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Thursday, September 19, 2013

Banks are still 'too big to fail', says SNB chairman

Swiss National Bank SNB Chairman Thomas Jordan speaks to media during a news conference in Bern June 20, 2013. REUTERS/Ruben Sprich

Swiss National Bank SNB Chairman Thomas Jordan speaks to media during a news conference in Bern June 20, 2013.

Credit: Reuters/Ruben Sprich

ZURICH | Sat Sep 14, 2013 4:34am EDT

ZURICH (Reuters) - More still needs to be done to let global banks be wound down without harming the wider economy, Swiss National Bank Chairman Thomas Jordan said in a newspaper interview published on Saturday.

"The too-big-to-fail problem is not yet fully solved," Jordan told Finanz und Wirtschaft.

Authorities have been grappling since the collapse of U.S. investment bank Lehman Brothers five years ago with the question of how banks regarded as systemically important, or too-big-to-fail, can be recapitalized without causing panic or needing taxpayer cash.

After Switzerland's biggest bank UBS (UBSN.VX) had to be bailed out by the government in 2008, Swiss regulators have implemented tough new capital requirements for banks, which go beyond the rules stipulated by Basel III.

"If the winding down isn't possible then the buffers will have to be raised accordingly," said Jordan, adding there were several possibilities including contingent-convertible bonds.

In its yearly stability report published in June, the SNB urged UBS (UBSN.VX) and Credit Suisse (CSGN.VX) to further improve their leverage ratios. The Swiss financial market regulator requires a leverage ratio of 4.3 percent by 2019.

"What matters now is that banks implement the respective requirements consistently and rapidly," Jordan said. "Whether further measures will be necessary depends above all on whether the goal of an orderly winding down of major international banks is achieved."

Jordan said he did not think it would be better to separate investment banking from retail banks.

"As long as banks have sufficiently high equity capital and a structure that lets them be unwound at their disposal, they can choose their preferred business strategy themselves," he said.

(Reporting by Caroline Copley; Editing by Alison Williams)


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Summers cancels Citi events, while Fed chief decision pending

Senior White House economic adviser Lawrence Summers speaks during an interview with Reuters in Washington, June 24, 2010. REUTERS/Molly Riley

Senior White House economic adviser Lawrence Summers speaks during an interview with Reuters in Washington, June 24, 2010.

Credit: Reuters/Molly Riley

By P.J. Huffstutter

CHICAGO | Sat Sep 14, 2013 5:11pm EDT

CHICAGO (Reuters) - Former Treasury Secretary Lawrence Summers has pulled out of speaking engagements and other events involving Citigroup Inc while President Barack Obama considers whether to nominate the Harvard economist as the next chairman of the Federal Reserve, the bank said in a statement.

"Mr. Summers has withdrawn from participation in all Citi events while he is under consideration to be Chairman of the Federal Reserve," Danielle Romero-Apsilos, a spokeswoman for the third-biggest U.S. lender, said in a statement e-mailed to Reuters on Saturday.

Summers, a former economic adviser to Obama, has bowed out of a keynote address on global economic challenges at a Citigroup research seminar next month, according to a Bloomberg report.

While Summers is widely thought to be Obama's preferred choice to replace Fed Chairman Ben Bernanke when his term is up in January, an unusually vitriolic public debate has erupted over that possibility in recent months.

The White House said on Friday that the president had not yet made up his mind on who should lead the U.S. central bank - a decision that traditionally has generated little interest beyond Wall Street and academia.

But since Summers emerged as a lead contender for the job this summer, his history as a consultant to large financial institutions including Citigroup has fueled debate among critics and lawmakers about his suitability for the top Fed job.

Summers has been praised as a brilliant economist and a shrewd policymaker. But his work with financial firms has critics maintaining that his relationship with Wall Street is too cozy to maintain the Fed's vaunted independence.

The central bank plays a key role in guiding the world's largest economy and has taken on new oversight responsibilities following the worst U.S. financial crisis since the Great Depression.

Summers, who has also been paid to write a column for Reuters, was a key economic adviser to Obama in his 2008 campaign as well as during his first term. After heading the White House National Economic Council, he left the administration in 2010 to pursue a career in the private sector.

Some Democrats are not happy with Summers, who served as Treasury secretary under President Bill Clinton, because he backed banking deregulation in the 1990s, which they believe sowed the seeds for the 2007-2009 financial crisis.

The financial crisis led to a massive taxpayer bailout of Wall Street that continues to anger many ordinary Americans and could become another issue for Summers.

Four Democrats on the Senate Banking Committee are now expected to vote "No" if Obama nominates Summers as the next chair of the Federal Reserve, further complicating one of the most vital decisions of his second term.

Fed Vice Chair Janet Yellen is also a candidate for the job.

A letter urging her nomination has been signed by 20 Senate Democrats. If nominated and confirmed, Yellen would be the first-ever woman to lead the U.S. central bank.

(Reporting By P.J. Huffstutter in Chicago. Additional reporting by Alister Bull, Mark Felsenthal and Rachelle Younglai in Washington.)


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Wednesday, September 18, 2013

SEC denies rejecting settlement over money fund that 'broke the buck'

By Casey Sullivan and Nate Raymond

Sat Sep 14, 2013 5:31pm EDT

n">(Reuters) - The U.S. Securities and Exchange Commission denied Saturday that the commission had rejected a proposed settlement with managers of a large money market fund that "broke the buck" during the 2008 financial crisis, saying their negotiations never reached that point of consideration.

SEC lawyer Nancy Brown, in a brief court filing, said lawyers for defendants including Reserve Management Co. made a "misstatement" when claiming they had reached a settlement in principle with the regulator at the end of August, only to learn on September 5, that the SEC subsequently rejected it.

The claim that the SEC rejected a settlement with the money managers was made by John Dellaportas, a lawyer for the defendants. Dellaportas made the claim in a September 5 court filing and complained that the commission's "sudden refusal to settle" harmed fund shareholders with additional delays and costs.

"Today, much to our surprise, we were informed that, not only had the Commission rejected the proposed settlement agreement in principle that had been negotiated between defendants and the SEC staff, but it was also unwilling to settle with defendants on any other terms," he wrote, italicizing the last four words for effect.

The alleged breakdown was viewed as significant because it could derail a separate accord reached last week in which the founder of the fund, Bruce Bent Sr, and others agreed to settle a class-action lawsuit by the fund's investors.

Brown, the lawyer for the SEC, countered on Saturday.

"Contrary to their contention that a settlement had been considered and rejected by the Commission, the parties' negotiations never reached the point at which a proposal was submitted to the Commission for its consideration," said Brown in the filing.

Later on Saturday, Dellaportas filed a court letter in response to Brown and detailed the settlement discussions between the SEC and defendants along with his colleague Robert Romano.

"On September 5, the staff called Mr. Romano and advised him that "the Commission" would not be settling on the terms to which we had previously agreed, nor would it settle on any other terms," Dellaportas said in the filing.

A spokeswoman with the SEC did not respond to a request for comment. Brown did not respond either.

The case stems from events on September 16, 2008, when the net asset value of the $62 billion Reserve Primary Fund fell below the $1 per share it was designed to maintain.

Reserve Primary had held $785 million of debt from Lehman Brothers Holdings Inc, which went bankrupt the day before, and worries about the Lehman stake had spurred a flood of redemption requests that the fund could not meet.

Last November, a federal jury in New York cleared Bent and his son Bruce Bent II of civil fraud charges relating to the collapse, while finding the son liable for negligence.

The jury also found two corporate entities, Reserve Management and Resrv Partners Inc, liable on one count of securities fraud, and Reserve Management for violating a federal law governing investment advisers.

The SEC and the Reserve defendants had negotiated over issues left over from the trial, according to court filings.

The cases are SEC v. Reserve Management Co, U.S. District Court, Southern District of New York, No. 09-04346; and In re: The Reserve Primary Fund Securities & Derivative Class Action Litigation in the same court, No. 08-08060.

(Reporting By Casey Sullivan and Nate Raymond)


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Rosneft CEO says plans energy projects in Belarus: reports

Rosneft President and Chairman of the Management Board Igor Sechin smiles before a signing ceremony after talks with the Chinese delegation at the Kremlin in Moscow March 22, 2013. REUTERS/Sergei Karpukhin

Rosneft President and Chairman of the Management Board Igor Sechin smiles before a signing ceremony after talks with the Chinese delegation at the Kremlin in Moscow March 22, 2013.

Credit: Reuters/Sergei Karpukhin

MOSCOW | Sat Sep 14, 2013 11:25am EDT

MOSCOW (Reuters) - Igor Sechin, the head of oil giant Rosneft (ROSN.MM), says it is planning energy projects in Belarus, Russian media reported on Saturday, a sign the close Kremlin ally will not let a potash dispute undermine the Russian state firm's business in Belarus.

The collapse of a potash trading agreement in July triggered a diplomatic spat between Russia and its ex-Soviet ally, including Belarus's arrest of the head of Russian fertilizer firm Uralkali (URKA.MM).

The arrest put a new strain on the close but sometimes tense relationship between Russia and Belarus, which relies on Moscow for energy supplies and financial help but is important to the Kremlin as a military and economic ally.

