from one location to another during  World War II. Often, the birds found the intended recipient. But not always.












A dead pigeon was recently discovered inside a chimney in Surrey, England. There for roughly 70 years, the bird had a curious canister attached to its leg. Inside was a coded message that has stumped the experts.


The code features a series of 27 groups of five letters. According to Reuters, nobody from Britain’s Government Communications Headquarters has been able to decipher it. The message was sent by a Sgt. W. Scott to someone or something identified as “Xo2.”


A spokesperson remarked, “Although it is disappointing that we cannot yet read the message brought back by a brave carrier pigeon, it is a tribute to the skills of the wartime code-makers that, despite working under severe pressure, they devised a code that was indecipherable both then and now.”


The bird was discovered by a homeowner doing renovations earlier this month. In an interview with Reuters, David Martin remarked that bits of birds kept falling from the chimney. Eventually, Margin saw the red canister and speculated that it might contain a secret message. And it seems as if the message will always be secret.


Carrier pigeons played a vital role in wars due to their incredible homing skills. All told, U.K. forces used about 250,000 of the birds during World War II.


Wireless News Headlines – Yahoo! News


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Four new cases of SARS-like virus found in Saudi, Qatar












LONDON (Reuters) – A new virus from the same family as SARS which sparked a global alert in September has now killed two people in Saudi Arabia, and total cases there and in Qatar have reached six, the World Health Organisation said.


The U.N. health agency issued an international alert in late September saying a virus previously unknown in humans had infected a Qatari man who had recently been in Saudi Arabia, where another man with the same virus had died.












On Friday it said in an outbreak update that it had registered four more cases and one of the new patients had died.


“The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case),” the WHO said.


The new virus is known as a coronavirus and shares some of the symptoms of SARS, or Severe Acute Respiratory Syndrome, which emerged in China in 2002 and killed around a 10th of the 8,000 people it infected worldwide.


Among the symptoms in the confirmed cases are fever, coughing and breathing difficulties.


Of the six laboratory-confirmed cases reported to WHO, four cases, including the two deaths, are from Saudi Arabia and two cases are from Qatar.


Britain’s Health Protection Agency, which helped to identify the new virus in September, said the newly reported case from Qatar was initially treated in October in Qatar but then transferred to Germany, and has now been discharged.


Coronaviruses are typically spread like other respiratory infections, such as flu, travelling in airborne droplets when an infected person coughs or sneezes.


The WHO said investigations were being conducted into the likely source of the infection, the method of exposure, and the possibility of human-to-human transmission of the virus.


“Close contacts of the recently confirmed cases are being identified and followed-up,” it said.


It added that so far, only the two most recently confirmed cases in Saudi Arabia were epidemiologically linked – they were from the same family, living in the same household.


“Preliminary investigations indicate that these two cases presented with similar symptoms of illness. One died and the other recovered,” the WHO’s statement said.


Two other members of the same family also suffered similar symptoms of illness, and one died and the other is recovering. But the WHO said laboratory test results on the fatality were still pending, and the person who is recovering had tested negative for the new coronavirus.


The virus has no formal name, but scientists at the British and Dutch laboratories where it was identified refer to it as “London1_novel CoV 2012″.


The WHO urged all its member states to continue surveillance for severe acute respiratory infections.


“Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases,” it said.


(Editing by Alison Williams)


Health News Headlines – Yahoo! News


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EU budget talks end without deal













The Brussels summit has ended without agreement on the 27-strong union’s next seven-year budget.












A BBC correspondent says another meeting will have to be called to sort out the difficulties but it is unclear how differences will be resolved.


European Council chief Herman Van Rompuy said he was confident a deal would be reached early next year.


Hours of talks failed to bridge big gaps between richer countries and those which rely most on EU funding.


The UK said current EU spending levels must be frozen.


Continue reading the main story

Start Quote



Angela Merkel and I both agreed that it would be better to take some time out”



End Quote Francois Hollande French president


The EU’s divisions are very clear and have become even more stark at a time of economic crisis, says the BBC’s Chris Morris in Brussels.


Mr Van Rompuy had reshuffled the allocations in his original proposed budget during the summit, but he kept in place a spending ceiling of 973bn euros (£783bn; $ 1.2tn).


