In the USA...United Surveillance America
December 2, 2013
As Hospital Prices Soar, a Single Stitch Tops $500
By ELISABETH ROSENTHAL
SAN FRANCISCO — With blood oozing from deep lacerations, the two patients arrived at California Pacific Medical Center’s tidy emergency room. Deepika Singh, 26, had gashed her knee at a backyard barbecue. Orla Roche, a rambunctious toddler on vacation with her family, had tumbled from a couch, splitting open her forehead on a table.
On a quiet Saturday in May, nurses in blue scrubs quickly ushered the two patients into treatment rooms. The wounds were cleaned, numbed and mended in under an hour. “It was great — they had good DVDs, the staff couldn’t have been nicer,” said Emer Duffy, Orla’s mother.
Then the bills arrived. Ms. Singh’s three stitches cost $2,229.11. Orla’s forehead was sealed with a dab of skin glue for $1,696. “When I first saw the charge, I said, ‘What could possibly have cost that much?’ ” recalled Ms. Singh. “They billed for everything, every pill.”
In a medical system notorious for opaque finances and inflated bills, nothing is more convoluted than hospital pricing, economists say. Hospital charges represent about a third of the $2.7 trillion annual United States health care bill, the biggest single segment, according to government statistics, and are the largest driver of medical inflation, a new study in The Journal of the American Medical Association found.
A day spent as an inpatient at an American hospital costs on average more than $4,000, five times the charge in many other developed countries, according to the International Federation of Health Plans, a global network of health insurance industries. The most expensive hospitals charge more than $12,500 a day. And at many of them, including California Pacific Medical Center, emergency rooms are profit centers. That is why one of the simplest and oldest medical procedures — closing a wound with a needle and thread — typically leads to bills of at least $1,500 and often much more.
At Lenox Hill Hospital in New York City, Daniel Diaz, 29, a public relations executive, was billed $3,355.96 for five stitches on his finger after cutting himself while peeling an avocado. At a hospital in Jacksonville, Fla., Arch Roberts Jr., 56, a former government employee, was charged more than $2,000 for three stitches after being bitten by a dog. At Mercy Hospital in Port Huron, Mich., Chelsea Manning, 22, a student, received bills for close to $3,000 for six stitches after she tripped running up a path. Insurers and patients negotiated lower prices, but those charges were a starting point.
The main reason for high hospital costs in the United States, economists say, is fiscal, not medical: Hospitals are the most powerful players in a health care system that has little or no price regulation in the private market.
Rising costs of drugs, medical equipment and other services, and fees from layers of middlemen, play a significant role in escalating hospital bills, of course. But just as important is that mergers and consolidation have resulted in a couple of hospital chains — like Partners in Boston, or Banner in Phoenix — dominating many parts of the country, allowing them to command high prices from insurers and employers.
Sutter Health, California Pacific Medical Center’s parent company, operates more than two dozen community hospitals in Northern California, almost all in middle-class or high-income neighborhoods. Its clout has helped California Pacific Medical Center, the state’s largest private nonprofit hospital, also earn the highest net income in California. Prices for many of the procedures at the San Francisco hospital are among the top 20 percent in the country, according to a New York Times analysis of data released by the federal government.
“Sutter is a leader — a pioneer — in figuring out how to amass market power to raise prices and decrease competition,” said Glenn Melnick, a professor of health economics at the University of Southern California. “How do hospitals set prices? They set prices to maximize revenue, and they raise prices as much as they can — all the research supports that.”
In other countries, the price of a day in the hospital often includes many basic services. Not here. The “chargemaster,” the price list created by each hospital, typically has more than ten thousand entries, and almost nothing — even an aspirin, a bag of IV fluid, or a visit from a physical therapist to help a patient get out of bed — is free. Those lists are usually secret, but California requires them to be filed with health regulators and disclosed.
California Pacific Medical Center’s 400-page chargemaster for this year contains some eye-popping figures: from $32,901 for an X-ray study of the heart’s arteries to $25,646.88 for gall bladder removal (doctor’s fees not included) to $5,510 for a simple vaginal delivery (not including $731 for each hour of labor, or $137 for each bag of IV fluid). Even basic supplies or services carry huge markups: $20 for a codeine pill (50 cents at Rite-Aid or Walgreens), $543 for a breast-pump kit ($25 online), $4,495 for a CT scan of the abdomen (about $400 at an outpatient facility nearby). Plenty of other hospitals set similar prices.
Dr. Warren Browner, the chief executive officer of California Pacific Medical Center, said that there were good reasons that hospitals charged what they did: They must have highly trained professionals available 24 hours a day, seven days a week. They must constantly upgrade to the latest equipment and building standards to meet patients’ expectations and state mandates. They charge paying or well-insured patients more to compensate for others they treat at a loss.
“Hospital care is extremely expensive to produce and to have available for everyone in the community,” he said, noting that hospitals needed to have a neurosurgeon on call in case a patient turned up with a blood clot on the brain. “We take every penny of the revenue we earn and use it to build new and better facilities for everyone in the city.”
Some health economists say that even though most hospitals are nonprofit, they nonetheless are often flush with revenue and guilty of unnecessary spending.
“Hospitals are self-fueling, ever-expanding machines,” said James Robinson, an economist and professor of health policy at the University of California, Berkeley. “There is an infinite amount of stuff to buy — amenities, machines, new wings, higher salaries, more nurses.”
“But,” he asked, “to deliver good health care, what do you need?”
There is little science to how hospitals determine the prices they print on hospital bills.
“Chargemaster prices are basically arbitrary, not connected to underlying costs or market prices,” said Professor Melnick, the economist. Hospitals “can set them at any level they want. There are no market constraints.”
Prices for any item or service are set by each hospital and move up and down yearly, and show extraordinary variability, health economists say. The codeine that costs $20 and the bag of IV fluid that costs $137 at California Pacific are charged at $1 and $16 at the University of California San Francisco Medical Center, across town. But U.C.S.F. Medical Center charges $1,600 for an amniocentesis, which costs $687 at California Pacific.
After each hospital stay or visit, computer programs and human coders and billers use the chargemaster price list to translate the services rendered into a price. Sutter employs more than 1,300 people at a special center in Roseville, Calif., to perform this and other administrative tasks for its hospitals. Emergency room visits typically include separate charges for doctor’s services and for supplies, as well as a “facility fee” — the charge for walking in the door.
Orla Roche’s bill, for example, included $529 for “supplies and devices,” though her mother is perplexed about what those are: Orla left the emergency room with gauze wrapped round her head (under $1 at Internet supply stores), festooned with a pink cartoon sticker. According to the chargemaster price list for California Pacific, a vial of skin glue is billed at $181, a tube of antibiotic cream at $125.84 and a vial of local anesthetic at $79.73. These items can be purchased for $15.99, $36.99 and $5 on the Internet, though hospitals — which buy wholesale and in bulk — pay far less.