However, Sechin, who is a close confidant of Russian President Vladimir Putin, appears committed to maintaining strong business ties with Belarus, a lucrative market for Russian energy firms due to an export tax waiver.

"Of course we have plans (in Belarus) - there is talk of oil projects and of oil and gas projects," RIA Novosti news agency quoted Sechin as saying.

The potash disagreement will not impact Rosneft's Belarussian plans, Sechin added, according to RIA. "It doesn't affect us... we have stable, normal partners."

Reports that Uralkali's top shareholder Suleiman Kerimov, whom Belarus has accused of abuse of power, is selling his stake are likely to have been welcomed by Belarus, with one commentator suggesting a deal would secure the release of the firm's chief executive from prison.

Sechin's comments follow a meeting on Wednesday between him and authoritarian Belarussian President Alexander Lukashenko in Minsk and the news that Russia's oil pipeline monopoly Transneft would cut supplies less than previously planned, despite the need for repairs.

RIA reported on Saturday that Sechin said Rosneft, which accounts for around half of Russian oil flows to Belarus, was not planning on cutting its oil supplies to the country, although exports were hampered by infrastructure constraints.

State-controlled Rosneft will produce more oil in 2014 than the 206 million metric tons it forecasts it will pump this year, Sechin added.

Belarus arrested Uralkali's CEO, Vladislav Baumgertner, on August 26, charging him with abuse of office.

(Reporting by Alessandra Prentice; editing by James Jukwey)


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Drummond says Colombia mines, port to reopen after government ends strike

BOGOTA | Sat Sep 14, 2013 9:43pm EDT

BOGOTA (Reuters) - The Colombian operations of U.S.-based coal miner Drummond DRMND.UL will reopen on Saturday evening, the company said, after the government intervened to end more than seven weeks of strike action that shut down its two mines and port.

The stoppage halted about one-third of production by the world's No. 4 coal exporter and was the second major strike in Colombia's coal sector this year, cutting royalty revenues for the government and crimping economic growth.

"We should be returning to normality of work from the night shift of today, September 14th," the company said in a statement, listing the different groups of workers that would cover various shifts in the coming days.

On Friday, Colombia's Labor Ministry said it was sending the case to an arbitration tribunal after the majority of the company's 5,000 direct, non-contract employees voted to resolve the dispute that way.

No one at the Sintramienergetica union, which organized the strike, answered calls to confirm members were returning to their jobs. On Friday night, a union negotiator, Cesar Flores, said no official notification had been received from the government that it was ending the strike.

The strike added to disruption in an already turbulent year for Colombia's coal sector, with a month-long strike at its biggest miner, Cerrejon, in February and logistics problems that had affected rail transport and the loading of ships.

The Drummond stoppage has had little impact on coal prices however, with the global market well-supplied, a factor that has weighed on prices for most of this year. Coal for delivery to Europe (ARA) traded at $78 a ton on Friday.

Drummond exported 26 million tons of coal in 2012, about one-third of the national total. It had been expected to produce 32 million tons out of some 94 million tons of forecast national output in 2013, which would earn the nation about 900 billion pesos ($480 million) in royalties, the government has said, up from 700 billion pesos last year.

Those targets are likely to be jeopardized after two prolonged stoppages in a sector that accounts for about 2.4 percent of the Andean nation's gross domestic product.

The strike immediately shut down Drummond's exports since it included workers at its privately operated port as well as laborers at its two mines, Pribbenow and El Descanso, in the north of the country.

Workers represented by the Sintramienergetica union are demanding a pay increase above the 5 percent Drummond has offered, a fixed monthly salary instead of hourly pay and new jobs for 400 port workers who are to be made redundant next January with the introduction of direct conveyor-belt loading of ships.

In a proposed three-year pay deal posted on its website, Drummond said it was also offering workers a one-time 8.5 million peso ($4,400) bonus on signing the agreement.

(Reporting by Peter Murphy; Editing by Peter Cooney)


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Maternal PTSD linked to children's trauma

By Kathleen Raven
NEW YORK | Thu Sep 12, 2013 11:36am EDT
NEW YORK (Reuters Health) - The children of mothers with posttraumatic stress disorder (PTSD) may be at high risk of being traumatized themselves, according to a small new study in urban U.S. neighborhoods.
Inner-city kids whose mothers had PTSD experienced more traumatic events - such as neighborhood shootings, domestic violence, dog bites or car accidents - before age five than kids whose mothers were depressed or had no mental health issues, researchers found.
Mothers with a combination of PTSD and depression were also more likely to report psychologically or physically abusing their child, compared to mothers with just one of those disorders.
"The main take-home message is that when parents are suffering, their children suffer, too," said Dr. Howard Dubowitz, professor of pediatrics at University of Maryland School of Medicine in Baltimore.
"Those of us who are involved in helping to take care of kids can't ignore what problems mothers and fathers may be struggling with," added Dubowitz, who was not involved in the study.
Children exposed to trauma are themselves at greater risk of a mix of health challenges later on in life, such as obesity, drug and alcohol addictions, heart disease, suicide and mental health disorders, experts said.

Analysis: Nigeria's property boom: only for the brave

A warning sign is seen on the boundary wall of a house in the Ikoyi district in Nigeria's commercial capital Lagos August 20, 2013. REUTERS/Akintunde Akinleye

1 of 4. A warning sign is seen on the boundary wall of a house in the Ikoyi district in Nigeria's commercial capital Lagos August 20, 2013.

Credit: Reuters/Akintunde Akinleye

By Joe Brock

ABUJA | Sun Sep 15, 2013 4:24am EDT

ABUJA (Reuters) - On one of the most exclusive streets in Nigeria's capital sits a crumbling mansion with an unwelcoming message painted at its entrance: "BEWARE! THIS HOUSE IS NOT FOR SALE".

The warning refers to a popular property scam. In the most elaborate version, robbers break into your house while you are away, change the locks, and then produce multiple copies of fake title deeds. Posing as estate agents, they show buyers around your house and sell as many copies of the deeds as possible. When you get back, your house belongs to six people.

This sort of deception epitomizes the tricky nature of Nigeria's real estate business, but despite the risks, there are huge returns to be had in a market where around 16 million homes are needed just to meet current demand.

Navigating through opaque land laws, corruption, a lack of development expertise and financing, a dearth of mortgages and high building costs will take courage and influential local partners.

"There are sizeable challenges to overcome but in many ways Nigeria represents the perfect storm for real estate investment; huge population, rapid urbanization and a growing middle-class," said Michael Chu'di Ejekam, Director of Nigerian Real Estate at Actis, a London-based private equity firm.

Actis has $5.2 billion under management, including two sub-Saharan Africa real estate equity funds totaling $434 million, which it says are attracting U.S. and European investors.

Nigeria's population of nearly 170 million is bigger than Russia's and its economy is growing at 6 percent, a combination which is producing a new wave of property buyers from bankers and airline staff to mobile phone and fast food shop owners.

"I see demand from the middle-class higher than ever before," said Deolu Dara, Associate Vice President at Nigeria-based Avante Property Asset Management, which manages several multi-million dollar residential projects in Lagos.

A successful real estate investment in Nigeria can earn an returns as high as 30-35 percent, while rental income yields in cities such as Lagos and Abuja can easily reach 10 percent, developers and estate agents say.

MIDDLE CLASS

Property in Lagos, a heaving metropolis of around 20 million people, can be among the most expensive in the world with two-bedroom flats costing more than $1 million in upmarket areas.

However, the top-end range is dominated by well established players and developers should target middle-income workers in major cities, such Lagos, Abuja and the oil-hub Port Harcourt. The most popular units fall in a price bracket of 20-35 million naira ($123,000-$214,100), developers and estate agents say.

Nigeria's middle class make up around 23 percent of the population and earn around 80,000- 100,000 naira ($490-$610) per month, according to report by investment bank Renaissance Capital.

In smaller cities and rural areas, a lack of information about land and regulation is off-putting, while a violent Islamist insurgency has made the north of Nigeria unattractive, despite huge unmet demand in cities such as Kano and Kaduna.

The majority of Nigerians live in poverty in shanty towns or in basic concrete block and iron-roofed houses they have built themselves, but building mass housing for the poor is not a popular investment.

"If you know the market, the people, focus on middle class and cherry pick your deals, you can clean out," added Dara, who said Africa's biggest oil and gas industry is also driving demand. One foreign oil major bought 300 flats recently.

Nigeria's construction and real estate sectors are growing at more than 10 and 12 percent respectively, a boon for foreign and Nigerian construction firms, including UPDC, Cappa D'Alberto and Julius Berger.

Yet, there is still not enough quality affordable housing because business is frustrated by widespread corruption, poor state infrastructure and a lack of expertise and financing.

Constructing a block of flats costs three times as much in Nigeria than in South Africa, builders say, and many developments are abandoned when projects run out of money or become slums because they are poorly built.

London-based estate agent Jones Lang LaSalle ranks Nigeria 96th out of 97 on its transparency index, just in front of Sudan but behind six other African countries.

Having support from powerful politicians or business magnates will help to avoid terminal financial pitfalls.

LOCAL PARTNERS

"It's a business that requires local partners and local knowledge or you'll run into problems," Dara at Avante says.

Avante's chairman is Wale Tinubu, the head of oil and gas firm Oando and a close relative of former Lagos state governor Bola Tinubu, who still wields influence there.