With the eurozone’s dominant states, Germany and France, unable to agree on the budget, UK Prime Minister David Cameron had warned against “unaffordable spending”.


The failure to decide on a budget came just days after the finance ministers of the 17 eurozone states failed to agree on conditions for releasing a new tranche of bailout money to Greece, raising questions about the union’s decision-making process.


‘No threats’


Mr Van Rompuy’s budget had been unacceptable to a number of other countries, not just Britain, Mr Cameron told reporters.


Continue reading the main story

Analysis


The summit laid bare clear divisions between richer northern countries in the EU, and the poorer south and east. It mirrored the divide that has emerged in the eurozone between northern creditors and southern debtors.


But the uneasy relationship between France and Germany also played a role – when they don’t agree, things tend to move slowly. Germany wanted further cuts in the budget proposal – not as many as Britain and others – but cuts all the same.


France on the other hand, supported by Italy and Spain, was keen to defend the EU’s biggest spending projects.


So striking a deal at a second summit in the New Year won’t be at all easy. But there are two reasons to think that it might succeed.


One is that failure to reach an agreement would mean the EU falling back on more expensive annual budgets.


The other is that many people are keen to avoid a prolonged budget stalemate, which could divert attention from other more important issues – notably the need to take more steps to resolve the crisis in the eurozone.



“Together, we had a very clear message: ‘We are not going to be tough on budgets at home just to come here and sign up to big increases in European spending’,” he said.


“We haven’t got the deal we wanted but we’ve stopped what would have been an unacceptable deal,” he added. “And in European terms I think that goes down as progress.”


German Chancellor Angela Merkel said she was sympathetic towards Mr Cameron’s view – but no more than she was to all countries involved in the discussion.


“The discussions, both the bilateral discussions and the common discussion, have shown us that there is sufficient potential for an agreement,” she added.


French President Francois Hollande said the summit had made “progress”.


“There were no threats, no ultimatums,” he told reporters. “Angela Merkel and I both agreed that it would be better to take some time out because we want there to be an agreement.”


Without naming the UK, he also said it was time the system of budget rebates was reconsidered.


“It is a paradox, because some net contributors [EU countries that pay in more than they get back] get some of the money back even though they are in a situation where they are wealthy enough for them not to get this money back,” he said.


Lithuanian President Dalia Grybauskaite remarked that the atmosphere at the summit had been “surprisingly good because the divergence in opinions was so large that there was nothing to argue about”.


European Commission chief Jose Manuel Barroso said the talks had failed owing to “important differences of opinion – especially in overall size of the budget”.


Revisions


The Commission, which drafts EU laws, had originally called for a budget of 1.025tn euros.




UK Prime Minister David Cameron: “We still believe a deal is do-able”



Its position was supported by the European Parliament and many countries which are net beneficiaries, including Poland, Hungary and Spain.


While most EU members supported some increase in the budget, several, mostly the big net contributors, argued it was unacceptable at a time of austerity.


Germany, the UK, France and Italy are the biggest net contributors to the budget, which amounts to about 1% of the EU’s overall GDP.


Mr Van Rompuy’s revised budget would have softened the blow to the two main areas of spending: development in the EU’s poorer regions, and agriculture.


Instead, there would have been greater cuts to energy, transport, broadband and the EU’s foreign service.


His proposal, put to leaders on Thursday evening, would have made no change to the level of administrative costs – something the UK might have found unacceptable.


Speaking after the summit, Mr Van Rompuy said: “My feeling is that we can go further… It has to be balanced and well prepared, not in the mood of improvisation, because we are touching upon jobs, we are touching upon sensitive issues.”


Failure to agree on the budget by the end of next year would mean rolling over the 2013 budget into 2014 on a month-by-month basis, putting some long-term projects at risk.


Analysts say that could leave the UK in a worse position, because the 2013 budget is bigger than the preceding years of the 2007-2013 multi-year budget.


BBC News – Business


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Country singer Kristofferson looks to end of road












GENEVA (Reuters) – Kris Kristofferson — Oxford scholar, athlete, U.S. Army helicopter pilot, country music composer, one-time roustabout, film actor, singer, lover of women, three times a husband and father of eight — seems ready to meet his maker.