The bill also included $1,167 for the facility fee, which was classified at Level 3 — the middle of the scale, though Orla’s treatment was one of the most simple emergency room interventions. At Lenox Hill in New York, Daniel Diaz’s unusually detailed bill for his stitches included $1,828 for emergency room services, $628 for repairing the wound, $571.83 for “application of a finger splint,” $97.10 for a tetanus shot, and $311 for someone to give the injection. At Sparrow Hospital in Lansing, Mich., 2-year-old Ben Bellar’s bill for six stitches, more than $2,000, included $145.20 for “pharmacy” — a spoonful of ibuprofen and local anesthetic, his mother said.
Economists note that hospitals can bill for emergency room care with relative impunity, since injured patients generally rush to the nearest treatment facility. But worried about high prices, even the sick sometimes shop around. When Jamie Burke, 33, a graduate student in North Carolina, came to after she was knocked out during a soccer game in April, she started searching on her smartphone for an in-network hospital as a friend drove.
“It was crazy,” she said, “but luckily I wasn’t unconscious, so I could figure it out.”
She is glad she did: Though the hospital billed $5,039, her insurer’s in-network contracted rate was about $2,700. With copays and coinsurance, she owed $600 for the visit.
The uninsured are particularly vulnerable to high prices since they have no one to argue on their behalf. When Arch Roberts Jr. got his bill of more than $2,000 for stitches, he explained that he was uninsured and his business had failed during the housing crisis, so he could not afford the fee. The hospital offered him a “charity care discount” — a price that was still out of range. “I don’t have $800 to pay them any more than I have $2,000” for three stitches, he said, noting that the hospital has been “relentless” in its collection efforts.
Paths to Profit
Once perennial money pits, emergency rooms have become big moneymakers for most hospitals in the last decade, experts say, as they raised their fees and “managed” their patient mix. California Pacific Medical Center has nearly doubled its emergency room fees since 2005, its chargemaster price lists show.
California Pacific’s emergency room is not a trauma center; poor or uninsured trauma patients who require lengthy inpatient stays can strain a hospital budget. And insurers allow emergency rooms to bill more than urgent-care centers for simple procedures like stitches or X-raying a sprained ankle, making such procedures profitable. Indeed, the financial prospects are so appealing that doctors’ groups in Texas are opening free-standing “emergency rooms” that are not connected to hospitals.
“Hospitals see where they’re making money and try to do more of that,” said Dr. David Gifford, a former health commissioner of Rhode Island, who has studied how labs price their tests. He said that laboratory tests and X-rays are priced high and are profitable, though there is no difference in quality from national commercial labs that charge far less. A blood count and blood electrolyte test — ordered every day for most inpatients and often in the emergency room — are priced at $259.06 and $293.25 on California Pacific Medical Center’s chargemaster price list. Insurers often pay outside labs less than $10 for the services.
And, like any business, many hospitals try to do fewer services that are not well paid. In 2012, over loud patient protests, California Pacific Medical Center outsourced its kidney dialysis unit to DaVita Health Care Partners, a commercial company, citing decreasing reimbursement. More than five years ago, after Sutter acquired St. Luke’s, a decrepit hospital in a poor neighborhood, it tried to shut the facility and convert it to an outpatient clinic, which often generate scans and other expensive tests. (The City of San Francisco rejected the plan.) It did close the hospital’s acute psychiatric unit, a division that almost always loses money.
“You need a Ph.D. in health economics” to understand medical pricing, said Dr. Browner, who has acknowledged that California Pacific’s chargemaster prices might appear high. But he added, “We have to recoup what it costs to keep open, what it costs to take care of the un- and underinsured and to rebuild.”
He said that MediCal, California’s Medicaid program, pays California Pacific Medical Center only 10 to 20 percent of its actual costs for care. Medicare pays about 70 percent, he said, generally with a predetermined flat fee for each admission based on the patient’s diagnosis. In contrast, many private insurers still pay separately for services rendered, based on discounts from the chargemaster prices.
Dr. Browner also pointed to what health care executives call the “Saudi sheikh problem” at some hospitals.
“You don’t really want to change your charges if you have a Saudi sheikh come in with a suitcase full of cash who’s going to pay full charges,” he said.
But how much actual charity care does a hospital like California Pacific Medical Center perform? And are insurers and patients paying hospitals for better quality? Or also for amenities like valet parking, useless medical gadgetry and inflated salaries?
Though hospitals’ nonprofit status allows them to reap tens or hundreds of millions of dollars in tax benefits, California Pacific Medical Center’s main campuses spent 1.27 percent of their more than $1.1 billion in net patient revenues in 2011 on free care for indigent or uninsured patients, lower than the state average of 2.07 percent, according to statistics compiled by the San Francisco Department of Public Health. The far smaller St. Luke’s branch spent 5.32 percent that year.
Sutter, based in Sacramento, employs 28 officials who make more than $1 million a year, and four of them are among the top-paid hospital executives in the state. Sutter’s chief executive officer makes more than $5 million. In 2011, Dr. Browner, 62, a distinguished physician who spent much of his career in academics, made more than $1.2 million, according to tax documents.
California Pacific, Sutter’s main campus, is in upscale Pacific Heights. It has just broken ground on a $2.7 billion renovation, which includes a new flagship hospital. Though the project was initiated to meet new state earthquake standards, the facility is designed as a sleek glass and marble structure with all private rooms, underground parking and roof gardens with flowers and bees “to enhance the quality of the healing environment,” according to California Pacific Medical Center’s website. Its Facebook page has called it “the coolest hospital in San Francisco, possibly the country and even the world.”
Consumers may appreciate — or demand — features that contribute to bigger hospital bills. But studies have found no correlation between prices and patient outcomes. A California state rating of hospital services by the California Health Care Foundation gave California Pacific Medical Center average scores in most categories, though its surgical-care measures were rated “superior.”
Its crosstown neighbor, University of California San Francisco, a nationally ranked academic institution, charges far less per day than California Pacific, when the greater severity of illnesses of its patients is factored in, Professor Melnick said. In fact, a recent study in the publication Annals of Surgery, a monthly review of surgical science, found that hospitals with the highest complication rates tended to have higher prices.
From such variations, economists conclude that “costs” are highly discretionary, noting that hospitals in other developed countries often provide high-quality care, with better outcomes in comparatively no-frills environments. Said Dr. Robinson, the Berkeley health economist: “If you pay hospitals more, they spend it. If you pay them less, they adjust. The only way to pay less for health care — is to pay less for health care.”
Hospital officials like to say that their list prices do not reflect what most patients actually pay, because private and government insurers negotiate discounts. Simone Singh, a professor of health management and policy at the University of Michigan, estimated that insurers generally paid 40 to 50 percent of charges. But with powerful chains like Sutter, prices are high and the discounts often are not so generous. Patients are left paying more.
A Price ‘Sequoia’
For her three stitches at California Pacific Medical Center, Deepika Singh ended up paying $768.56 — a lot of money for a 26-year-old retail supply chain manager — of the $1,813 rate her insurer negotiated for the approximately $2,200 bill. Ms. Duffy owed $1,366 after her insurer’s discount on 2-year-old Orla’s $1,700 bill, since the family had not met its annual deductible. “How much is that per minute?” she asked.