London-based Actis has given directorships to Nigerian energy firm Seven Energy and local conglomerate UAC.

Once the supply challenges have been overcome, there remains a problem with that huge latent demand. No mortgages. Unless you are willing to pay a 25 percent interest rate.

The mortgage debt-to-GDP ratio in Nigeria is under 0.5 percent, compared with 72 percent in the U.S. and over 30 percent in Malaysia and South Africa, government figures show.

"In places like America you seem to be able to buy property without a stress but it just isn't like that here," said Ike Ejekam, 31, who is about to buy a newly-built two-bedroom apartment for 20 million naira in a gated community in the popular Lekki district on the Lagos peninsula.

Ejekam represents the new breed of buyers who expect well-built housing with all the modern conveniences. He works at a branch of a local bank and is using his life savings and funds borrowed from family members to buy his property outright.

"I don't like to think about mortgages because it scares me when I see how difficult it is for my friends to get a loan."

Nigerian banks don't like giving out mortgages because reliable information about buyers and land is scarce, while there is no secondary market to offset the risks.

MORTGAGE DENIED

The government says it is trying to fix this by securing a $300 million loan from the World Bank to establish a mortgage refinancing company, which should free up some bank lending.

A Federal Mortgage Bank was also launched this year, which government hopes will help build 500,000 new homes. The bank plans to float a 200 billion naira mortgage bond, the proceeds from which can be handed over to home buyers with the state guaranteeing against default for five years.

The government is also discussing passing legislation to create a secondary mortgage market and to improve land laws.

"With this sense of urgency we could have a significant improvement in the mortgage market by 2015," United Bank for Africa CEO Phillips Oduoza told Reuters.

This optimism is also being felt by developers as dozens of well-financed projects are underway, including the Eko Atlantic City - a multi-billion dollar project built from 9 square kilometers of land being reclaimed from the sea in Lagos.

The billionaire Chagoury brothers, who are of Lebanese descent, are leading the mega-project, which will feature parks, swimming pools and skyscrapers with floor-to-ceiling glass. Banks, including France's BNP Paribas, Belgium's KBC and several Nigerian lenders are on board.

In Abuja, UPDC has started its 228-unit 'Metro City', which consists of well-designed blocks with balconies built in palm-fringed private compounds. Privately owned Churchgate Group is building its ambitious $1 billion World Trade Centre, a series of skyscrapers housing offices, flats and upscale shops.

"Nigeria is a huge real estate opportunity," said Ejekam at Actis. "The story is getting out, slowly."

($1 = 162.9 Nigerian naira)

(Writing by Joe Brock; Editing by Giles Elgood)


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Huge tobacco use in India seen killing 1.5 million a year

A daily wage labourer smokes as he waits for an employer in the old quarters of Delhi, April 29, 2010. REUTERS/Adnan Abidi

A daily wage labourer smokes as he waits for an employer in the old quarters of Delhi, April 29, 2010.

Credit: Reuters/Adnan Abidi

By Kate Kelland

LONDON | Thu Sep 12, 2013 4:28am EDT

LONDON (Reuters) - Tobacco inflicts huge damage on the health of India's people and could be clocking up a death toll of 1.5 million a year by 2020 if more users are not persuaded to kick the habit, an international report said on Thursday.

Despite having signed up to a global treaty on tobacco control and having numerous anti-tobacco and smoke-free laws, India is failing to implement them effectively, leaving its people vulnerable to addiction and ill health, according to the report by the International Tobacco Control Project (ITCP).

"Compared with many countries around the world, India has been proactive in introducing tobacco control legislation since 2003," said Geoffrey Fong, a professor of psychology at Canada's University of Waterloo and a co-author of the report.

"However ... the legislation currently in place is not delivering the desired results - in terms of dissuading tobacco use and encouraging quitting."

As a result, India, with a population of 1.2 billion, currently has around 275 million tobacco users, the report said.

Harm from tobacco accounts for nearly half of all cancers among males and a quarter of all cancers among females there, as well as being a major cause of heart and lung diseases.

"The tobacco epidemic in India requires urgent attention," the report said, adding that by 2020, tobacco consumption will account for more than 1.5 million Indian deaths a year.

Worldwide, the number of deaths caused by tobacco is expected to rise from around 6 million a year now to more than 8 million by 2030, according to the World Health Organisation.

The ITCP India Survey conducted face to face interviews with 8,000 tobacco users and 2,400 non-users across four Indian states - Bihar, Madhya Pradesh, Maharashtra and West Bengal.

So-called smokeless tobacco - including chewing products such as gutkha, zarda, paan masal and khaini - is the most common form of tobacco use in India, with many poorer people and women preferring these over smoking cigarettes or bindis - small, cheap, locally-made cigarettes.

According to the Global Adult Tobacco Survey, 26 percent of adults in India consume smokeless tobacco - 33 percent of men and 18.4 percent of women. Smokeless tobacco can cause oral and other cancers, as well as other mouth diseases and heart disease.

Among several striking findings in the ITCP report was that, while many smokers and tobacco users said they knew of the health risks, only a small proportion said they would like to quit.

Up to 94 percent of smokers and up to the same proportion of smokeless users in the survey said they had no plans to give up.

Set against this, the report also found that up to 81 percent of smokers and up to 87 percent of smokeless tobacco users expressed regret for taking up the habit, and more than 90 percent of tobacco users and non-users in all four states had negative views on smoking and tobacco.

The report said that, while India has been a regional leader in enacting tobacco control legislation over the past 10 years, the laws are poorly enforced, regulations covering smoke-free zones are patchy, and tobacco remains relatively cheap.

Fong said the low percentage of people wanting to quit meant deaths from tobacco use were destined to stay high.

"If there is any single indicator of the urgent need for continued and strengthened efforts for strong, evidence-based tobacco control in India - this is it."


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Entergy to resubmit stalled ITC Holdings grid sale plan in Texas

By Eileen O'Grady

HOUSTON | Fri Sep 13, 2013 8:02pm EDT

HOUSTON (Reuters) - Entergy Corp (ETR.N) will soon resubmit a plan to transfer its electric transmission assets to ITC Holdings (ITC.N) to Texas regulators for a second look, company officials said Friday.

Last month, the $1.78 billion proposal faced certain rejection by the Texas Public Utility Commission and was withdrawn by Entergy Texas and ITC officials.

Since then, other state regulators that also must approve the plan moved to delay consideration, fueling speculation that the deal might not be completed.

"We will soon re-file our application in Texas for the ITC transaction, and we'll request expedited treatment," Entergy spokesman Mike Burns said in a statement.

The transaction is a spin-off and merger of Entergy's 15,400-mile transmission network serving parts of Arkansas, Louisiana, Mississippi and Texas. It has been approved by federal regulators and ITC shareholders.

But state regulators, who would give up authority to set ITC transmission rates after the transfer, questioned whether ITC ownership would provide sufficient benefits to consumers to outweigh the cost.

Entergy and ITC have responded by offering a total of $453 million to lower consumer rates over five years to Entergy customers to offset ITC's higher rate of return.

"After re-filing in Texas, we'll get procedures restarted in Arkansas, Louisiana and New Orleans. In Mississippi, we'll respond to proposed conditions later this month," Burns said.

In a note to clients on Thursday, Morgan Stanley analysts cited "mounting regulatory headwinds" and said several conditions set out by Ken Anderson, one of three commissioners of Texas Public Utility Commission (PUC), made the completion of the deal "unlikely."

"We believe the transaction will not close due to several key conditions of Commissioner Anderson's that are in our view likely to be non-starters for (Entergy) and ITC," the note said.

Those conditions included a requirement that ITC seek PUC approval before upgrading or replacing Entergy Texas facilities for which it wanted to recover its costs. Other conditions were that ITC not seek higher rates for existing Texas transmission assets for five years and not seek higher "incentive" rates for new facilities in Texas without PUC approval for 10 years.

David Cruthirds, a Houston-based attorney who tracks utility regulation, said Anderson's conditions may require Entergy and ITC to rethink the transaction.

"My guess has been that they are working to address those issues, but to do that I think they (Entergy and ITC) are going to have to redo the whole transaction and the timing," said Cruthirds. "That's a significant amount of work. And there's no guarantee they will be successful."

As a prerequisite to the ITC deal, Entergy has joined the Midcontinent Independent System Operator, or MISO, an independent regional transmission organization, or RTO, where ITC operates.

"We remain convinced that independent transmission—and ITC ownership—produces the greatest benefit for our customers, our employees and our communities," Entergy's Burns said.

The Department of Justice which launched a broad civil investigation of Entergy's competitive practices in 2010 is also watching the Entergy-ITC transaction.

RTO membership and divestiture of Entergy's grid network are necessary to resolve the investigation, according to the agency.

(Editing by Leslie Adler and Diane Craft)


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Exercise may help alleviate depression: review

Clients work out on machines at the Bally Total Fitness facility in Arvada, Colorado June 15, 2009. REUTERS/Rick Wilking

Clients work out on machines at the Bally Total Fitness facility in Arvada, Colorado June 15, 2009.

