Fewer health care options for illegal immigrants

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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At least three injured, one dead in Conn. elementary school shooting

Students evacuate Sandy Hook elementary in Newtown, Conn., on Dec. 14, 2012. (AP)

At least three are  injured and multiple people dead after a shooting in a Connecticut elementary school Friday morning, according to local news reports. At least one child is dead, according to the Hartford Courant.

State police entered the elementary school after a shooting was reported there, spokesman Lt. Paul Vance told Yahoo News. Vance said the scene is still "active" and that "every available on- and off-duty officer in the vicinity" is responding to the scene.

State police told the Hartford Courant the shooter is believed to be dead, and that two handguns have been recovered from the scene. According to the newspaper, the gunman had been in the main office of Sandy Hook Elementary in Newtown, Conn., during the attack. Police said a person in one room had "numerous gunshot wounds." At least three people were taken to a nearby hospital in an ambulance, according to NBC Connecticut.

Matt Pitrone's family owns a glass business about a quarter mile from Shady Hook. He and his mother rushed to the school when they saw police cars and ambulance headed for the school.

"My nephew was in there," Pitrone told Yahoo News. "He's fine, but it was a crazy scene.""An EMT told me that there were two casualties, both of them adults," Pitrone said. "It doesn't look like any of the kids were hurt, just shaken up and crying."

The school is on lockdown and police began evacuating the building this morning, NBC Connecticut also reports.

Connecticut's News 8 WTNH-TV says a witness saw one child with a bloody face leaving the building.

The school's website says only that afternoon kindergarten is canceled today. Newtown has a population of 27,000 and is located about 80 miles northeast of New York City.

—Yahoo News reporter Jason Sickles contributed to this report.

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Panetta: Karzai to meet Obama in Washington

KABUL (AP) — Defense Secretary Leon Panetta says Afghan President Hamid Karzai has accepted an invitation from President Barack Obama to meet in Washington.

Panetta said at a joint news conference with Karzai that the meeting is to be held during the week of Jan. 7.

The two leaders will use the meeting to discuss Afghanistan's future. Karzai said he and Obama will discuss the number of U.S. troops that will remain in Afghanistan after the combat mission ends there in December 2014.

Panetta also said that a suicide car bomber who staged an attack at the Kandahar Air Base killed one American serviceman and wounded three others. Two Afghan civilians were also killed in the attack Thursday.

Taliban spokesman Qari Jusuf Ahmedi claimed responsibility for the attack in an email, saying a suicide car bomber had targeted foreign military vehicles that were stopped near the gate of Kandahar Airfield.

It was unclear if the attack had anything to do with Panetta's unannounced visit to Kandahar Airfield. Kandahar is a huge and sprawling facility that houses more than 20,000 service members from 20 countries and has more than 11,000 civilian contract workers.

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Lidl Christmas dinner offer goes viral on Twitter

BRUSSELS (Reuters) – Discount retailer Lidl faces a 200,000-euro ($ 260,000) Christmas dinner bill after an offer of chicken vol-au-vents and ice cream cake for the poor went viral.

The supermarket launched a Twitter campaign in Belgium on Monday, saying it would hand out five four-course Christmas dinners to food banks for each tweet on a hash tag.

Lidl had expected to hand out about 1,000 of the 20-euro dinner packs, consisting of tomato soup, vol-au-vents with chips, an ice-cream cake and chocolates, a spokesman for the German-based company’s Belgium unit said on Wednesday.

But local newspapers wrote about the offer and people retweeted using the hash tag – #luxevooriedereen, Dutch for “luxury for everyone”.

By the end of the 24-hour campaign, 1,500 people had tweeted, meaning Lidl has to deliver 7,500 dinners. That sparked reports the supermarket had been caught out by its campaign.

To quash such talk, Lidl rounded up the number of dinners to 10,000, and branded the campaign a success.

Lidl said it had not yet decided whether to repeat the exercise next year.

“We’ve learnt quite a few lessons over the past 48 hours, to say the least,” the spokesman said.

($ 1 = 0.7693 euros)

(Reporting By Ben Deighton. Editing By Sebastian Moffett.)