Across California, Sutter hospitals have proved expert at the business of medicine. “Our members are very exercised about Sutter — it has increased prices disproportionately,” said David Lansky, chief executive officer of the Pacific Business Group on Health, which represents 60 of California’s biggest private employers in its health care negotiations. “Sutter has been successful at leveraging their huge size in dictating not just price but contract terms.”
Its major competitor is Kaiser, a health maintenance organization that runs a closed network of hospitals and doctors. California Pacific Medical Center delivers more than half the babies in San Francisco and is the city’s largest employer after Wells Fargo. Sutter contracts also include “gag clauses” that prevent employers from knowing what rates have been negotiated by their insurers on their behalf, Mr. Lansky said.
Chuck Idelson, a spokesman for the Institute for Health and Socio-Economic Policy, the research arm of the California Nurses Association, said Sutter prices were 40 to 70 percent above its rivals’ for similar services. When Sutter bought Summit Hospital in Oakland in 1999, rates there went up 29 percent to 72 percent, researchers found. Because of pricing issues, proposed insurance plans under the Affordable Care Act did not initially include Sutter hospitals.
Terry Miller, 62, a businessman in the Bay Area, got a bill for $117,000 for a two-night stay at California Pacific Medical Center to place a stent to open one of his heart’s clogged arteries — a charge that did not include fees for the cardiologist and radiologist. According to the Medicare database, California Pacific Medical Center charged $43,679 for hospitalization to treat a simple pneumonia and $96,642 to treat a stroke; the Medicare payments for those illnesses were $8,046 and $9,583.
The high prices have had a ripple effect across Northern California, allowing smaller hospitals to charge more as well. “Sutter is the tallest Sequoia and everyone goes up just underneath them a bit,” said Professor Melnick. He noted that hospital prices in California had more than doubled in the past decade, after adjustment for inflation.
And payouts in the Pacific region for simple emergency room treatments — stitches, a sprained ankle and an upper respiratory infection — were by far the highest in the country, about 50 percent higher than in the Northeast, according to an analysis performed for The Times. by the health care consulting firm Truven Health Analytics.
The Merger Factor
In theory, health care consolidation can lead to economies of scale, but not if it produces complex supersize systems. Excess administrative costs accounted for about $190 billion of the $2.5 trillion medical bill of the United States in 2009, the Institute of Medicine estimated this year — money that could be used for other purposes.
“There is a big flurry of consolidation and the effects depend on what the objective of the health care system is,” said Orry Jacobs of the health care consulting firm BDC Advisors. “If the intent is to improve care and bend cost curves, then networks can do so. If the objective is to corner the market and demand higher rates, then that will happen.” Indeed, research shows that today’s hospital mergers tend to drive up prices.
And employers have limited ability to fight back. Sutter operates the only hospital in some California cities. Beginning on Jan. 1, the University of California, Berkeley, will exclude Sutter’s two nearby hospitals from its plan because it could not reach a price agreement. The university’s employees will have to cross the bay or drive inland for in-network hospital treatment, or pay more.
As is often the case in American medicine, patients will decide if they are willing to pay the high price of care. Back home in New York City, Orla Duffy’s head wound has healed nicely without further treatment. Deepika Singh had her stitches taken out at an urgent care clinic, costing $25 with her copay, during a business trip to Washington.
Daniel Diaz, who had been treated at Lenox Hill, Mr. Roberts and Amy Bernstein had no choice but to visit an emergency room this year for stitches. But they all refused to see a doctor for the follow-up.
“The amount was outrageous for the time it took to put them in,” said Ms. Bernstein, 54, a real estate lawyer from Long Island, who cut herself cleaning knives while fixing a kitchen damaged by Hurricane Sandy. “I was so disgusted, I took them out myself.”
Jo Craven McGinty contributed reporting from New York.
December 2, 2013
Cost of Health Care Law Is Seen as Decreasing
By ANNIE LOWREY
WASHINGTON — The rollout of President Obama’s health care law may have deeply disappointed its supporters, but on at least one front, the Affordable Care Act is beating expectations: its cost.
Over the next few years, the government is expected to spend billions of dollars less than originally projected on the law, analysts said, with both the Medicaid expansion and the subsidies for private insurance plans ending up less expensive than anticipated.
Economists broadly agree that the sluggish economy remains the main reason that health spending has grown so slowly for the last half-decade. From 2007 to 2010, per-capita health care spending rose just 1.8 percent annually. Since then, the annual increase has slowed even further, to 1.3 percent. A decade ago, spending was growing at roughly 5 percent a year.
But even though the Affordable Care Act might be more a beneficiary of changes in health care spending than the primary driver of them, the law’s provisions to control costs could prove increasingly important as the economy improves, demand for health care increases and spending picks back up.
“It was a trend that was happening; we noticed that trend; we took advantage of that trend,” said Jason L. Furman, the chairman of the White House’s Council of Economic Advisers. “Some of it was the Affordable Care Act catching up with the private sector, and some of it was pushing the private sector forward.”
Administration officials have pointed to falling hospital readmission rates as one strong sign that cost-control provisions in the Affordable Care Act are working. Also, they noted that a growing number of insurers and health care providers are agreeing to contracts that pay for the quality of care, rather than the quantity, another indication that the law’s encouragement on that front is starting to pay dividends.
But those are responsible for only a tiny portion of the slowing rise of health care costs; other changes, like rising deductibles and copays that discourage some people from seeking extra services, play a bigger role, analysts say. Still, the Kaiser Family Foundation, a nonprofit research group, estimates that the weak economy accounts for as much as three-quarters of the slowdown in the growth of spending on health care.
But even if only about a quarter of the savings is because of noneconomic factors, said Larry Levitt, a top official at the Kaiser Family Foundation, “that’s real change in the health system.”
Critics, however, say they see little evidence that the law will lead to significant cost savings.
“These claims are just as groundless as the ones that misled so many Americans to believe they would be able to keep their previous coverage,” argued Charles Blahous, a former Bush administration official now at the Mercatus Center at George Mason University.
To be sure, the Affordable Care Act will lead to a drastic bump in health spending by the government starting next year, with an estimated nine million Americans signing up for Medicaid and perhaps as many as seven million buying a subsidized health plan through the government exchanges. But economists expect the underlying rate of spending growth to remain low.
And whatever the reasons for the slower growth, taxpayers appear set to reap some benefits.
Already, the Congressional Budget Office has quietly erased hundreds of billions of dollars from its projections. It now estimates that Medicare spending in 2020 will be $137 billion lower than it thought in 2010, a drop of 15 percent; Medicaid spending will be $85 billion, or 16 percent, lower; and private health insurance premiums are expected to be about 9 percent lower.
Some economists say they believe that the Congressional Budget Office might be underestimating the long-term effect of the slowdown, because it expects that spending growth will eventually return to its previous trend line. David M. Cutler, a Harvard economist and former Obama adviser, cautiously suggests that the slower growth might stick around, and if so the savings for the government might be a whopping $750 billion over 10 years, he says.