Credit: Reuters/Rick Wilking

By Andrew M. Seaman

NEW YORK | Thu Sep 12, 2013 3:37pm EDT

NEW YORK (Reuters Health) - Exercise may help ease symptoms of depression, according to a fresh look at past research.

Researchers who analyzed data from previous studies found people who exercised experienced a "moderate" reduction in their depressive symptoms compared to those who did other activities, such as using relaxation techniques, or received no treatment.

"This review provides some additional evidence that there may be some benefit (to exercise)," Dr. Gillian Mead, the study's senior author from the University of Edinburgh in Scotland, told Reuters Health.

A 2009 review from the Cochrane Collaboration, an international organization that evaluates medical research, found similar results, but more studies looking at the link between exercise and depression have since been published.

"We'd become aware of some new trials in the area and - in general - the Cochrane review should be kept updated if there is new evidence that may lead to changes," Mead said.

About one in ten Americans reports being depressed, according to the U.S. Centers for Disease Control and Prevention. The most popular treatments for depression include antidepressant medications and psychotherapy.

Mead and her fellow researchers write in The Cochrane Library, however, that many people prefer alternative treatments, and some doctors recommend exercise as a potential option.

For the new review, they searched databases for all medical trials conducted through March 2013 that compared exercise among adults with depression to other activities or no treatment.

Overall, the researchers were able to combine data from 35 trials that included 711 people who were randomly assigned to an exercise program and 642 who were randomized to comparison groups.

Because the studies used various scales to assess depression, they converted the results into a single measurement to compare people in exercise and non-exercise groups. Using that measurement, a difference between groups of 0.2 represents a small effect, 0.5 a moderate effect and 0.8 a large effect.

Mead's team found a 0.62-point difference in depressive symptoms favoring people who exercised.

In one of the included trials from 2007, for instance, researchers found 45 percent of people who took part in supervised exercise no longer met the criteria for depression after four months, compared to 31 percent taking an inert placebo pill.

In another trial from 2002, 55 percent of older people experienced a significant decline in depression symptoms after 10 weeks of exercise, compared to 33 percent who attended informational talks during that time.

The difference between groups, however, was greatly diminished when the review authors only analyzed data from the six trials that were considered high quality.

Still, exercise appeared to reduce depressive symptoms as much as psychotherapy or antidepressant medications. But Mead cautioned that those findings are only based on data from a small number of trials.

"One has to be careful saying it was as effective as other therapies," she said.

She added that it's still unknown how exercise affects depression.

"There are lots of ideas about potential mechanisms, but I don't think there is enough evidence in the literature that one mechanism applies more than another," Mead said.

The researchers were also unable to say which type of exercise is best, but Mead said previous reviews have recommended people choose an activity that they'll stick with over the long run.

"Once people are prescribed exercise or they choose exercise, the big challenge is to make the exercise real," Dr. Madhukar Trivedi, who has studied the effect of exercise on depression but wasn't involved with the new research, told Reuters Health.

"If the recommendation from the treating clinician is that you should be exercising with some frequency and intensity… it's important that the patient follow that regimen week after week," Trivedi, a professor of psychiatry at the UT Southwestern Medical Center in Dallas, said.

Michel Lucas, who was also not involved with the new review but has studied the topic before, said studies tend to show a dose-response relationship between exercise and depression.

"The dose is very important. If you're walking at a very slow pace, this has no effect," Lucas, a visiting scientist at the Harvard School of Public Health in Boston, told Reuters Health.

SOURCE: bit.ly/15Zz1nD The Cochrane Library, online September 11, 2013.


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Peers bid for fittings maker Grohe, IPO still possible: sources

FRANKFURT | Sat Sep 14, 2013 4:11am EDT

FRANKFURT (Reuters) - Three peers of Europe's biggest bathroom equipment maker, Grohe GROH.UL, submitted final offers for the private-equity owned company by a Friday midnight deadline, three sources familiar with the deal told Reuters.

Grohe's owners, TPG Capital TPG.UL and the private equity arm of Credit Suisse (CSGN.VX) are selling the group in a so-called dual track process, which includes the option of floating it on the stock exchange.

They may launch the initial public offering within the next couple of weeks, while continuing to talk to possible buyers to retain competitive tension in the sales process and reap the highest possible price, two of the sources said.

A potential stock market listing would likely take place by mid-November, they said.

The sellers had originally been hoping for a valuation up to 4 billion euros ($5 billion) in equity and debt. That would have been in line with the valuation of Swiss peer Geberit (GEBN.VX), which trades at 14 times earnings before interest, taxes, depreciation and amortization.

However, Geberit, Japan's Lixil (5938.T) and Brazil's Duratex (DTEX3.SA) have made final bids valuing the German company at no more than roughly 3 billion euros, two of the sources said.

They added that the bids came in below the 3.2-3.5 billion euros that of one of IPO organizers has signaled the group could be valued at in a flotation.

U.S.-based Fortune Brands (FBHS.N) has dropped out of the auction, while two private equity groups have also submitted final offers, one of the sources said on Saturday.

TPG and Credit Suisse bought Grohe for 1.5 billion euros in 2004 from BC Partners, a transaction that sparked criticism of private equity investors in Germany.

The sale of Grohe could be one of the largest European private equity sales this year along with BC Partners' BCPRT.UL acquisition of German publisher Springer Science SPSBM.UL and CVC's CVC.UL purchase of German energy-metering firm Ista CHCAPI.UL.

Grohe, its owners and their advisers - Credit Suisse and Goldman Sachs - as well as Geberit, Lixil and Duratex declined to comment. Fortune was not available for comment.

Analysts say that buying Grohe could be a stretch for some of the company's smaller peers: Duratex has a market capitalization of $3.5 billion and Lixil's is $6.6 billion.

In the first half of 2013, Grohe increased its adjusted Ebitda by six percent to 141 million euros, while sales rose 5 percent to 730 million euros.

(Reporting by Arno Schuetze; Editing by Ron Popeski)


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Tuesday, September 17, 2013

KKR mulls teaming with Japan state fund on Panasonic unit stake: media

Panasonic Corp's President, Kazuhiro Tsuga (R), speaks during a news conference at the company's office in Tokyo March 28, 2013. REUTERS/Yuya Shino
Panasonic Corp's President, Kazuhiro Tsuga (R), speaks during a news conference at the company's office in Tokyo March 28, 2013.
Credit: Reuters/Yuya ShinoBy Junko Fujita and Taiga Uranaka
TOKYO | Fri Sep 13, 2013 3:48am EDT
TOKYO (Reuters) - KKR & Co LP is considering teaming up with a state-backed Japanese investment fund to secure a stake in Panasonic Corp's healthcare business, media reported, although people familiar with the matter said the U.S. firm has not approached the fund yet.
A purchase, which could be worth $1.5 billion, would mark the private-equity firm's largest investment in a Japanese company. Last year KKR sought a controlling stake in chipmaker Renesas Electronics Corp but lost out to a group led by the state-backed Innovation Network Corp of Japan.
In its bid this time for the Panasonic unit, Bloomberg and the Wall Street Journal reported, KKR is seeing to assuage local misgivings about foreign buyout firms by considering investing with the government-private fund.
But people familiar with the process said the U.S. firm has not approached the Japanese fund. Two people said teaming up with INCJ is one of various options KKR could pursue.
The people said KKR, which recently raised a $6 billion Asia fund, had enough cash to make the purchase alone.
KKR and INCJ declined to comment.
Sources familiar with the matter told Reuters last week that KKR was set to gain preferential negotiating rights for the majority stake in Panasonic Healthcare Co, which makes blood-sugar monitoring equipment and electronic medical record-keeping systems.
KKR and other foreign buyout firms have struggled to secure deals in Japan amid suspicion they will strip assets and lay off workers to gain the biggest possible return on their investments.
Panasonic, which has lost $15 billion over the past two years, is offloading a majority stake in the profitable healthcare unit as it pulls back from outlying businesses and loss-making consumer electronics to focus on automotive components, appliances, industrial machinery and other fields where it is a leading manufacturer.
In the financial year ended in March, Panasonic Healthcare made 8.7 billion yen in operating income on 134.3 billion yen in sales, giving it an operating profit margin of 6.5 percent.
(Additional reporting by Emi Emoto, Stephan Aldred, Chikafumi Hodo, Reiji Murai and Tim Kelly; Writing by William Mallard; Editing by Chris Gallagher)

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Suzuki recalls 193,936 SUVs, SX4s over air bags

WASHINGTON | Sat Sep 14, 2013 8:27pm EDT

WASHINGTON (Reuters) - Japan's Suzuki Motor Co is recalling 193,936 Grand Vitara SUVs and SX4s cars because of a defective air bag sensor mat in the front passenger seat, U.S. officials said.

The recall covers Grand Vitaras from the 2006 through 2011 model years and the 2007 through 2011 SX4 small cars, according to a National Highway Traffic Safety Administration letter acknowledging the recall.

Sensor mats measure passengers' weight and determine if the air bag should deploy. Children can be hurt if the sensor cannot determine who is sitting in the seat.

The letter said the sensor mat installed in the front passenger seat may fail because of repeated flexing. During a crash, the air bag will deploy regardless of whether the person is an adult or a child.

There have been no reports of accidents or injuries. Suzuki will notify owners starting in October and dealers will replace mats for free, the letter said.

