triumphal latecomer: June 2013

Sunday, June 30, 2013

Obama to announce new power initiative for Africa

U.S. President Barack Obama and first lady Michelle Obama wave as they depart Waterkloof Air Base for a flight to Cape Town on Sunday, June 30, 2013, in Centurion, South Africa. The president is in South Africa, embarking on the second leg of his three-country African journey. The visit comes at a poignant time, with former South African president and anti-apartheid hero Nelson Mandela ailing in a Johannesburg hospital. (AP Photo/Evan Vucci)

U.S. President Barack Obama, left, stands for a moment of silence for Nelson Mandela during an official dinner with South African President Jacob Zuma at the Presidential Guest House on Saturday, June 29, 2013, in Pretoria, South Africa. The visit comes at a poignant time, with former South African president and anti-apartheid hero Nelson Mandela ailing in a Johannesburg hospital. (AP Photo/Evan Vucci)

U.S. President Barack Obama and first lady Michelle Obama toast during an official dinner hosted by South African President Jacob Zuma at the Presidential Guest House on Saturday, June 29, 2013, in Pretoria, South Africa. The visit comes at a poignant time, with former South African president and anti-apartheid hero Nelson Mandela ailing in a Johannesburg hospital. (AP Photo/Evan Vucci)

Performers dressed in traditional Xhosa outfits dance at the wedding of Sbongiseni Tetani and his wife Charity from the Xhosa tribe, near the home of former South African president Nelson Mandela house in Qunu, South Africa, Saturday, June 29, 2013. President Barack Obama plans to visit privately Saturday with relatives of former South African President Nelson Mandela, but doesn't intend to see the critically ill anti-apartheid icon he has called a "personal hero." (AP Photo/Schalk van Zuydam)

CAPE TOWN, South Africa (AP) ? President Barack Obama on Sunday will announce a new initiative to double access to electric power in sub-Saharan Africa, part of his effort to build on the legacy of equality and opportunity forged by his personal hero, Nelson Mandela.

Obama, who flew from Johannesburg to Cape Town Sunday, will pay tribute to the ailing 94-year-old Mandela throughout the day. The president and his family were visiting Robben Island, where the anti-apartheid leader spent 18 years confined to a tiny cell, including a stop at the lime quarry where Mandela toiled and developed the lung problems that put him in the hospital for most of the month.

The White House said Obama's guide during his tour of the island will be 83-year-old South African politician Ahmed Kathrada, who also was held at the prison for nearly two decades and guided Obama on his 2006 visit to the prison as a U.S. senator. The president will also see the prison courtyard where Mandela planted grapevines that remain today, and where he and others in the dissident leadership would discuss politics, sneak notes to one another and hide writings.

During the tour, which took place against the backdrop of sunshine and clear, blue skies, Obama, first lady Michelle Obama and their daughters took in the expansive view of the island's lime quarry, a huge crater with views of the rusty guard tower from where Mandela likely would have been watched. Obama commented on the "hard labor" Mandela endured and asked Kathrada to remind his daughters, Malia and Sasha, how long Mandela was in prison.

Michelle Obama asked how often Mandela would work and was told he worked daily. As the family turned to leave, Obama asked Kathrada to tell his daughters how the African National Congress, the South African political party, got started.

After the tour, Obama will deliver what the White House has billed as the signature speech of his weeklong trip, an address at the University of Cape Town that will be infused with memories of Mandela.

During the speech, Obama will unveil the "Power Africa" initiative, which includes an initial $7 billion investment from the United States over the next five years. Private companies, including General Electric and Symbion Power, are making an additional $9 billion in commitments with the goal of providing power to millions of Africans crippled by a lack of electricity.

Gayle Smith, Obama's senior director for development and democracy, said more than two-thirds of people living in sub-Saharan Africa do not have electricity, including 85 percent of those living in rural areas.

"If you want lights so kids can study at night or you can maintain vaccines in a cold chain, you don't have that, so going the extra mile to reach people is more difficult," Smith said.

The U.S. and its private sector partners initially will focus its efforts on six countries: Ethiopia, Ghana, Kenya, Liberia, Nigeria and Tanzania, where Obama will wrap up his trip later this week. Former President George W. Bush, who supports health programs throughout the continent, will also be in Tanzania next week, and the White House did not rule out the possibility that the two men might meet.