Whether such improvements will last depends on whether private firms — nudged along by Washington — create and retain incentives to keep spending low.
“In the past five decades, there are only two periods when we’ve been able to sustain low excess health care cost growth for an extended period,” Mr. Levitt, of the Kaiser foundation, said, referring to the current trend and a period in the 1990s, when the Clinton administration tried and failed at overhauling the health care system. “There was a sense in the system: ‘Something is coming, and we need to get ready for it.’ ”
This time may be more durable. Insurance and hospital executives in Massachusetts, Illinois and California, among other places where reforms have gone the furthest, report a consensus that spending growth had become unsustainable, and that expectations that Washington would force changes to the system spurred them to make changes themselves.
Whatever the reasons, the overall slowdown in health costs has led to lower 2014 insurance premiums than analysts anticipated. That means not only cheaper plans for many consumers, but significant savings for the government.
One study by the liberal Center for American Progress, for instance, found that an average individual premium for a plan with relatively high out-of-pocket expenses in the insurance marketplaces is $3,900, about 16 percent lower than the $4,700 expected. If those savings were to stick, the Affordable Care Act would cost about $190 billion less than expected over the course of a decade, the center estimated.
Mr. Levitt pointed out that “premiums are particularly important for federal costs because of the way the tax credits work.” An individual purchasing a middle-of-the-road “silver” plan, for example, is required to devote a certain fixed proportion of his income to health insurance, with the federal government picking up the rest of the tab. “The government pays the rest of the premium, so it is more exposed to changes,” he said.
On top of that, the law might be smaller in scale than originally envisioned. Pervasive problems with the HealthCare.gov site might result in fewer sign-ups than government analysts anticipated, for one. But analysts cautioned that it was too soon to tell how the problems with the website would affect enrollment in private insurance.
On the public front, the 2012 Supreme Court decision allowing states to opt out of the Medicaid expansion slashed the number of people eligible for that program. The White House has stressed that it hopes that all states join the Medicaid expansion, which would help reduce costs for state governments as the federal government picks up most of the bill for the newly covered.
But if the 25 states that have not expanded Medicaid continue to elect not to join in the expansion, federal spending would be about $45 billion lower in 2016, according to calculations by the Urban Institute and the Kaiser Family Foundation.
December 2, 2013
A New Wave of Challenges to Health Law
By SHERYL GAY STOLBERG
WASHINGTON — More than a year after the Supreme Court upheld the central provision of President Obama’s health care overhaul, a fresh wave of legal challenges to the law is playing out in courtrooms as conservative critics — joined by their Republican allies on Capitol Hill — make the case that Mr. Obama has overstepped his authority in applying it.
A federal judge in the District of Columbia will hear oral arguments on Tuesday in one of several cases brought by states including Indiana and Oklahoma, along with business owners and individual consumers, who say that the law does not grant the Internal Revenue Service authority to provide tax credits or subsidies to people who buy insurance through the federal exchange.
At the same time, the House Judiciary Committee will convene a hearing to examine whether Mr. Obama is “rewriting his own law” by using his executive powers to alter it or delay certain provisions. The panel also will examine the legal theory behind the subsidy cases: that the I.R.S., and by extension, Mr. Obama, ignored the will of Congress, which explicitly allowed tax credits and subsidies only for those buying coverage through state exchanges.
“We have agencies under this administration having an attitude that they can fix a statute, that they can improve upon a statute, that they can look at a statute’s clear language and disregard it,” Scott Pruitt, the Oklahoma attorney general, who is bringing one of the cases, said in an interview Monday. “The president himself has said on more than one occasion, ‘I can’t wait on Congress.’ In our system of government, he has to.”
The subsidy lawsuits grow out of three years of work by conservative and libertarian theorists at Washington-based research organizations like the Cato Institute, the American Enterprise Institute and the Competitive Enterprise Institute. The cases are part of a continuing, multifaceted legal assault on the Affordable Care Act that began with the Supreme Court challenge to the law and shows no signs of abating.
“After the A.C.A. was enacted and after the president signed it, a lot of people — me included — decided that we weren’t going to take this lying down, and we were going to try to block it and ultimately either get the Supreme Court to overturn it or Congress to repeal it,” said Michael F. Cannon, a health policy scholar at the libertarian-leaning Cato Institute, who helped develop the legal theory for the subsidy cases and will testify in the House on Tuesday.
On Monday, the Supreme Court refused to hear a challenge brought by Liberty University, a Christian college in Virginia, to the “employer mandate,” which requires companies with more than 50 employees to offer coverage. In another challenge, the Pacific Legal Foundation, a conservative group, has filed suit claiming that the law is unconstitutional because it was introduced in the Senate, not the House, where tax bills must originate.
The law has also spawned a separate raft of religious freedom cases over its requirement that employers provide insurance coverage for contraception to their workers. The University of Notre Dame plans to file suit on Tuesday challenging an Obama administration rule that exempts religious employers like churches, but not nonprofits, like schools, which may cover contraception through third-party administrators. The Supreme Court agreed last week to hear a pair of similar suits from commercial corporations.
Jonathan Adler, a law professor at Case Western Reserve University and Mr. Cannon’s writing partner, predicts the act will be the subject of lawsuits for years.
“Among critics of the law there is a feeling that the law doesn’t have the same legitimacy as a law that passed with bipartisan support,” he said.
The subsidy cases, if successful, would strike at the foundation of the law. Subsidies and tax credits, which could be available to millions of low- and middle-income Americans, are central to Mr. Obama’s promise of affordable care. In drafting the law, Congress wrote that such financial help would be available to people enrolled “through an exchange established by the state” under the law.
But since passage of the Affordable Care Act in March 2010, the vast majority of states — roughly three dozen — decided not to set up their own exchanges, in part because many Republican governors opposed the law. That has left HealthCare.gov, the online federal insurance exchange, to handle the bulk of enrollment requests.
If courts rule that customers cannot get subsidies through the federal exchange, it would “make the HealthCare.gov problems look like a hiccup,” Mr. Cannon said.
The House hearing, titled “The President’s Constitutional Duty to Faithfully Execute the Laws,” will focus largely on the Affordable Care Act. Representative Robert W. Goodlatte, Republican of Virginia and chairman of the committee, argues that Mr. Obama has “changed key provisions in Obamacare without congressional approval,” through executive actions, like delaying the employer mandate for one year.
Aides to Mr. Obama say the president offers a legal rationale with each administrative decision, and legal experts say judges ordinarily give agencies like the I.R.S. broad latitude in interpreting federal law. An administration official, speaking on condition of anonymity to discuss pending litigation, defended the I.R.S. interpretation.
“Our position, at bottom, is that when Congress enacted the Affordable Care Act, it was creating a national solution to a national problem,” the official said.
Tim Jost, a law professor and health policy expert at Washington and Lee University, agreed, saying that by including a “federal fallback exchange” in the law, Congress clearly intended to extend tax credits to users of HealthCare.gov.