(Reporting by Ian Simpson; Editing by Dan Whitcomb and Philip Barbara)


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Chinese authorities probing German drugmaker Bayer

The logo of Germany's largest drugmaker Bayer HealthCare Pharmaceuticals is pictured on the front of its building in Berlin April 28, 2011. REUTERS/Fabrizio Bensch

The logo of Germany's largest drugmaker Bayer HealthCare Pharmaceuticals is pictured on the front of its building in Berlin April 28, 2011.

Credit: Reuters/Fabrizio Bensch

SHANGHAI | Fri Sep 13, 2013 3:55am EDT

SHANGHAI (Reuters) - Chinese authorities visited a local office of German drugmaker Bayer AG in late August to investigate a potential case of unfair competition, the company said on Friday.

China's regulators have been probing numerous international and Chinese drugs firms, with investigations into the pharmaceutical sector spanning alleged corruption to how drugs are priced.

Bayer said it was working with Chinese authorities, led by a local branch of China's State Administration for Industry and Commerce (SAIC), but did not expand on the status of the probe.

"We are taking the investigation seriously and are fully cooperating with the authority," Bayer said in an emailed statement to Reuters.

SAIC is one of China's three anti-trust regulators. It handles non-price related anti-competition issues and commercial bribery.

The most high-profile investigation into corruption in the pharmaceutical sector in China involves British drugmaker GlaxoSmithKline.

Police have detained four Chinese executives from GSK over allegations it funneled up to 3 billion yuan ($490.36 million) to travel agencies to facilitate bribes to doctors to boost the sale of its medicines. GSK has said some of its senior Chinese executives appear to have broken the law.

Bayer employs around 11,000 people in Greater China and gets a quarter of its global revenue from the Asia-Pacific region.

"In case of allegations or non-observance of the Bayer Corporate Compliance Policy by employees, Bayer will investigate them thoroughly and take full responsibility for appropriate measures," the Bayer statement said.

Corruption in China's pharmaceutical industry is widespread, fueled in part by low base salaries for doctors at the country's 13,500 public hospitals.

Bayer was down 0.1 percent in Frankfurt at 0720 GMT (2:20 EDT), roughly in line with the broader index.

(Reporting by Adam Jourdan; Editing by Kazunori Takada and Dean Yates)


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Four men in court over alleged UK Santander cyber raid

Customers use ATM machines at the Surrey Quays branch of Santander Bank, whilst the premises remain closed , in Surrey Quays, south London, September 13, 2013. REUTERS/Toby Melville

Customers use ATM machines at the Surrey Quays branch of Santander Bank, whilst the premises remain closed , in Surrey Quays, south London, September 13, 2013.

Credit: Reuters/Toby Melville

LONDON | Sat Sep 14, 2013 1:25pm EDT

LONDON (Reuters) - Four men appeared in a British court on Saturday over an alleged attempt to steal millions of pounds from Santander by hacking into the bank's computer system, police said.

Twelve men were arrested on Friday, following an operation by the Metropolitan Police's Central e-Crime Unit, over the alleged plot which centered on a Santander branch in southeast London.

Four were charged late on Friday and appeared on Saturday at Westminster Magistrates' Court for an initial hearing. They were named as 25-year-old Lanre Mullins-Abudu, 34-year-old Dean Outram, Akash Vaghela, 27, and Asad Ali Qureshi, 35.

Eight others have been released on police bail pending further enquiries.

(Reporting by Kate Holton; Editing by Louise Ireland and Janet Lawrence)


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Sanofi, Zealand hit by U.S. setback for diabetes drug

An employee walks into an office of French drugmaker Sanofi in Shanghai August 2, 2013. REUTERS/Aly Song

An employee walks into an office of French drugmaker Sanofi in Shanghai August 2, 2013.

Credit: Reuters/Aly Song

By Natalie Huet and Lionel Laurent

PARIS | Thu Sep 12, 2013 9:17am EDT

PARIS (Reuters) - French drugmaker Sanofi withdrew its U.S. application for diabetes treatment lixisenatide on Thursday, delaying the drug's launch in the world's biggest pharmaceutical market.

The decision sent shares in Sanofi down around 2 percent by 1300 GMT, while Zealand Pharma, its smaller Danish partner on the drug, dropped 16 percent.

Sanofi said it would resubmit its application to the U.S. Food and Drug Administration in 2015, after completion an ongoing cardiovascular patient study, and said the withdrawal was "not related to safety issues or deficiencies in the new drug application."

Sanofi argued that revealing interim data from the cardiovascular trial to the FDA before it was completed could potentially influence patients and doctors' response and affect the integrity of the study, and that it was therefore wiser to wait for its full results to submit a new drug application.

Lixisenatide is part of a new class of diabetes treatments called GLP-1 analogues that prompt the body to release insulin when a diabetic's blood sugar level climbs too high.

It has already been approved for sale in Europe under the brand name Lyxumia and is one of the new products Sanofi is betting on to restore growth after losing several blockbusters to generic competition.

Sanofi is the world's fourth-largest pharmaceutical company by prescription drug sales and the second-biggest player in the $43 billion diabetes market.

Lyxumia competes with other GLP-1 drugs as Victoza, from Novo Nordisk, and Byetta and Bydureon, from Bristol-Myers Squibb and AstraZeneca.

Sanofi said it expected to have the full results of its evaluation of lixisenatide in acute coronary syndrome, which is focused on patients with high cardiovascular risk, in about 15 months. Market analysts had expected the FDA to rule on lixisenatide by the end of the year.

"MINOR NEGATIVE"

"The net effect is that U.S. filing will be delayed to 2015, resulting in a 2-3 year delay to launch (likely to 2016), assuming nothing untoward emerges in the long-term cardiovascular outcome trial," Deutsche Bank analysts wrote in a note.

They had estimated the drug to bring 300 million euros ($399 million) of sales in the United States in 2016, and said they would now have to push back this forecast by a couple of years.

"We view this news as only a minor negative," they noted however, highlighting that Sanofi was sticking to its development plans for a combination of lixisenatide with its existing insulin drug Lantus that could reap higher sales.

The combination, a pen-shaped device known as LixiLan, remains on schedule to enter into final Phase III clinical testing in the first half of 2014, Sanofi said.

Sanofi has previously said that combining Lyxumia with Lantus insulin could help diabetics control blood sugar levels better than each therapy used alone.

After Sanofi's announcement on Thursday, analysts at Swiss-based broker Helvea revised their forecast for U.S. sales of lixisenatide in 2022 to 490 million euros from 830 million, and global sales to 1 billion euros from 1.5 billion.

They said they expected rival Novo Nordisk's Victoza drug to benefit from Sanofi's move.

Drugmakers are competing fiercely in the type 2 diabetes market as the number of people with the disease, which is linked to obesity, continues to grow rapidly - including in emerging markets where middle classes are switching to a Western diet.

An estimated 371 million people worldwide are living with diabetes, with China now topping the list, according to the International Diabetes Federation. It predicts as many as 552 million may have the disease by 2030.

(Editing by Jane Merriman and Ben Hirschler)


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Exclusive: BlackBerry bidders may want to carve up business - sources

A Blackberry smartphone is displayed in this August 12, 2010 illustrative photo taken in Hong Kong. REUTERS/Bobby Yip

A Blackberry smartphone is displayed in this August 12, 2010 illustrative photo taken in Hong Kong.

Credit: Reuters/Bobby Yip

By Nadia Damouni and Nicola Leske

NEW YORK | Fri Sep 13, 2013 7:57pm EDT

NEW YORK (Reuters) - A handful of potential bidders, including private equity firms, are lining up to look at BlackBerry Ltd, but initial indications suggest that interest is tepid and buyers are eyeing parts of the Canadian smartphone maker rather than the whole company, several sources familiar with the situation said.

Private equity firms are mostly interested in businesses such as BlackBerry's operating system and the patents around its keyboard, two of the sources said. However, one possibility is for a Canadian pension fund to team up with an investor to buy the whole company, which is currently worth a little more than $5 billion, one of the sources said.

BlackBerry's biggest shareholder, Fairfax Financial Holdings Ltd, has approached several large Canadian investment funds about forging a deal to take the smartphone maker private, Reuters reported last week.

Fairfax has a 10 percent stake, and its chairman and chief executive, Prem Watsa, has left BlackBerry's board already to avoid any possible conflict of interest as the company assesses its strategic options.

Nevertheless, in recent days a few private equity firms have signed confidentiality agreements or have agreed to meetings with the company to gain access to the company's books, the sources said, adding that the sale process was expected to start in a few weeks.

BlackBerry declined to comment.

The apparent lack of interest among private equity firms in the whole company underscores the challenges BlackBerry has been facing in competing with rivals such as Apple Inc's iPhone and devices using Google Inc's Android technology.

Its new BlackBerry devices hit store shelves this year just as the high-end smartphone segment was showing signs of saturation in markets such as the United States. Samsung Electronics recently reported results that fell shy of expectations, while Apple earlier this year reported its first quarterly profit decline in more than a decade.

The new BlackBerry device has so far failed to gain traction with consumers, and the company - which pioneered mobile email with its first smartphones and email pagers and was once a stock market darling - has seen its shares plummet. Its market value has fallen to $5.4 billion, from $84 billion at its peak in 2008. Shares closed down 1.4 percent at $10.28 on the Nasdaq on Friday.