At least, that was the clear impression he left with an audience of middle-aged-and-upwards fans at a concert in Geneva this week, a message underscored by his 28th and latest album, “Feeling Mortal” and its coffin-dark cover.












At a frail-looking 76, his ample beard more straggly than ever and his always gravel-laden voice gasping out the familiar lyrics of his great classics from “Bobby McGee” to “Rainbow Again”, the hereafter appears at the front of his mind.


“I’ve begun to soon descend, like the sun into the sea,” runs the title song of the new CD.


On the stage without backing group in Geneva, the first leg of a solo European tour to promote the disc from his own record company, “God” trips off his lips like a punctuation mark.


Even the old songs that made him — as well as other country artists like Willy Nelson, Johnny Cash, and his one-time girl-friend Janis Joplin — internationally famous, sound shaped by the fading voice to underscore a spiritual dimension.


“Sunday Morning Coming Down” emerges less as an ode to elderly loners facing old age without family and children and more as a call to prepare for the next life.


Religiosity was never that far from Kristofferson, son of a major-general in the U.S. Air Force, grandson of a Swedish army officer and in the 1ate 1950s a Rhodes Scholar in English Literature at England’s Oxford University.


CRUCIFIXION


In the 1971 “Jesus was a Capricorn” he predicts the Christian savior would be crucified again if he came back preaching peace and love among all races and creeds.


In the new album, “Ramblin’ Jack” is semi-autobiographical — a song about a wandering singer “with a face like a tumbled-down shack” of “wild and righteous, wicked ways” who “ain’t afraid of where he’s goin’.”


Kristofferson is adored by many believers, probably the vast majority of U.S. country fans and performers. But his fans among the unreligious and the atheists were also happy just to relish the poetry of his lyrics and the idiosyncrasy of his voice.


In Geneva, despite its Calvinist past as secular today as any major European city, the ageing 1,000-odd audience in a theatre seating twice that number, were certainly ready to enjoy anything he gave them.


They cheered and applauded his political declaration, an aside injected after a song line: “nobody wins.” “But somebody has just won. Obama won, so the whole world has won!” he rasped, waving his electric guitar in the air.


SELF-MOCKERY


They loved his self-mockery when, overcome briefly by a sniffle and pulling a blue bandana — cousin of the red one in “Bobby McGee”? — from his jeans pocket, he asked them if they minded having paid $ 100 “to watch an old fart blow his nose.”


And they laughed with him when — in the full flood of lyrics on the pleasure of being around “a lot of lovely girls in the best of all possible worlds — he confided: “I wrote this song a LONG time ago.”


His 22-year-old angel-faced daughter Kelly, a banjoist and vocalist, joined him on stage for a handful of numbers, while in the hall outside son Jesse manned a stall selling the new CD and the black “Feeling Mortal Tour” t-shirts.


Children — their dreams and the dreams of their parents for them — have also long been a central theme of his music.


“I wrote this for my little girl,” he says of a father’s song pledging he will be “forever there” for a daughter through life, and after. “Spread your wings,” he tells her.


More prosaically, he recalls a rebuke from Jesse at age five over his 1970s hit: “The Silver-Tongued Devil”: “That’s a bad song. You’re blaming all your troubles on someone else.”


After the concert, the Kristofferson family left for Zurich and Vienna to continue the tour. “This may be our last goodbye,” he sang in a final song. “We may not pass this way again.”


“We’ll miss you,” called a voice from the audience.


(Reported by Robert Evans)


Music News Headlines – Yahoo! News


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Marc Anthony comes to aid of Dominican orphanage












SANTO DOMINGO, Dominican Republic (AP) — Singer Marc Anthony is coming to the aid of an orphanage in the Dominican Republic.


A foundation run by Anthony with music and sports producer Henry Cardenas plans to build a new residence hall, classrooms and a baseball field for the Children of Christ orphanage in the eastern city of La Romana. Anthony attended the groundbreaking ceremony Friday with his model girlfriend Shannon de Lima.












Children of Christ Foundation Director Sonia Hane said Anthony visited the orphanage previously and decided to help. His Maestro Cares Foundation raised $ 200,000 for the expansion on land donated by a sugar company. The orphanage was founded in 1996 for children who were abused or abandoned or whose parents were unable to care for them.