Obama will also highlight U.S. efforts to bolster access to food and health programs on the continent. His advisers said the president sees reducing the poverty and illness that plague many parts of Africa as an extension of Mandela's example of how change can happen within countries.

The former South African president has been hospitalized in critical condition for three weeks. Obama met Saturday with members of Mandela's family, but did not visit the anti-apartheid icon, a decision the White House said was in keeping with his family's wishes.

Obama's weeklong trip, which opened last week in Senegal, marks his most significant trip to the continent since taking office. His scant personal engagement has come as a disappointment to some in the region, who had high hopes for a man whose father was from Kenya.

Obama visited Robben Island when he was a U.S. senator. But since being elected as the first black American president, Obama has drawn inevitable comparisons to Mandela, making Sunday's visit particularly poignant.

The president said he's also eager to bring his family with him to the prison to teach them about Mandela's role in overcoming white racist rule, first as an activist and later as a president who forged a unity government with his former captors.

He told reporters Saturday he wanted to "help them to understand not only how those lessons apply to their own lives but also to their responsibilities in the future as citizens of the world, that's a great privilege and a great honor."

Ben Rhodes, Obama's deputy national security adviser, said Mandela's vision was always going to feature prominently in the speech. But his deteriorating health "certainly puts a finer point on just how much we can't take for granted what Nelson Mandela did."

Harkening back to a prominent theme from Obama's 2009 speech in Ghana ? his only other trip to Africa as president ? Obama will emphasize that Africans must take much of the responsibility for finishing the work started by Mandela and his contemporaries.

"The progress that Africa has made opens new doors, but frankly, it's up to the leaders in Africa and particularly young people to make sure that they're walking through those doors of opportunity," Rhodes said.

Obama will speak at the University of Cape Town nearly 50 years after Robert F. Kennedy delivered his famous "Ripple of Hope" speech from the school. Kennedy spoke in Cape Town two years after Mandela was sentenced to life in prison.

___

Follow Nedra Pickler and Julie Pace on Twitter: http://www.twitter.com/nedrapickler and http://www.twitter.com/jpaceDC .

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/cae69a7523db45408eeb2b3a98c0c9c5/Article_2013-06-30-Obama/id-d32f09cf210a4017ba898b99d7ff54ee

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Final gov't birth control rule for faith groups

WASHINGTON (AP) ? The Obama administration issued its final compromise Friday for religiously affiliated charities, hospitals and other nonprofits that object to covering birth control in their employee health plans.

The Health and Human Services Department said the final plan simplifies how insurers provide the coverage separately from faith-based groups and gives religious nonprofits more time to comply. However, the changes are unlikely to resolve objections from faith groups that the requirement violates their religious freedom.

More than 60 lawsuits have been filed challenging the rule. The cases are expected to reach the Supreme Court.

The birth-control rule was first introduced in February 2012, as part of President Barack Obama's health care overhaul, drawing praise from women's groups and condemnation from religious leaders. The original plan exempted churches and other houses of worship, but required faith-affiliated charities, universities and other nonprofits to provide the coverage for their employees.

The regulation became an election-year issue as Roman Catholic bishops, evangelicals and some religious leaders who have generally been supportive of Obama's policies lobbied fiercely for a broader exemption. The Obama administration offered a series of accommodations, leading to the final rules released Friday.

Under the compromise, administration officials said they simplified the definition of religious organizations that are fully exempt from the requirement. The change means a church that also ran a soup kitchen would not have to comply.

Other religious nonprofits must notify their insurance company that they object to birth control coverage. The insurer or administrator of the plan will then notify affected employees separately that coverage will be provided at no cost. The insurers would be reimbursed by a credit against fees owed the government.

Michael Hash, director of the health reform office of the Health and Human Services Department, said the final regulation spells out in more detail the buffer between religious charities and contraceptive coverage. Faith-based groups were given another reprieve ? until Jan. 1 ? to comply.

"There's a much brighter line here ? a simpler line ? and we think that responds to a good many of the comments that we got," said Michael Hash, director of the Health and Human Services office of health reform. More than 400,000 comments were submitted over the last several months, the agency said.