Last month, the company said it was weighing its options, which could include an outright sale, after Reuters first reported that company's board was warming up to the possibility of going private.

Industry sources said several of the biggest private equity firms and some of the Asian hardware makers had decided against a deal for the company. Still, the sources added some BlackBerry's assets could be of interest to buyers.

According to analysts, BlackBerry's assets include a shrinking, yet well-regarded services business that powers its security-focused messaging system, worth $3 billion to $4.5 billion; a collection of patents that could be worth $2 billion to $3 billion; and $3.1 billion in cash and investments.

Even at a conservative estimate, that is more than the company's $5.4 billion market value. Analysts said the smartphones that bear its name have little or no value and it might cost $2 billion to shut the unit that makes them.

Many hurdles remain to a deal. Private equity firms have circled the company for more than two years and have tried without success so far to figure out ways to structure a deal.

Moreover, Ottawa reviews any big takeover of a Canadian company for competitive and national security reasons. Government officials have often said they want BlackBerry to succeed as a Canadian company, but concede they do not know how things will play out.

(Reporting by Nadia Damouni and Nicola Leske; Additional reporting by Soyoung Kim and Euan Rocha; Editing by Lisa Shumaker)


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Sainsbury's recalls watercress products on E. Coli concerns

n">(Reuters) - Britain's Food Standards Agency (FSA) said on Thursday that J Sainsbury is recalling all of its own brand bagged watercress and salads containing watercress, fearing a possible link to a national E. Coli outbreak that has made 15 people ill.

Sainsbury's, Britain's third-largest supermarket, said it was carrying out tests on all of its affected lines but that no traces of contamination had been found in its products as of yet, the FSA said in a report on its website.

"The FSA has made us aware that a small number of people have fallen ill with a bacterial infection, and that one of their lines of investigation is watercress bought at Sainsbury's since August 1," a Sainsbury's spokesperson said.

"We have, as a precautionary measure, withdrawn six lines of pre-packed salad containing watercress from the supplier concerned."

The bacterium blamed for the illness, E. Coli 0157, can cause bloody diarrhoea, dehydration and, in the most severe cases, kidney failure.

(Reporting by Richa Naidu in Bangalore and Steve Orlofsky)


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China to invest 80 billion yuan in oil and gas exploration this year

Cars drive into a Petrol China gas station, as other vehicles drive past on the Beijing-Tibet expressway in Beijing, March 23, 2012. CREUTERS/Soo Hoo Zheyang

Cars drive into a Petrol China gas station, as other vehicles drive past on the Beijing-Tibet expressway in Beijing, March 23, 2012. C

Credit: Reuters/Soo Hoo Zheyang

BEIJING | Sun Sep 15, 2013 3:46am EDT

BEIJING (Reuters) - China will invest 80 billion yuan ($13.07 billion) in oil and gas exploration in 2013, state media said on Sunday, as it tries to boost energy supplies reduce its dependence on energy imports.

Oil and gas investment in China has risen from 19 billion yuan in 2002 to 67.3 billion yuan in 2011, the official Xinhua news agency said, citing Ministry of Land and Resources figures.

More than 5 billion tons of petroleum reserves and 2.6 trillion cubic meters of natural gas were discovered between 2008-2011, Xinhua said.

China, the world's biggest energy consuming country, has promised to cut its growing dependence on overseas oil and gas supplies.

Still, some analysts expect China to overtake the United States as the world's biggest crude oil importer as soon as 2017. Much of it comes from the Middle East and Africa and is transported via vulnerable sea lanes.

Gas imports are important to China because domestic production is not sufficient to meet growing demand. Imported gas is delivered via pipeline from Central Asia and by ship from countries such as Australia, Indonesia and Qatar.

China bought 42.5 billion cubic metres (bcm) of gas from overseas last year. That was up more than 30 percent compared with 2011 and a nearly 10-fold increase from 2007.

(Reporting by Michael Martina; Editing by Robert Birsel)


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Doctors doing little to promote sunscreen use: study

By Kathryn Doyle

NEW YORK | Fri Sep 13, 2013 1:35pm EDT

NEW YORK (Reuters Health) - Doctors rarely talk to patients about using sunscreen, even when patients have a history of skin cancer, according to surveys of U.S. physicians over two decades.

Despite professional guidelines encouraging doctors to educate their patients about sun protection, in more than 18 billion patient visits from 1989 to 2010, sunscreen was mentioned less than one percent of the time.

Even dermatologists managed to mention sunscreen in less than two percent of visits, researchers found.

"The rate of discussing sunscreen at visits, especially for high-risk patients with cancer or pre-cancerous lesions, was lower than we would have expected," said one of the study's authors, Scott Davis, of the dermatology department at Wake Forest School of Medicine in Winston-Salem, North Carolina.

The survey data may not capture all mentions of sunscreen with complete accuracy, but that does not change the conclusion that frequency is much too low, Davis told Reuters Health.

Failing to mention sunscreen often enough is contributing to excessive unprotected sun exposure, especially for children, that will lead to skin cancer later in life, he said.

Davis and his coauthors examined data from an ongoing annual government survey that asks randomly selected doctors representative of their areas to record their patient interactions in detail for one week.

Over the two decades of the survey, there were about 18.3 billion patient visits to outpatient physician offices, and based on doctors' survey responses, sunscreen came up at less than 13 million of those visits, which is 0.07 percent.

When visits specifically concerned skin disease, doctors still mentioned sunscreen less than one percent of the time, according to the results published in JAMA Dermatology.

Dermatologists talked about sunscreen more than any other specialty, at 1.6 percent of all visits and 11.2 percent of visits involving a patient with current or past skin cancer.

"I don't think the results are surprising, at least not for someone who is familiar with what research has said about skin cancer counseling practices," said Dr. Jennifer S. Lin, who studies evidence-based healthcare decision making at The Center for Health Research of Kaiser Permanente Northwest in Portland, Oregon.

"It is certainly disappointing," said Lin, who has conducted reviews to support the U.S. Preventive Services Task Force for the past seven years, but is not herself part of the USPSTF.

In the study, Davis and his coauthors found that doctors mentioned sunscreen most often to white patients, and to those in their 80s, but least often during visits by children.

Evidence supports UV and sun protection counseling to prevent skin cancer, especially for kids and teens, so extremely low counseling for those groups is "incredibly problematic," Lin said.

But she cautions that sunscreen is only one part, and not the most important part, of UV protection, which includes avoiding midday sun, wearing appropriate clothing and avoiding tanning beds.

"My belief as a primary care doctor, not based on my research, is that our health system does not value counseling or patient education as much as it does procedures, testing, medications, etcetera," Lin said.

Even for patients who already know about sunscreen, discussing it can help, Davis said.

As with smoking and unhealthy eating, most people are aware of the risks, but bringing it up during an office visit shows the patient that the doctor is concerned and wants to help change the behavior, he said.

The American Academy of Pediatrics recommends bringing up sun protection at annual checkups, Davis said.

"The fact that it was recommended least frequently to children is very concerning, since children tend to get the most sun exposure, and may develop lifelong habits of poor sun protection," Davis said. "This may be where physicians have the greatest opportunity to fight the ongoing, growing epidemic of skin cancer."

Skin cancer continues to be the most common form of cancer in the U.S., diagnosed in more than 60,000 people yearly, according to the Centers for Disease Control and Prevention.

Patients may need to take the initiative and bring up sun protection themselves if they have questions, he said.

"Physicians are pressed for time and feel they cannot take the extra time needed for discussion of preventive care topics," Davis said.

"But the main thing may be that physicians just aren't thinking of it. This research may make health care providers more aware of the need to encourage commonsense sun protection, especially for younger patients," he said.

SOURCE: bit.ly/159fllF JAMA Dermatology, online September 4, 2013.


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Canadian union and General Motors reach tentative deal

The General Motors logo is seen outside its headquarters at the Renaissance Center in Detroit, Michigan in this file photograph taken August 25, 2009. REUTERS/Jeff Kowalsky/Files

The General Motors logo is seen outside its headquarters at the Renaissance Center in Detroit, Michigan in this file photograph taken August 25, 2009.

Credit: Reuters/Jeff Kowalsky/Files

By P.J. Huffstutter

CHICAGO | Sat Sep 14, 2013 6:07pm EDT

CHICAGO (Reuters) - The union representing Canada's auto workers said on Saturday it has reached a tentative agreement with General Motors for production and skilled trades workers at its assembly plant in Ingersoll, Ontario.

Unifor, which represents approximately 2,700 workers at the CAMI-GM plant, said details of the four-year contract will be withheld until after the ratification vote on Sunday in London, Ontario.

The outcome of Sunday's vote is expected to be released on Sunday evening, said a statement from Unifor. The recently formed union is a merger of the Canadian Auto Workers and the Communications, Energy and Paperworkers Union of Canada.

General Motors could not be reached for comment Saturday evening.

The workers at the CAMI plant are represented by Unifor Local 88, and manufacture the Chevrolet Equinox and GMC Terrain vehicles, Unifor said.

Contract talks had started earlier in February, but union officials told reporters last spring that the negotiations required more time. The existing contract was scheduled to expire on Monday, according to media reports.