Social Media News Headlines – Yahoo! News

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'Lincoln' leads Golden Globes with 7 nominations

BEVERLY HILLS, Calif. (AP) — Steven Spielberg's Civil War epic "Lincoln" led the Golden Globes on Thursday with seven nominations, among them best drama, best director for Spielberg and acting honors for Daniel Day-Lewis, Sally Field and Tommy Lee Jones.

Tied for second-place with five nominations each, including best drama are Ben Affleck's Iran hostage-crisis thriller "Argo" and Quentin Tarantino's slave-turned-bounty-hunter tale "Django Unchained."

Other best-drama nominees put forward by The Hollywood Foreign Press Association are Ang Lee's shipwreck story "Life of Pi" and Kathryn Bigelow's Osama bin Laden manhunt thriller "Zero Dark Thirty."

Nominated for best musical or comedy were: the British retiree adventure "The Best Exotic Marigold Hotel"; the Victor Hugo musical "Les Miserables"; the first-love tale "Moonrise Kingdom"; the fishing romance "Salmon Fishing in the Yemen"; and the lost-soul romance "Silver Linings Playbook."

Globe attention can give contenders a boost for Hollywood's top honors, the Academy Awards, whose nominations come out Jan. 10, three days before the Globe ceremony.

The directing lineup came entirely from dramatic films, with Affleck, Bigelow, Lee, Spielberg and Tarantino all in the running.

"It's very gratifying to get this many nominations from the HFPA for a film I worked so hard on and am so passionate about. I look forward to having fun at the Golden Globes with my cast mates and fellow nominees," Tarantino said in a statement.

Filmmakers behind best musical or comedy nominees were shut out for director, including Tom Hooper for "Les Miserables" and David O. Russell for "Silver Linings Playbook."

Along with Day-Lewis as Abraham Lincoln in Spielberg's epic, best dramatic actor contenders are Richard Gere as a deceitful Wall Streeter in "Arbitrage"; John Hawkes as a polio victim trying to lose his virginity in "The Sessions"; Joaquin Phoenix as a Navy veteran under the sway of a cult leader in "The Master"; and Denzel Washington as a boozy airline pilot in "Flight."

Dramatic-actress nominees are Jessica Chastain as a CIA analyst hunting Osama bin Laden in "Zero Dark Thirty"; Marion Cotillard as a whale biologist beset by tragedy in "Rust and Bone"; Helen Mirren as Alfred Hitchcock's strong-minded wife in "Hitchcock"; Naomi Watts as a woman caught up in a devastating tsunami in "The Impossible"; and Rachel Weisz as a woman ruined by an affair in "The Deep Blue Sea."

For musical or comedy actress, the lineup is Emily Blunt as a consultant for a Mideast sheik in "Salmon Fishing in the Yemen"; Judi Dench as a widow who retires overseas in "The Best Exotic Marigold Hotel"; Jennifer Lawrence as a young widow in a new romance in "Silver Linings Playbook"; Maggie Smith as an aging singer in a retirement home in "Quartet"; and Meryl Streep as a wife trying to save her marriage in "Hope Springs."

Nominees for musical or comedy actor are Jack Black as a solicitous mortician in "Bernie"; Bradley Cooper as a troubled man fresh out of a mental hospital in "Silver Linings Playbook"; Hugh Jackman as Hugo's long-suffering hero Jean Valjean in "Les Miserables"; Ewan McGregor as a British fisheries expert in "Salmon Fishing in the Yemen"; and Bill Murray as Franklin Roosevelt in "Hyde Park on Hudson."

Cooper said he watched the telecast from his mother's bedroom in Los Angeles and both were thrilled when co-presenter Megan Fox called his name.

"It's funny, you're listening, you're watching their mouths move, you know, and trying to see if they're going to form your word, the word of your name. It's actually kind of pathetic. So when Megan Fox actually said Bradley Cooper, I thought, 'Oh wow!'"

Competing for supporting actor are Alan Arkin as a Hollywood producer helping a CIA operation in "Argo"; Leonardo DiCaprio as a cruel slave owner in "Django Unchained"; Philip Seymour Hoffman as a mesmerizing cult leader in "The Master"; Tommy Lee Jones as firebrand abolitionist Thaddeus Stevens in "Lincoln"; and Christoph Waltz as a genteel bounty hunter in "Django Unchained."