Judy Waxman of the National Women's Law Center, an advocacy group based in Washington, said she would prefer women hear directly about the coverage from their insurer, but her organization could accept the plan. "It's fair," she said.

However, Eric Rassbach, an attorney with the Becket Fund for Religious Liberty, a public interest law firm challenging the contraception coverage rule, said "it doesn't really change the overall way they're trying to do this." The Becket Fund represents many of organizations challenging the regulation in federal court.

The Catholic Church prohibits the use of artificial contraception. Evangelicals generally accept the use of birth control, but some object to specific methods such as the morning-after contraceptive pill, which they argue is tantamount to abortion, and is covered under the policy.

The lawsuits are split almost evenly between nonprofit plaintiffs ? including several Roman Catholic dioceses ? and for-profit businesses who say the rules go against their religious beliefs. For-profit businesses are not included in the accommodation released Friday and were not eligible for the time extension.

The Oklahoma-based Hobby Lobby Stores Inc. is the largest and best-known of the businesses that have sued. On Thursday, the 10th U.S. Circuit Court of Appeals in Denver allowed the lawsuit to move forward on religious grounds. The judges said the portion of the law that requires them to offer certain kinds of birth control to their employees is particularly onerous and sent the case back to a lower court in Oklahoma. On Friday the lower court granted Hobby Lobby a temporary injunction against full enforcement of the law. Businesses that fail to comply potentially face fines based on the number of workers they employ and other factors. The amount for Hobby Lobby could reach into the hundreds of millions of dollars.

Many of the nonprofit lawsuits had been put on hold until the final rules were announced.

Neither the Catholic Health Association, a trade group for hospitals, nor the U.S. Conference of Catholic Bishops had an immediate reaction Friday, saying the regulations were still being studied. New York Cardinal Timothy Dolan, president of the bishops' conference, said he appreciated the time extension.

___

AP Religion Writer Rachel Zoll reported from New York.

Source: http://news.yahoo.com/final-govt-birth-control-rule-faith-groups-154455085.html

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Ob-Gyn Shortage Is Going to Get Worse (Op-Ed)

Dr. Richard E. Anderson is chairman and chief executive officer of medical malpractice insurer The Doctors Companyand past chairman of the department of medicine at Scripps Memorial Hospital in La Jolla, Calif. He contributed this article to LiveScience's Expert Voices: Op-Ed & Insights.

Some of our most senior Americans can still remember a time when doctors used to make the trek to family homes to deliver newborns. That scenario may rarely happen these days, but could we ever have envisioned a point when women approaching childbirth might have trouble finding an obstetrician to deliver them?

Yet doctors who perform childbirth duties are becoming increasingly scarce. Data from the American College of Obstetricians and Gynecologists (ACOG) projects a shortfall of between 9,000 and 14,000 obstetrician-gynecologists (ob-gyns) in the next 20 years, and an ACOG survey found that 1 in 7 ob-gyns has stopped delivering babies. More than 20 states are now in "Red Alert" crisis mode ? meaning the number of ob-gyns isn't sufficient to meet patients' needs.

Two compelling reasons exist for the shortage. The first, historically unchanged, is that as obstetricians age, their practice tends to age with them and a constant call schedule is hard to sustain for a small number of pregnant patients. The second cause is that the additional cost of malpractice insurance may not be sustainable for an obstetrician who is not performing a large number of deliveries. [9 Uncommon Conditions That Pregnancy May Bring]

On average, obstetricians pay the second-highest liability insurance premiums of any medical specialty, with only neurosurgeons paying more, and spend an average of nearly 15 percent of their careers fighting mostly fruitless or frivolous malpractice claims. Indeed, ob-gyns answering the ACOG survey blamed their decision to drop obstetrics on the twin burdens of insurance affordability and an outright fear of lawsuits. In many cases, ob-gyns can reduce their malpractice premiums in half by eliminating their obstetrical duties.

This distressing situation makes it easy to support a new opinion paper released by ACOG earlier this month. The paper essentially conveys that gynecologists who choose to forego late-pregnancy and delivery duties can still provide early pregnancy care without considering themselves obstetricians.