The seeds of the subsidy cases were planted as far back as December 2010, when Thomas P. Miller, a scholar at the American Enterprise Institute, convened a forum to explore legal avenues to undo the health law. By spring 2012, even before the Supreme Court had ruled on the constitutional challenge to the “individual mandate” — the requirement that nearly all Americans purchase insurance or pay a fine — Mr. Miller said he approached Sam Kazman, general counsel of the Competitive Enterprise Institute, about finding plaintiffs.
One plaintiff in the District of Columbia case, David Klemencic, the sole owner of a carpet and flooring store in the town of Ellenboro, W.Va., was also a plaintiff in the constitutional challenge to the individual mandate. In an interview, Mr. Klemencic, who does not have any employees, said he had deep, philosophical objections to any effort by the government to require him to purchase insurance, and would refuse to accept a subsidy even if eligible.
“I go to the doctor now, I go to the dentist now, I take my checkbook and I pay for it,” he said. “If I’m forced into some sort of program where it’s subsidized by the government, I won’t go see a doctor.”
Richard Pérez-Peña contributed reporting from South Bend, Ind.
December 2, 2013
Insurers Are Offered Assistance for Losses
By ROBERT PEAR
WASHINGTON — The White House is offering more money to insurance companies as an incentive for them to let people keep insurance policies that were to have been canceled next year.
The administration floated several proposals on Monday to “help offset the loss in premium revenue and profit” that it said might occur if insurers went along with President Obama’s request to reinstate canceled policies.
Millions of people have received notices saying their policies were being canceled because they did not comply with minimum coverage requirements of the new health care law.
In a notice published Monday in the Federal Register, the administration acknowledged that insurers had a valid concern: They may be stuck with sicker, higher-cost customers in the new insurance exchanges because healthier Americans will stay on their existing health plans for another year.
Facing a political furor over the cancellation of insurance policies, Mr. Obama announced on Nov. 14 that he would temporarily waive some requirements of the new federal law and allow insurers to renew “current policies for current enrollees” for a year.
Insurers criticized the president’s move, saying it could upset the assumptions on which they had set premiums for new insurance products providing coverage in 2014.
Many people with serious illnesses were excluded from the old policies. As a result, the administration said, people on those policies may be healthier than average.
If they do not enroll in the new health plans, the administration said, the average cost of claims for people in those plans may be higher than expected, and this increase in costs could lead to unexpected financial losses for insurance companies.
To reduce this risk, the administration said it could provide financial assistance to certain insurers through a program under which the government will share in their losses and profits for the next three years.
Any such assistance would come on top of federal subsidies that the government plans to pay insurers to make coverage more affordable for low- and middle-income people under the new law. The Congressional Budget Office estimates that those subsidy payments will exceed $1 trillion over the next 10 years.
The administration said it could not immediately determine the cost of the assistance for insurers because it did not know how many people would stay in existing plans or how many would decide to enroll in new policies that provide additional benefits and consumer protections, as required by the 2010 health law.
Robert E. Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group, welcomed the proposal, saying, “We appreciate that the administration is taking steps to stabilize the market and minimize disruptions for consumers.”
But Jamie Court, the president of Consumer Watchdog, a liberal advocacy group, said the proposal was premature. “Insurers are already being paid by taxpayers for the vast majority of new enrollees,” he said.
The notice published on Monday includes proposals on several other issues. Certain health plans sponsored by labor unions would be exempted from new fees imposed on insurance companies and on many self-insured group health plans.
Labor unions have been lobbying for such an exemption, saying the fees could be “highly disruptive” to Taft-Hartley plans administered jointly by labor and management representatives in construction, entertainment and other industries.
But Republicans denounced the administration proposal. Senator John Thune, Republican of South Dakota, said it would provide “special treatment to President Obama’s political allies.”
The fees, to be levied from 2014 to 2016, will provide money to insurers that incur high-dollar claims for consumers in the individual insurance market.
The administration on Monday also reported a surge in the number of people using the website for the federal insurance marketplace, HealthCare.gov.
Julie Bataille, a spokeswoman at the Centers for Medicare and Medicaid Services, said that 375,000 people visited the website in the first 12 hours on Monday, about twice the normal traffic.
Because of the increase in demand, Ms. Bataille said, “we deployed a new customer queuing system, or waiting room, to help manage the traffic.” People will receive email messages inviting them to return to the site at another time when it is less busy.
The surge came just a day after the White House said the website was greatly improved and would “work smoothly for the vast majority of users.”
Jeffrey D. Zients, the presidential adviser leading efforts to fix the site, said Sunday that it could handle 50,000 users at a time. He reported that pages on the site were loading much faster, with a response time of less than one second and an error rate less than 1 percent.
But Ms. Bataille said federal officials decided to divert traffic from the website at a time when it had about 35,000 users on Monday. The performance of the site appeared to be faltering, as the response time exceeded two seconds and the error rate was nine-tenths of 1 percent, officials said.
December 2, 2013
New F.C.C. Chief Promises He Will Protect Competition
By EDWARD WYATT
WASHINGTON — The chairman of the Federal Communications Commission said on Monday that he intended to aggressively promote and protect competition in the telecommunications industry, including making sure that smaller mobile phone companies have a reasonable chance of buying public airwaves in auctions next year.
The chairman, Tom Wheeler, also said that the F.C.C. would continue to ensure that the Web remained fully open, allowing users “to access all lawful content” regardless of what company provides the Internet service.
“Regulating the Internet is a nonstarter,” he said. But, he added, “The Internet is not a law-free zone. It depends upon standards of conduct. And it depends on the ability of the government to intervene in the event of aggravated circumstances.”
The remarks, which Mr. Wheeler made at Ohio State University, his alma mater, are the first public outline of his priorities since he became chairman, and they signal his intention to take a combative stance against any efforts by the telecom giants to squash competition.
“A key goal of our spectrum allocation efforts is ensuring that multiple carriers have access to airwaves needed to operate their networks,” Mr. Wheeler said.
The protection of competition, Mr. Wheeler said, would apply to the coming auctions of additional airwaves, or spectrum, for mobile broadband. In April, the Justice Department told the F.C.C. that it could help to protect competition by ensuring that the two largest companies — AT&T and Verizon — were not allowed to use their financial might to buy up all the available spectrum being auctioned, shutting out smaller carriers.
But asked in a question-and-answer session after his speech whether he specifically favors restricting the ability of the biggest mobile companies to bid in the auctions, Mr. Wheeler said: “You’re going to have to wait for that answer. We’re going to come out with a rule that explains that.”
On the topic of the agency’s role in competition, Mr. Wheeler said, “It’s because of the F.C.C. that you have multiple competitive choices for your mobile phone service.” He noted that since the successful effort by the F.C.C. and the Justice Department to stop AT&T’s takeover bid of T-Mobile in 2011, T-Mobile and Sprint had attracted “significant investment capital to build out their networks and increase competition.”
While promoting competition, Mr. Wheeler also said that regulations should not be imposed where they are not needed. “I have zero interest in imposing new regulations on a competitive market just because we can,” he said.
For the last several years, the F.C.C. has pointedly refused to say that the market for mobile communications is competitive in an annual report that the commission makes to Congress.