The supporting-actress picks are Amy Adams as a cult leader's devoted wife in "The Master"; Sally Field as Mary Todd Lincoln in "Lincoln"; Anne Hathaway as a mother fallen into prostitution in "Les Miserables"; Helen Hunt as a sexual surrogate in "The Sessions"; and Nicole Kidman as a trashy mistress of a Death Row inmate in "The Paperboy."

Field said the story of Lincoln connected with moviegoers on a personal level. "It really reflects about a family, a family who's in the heart of it, who faces such hardship. And families are facing terrible hardships all over the world, and then this one man who rises above it and keeps his eye on the prize and really the cost that that he paid."

Kidman was a dual nominee, also in the running as best actress in a TV movie or miniseries for "Hemingway & Gellhorn."

"As an actor you look for roles that are rich, complicated, and that stretch you and this year I was blessed to find two," Kidman said in a statement. "To have the chance to play them was a gift in itself and to then be acknowledged this way is icing on the cake."

"Quartet" star Smith also had a second nomination, for supporting actress in a TV series, miniseries or movie for "Downton Abbey."

Snubbed completely was the low-budget critical darling "Beasts of the Southern Wild," which won top honors at last January's Sundance Film Festival. Also shut out was the stripper hit "Magic Mike," which had good buzz for supporting player Matthew McConaughey, who also earned acclaim for roles in "Bernie" and "Killer Joe." Another film to not notch a single nomination was "The Hobbit," a prelude to the "The Lord of the Rings" films, which all got Globe nods.

With three nominations, "Salmon Fishing in the Yemen" was a surprise inclusion Thursday, since the film had virtually no awards buzz behind it.

There will be some friendly rivalry among the hosts at the Globe ceremony, Tina Fey and Amy Poehler. Both were nominated for best actress in a TV comedy, Fey for "30 Rock" and Poehler for "Parks and Recreation."

Fey and Poehler follow Ricky Gervais, who was host the last three years and rubbed some Hollywood egos the wrong way with sharp wisecracks about A-list stars and the foreign press association itself.

The Sarah Palin drama "Game Change" leads TV contenders with five nominations: including best movie or miniseries and acting honors for Julianne Moore, Woody Harrelson, Ed Harris and Sarah Paulson.

Best TV comedy series nominees are "The Big Bang Theory," ''Episodes," ''Girls," ''Modern Family" and "Smash." TV drama picks are "Breaking Bad," ''Boardwalk Empire," ''Downton Abbey: Season 2," ''Homeland" and "The Newsroom."

Hayden Panettiere was in Nashville, Tenn., when she got word that she'd been nominated as best supporting actress in a TV series for "Nashville."

"I had my phone on my chest sleeping because they told me to be around just in case, but I never expected to get this call," she said. "It took me a second and then it hit me and I just started welling up. I got pretty emotional."

Globe acting winners often go on to receive the same prizes at the Oscars. All four Oscar winners last season — lead performers Meryl Streep of "The Iron Lady" and Jean Dujardin of "The Artist," and supporting players Octavia Spencer of "The Help" and Christopher Plummer of "Beginners" — won Globes first.

The Globes have a spotty record predicting which films might go on to earn the best-picture prize at the Academy Awards, however.

Last year's Oscar best-picture winner, "The Artist," preceded that honor with a Globe win for best musical or comedy. But in the seven years before that, only one winner in the Globes' two best-picture categories — 2008's "Slumdog Millionaire" — followed up with an Oscar best-picture win.

Along with 14 film prizes, the Globes hand out awards in 11 television categories.

Jodie Foster, a two-time Oscar and Globe winner for "The Accused" and "The Silence of the Lambs," will receive the group's Cecil B. DeMille Award for lifetime achievement.

With stars sharing drinks and dinner, the Globes have a reputation as one of Hollywood's loose and unpredictable awards gatherings. Winners occasionally have been off in the restroom when their names were announced, and there have been moments of onstage spontaneity such as Jack Nicholson mooning the crowd or Ving Rhames handing over his trophy to fellow nominee Jack Lemmon.

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AP Entertainment Writer Sandy Cohen contributed to this report.

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Online:

http://www.goldenglobes.org

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Dozens sue pharmacy, but compensation uncertain

NASHVILLE, Tenn. (AP) — Dennis O'Brien rubs his head as he details ailments triggered by the fungal meningitis he developed after a series of steroid shots in his neck: nausea, vomiting, dizziness, drowsiness, blurred vision, exhaustion and trouble with his speech and attention.