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Laws don’t curb pricey prostate cancer treatments












NEW YORK (Reuters Health) – Laws meant to prevent the overuse of expensive healthcare services don’t stop doctors from using pricey prostate cancer treatments, according to two new studies.


Researchers found doctors used robots and special radiation to treat prostate cancer regardless of whether their area had laws requiring government approval before money is spent on healthcare facilities and new equipment.












“Certificate of need laws were designed to align public need with use of different services,” said Dr. Bruce Jacobs, a lead author of one of the studies from the University of Michigan in Ann Arbor.


The U.S. government required states to implement the laws in the 1970s and early 1980s, but stopped a few decades ago. Still, some states continue to use the laws in an effort to control costs.


In each study, the researchers looked at treatments for prostate cancer, which is the most common cancer in American men.


The American Cancer Society estimates that one in every six men will be diagnosed with prostate cancer in their lifetime, but most will not die from it. Past research found that many men’s prostate cancer is slow-growing, and most are candidates for active surveillance or “watchful waiting.”


In Jacobs’s study, the researchers looked at whether states with strict laws – those that require approval for even low-cost equipment – used robotic surgery to remove fewer prostates than states with less strict or no laws.


Jacobs and his colleagues write in The Journal of Urology that the price of such robots, and the questions surrounding whether or not robotic surgery to remove a prostate is better than the old-fashioned way should make it an “ideal target” for review under the laws.


In September, for example, one of the studies that have questioned the usefulness of robotic surgery found that men who had robotic surgery ended up having fewer short-term complications, but questioned its long-term benefits and whether the hefty price tag of $ 1.5 million in startup costs is worth it. (see Reuters Health article of Sep. 12, 2012:)


But another recent study found robotic surgery led to fewer complications, fewer readmissions to the hospital, and fewer deaths due to surgery than traditional methods, according to Intuitive Surgical, the maker of the da Vinci Surgical System.


“That is significant for the patient and for reducing overall costs to the system,” wrote Angela Wonson, a spokesperson for Intuitive Surgical, in an email to Reuters Health.


Overall, in the new study, the use of robotic surgery to remove prostates in Medicare patients increased regardless of whether there were strict, less strict or no laws in place. Also, the chance a surgeon used robots had nothing to do with the laws.


RADIATION AND COSTS


A second study by another group of researchers looked at whether the laws limited the use of intensity modulated radiation therapy (IMRT) or slowed the growth of healthcare costs related to prostate cancer.


IMRT allows doctors to focus radiation beams onto the cancer without harming healthy tissue.


However, the researchers write that IMRT is costly and – to their knowledge – has not been compared to other prostate cancer treatments in a randomized controlled trial, which is considered the “gold standard” of medical research.


In a group of Medicare patients, Dr. Ganesh Palapattu, the chief of urologic oncology at the University of Michigan and the study’s senior researcher, found that areas with the laws actually saw greater growth in IMRT use.


Palapattu and his colleagues found that IMRT use increased from about 2 percent of all prostate cancer treatments in 2002 to almost half in 2009 in areas with the laws.


In areas without the laws, IMRT use increased from about 11 percent of all prostate cancer treatments to about 42 percent over the same time span.


The laws also didn’t seem to help control prostate cancer treatment costs when the researchers compared the price to treat one person with prostate cancer in states with laws, compared to states without laws.


Palapattu told Reuters Health that it may be time to reevaluate the regulations.


“If the goal is to limit the overutilization of more expensive therapies and to improve efficacy or health, then we have to reexamine how we’re doing this,” he said.


Jacobs told Reuters Health that there is more research to be done, because his group’s study did not look at how many applications for equipment may have been turned down by the states’ approval board.


“I think if we really want to get to the bottom of how effective these (laws) are, the next step is to really look closely at each state’s process of review,” he said.


Palapattu said he’d also like to see if the findings are the same for non-Medicare patients. But, for now, he said men with prostate cancer should talk to their doctors about which treatment is right for them.


“Newer isn’t always better, and it’s important to have a meaningful conversation with your physician on treatment options and which one might be best for you and why,” he said.


SOURCE: http://bit.ly/QzKXvE and http://bit.ly/R5AUhH The Journal of Urology, online November 19, 2012.


Seniors/Aging News Headlines – Yahoo! News


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