(Reporting By P.J. Huffstutter; editing by Gunna Dickson)


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Global Fund seeks $15 billion to control three big killers

By Kate Kelland

LONDON | Thu Sep 12, 2013 12:07pm EDT

LONDON (Reuters) - The world's biggest funder of the fight against AIDS, tuberculosis (TB) and malaria said on Thursday it needs $15 billion over the next three years to begin bringing "the three big global pandemics" under control.

In a report released ahead of a pledging conference later this year, the Global Fund to Fight AIDS, TB and Malaria said timely investments could avert $47 billion in extra treatment costs and save millions of lives, but warned that acting too late would mean missing important opportunities.

"The cost of inaction is far greater than the cost of action, from both a moral and an economic perspective," Joanne Carter, head of the RESULTS Educational Fund in the United States and a former Global Fund board member, told reporters.

"We are at the tipping point in the fight against HIV, TB and malaria. If we invest ambitiously now we can save millions of lives and literally defeat these diseases in our lifetime."

The public-private Global Fund, based in Geneva, accounts for around a quarter of international financing to fight HIV and AIDS, and the majority of global funds to fight TB and malaria.

Founded in 2002, the fund raises money from donors every three years and in 2010 secured just under $12 billion for the years 2011 to 2013.

According to the World Health Organisation, malaria infected some 219 million people in 2010, killing around 660,000 of them. Robust figures are, however, hard to establish and other health experts say the annual malaria death toll could be double that.

Some 34 million people were living with the human immunodeficiency virus (HIV) that causes AIDS at the end of 2011, while deaths from AIDS fell to 1.7 million that year from a peak of 2.3 million in 2005.

The Global Fund says that of the estimated 9 million cases of TB worldwide in 2012, only 6 million were diagnosed and treated - leaving an estimated 3 million people with TB who went undiagnosed, untreated or unreported.

International health experts say the tools, medicines and expertise already exist to be able to all but end these three infectious diseases, but say it is a battle to keep up funding levels in a tough global economic climate.

"There are three compelling factors that make this a unique opportunity to fight and defeat these diseases," said Mark Dybul, the Global Funds' executive director.

"We have the experience to know how to fight them effectively, we have new scientific tools, and we understand the epidemiology of these diseases better than ever. We can make a transformative difference, and if we do not act now, the costs will be staggering."

If international donors fail to stump up the at least $15 billion needed, Dybul said this could lead to millions of avoidable cases of HIV during the funding period of 2014 to 2016, which over these patients lifetimes would add up to $47 billion of treatment costs.

Some 3 million fewer people would be treated for TB, and a million lives would be unnecessarily lost because of that, he said, and in malaria the consequences of inadequate funding would be 196,000 lives lost per year and 430 million malaria cases that could have been prevented.

The lion's share of the funding for the Global Fund comes from OECD governments. Private sector entities such as the Bill and Melinda Gates Foundation and Coca-Cola also contribute financially and with services.

(Editing by Sonya Hepinstall)


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Monday, September 16, 2013

Work on financial transaction tax to go on, EU executive says

VILNIUS | Sat Sep 14, 2013 7:26am EDT

VILNIUS (Reuters) - The European Commission rebuffed on Saturday an EU legal opinion that questioned the legality of a planned financial transaction tax and said work on the levy in 11 European Union countries would go on.

The legal services of the European Council, the institution which represents governments of the 28-nation EU, said in their 14-page legal opinion dated September 6 that the Commission's transaction tax plan "exceeded member states' jurisdiction for taxation under the norms of international customary law".

European Union finance ministers discussed the financial transaction tax briefly on Saturday, with the Commission saying there was a misunderstanding on the opinion.

"We are confident that the Commission's arguments and arguments of the legal service of the Commission will demonstrate very clearly to our member states that the approach which has been taken in the proposal is the correct one and does not breach any provisions of the Treaty," European Commissioner Algirdas Semeta, who is responsible for taxation told reporters.

Germany, France, Italy, Spain, Austria, Portugal, Belgium, Estonia, Greece, Slovakia and Slovenia were planning to adopt the tax on stocks, bonds, derivatives, repurchase agreements and securities lending.

Semeta said first reading of the proposal by the member states was already concluded.

"I believe that we will present arguments to our member states for the next meeting of the Council working group. So the work is in progress and I do not see any reasons to stop this work or to make some additional reflections," added Semeta.

Britain, the bloc's largest financial center, and 15 other EU member states refused to support the transaction tax proposal raising questions about how it would work with only some members participating.

(Reporting by Martin Santa; editing by James Jukwey)


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Group therapy may prevent depression in at-risk teens

By Kathryn Doyle

NEW YORK | Thu Sep 12, 2013 1:13pm EDT

NEW YORK (Reuters Health) - Kids of depressed parents have an increased likelihood of becoming depressed, too, but group therapy sessions may help reduce that risk, according to a new study.

"What was exciting was the sustained effect over the length of the follow-up," said lead author Dr. William R. Beardslee of the psychiatry department at Boston Children's Hospital.

He and his coauthors had previously found a reduced risk of depression nine months after the cognitive behavioral therapy sessions began. The new results show that risk was still reduced two years after they ended.

The study included 316 teenagers of parents with current or past depressive disorders.

Half were assigned to the therapy program, which involved eight weekly 90-minute group sessions with a trained therapist followed by six monthly sessions, and the other half received standard care. The kids had symptoms of depression, but not diagnosable depressive disorders.

The researchers tracked teens' "depressive episodes" lasting at least two weeks, as reported by the kids and their parents.

During the study and the two-year follow-up period - a total of 33 months - 37 percent of kids assigned to the therapy sessions had at least one depressive episode, versus 48 percent of those in the comparison group.

But that difference was only seen among teens whose parents were not clinically depressed when the study began.

When parents were not depressed at the time of the study, cognitive behavioral therapy prevented one depressive episode for every six kids in the program, the researchers found. However, for kids with currently depressed parents, therapy sessions didn't seem to have an effect, they wrote in JAMA Psychiatry.

"First, we need to understand how current parental depression is related to differential outcomes," Beardslee told Reuters Health. "Then, we need to target these factors to reduce their effects on child outcome."

"The next step is to learn more about how to target programs like this to populations who can most benefit and to develop and test systems to deliver such programs effectively to the public," said Irwin Sandler, a psychology professor and director of the Prevention Research Center at Arizona State University in Tempe.

Of all other strategies to prevent depression, only a handful have demonstrated effectiveness one year after the intervention, Sandler, who didn't participate in the new research, said.

"The current study is one of very few recent studies to extend that finding to 33 months, a very exciting and hopeful development," he told Reuters Health.

Cognitive behavioral therapy is designed to help patients understand how their thoughts and attitudes affect how they feel and how they respond to situations - then addresses practical steps they can take to improve negative thoughts and outcomes.

The sessions seem to be cost-effective based on other evidence, Beardslee said, but most teens have an easier time accessing the therapy if they are already depressed than for prevention of depression.

Cognitive behavioral therapy is a very effective treatment so it wasn't surprising to see it work for prevention, according to Myrna Weissman, a professor of epidemiology in psychiatry at Columbia University in New York, who was not involved in the study.

"I'm also not surprised a depressed parent impeded prevention," which reinforces the need for depressed parents to get treatment too, she told Reuters Health.

SOURCE: bit.ly/17OTr7D JAMA Psychiatry, online September 4, 2013.


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Lufthansa boss in line for Roche chairman job: paper

Christoph Franz, CEO of German air carrier Lufthansa attends the general meeting in Cologne May 7, 2013. REUTERS/Ina Fassbender

Christoph Franz, CEO of German air carrier Lufthansa attends the general meeting in Cologne May 7, 2013.

Credit: Reuters/Ina Fassbender

ZURICH | Sun Sep 15, 2013 5:10am EDT

ZURICH (Reuters) - Christoph Franz, chief executive of Deutsche Lufthansa (LHAG.DE), is in pole position to take over as chairman of Swiss drugmaker Roche (ROG.VX), the NZZ am Sonntag newspaper reported on Sunday.

Citing two reliable sources, the paper said 53-year-old Franz is the favorite candidate to replace current chairman Franz Humer, who plans to step down next spring.

Roche's board is scheduled to meet on September 26-27 to elect the next chairman, according to the paper.

A spokesman for Roche declined to comment on the report.

Franz has been a member of Roche's board since 2011. While he lacks a pharmaceutical background, he is a German speaker, with experience running a global listed company and knowledge of Switzerland --all of which are deemed crucial for the role.

But Franz, who has been chief executive officer and chairman at Lufthansa since 2011, is in the middle of a strategic overhaul at the German airline, which could complicate any departure.

According to the paper, Franz is in discussions with Lufthansa about the modalities of a possible resignation.

Lufthansa declined to comment to the newspaper about Franz's plans.

(Reporting by Caroline Copley; Editing by Robert Birsel)


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Diet quality linked to pancreatic cancer risk

By Veronica Hackethal, MD

NEW YORK | Fri Sep 13, 2013 11:24am EDT

NEW YORK (Reuters Health) - In a large new study of older Americans, researchers find that people with the healthiest eating habits are about 15 percent less likely to develop pancreatic cancer than those with the poorest diets.