He estimates the disease has cost him and his wife thousands of dollars in out-of-pocket expenses and her lost wages, including time spent on 6-hour round trip weekly visits to the hospital. They've filed a lawsuit seeking $4 million in damages from the Massachusetts pharmacy that supplied the steroid injections, but it could take years for them to get any money back and they may never get enough to cover their expenses. The same is true for dozens of others who have sued the New England Compounding Center.

"I don't have a life anymore. My life is a meningitis life," the 59-year-old former school teacher said, adding that he's grateful he survived.

His is one of at least 50 federal lawsuits in nine states that have been filed against NECC, and more are being filed in state courts every day. More than 500 people have gotten sick after receiving injections prepared by the pharmacy.

The lawsuits allege that NECC negligently produced a defective and dangerous product and seek millions to repay families for the death of spouses, physically painful recoveries, lost wages and mental and emotional suffering. Thirty-seven people have died in the outbreak.

"The truth is the chance of recovering damages from NECC is extremely low," said John Day, a Nashville attorney who represents several patients who have been sickened by fungal meningitis.

To streamline the process, attorneys on both sides are asking to have a single judge preside over the pretrial and discovery phases for all of the federal lawsuits.

This approach, called multidistrict litigation, would prevent inconsistent pretrial rulings and conserve resources of all parties. But unlike a class-action case, those lawsuits would eventually be returned to judges in their original district for trial, according to Brian Fitzpatrick, a law professor at Vanderbilt University Law School in Nashville.

Even with this approach, Fitzpatrick noted that federal litigation is very slow, and gathering all the evidence, records and depositions during the discovery phase could take months or years.

"Most of the time what happens is once they are consolidated for pretrial proceedings, there is a settlement, a global settlement between all the lawyers and the defendants before anything is shipped back for trial," he said.

A lawyer representing NECC, Frederick H. Fern, described the consolidation process as an important step.

"A Boston venue is probably the best scenario," Fern said in an email. "That's where the parties, witnesses and documents are located, and where the acts subject to these complaints occurred."

Complicating efforts to recover damages, attorneys for the patients said, NECC is a small private company that has now recalled all its products and laid off its workers. The company's pharmacy licenses have been surrendered, and it's unclear whether NECC had adequate liability insurance.

Fern said NECC has insurance, but they were still determining what the policy covers.

But Day says, "It's clear to me that at the end of the day, NECC is not going to have sufficient assets to compensate any of these people, not even 1 percent."

As a result, many attorneys are seeking compensation from other parties. Among the additional defendants named in lawsuits are NECC pharmacist and co-founder Barry Cadden; co-founder Greg Conigliaro; sister company Ameridose and its marketing and support arm, Medical Sales Management.

Founded in 2006 by Cadden and Conigliaro, Ameridose would eventually report annual revenue of $100 million. An NECC spokesman didn't respond to a request for the pharmacy's revenue.

While Federal Drug Administration regulators have also found contamination issues at Westborough, Mass.-based Ameridose, the FDA has said it has not connected Ameridose drugs to infection or illness.

Under tort law, a lawsuit has to prove a defendant has a potential liability, which in this case could be anyone involved in the medical procedure. However, any such suit could take years and ultimately may not be successful.

"I would not be surprised if doctors, hospitals, people that actually injected the drugs, the people that bought the drugs from the compounding company, many of those people will also be sued," said Fitzpatrick.

Plaintiffs' attorneys said they're considering that option but want more information on the relationships between the compounding pharmacy and the hundreds of hospitals and clinics that received its products.

Day, the attorney in Tennessee, said the clinics and doctors that purchase their drugs from compounding pharmacies or manufacturers could be held liable for negligence because they are in a better position to determine the safety of the medicine than the patients.

"Did they use due care in determining from whom to buy these drugs?" Day said.

Terry Dawes, a Michigan attorney who has filed at least 10 federal lawsuits in the case, said in traditional product liability cases, a pharmaceutical distributor could be liable.

"We are looking at any conceivable sources of recovery for our clients including pharmaceutical supply places that may have dealt with this company in the past," he said.