He promised that the F.C.C. would not rush the development of the complex software needed to conduct the spectrum auctions, because it does not want its program to suffer the same experience as the Obama administration’s health care website.
Mr. Wheeler also stressed the agency’s commitment to enforcing its so-called Open Internet rules, which forbid Internet service providers from favoring their own content or paid content when allowing data to flow through their system. That policy, also known as net neutrality, is being challenged in federal court.
In response to a question, Mr. Wheeler indicated that he would not oppose some type of usage-based pricing, with Internet service providers charging so-called data hogs different amounts for service depending on how much data they receive and transmit. Those types of pricing plans have been strongly opposed by some consumer-protection groups.
Mr. Wheeler said variable pricing and service plans represented the effects of competition. “We might see a two-sided market,” he added, in which a company like Netflix might pay an Internet service provider to guarantee that Netflix customers get the best available transmission speeds.
Many of the chairman’s ideas and policies are discussed in a free e-book that Mr. Wheeler released Monday, “Net Effects: The Past, Present and Future Impact of Our Networks.”
on: Dec 03, 2013, 07:54 AM
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on: Dec 03, 2013, 07:41 AM
|Started by Steve - Last post by Rad|
4,000 year old skull discovery shows young women were sacrificed in ancient China
By Agence France-Presse
Monday, December 2, 2013 8:51 EST
Archaeologists in China have unearthed the skulls of more than 80 young women who may have been sacrificed more than 4,000 years ago, state media reported Monday.
The skulls were found in what appears to have been a mass grave at the Shimao Ruins, the site of a neolithic stone city in the northern province of Shaanxi.
The women’s bodies were not present, the official news agency Xinhua said, adding that archaeologists concluded that the skulls were “likely to be related to the construction of the city wall” in “ancient religious activities or foundation ceremonies” before construction began.
There may have been an outbreak of mass violence or ethnic conflict in the region at the time since “ancient people were prone to use their enemies or captives as sacrifices”, it added.
The discovery is not the first instance of researchers unearthing remains related to human sacrifice in early China. Kings and emperors were regularly buried along with their servants and concubines, who were sometimes killed first — and on other occasions buried alive.
The Shimao Ruins cover more than four square kilometres and were discovered in 1976.
The total includes 40 skulls that the Shaanxi provincial government said earlier had been discovered at the site last year.
Sun Zhouyong, deputy head of the Shaanxi Provincial Institute of Archaeology, told state broadcaster CCTV that the initial batch “show signs of being hit and burned”.
“This collective burial might also have something to do with the founding ceremony of the city,” he said.
Archaeologists have also found more than 100 remains of murals as well as large amounts of jadeware at the site of the ancient city, which sits in the Yellow River basin and is believed to date back to 2000 BC.
In 2005 archaeologists at Hongjiang in the central province of Hunan found an altar devoted to human sacrifice as well as the skeleton of one victim.
A separate altar was used for sacrificing animals at the 7,000-year-old site, which is believed to be the earliest human sacrificial site ever found in the country.
on: Dec 03, 2013, 07:39 AM
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Researchers: Male koalas use extra vocal cords to woo females
By Agence France-Presse
Monday, December 2, 2013 17:15 EST
Male koalas may be small, but to woo the ladies they make a low-pitched grunt as deep as an elephant’s call, thanks to an extra set of vocal cords, researchers said Monday.
This previously unknown organ lies outside the voice box, or larynx, and is not known to exist in any other land mammal, said the study in the journal Current Biology.
Koalas seeking to mate make noises that sound like a mix between snoring and belching, something akin to a donkey’s braying, explained lead researcher Benjamin Charlton of the University of Sussex.
“They are actually quite loud,” he said.
The koala makes a bellowing call 20 times deeper than would be expected for an animal that weighs just eight kilograms (17 pounds) on average, the study said.
But since these vocal cords lie where the oral and nasal cavities connect, they are not limited by the size constraints of the voice box, which typically makes for higher-pitched calls among smaller creatures.
These extra vocal cords are like two lips inside the soft palate, a location researchers described as “highly unusual.”
After locating them, scientists performed an experiment using three koala cadavers “by sucking air through the pharynx and the larynx via the trachea, mimicking inhalation of air using the lungs,” the study said.
A tiny camera was also inserted in the trachea to film the movement of the vocal cords during this time, and sound recordings captured the noises, confirming the organ’s role in making the deep sounds.
Researchers said more study is needed to find out if female koalas have these vocal cords as well. Females are sometimes known to bellow deeply, though not as often as males.
Scientists are also taking a closer look at other mammals to see if this extra set of vocal cords is truly unique to koalas or if other creatures may be similarly equipped.
Koalas live in eastern Australia and spend most of their lives clinging to eucalyptus trees and eating their leaves.
While not endangered, experts say the fuzzy gray marsupials are on the decline due to human settlements and loss of habitat.
The study was co-authored by researchers at the Leibniz Institute of Zoo and Wildlife Research in Berlin, the Moggill Koala Hospital in Queensland and the University of Vienna.
[Image via Agence France-Presse]
on: Dec 03, 2013, 07:37 AM
|Started by Rad - Last post by Rad|
Africa risks losing 20 percent of elephants in 10 years if poaching isn’t curbed: study
By Agence France-Presse
Monday, December 2, 2013 8:18 EST
Africa could lose 20 percent of its elephant population in a decade if current poaching levels are not slowed, animal conservation groups warned Monday.
An estimated 22,000 elephants were illegally killed across the continent last year, as poaching reached “unacceptably elevated levels,” said a joint statement by CITES, TRAFFIC and IUCN.
“If poaching rates are sustained at current levels, Africa is likely to lose a fifth of its elephants in the next ten years,” the statement said.
The study was released as experts and ministers met in Botswana Monday to look at ways to stamp out the elephant slaughter, which is fuelled by a growing demand for ivory in Asia.
“We continue to face a critical situation,” said John E. Scanlon, secretary general of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES).
“Current elephant poaching in Africa remains far too high, and could soon lead to local extinctions if the present killing rates continue,” he said.
Scanlon described the situation in central Africa, where the estimated poaching rate is twice the continental average, as “particularly acute”.
There are around half a million elephants left in Africa compared with 1.2 million in 1980 and 10 million in 1900.
Researchers believe that poverty and weak governance in African countries harbouring elephants are the driving forces behind a spike in elephant poaching.
Elephants are killed for their tusks that are used to make prized ornaments.
Ivory trade is banned under the CITES, yet illegal ivory trade is estimated to be worth up to $10 billion a year.
The price of ivory on the black market shot up tenfold in the past decade to more than $2,000 per kilogramme. On average, an adult elephant tusk can weigh 20 kg (44 pounds), according to experts.
In the past 13 years, the quantities of ivory traded have steadily shot up, according to Tom Milliken, an ivory trade expert with the wildlife monitoring agency TRAFFIC.
“2013 already represents a 20% increase over the previous peak year in 2011; we’re hugely concerned,” said Milliken.