For example, a gynecologist whose patient develops an ectopic (or tubal) pregnancy may be the best-equipped physician to surgically treat the patient, even if that gynecologist doesn't usually treat pregnant women or deliver babies. This type of "gray zone" between the typical duties of gynecologists and those of obstetricians ? who provide care throughout pregnancy and childbirth ? is broached in the paper, which states that ACOG considers early pregnancy care to be within the scope of a gynecology-only practice. Accordingly, those physicians may choose not to carry liability insurance for obstetrics, ACOG says.

It's widely understood that the early weeks of gestation can be rife with complications, including bleeding, miscarriage and ectopic pregnancy. But it's also well-documented that few malpractice claims stem from treating those issues, while far more claims arise from problems during delivery or birth injuries to newborns. The average payment for claims involving neurologically impaired infants was $1.15 million, according to 2011 ACOG data.

Should malpractice insurers that underwrite gynecology-only practices provide coverage for treatment involving first-trimester and early second-trimester pregnancies and their complications? ACOG says yes, and I fully agree. It's perfectly reasonable for the college to draw attention to the fact that there needn't be a hard-and-fast rule or bright line separating gynecology and obstetrics when it comes to liability coverage. A doctor who is no longer delivering newborns, but still participating in early pregnancy care, may not have a significantly different risk profile than a gynecologist who does not provide that service. At The Doctors Company, we customize coverage and premium rates to our members' specific practice risk profiles, including factors like patient volume, on-call coverage and hospital privileges and we would have no problem providing coverage in the circumstances contemplated by ACOG.

At first glance, it's difficult to understand ACOG's context for issuing this brief opinion paper, since it doesn't appear to change doctors' choices or their potential malpractice coverage. Perhaps, like so many others in the medical field, ACOG is also casting a wary eye on the looming shortage of primary care physicians across America, a byproduct of health care reform. [Doctor Shortage Looms in Health Care Reform (Op-Ed)]

Combined with the lack of sufficient obstetricians to meet the needs of our population, the significant shortfall of primary care physicians will place more pressure on gynecologists to care for pregnant women. It does makes sense ? the vast majority of gynecologists have training in obstetrics ? but their malpractice insurance needs will naturally differ if they are, in fact, delivering babies. For our company, and I suspect for other malpractice insurers as well, the question of an additional premium for these physicians is not based on a political notion ? it's based on a physician's overall liability profile.

Read Anderson's recent Op-Ed Who Shoulders the Blame for Misdiagnoses?

The views expressed are those of the author and do not necessarily reflect the views of the publisher. This article was originally published on?LiveScience.com.

Source: http://news.yahoo.com/ob-gyn-shortage-going-worse-op-ed-202118753.html

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Saturday, June 29, 2013

Eric Cantor Concerned Immigration Reform Push Might Force House Members To Do Things Like 'Read Words'

House Majority Leader Eric Cantor (R-Va.) tells Yahoo! News' Chris Moody he's concerned that the Senate's passage of a comprehensive immigration reform bill might put him in the position of having to read some words that are published in the English language. And there might be no end to the widespread need for members of Congress to do the same:

?I can?t tell you what?s in that big Senate bill, and the well over 1,000 or 1,500 pages that it may be, and that?s my concern...I don?t know if you could ask a lot of the senators what?s in that bill. And that?s my concern.?

As always, I'll point out that back when various members of the House were kvetching about how they had to read the House Health Care Reform bill, the folks over at Computational Legal Studies noted that "those versed in the typesetting practices of the United States Congress know that the printed version of a bill contains a significant amount of whitespace including non-trivial space between lines, large headers and margins, an embedded table of contents, and large font." Consequently, a mere page count "vastly overstates the actual length of [the] bill." CLS went on to note that the House Health Care Reform Bill had 363,086 words. By contrast, "Harry Potter And The Order Of The Phoenix" contained 257,000 words.

Two additional data points:

1. "Harry Potter And The Order Of The Phoenix" is a book for small children.

2. "Nearly One in Five Members of Congress Gets Paid Twice."

Suck it up, Eric.

[Would you like to follow me on Twitter? Because why not?]

Also on HuffPost:

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Source: http://www.huffingtonpost.com/2013/06/28/eric-cantor-immigration-bill_n_3518075.html

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Obama recasts chase for Snowden as unexceptional (The Arizona Republic)

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