Ten years ago, seven fungal meningitis illnesses and deaths were linked to injectable steroid from a South Carolina compounding pharmacy. That resulted in fewer than a dozen lawsuits, a scale much smaller than the litigations mounting up against NECC.

Two companies that insured the South Carolina pharmacy and its operators tried unsuccessfully to deny payouts. An appellate court ruled against their argument that the pharmacy willfully violated state regulations by making multiple vials of the drug without specific prescriptions, but the opinion was unpublished and doesn't set a precedent for the current litigation.

The lawsuits represent a way for patients and their families recover expenses, but also to hold the pharmacy and others accountable for the incalculable emotional and physical toll of the disease.

A binder of snapshots shows what life is like in the O'Briens' rural Fentress County, Tenn., home: Dennis hooked up to an IV, Dennis in an antibiotics stupor, bruises on his body from injections and blood tests. He's had three spinal taps. His 11-day stay in the hospital cost over $100,000, which was covered by health insurance.

His wife said she sometimes quietly checks at night to see whether her husband of 35 years is still breathing.

"In my mind, I thought we were going to fight this and get over it. But we are not ever going to get over it," said Kaye O'Brien.

Marjorie Norwood, a 59-year-old grandmother of three who lives in Ethridge, Tenn., has spent just shy of two months total in the hospital in Nashville battling fungal meningitis after receiving a steroid injection in her back. She was allowed to come home for almost a week around Thanksgiving, but was readmitted after her symptoms worsened.

Family members are still dealing with much uncertainty about her recovery, but they have not filed a lawsuit, said their attorney Mark Chalos. He said Norwood will likely be sent to a rehabilitation facility after her second stay in the hospital rather than return home again.

Marjorie Norwood's husband, an autoworker, has taken time off work to care for her and they depend on his income and insurance.

"It doesn't just change her life, it changes everyone else's life around her because we care about her and want her to be happy and well and have everything that she needs," said her daughter, Melanie Norwood.

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GOP advisor: 'Let the fiscal cliff happen'

As politicians, businessmen and ordinary citizens brace for spending cuts and tax hikes in the new year, a long-term Republican advisor says the U.S. should take the "fiscal cliff" plunge.

"Let the fiscal cliff happen and reduce the deficit very substantially as a consequence,"says Bruce Bartlett, author of The Benefit and Burden: Tax Reform--Why We Need It and What It Will Take. The combination of spending cuts and tax hikes will eventually strengthen the economy he says, citing CBO analysis.

In contrast, Republicans' refusal to raise taxes would hurt the economy in the long run, Bartlett argues.

Related: Higher Taxes Will Create Jobs and Cut the Deficit: David Cay Johnston

Bartlett, a former advisor to Presidents Ronald Reagan and George H.W. Bush and Congressman Ron Paul, explains why the GOP tax pledge has harmful consequences for the economy. Government spending will rise over the coming decades as more baby boomers retire. But if tax revenues don't keep pace with spending, the federal government will be forced to increase borrowing, which will increase interest payments on the debt.

According to Bartlett, a GAO report projects that the Republican plan to keep revenues at just under 18% of GDP will cause interest on the debt to surge from 19.2% of the deficit this year to 62% in 2020.

Related: Fiscal Cliff Deal Likely but U.S> at Risk of "Looking Ridiculous," Rivlin Says

Bartlett is not advocating big spending increases --- he'd rather trim spending-- but he says revenues must keep up with spending. Going over the fiscal cliff is a move in that direction because revenues would rise as the Bush-era tax cuts expire for everyone, not just the top 2%, at the same that spending is reduced.

"Revenues are too low rather than spending too high," he tells The Daily Ticker's Aaron Task.

Bartlett doesn't know if and when Republicans and Democrats will agree to fiscal cliff deal, but he predicts that any deal will not happen "before the absolute last possible minute." Stay tuned.

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US: Afghans resisting efforts to track cash exodus

KABUL, Afghanistan (AP) — A U.S. watchdog agency said Tuesday that Afghan officials were resisting U.S. efforts to help track billions of dollars being flown out of Kabul airport every year, some likely linked to crime and drugs.

The U.S. and other nations have long expressed concern about the amount of cash being flown out of the country — an estimated $4.5 billion last year, according to the U.S. Congressional Research Service. Afghanistan has a cash-based economy and moving large bundles of cash is common, yet it raises the risk of money laundering and cash smuggling to finance terrorist, narcotics and other illicit activities.