In recent years ivory trafficking routes appear to be shifting from the traditional West and central African seaports to east Africa with Kenya and Tanzania as the exit points.
Most of the ivory ends up in Thailand and China.
The group meeting in Botswana is expected to adopt a pact that will commit signatories, including the biggest ivory markets such as China, to demonstrate political will at the highest level in the fight against poaching and ivory trafficking.
African ministers and experts meet from Monday in Botswana to find ways to curb a spike in the killing of elephants for ivory. Ali Kaka, from the International Union for Conservation of Nature, says action is urgently needed to prevent extinction.
on: Dec 03, 2013, 07:33 AM
|Started by Steve - Last post by Rad|
64 bodies found in mass graves in drug-plagued western Mexico
By Agence France-Presse
Tuesday, December 3, 2013 7:18 EST
A total of 64 bodies have been found in mass graves in the western Mexican state of Jalisco, authorities said as they wrapped up a probe of alleged victims of a drug cartel.
A total of 35 graves were found, an official at the attorney general’s office said.
The search in an area bordering the drug-plagued state of Michoacan stemmed from a probe into the November 3 disappearance of two federal police officers. They were not among the bodies found.
One civilian and some 20 police officers were arrested in the case of the missing two. They allegedly confessed to capturing the pair of federal agents and turning them over to a drug gang called Jalisco New Generation.
The detainees led police to the many mass graves.
Some of the bodies had been dead for months, others for two or three years, a spokesman for the attorney general’s office said.
Some were bound by the hands and feet and showed signs of torture.
Jalisco New Generation is trying to penetrate into Michoacan and chase out a cartel called the Knights Templar.
Under the presidency of Felipe Calderon from 2006 to 2012, 26,121 people went missing in Mexico and drug-related violence claimed more than 70,000 lives as federal forces fought drug cartels.
on: Dec 03, 2013, 07:32 AM
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Venezuelan cities plunged into darkness by power cut during president’s speech
By Agence France-Presse
Tuesday, December 3, 2013 7:21 EST
Caracas and other cities in Venezuela plunged into darkness Monday night as a power cut hit just as the president was speaking on TV and radio, with local elections five days away.
President Nicolas Maduro, who was elected in n April after the death of Hugo Chavez, later blamed the backout on the “fascist right.”
He called it “live sabotage on the electrical grid.” Maduro, a former union leader and bus driver, is struggling to establish the stature and following enjoyed by his political mentor Chavez, who died of cancer in March.
The December 8 municipal elections are considered a test of Maduro’s popularity and performance since taking power.
“There is no reason for today’s blackout,” he said from the presidential palace. “All Venezuelans are strangely surprised.”
Power started being restored a few hours later.
Electricity Minister Jesse Chacon said the outage hit the metropolitan Caracas region and states in central and western Venezuela.
He said it started in the same place where a blackout in September left 70 percent of the country without power for at least three hours.
Then, too, the leftist Maduro blamed his political opponents.
Chacon said a probe was underway.
State-run oil company Petroleos de Venezuela said its facilities were operating normally.
In Caracas, cars drove through darkened streets. Only hotels and other buildings with emergency generators had some light.
In 2010 Chavez imposed severe electricity rationing because of what he called problems with Venezuela’s main hydroelectric dam and wasteful use of energy.
In April Maduro declared another electricity emergency and extended it in August for another 90 days, even though he said the sector had improved considerably.
Monday’s power outage struck at around 8:10 pm (0040 GMT). Power began being restored less than an hour later.
Despite being one of the world’s largest oil producers, Venezuela is regularly affected by power cuts.
on: Dec 03, 2013, 07:28 AM
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December 2, 2013
Top U.N. Rights Official Links Assad to Crimes in Syria
By NICK CUMMING-BRUCE
GENEVA — The top United Nations human rights official linked President Bashar al-Assad of Syria to war crimes and crimes against humanity for the first time on Monday, citing evidence collected by her panel of investigators over the course of the 33-month-old conflict in that country.
The four-member panel investigating human rights offenses in Syria has produced “massive evidence” of the commission of war crimes and crimes against humanity, the official, Navi Pillay, the United Nations high commissioner for human rights, told reporters here in Geneva. She went on: “They point to the fact that the evidence indicates responsibility at the highest level of government, including the head of state.”
The panel, which has not been allowed to enter Syria, has gathered information from Syrian refugees and other sources. The panel has compiled lists of names of individuals, military units and intelligence agencies implicated in the human rights abuses committed on a wide scale since the conflict began in March 2011, with a view to ensuring that those responsible are eventually brought to justice.
As long ago as February 2012, the panel found “reasonable grounds to believe that particular individuals, including commanding officers, and officials at the highest levels of government bear responsibility for war crimes and gross human rights violations.” The panel also found Syrian opposition groups implicated in war crimes and crimes against humanity, although on a lesser scale.
But panel members, led by Paulo Pinheiro, a Brazilian rights expert, and including Carla Del Ponte, the former war crimes tribunal prosecutor, have studiously avoided going further in identifying either the individuals or even the number of names on their lists.
Ms. Pillay later sought to clarify her comment, observing that “I have not said that a head of state is a suspect. I was quoting the fact-finding mission, which said that based on their facts, responsibility points at the highest level.”
Her comments, however, drew a riposte from Syria’s deputy foreign minister, Faisal Mekdad. “She has been talking nonsense for a long time and we don’t listen to her,” he was quoted by The Associated Press as saying.
Ms. Pillay said the panel had handed her lists of names to be held securely at the human rights office in Geneva. Ms. Pillay also repeated demands that she and the panel have made that the situation in Syria should be referred to the International Criminal Court in The Hague.
“Accountability should be key priority of international community, and I want to make this point again and again as the Geneva 2 talks begin,” she said, alluding to the second international conference on Syria scheduled to start in Geneva on Jan. 22.
In other Syria-related developments on Monday, the top United Nations official in charge of coordinating the destruction of Syria’s chemical weapons stockpile confirmed that the country’s ability to produce those munitions had been rendered inoperable since a joint mission with the Organization for the Prohibition of Chemical Weapons began work in October.
But the official, Sigrid Kaag, said at the organization’s annual meeting of member states in The Hague that “the most complex and challenging work still lies ahead,” referring to the safe disposal of the weapons. According to a United Nations Security Council resolution, they must be destroyed by mid-2014.
The organization’s director general, Ahmed Uzumcu, announced on Saturday that the United States had offered to help eradicate the weapons at sea, on an American vessel equipped with special destruction technology. He also said the organization had received 35 “expressions of interest” from commercial companies to destroy the weapons.
In Lebanon, Syria’s western neighbor, the authorities announced that the army would undertake “all necessary procedures” to restore order in the northern city of Tripoli, where days of sectarian street clashes tied to competing allegiances in the Syria conflict have left at least 10 people dead. The army sent reinforcements to the city and was raiding areas often used by gunmen, Lebanon’s National News Agency said.