Hundreds of millions of dollars from the collapsed Kabul Bank were flown out of Afghanistan — some in airplane food trays — to more than two dozen other countries, a recent report on the collapse said. The demise of the bank, the nation's largest financial institution, became a symbol of endemic corruption that plagues Afghanistan.

"The persistent delays in instituting basic anti-money laundering procedures by the Afghan government at Kabul International Airport are deeply troubling," the report by the Special Inspector General for Afghanistan Reconstruction said. "Although proper controls to monitor cash flows are important for any country to institute, they are particularly critical for a country fraught with corruption, narcotics trafficking and insurgent activity."

To help Afghanistan track the cash moving through the airport, the U.S. purchased $117,275 worth of bulk currency counting equipment. Though the contract to install them was awarded in July 2010, they were not put in until April 2011, the report said.

SIGAR staff made follow-up visits to the airport in September and November but never saw the cash counters being used. Moreover, the report said VIPs — some carrying cash — continue to bypass controls.

The report said the cash counters were in a small, closet-like area not easily accessible to customs or banking officials in the international terminal.

While they were plugged in and appeared to be in working order, they were not connected to the Internet or a computer server. The report said that being connected is essential for sending the serial numbers of the bills and other data to the Financial Transactions and Records Analysis Center of Afghanistan, which is part of the Afghan central bank.

"U.S. Department of Homeland Security officials told us that their efforts to address these problems have stalled, even though the use of bulk currency counters to record and transmit data is critically important for their law enforcement activities," the report said. "According to one official, Afghan officials have neither committed to connecting the machines to the Internet nor agreed to establish a working link to FinTRACA."

During the visit, Afghan customs and banking officials were unable to explain why the machines remained without Internet connectivity, the report said.

"However, one DHS official told us that Afghan customs at Kabul airport were afraid that they would experience negative repercussions from the Afghan government if progress in instituting controls at the airport was made," the report said.

SIGAR expressed dismay that cash being carried by VIPs was being declared, but still not scanned.

"No bulk currency counter was available for the counting or data collection of currency declared by VIPs, who do not undergo main customs or security screenings. According to a DHS official, many of the individuals who traffic money leave from the VIP area," the report said. "A new Very Very Important Persons (VVIPs) lounge was built to provide easier boarding access for high-ranking officials, again allowing transit without main customs screenings or use of a bulk currency counter."

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Cast revealed for 'Pump Boys and Dinettes' revival

NEW YORK (AP) — The Broadway revival of the honkey-tonk musical revue "Pump Boys and Dinettes" will have a former Idol in the cast.

Producers on Tuesday revealed the stars of the show set in a highway diner in North Carolina and "American Idol" runner-up Bo Bice will be among them.

Since losing the title to Carrie Underwood in 2005, Bice, 37, released the single "Inside Your Heaven," which went to No. 1 in 2005, followed by his debut CD, "The Real Thing." Two other albums followed: "See the Light" in 2007 and "''Bo Bice 3" in 2010.

The rest of the cast includes Alexander Gemignani ("The People in the Picture"), Erik Hayden ("Million Dollar Quartet"), Justin Hosek (a member of the country band The Ranchhands), Jane Pfitsch ("Company") and Leenya Rideout ("War Horse"). All the actors will also play musical instruments onstage.

The play tells the story of two waitresses at the Double Cupp Diner on Highway 57 in North Carolina and the four men who work at a gas station next door. The songs include "Be Good or Be Gone" and "Tips."

The play was written by John Foley, Mark Hardwick, Debra Monk, Cass Morgan, John Schimmel and Jim Wann, all of whom also starred in the original 1981 off-Broadway production. It hit Broadway in 1982 and ran for 573 performances.

The revival will begin March 19 at Circle in the Square Theatre. John Doyle will direct.

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New tests could hamper food outbreak detection

WASHINGTON (AP) — It's about to get faster and easier to diagnose food poisoning, but that progress for individual patients comes with a downside: It could hurt the nation's ability to spot and solve dangerous outbreaks.

Next-generation tests that promise to shave a few days off the time needed to tell whether E. coli, salmonella or other foodborne bacteria caused a patient's illness could reach medical laboratories as early as next year. That could allow doctors to treat sometimes deadly diseases much more quickly — an exciting development.