Ben Hubbard contributed reporting from Beirut, Lebanon, and Rick Gladstone from New York.
on: Dec 03, 2013, 07:26 AM
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December 2, 2013
In Taking Jobs, Women Take On a Saudi Taboo
By BEN HUBBARD
RIYADH, Saudi Arabia — The bearded religious police were not the ones who chastised the princess running the Harvey Nichols department store here when she decided to enhance the upscale shopping atmosphere with some instrumental lute music.
Instead, the irate caller accusing the store of anti-Islamic behavior was a frequent shopper, a woman who on average spent $13,000 per visit.
“Maybe I should get whale sounds,” said the princess, Reema Bint Bandar al-Saud, making light of the blowback that businesspeople in this intensely religious and conservative kingdom often face when making even glacial changes to How Things Are Done.
But this is part of being a pioneer in Saudi Arabia, where women are severely restricted in all public activities and are treated as the wards of their male relatives. Despite her royal credentials, the princess did away with the music but has pushed ahead on the equally touchy front of hiring women as sales clerks. This step — or leap, in the Saudi context — seeks not only to shift social conventions but also to aid the country’s long-term economic health.
At Harvey Nichols, several dozen female clerks were spread throughout the store, all cloaked in black, their hair covered, some with only their eyes peering through narrow slits in face veils. They were busy arranging dresses, hawking cosmetics and swiping credit cards.
Just two years ago there were only a few women working here.
The kingdom’s restrictions on women have long drawn the condemnation of rights groups, most recently after dozens of women drew headlines by defying a ban on driving.
But some women’s rights advocates here say that the international attention given to small numbers of women getting behind the wheel overshadows the deep, if gradual, shifts in Saudi society as more women work, broadening their range of experience, helping to run organizations and earning a degree of economic independence.
Although the effort has been promoted by the Ministry of Labor as part of a campaign to reduce unemployment and the dependence on foreign workers, it has butted up against strict social codes. The percentage of Saudi women who work remains minuscule by world standards, at about 15 percent.
Still, many employers say they prefer hiring Saudi women to Saudi men; they have added separate break rooms and office areas for women, and have installed partitions and cameras to prevent unwelcome mingling.
“We are promoting recruitment of Saudi women because they have a low level of attrition, a better attention to detail, a willingness to perform and a productivity about twice that of Saudi men,” said a grocery store manager with branches throughout the kingdom.
Despite that, Saudi women make up less than 5 percent of his staff of more than 1,000 because of social taboos in many areas. He spoke on the condition that neither he nor his company be identified to avoid being targeted by opponents of women’s employment.
While working women in the Red Sea city of Jidda are relatively accepted, he said, the addition of female checkout clerks in a more conservative city caused such an uproar that a local prince intervened and paid the women’s salaries for more than a year — as long as they stayed home.
Others have found business opportunities in bridging the gap between employers and women.
“For some employers, it is their first time to hire women, and they don’t know how to deal with them,” said Khalid Alkhudair, 30, who runs a women’s employment service called Glowork that cooperates with the government to increase female employment.
Frosted glass partitions bearing inspirational quotes divide the company’s pink-walled office in Riyadh. On a recent morning, a dozen female employees sipped coffee as they sorted through applicants’ résumés on flat-screen monitors. All wore loose black gowns, some with their hair uncovered — a rare but increasingly common sight in some private offices.
In two years, the company has found jobs for more than 10,000 women, including one chief financial officer, several human resource managers and a group of women at a light bulb factory, Mr. Alkhudair said.
Yet across the kingdom, about two-thirds of female university graduates are unemployed, showing that the labor market has yet to catch up with huge advances in women’s education.
Some Saudis laud King Abdullah as a reformer for appointing 30 women to a royal advisory council and granting women the right to run and vote in municipal elections.
Others blast the kingdom for falling behind the rest of the world by not appointing female judges, ambassadors and ministers and leaving in place “guardianship laws” that bar women from traveling, working, marrying or undergoing certain medical procedures without permission from a male relative.
“It is a crisis in dealing with modernity from the conservative society and the clerics,” said Hatoon al-Fassi, an associate professor of women’s history at King Saud University in Riyadh. “Every time something new occurs, they are suspicious and immediately think there must be a conspiracy of some kind that wants to decay our society.”
Harvey Nichols has served as a pioneering case, benefiting from a small staff, ample resources and, of course, a royal boss.
“This store is a big social experiment because we are talking about ladies who had severe obstacles in coming here,” said Princess Reema, 38, who was educated in the United States while her father, Prince Bandar bin Sultan, served as ambassador.
Leading a visitor through her now music-free store, she explained that she had opened a nursery for employees’ children and given transportation stipends to women who could not drive themselves to work.
The store does not regulate face veils, she said, adding that some women prefer to cover their faces at work.
“Their families don’t necessarily want other people to know that their daughter is working in retail,” she said. For the same reason, female employees do not wear name tags.
Two years ago, the store employed only 12 Saudi women, she said, including herself. That number has nearly quadrupled since then, she said, and it will keep growing.
Jawharah, a 35-year-old saleswoman standing between racks of high-end dresses in a full face veil, said that this was her first job and that her husband had inspected the store before letting her take it.
While her mother and aunts never worked, she said, all of her sisters now do. “It’s nice to get out and work and get paid,” she said.
on: Dec 03, 2013, 07:22 AM
|Started by Steve - Last post by Rad|
Somalia's prime minister and cabinet ousted
Parliamentary vote to remove Abdi Farah Shirdon proves country's institutions have come of age, says UN representative
theguardian.com, Monday 2 December 2013 19.16 GMT
Somali politicians have voted 184-65 to oust the prime minister and his cabinet after 14 months in office. Abdi Farah Shirdon would remain in office until the president, Hassan Sheikh Mohamud, nominated a new prime minister, who would have 30 days to appoint a cabinet, the parliamentary speaker, Sheik Osman Jawari Jawari, said.
The vote came after disputes emerged between Shirdon, a former businessman, and Mohamud. Politicians said Shirdon had refused to include the president's choices in his cabinet.
The UN representative to Somalia, Nicholas Kay, said the rejection of the prime minister by vote from the parliament showed that Somalia's institutions were coming of age. "The UN is here to support their development, and looks forward to working constructively with the new administration. Outgoing Prime Minister Shirdon had worked hard to promote growth and progress and played an important part in creating the New Deal Compact between international partners and Somalia," Kay said.
The government is in place largely thanks to African Union troops, and controls only small parts of the country and continues to struggle to provide security and battle corruption. The capital, Mogadishu, though, is much better off today than the years 2006-2011, when the militant group al-Shabab controlled much of the capital.
on: Dec 03, 2013, 07:20 AM
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Sea eagle steals camera and films bird's eye view - video
A sea eagle in Western Australia's Kimberley region swipes a camera and inadvertently makes a short wildlife film. The young bird of prey picked up the motion-sensor camera, which had been set up to film fresh-water crocodiles, and took it on a journey of more than 100km. The footage shows the young bird of prey scooping up the recorder, and taking to the air before putting it down and pecking at it.
Click to watch: http://www.theguardian.com/environment/video/2013/dec/03/sea-eagle-steals-camera-australia-video