The problem: These new tests can't detect crucial differences between different subtypes of bacteria, as current tests can. And that fingerprint is what states and the federal government use to match sick people to a contaminated food. The older tests might be replaced by the new, more efficient ones.

"It's like a forensics lab. If somebody says a shot was fired, without the bullet you don't know where it came from," explained E. coli expert Dr. Phillip Tarr of Washington University School of Medicine in St. Louis.

The federal Centers for Disease Control and Prevention warns that losing the ability to literally take a germ's fingerprint could hamper efforts to keep food safe, and the agency is searching for solutions. According to CDC estimates, 1 in 6 Americans gets sick from foodborne illnesses each year, and 3,000 die.

"These improved tests for diagnosing patients could have the unintended consequence of reducing our ability to detect and investigate outbreaks, ultimately causing more people to become sick," said Dr. John Besser of the CDC.

That means outbreaks like the salmonella illnesses linked this fall to a variety of Trader Joe's peanut butter might not be identified that quickly — or at all.

It all comes down to what's called a bacterial culture — whether labs grow a sample of a patient's bacteria in an old-fashioned petri dish, or skip that step because the new tests don't require it.

Here's the way it works now: Someone with serious diarrhea visits the doctor, who gets a stool sample and sends it to a private testing laboratory. The lab cultures the sample, growing larger batches of any lurking bacteria to identify what's there. If disease-causing germs such as E. coli O157 or salmonella are found, they may be sent on to a public health laboratory for more sophisticated analysis to uncover their unique DNA patterns — their fingerprints.

Those fingerprints are posted to a national database, called PulseNet, that the CDC and state health officials use to look for food poisoning trends.

There are lots of garden-variety cases of salmonella every year, from runny eggs to a picnic lunch that sat out too long. But if a few people in, say, Baltimore have salmonella with the same molecular signature as some sick people in Cleveland, it's time to investigate, because scientists might be able narrow the outbreak to a particular food or company.

But culture-based testing takes time — as long as two to four days after the sample reaches the lab, which makes for a long wait if you're a sick patient.

What's in the pipeline? Tests that could detect many kinds of germs simultaneously instead of hunting one at a time — and within hours of reaching the lab — without first having to grow a culture. Those tests are expected to be approved as early as next year.

This isn't just a science debate, said Shari Shea, food safety director at the Association of Public Health Laboratories.

If you were the patient, "you'd want to know how you got sick," she said.

PulseNet has greatly improved the ability of regulators and the food industry to solve those mysteries since it was launched in the mid-1990s, helping to spot major outbreaks in ground beef, spinach, eggs and cantaloupe in recent years. Just this fall, PulseNet matched 42 different salmonella illnesses in 20 different states that were eventually traced to a variety of Trader Joe's peanut butter.

Food and Drug Administration officials who visited the plant where the peanut butter was made found salmonella contamination all over the facility, with several of the plant samples matching the fingerprint of the salmonella that made people sick. A New Mexico-based company, Sunland Inc., recalled hundreds of products that were shipped to large retailers all over the country, including Target, Safeway and other large grocery chains.

The source of those illnesses probably would have remained a mystery without the national database, since there weren't very many illnesses in any individual state.

To ensure that kind of crucial detective work isn't lost, the CDC is asking the medical community to send samples to labs to be cultured even when they perform a new, non-culture test.

But it's not clear who would pay for that extra step. Private labs only can perform the tests that a doctor orders, noted Dr. Jay M. Lieberman of Quest Diagnostics, one of the country's largest testing labs.

A few first-generation non-culture tests are already available. When private labs in Wisconsin use them, they frequently ship leftover samples to the state lab, which grows the bacteria itself. But as more private labs switch over after the next-generation rapid tests arrive, the Wisconsin State Laboratory of Hygiene will be hard-pressed to keep up with that extra work before it can do its main job — fingerprinting the bugs, said deputy director Dr. Dave Warshauer.

Stay tuned: Research is beginning to look for solutions that one day might allow rapid and in-depth looks at food poisoning causes in the same test.

"As molecular techniques evolve, you may be able to get the information you want from non-culture techniques," Lieberman said.

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Follow Mary Clare Jalonick on Twitter at http://twitter.com/mcjalonick

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