In the analysis of data on more than 500,000 Americans over age 50, men in particular, especially those who were overweight or obese, appeared to benefit most from a high quality diet.

"It is important to note that our findings are based on overall diet and not individual foods. A combination of many foods contributed to the observed association between greater compliance with the Dietary Guidelines and lower risk of pancreatic cancer," lead author Hannah Arem of the National Cancer Institute in Bethesda, Maryland, told Reuters Health in an email.

Though pancreatic cancer is rare - about 1.5 percent of Americans will develop the disease during their lifetimes - it is one of the most aggressive and lethal cancers. Only about six percent of people with pancreatic cancer are still alive five years after diagnosis, according to Arem.

Past studies looking at the relationship between diet and risk for pancreatic cancer have tended to focus on individual foods and found few connections, according to her team's report, published in the Journal of the National Cancer Institute.

To examine links between overall diet and cancer risk, Arem and her colleagues used the government-designed Healthy Eating Index published in 2005 (HEI-2005) as a basis for rating the overall quality of people's diets.

They applied those criteria to responses from 537,218 men and women who were part of the American Association for Retired Persons Diet and Health Study. Between 1995 and 1996, participants filled out diet questionnaires about how often they ate items on a list of 124 foods.

Arem's team then divided participants into five groups based on how closely their diets met HEI-2005 recommendations for consuming healthy foods such as fruits, vegetables and whole grains and limiting unhealthy ones, like red meat and junk foods.

Scores on the index range from 0 (no guidelines met) to 100 (all guidelines met), with high scores indicating the healthiest eating patterns.

Using state cancer registries and Social Security Administration data, the researchers followed participants for about 10 years and found that 2,383 people developed pancreatic cancer.

About 22 percent of the pancreatic cancer cases were among people with the lowest HEI-2005 scores, while 19 percent were in people with the highest scores. Overall, that translates to a 15 percent lower risk among those with the healthiest diets.

Among men who were overweight or obese, however, those with healthy eating scores in the top-fifth group were 28 percent less likely than their counterparts in the bottom-fifth to develop pancreatic cancer. The same effect was not seen among overweight women.

When the researchers adjusted for other factors linked to pancreatic cancer risk, including smoking, alcohol consumption and diabetes, the effects of diet quality remained the same.

Arem's team also looked at specific subgroups of foods and found that people who ate the greatest amounts of certain healthy foods, such as dark-green and orange vegetables, legumes, whole grains and low-fat milk had lowered risk for pancreatic cancer.

The researchers point out in their report, though, that other recent reviews of the literature have not found similar results for people who ate lots of fruits and vegetables, for example.

"Our study showed an association between diet and pancreatic cancer risk, rather than cause and effect. In general, maintaining a healthy diet has many health benefits," Arem said.

Dr. Rachel Ballard-Barbash, also of the National Cancer Institute, and her colleagues also note in an editorial accompanying the new study that attempts to link individual foods or nutrients to cancer risk have yielded conflicting results.

While some understanding about the relationship between diet and certain cancers has been gained, that "knowledge has not yet translated into noticeable reductions in the incidence of the major cancers with diet-related etiology," they write.

Dr. Alfred Neugut, who studies digestive cancers and epidemiology but was not involved in the current research, agreed there are still a lot of unknowns about the links between diet and cancer.

"If you go out of your way to have a healthy diet, then you're probably going out of your way to be healthy in other ways," Neugut, a professor of medicine at Columbia Presbyterian Medical Center in New York, told Reuters Health. So it's difficult to tease out whether it's really the diet alone that explains the decreased risk seen in the new study.

"It's always safe to say that it's prudent to eat a healthy diet," he said. But, he added, "I would say that diet and cancer is a topic that, despite huge numbers of studies and huge amounts of money invested, has eluded any dramatic findings."

SOURCE: bit.ly/17o1kAA and bit.ly/1begcFn Journal of the National Cancer Institute, online August 15, 2013.


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Unions fail to get fix from White House on key 'Obamacare' concern

U.S. President Barack Obama speaks about health insurance reform during a visit to Portland, Maine April 1, 2010. REUTERS/Kevin Lamarque

U.S. President Barack Obama speaks about health insurance reform during a visit to Portland, Maine April 1, 2010.

Credit: Reuters/Kevin Lamarque

By Roberta Rampton

WASHINGTON | Fri Sep 13, 2013 10:11pm EDT

WASHINGTON (Reuters) - Top labor leaders left the White House on Friday after an hour-long meeting with President Barack Obama, still looking for a way to address concerns that "Obamacare" will hurt their members' healthcare plans.

The dispute with unions - traditional allies of Democrats - as the Obama administration begins to roll out Obama's signature healthcare reforms is providing political ammunition for Republicans who want to defund or repeal the law.

Striding down the White House driveway, Richard Trumka and six other union officials declined to answer detailed questions from reporters.

"We're continuing to work on problem-solving," said Trumka, president of the AFL-CIO, the umbrella organization for 57 member unions representing more than 13 million workers.

Trumka said he hoped further discussions would yield solutions "in the next week," but would go no further.

Earlier this week, AFL-CIO members passed a resolution calling for significant changes to the healthcare law, stopping short of asking for its repeal, but exposing the rift between the labor movement and the Obama administration.

Unions say the law is unfair because lower-income members who belong to multi-employer healthcare plans common in the retail, construction and service industries will not be eligible for subsidies other low-earning workers will qualify for when buying health insurance on state exchanges beginning on October 1.

"We don't want it repealed, we want it fixed, fixed, fixed," said Terry O'Sullivan, president of the Laborers International Union of North America, in a speech at the union's convention in Los Angeles on Wednesday.

"But if the Affordable Care Act is not fixed ... then I believe it needs to be repealed," he said.

NO DOUBLE-DIPPING

Shortly after Friday's White House meeting, the Treasury Department issued a letter that confirmed that people in multi-employer healthcare plans could not receive the Obamacare tax credits to help cover the cost of premiums.

The letter was addressed to Senator Orrin Hatch, the top Republican on the Finance Committee, who argued earlier this week that unions should not get special treatment under the law because members are not taxed on the contributions their employers make on their behalf.

"Giving union workers exchange subsidies in addition to the income tax exclusion would be 'double dipping,'" Hatch said.

Hatch also said he was opposed to the idea of making it easier for the multi-employer plans to be moved on to healthcare exchanges.

But a senior administration official said that possibility was still being explored.

"The administration will work with multi-employer plans and other non-profit plans and encourage them to offer coverage through the marketplace," the official said, offering no details about how that might work.

The process would likely be complicated, said Timothy Jost, an expert on healthcare regulation at Washington and Lee University's School of Law.

"They would have to be licensed as insurance companies and be open to anyone who wanted to purchase, and they could not accept contributions from employers," Jost said.

Healthcare exchanges, set to open on October 1, are trying to clear a raft of hurdles, both technical and political.

Republicans have said they want to demand concessions on the healthcare law as a condition for averting a government shutdown and increasing the government's debt limit.

The conflict between unions and the administration plays into the political fight. On Friday, the Senate Republican Conference sent an email to reporters trumpeting a dozen links to articles about unions' Obamacare complaints.

"You want to have all the allies you can," said Henry Aaron, a healthcare expert at the Brookings Institution think tank, who is also on the executive board of the healthcare exchange for the District of Columbia.

"Not having the unions with you is not good news, from that standpoint," Aaron said.

(Additional reporting by Amanda Becker and Lewis Krauskopf; Editing by Peter Cooney)


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FDA rejects Delcath's cancer therapy, asks for more trials

n">(Reuters) - Delcath Systems Inc said the U.S. Food and Drug Administration rejected its cancer therapy, and asked for more trials, more than four months after a panel of U.S. advisers recommended against its approval.

The company also said it fired Chief Executive Eamonn Hobbs on September 10 and appointed two interim co-CEOs.

Further studies should show that the treatment is safe and effective based on overall survival, and that benefits outweigh risks, the FDA said.

Delcath said the regulator issued on Thursday a complete response letter — its standard method of telling a company why a drug has not been approved.

Seven percent of the 122 patients treated died due to side effects related to the therapy comprising chemotherapy drug melphalan and a drug delivery device, packaged as the Melblez kit.

An independent panel of advisers to the FDA unanimously recommended against approval to the therapy, which intends to treat a rare form of eye cancer that spreads to the liver.

Delcath said it was evaluating the rejection letter and would discuss a way forward with the FDA.

A transition committee would search for a new CEO and evaluate strategic options, said the company valued at $37.6 million based on its stock's close on the Nasdaq on Thursday.

Global head of business operations Jennifer Simpson and Chief Financial Officer Graham Miao would serve as co-CEOs.

(Reporting By Vrinda Manocha in Bangalore; Editing by Joyjeet Das)


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Obama to mark 5-year anniversary of U.S. financial crisis

U.S. President Barack Obama speaks during a cabinet meeting in the West Wing of the White House in Washington, September 12, 2013. REUTERS/Jason Reed

U.S. President Barack Obama speaks during a cabinet meeting in the West Wing of the White House in Washington, September 12, 2013.

Credit: Reuters/Jason Reed

WASHINGTON | Sat Sep 14, 2013 2:57pm EDT

WASHINGTON (Reuters) - President Barack Obama will mark the five-year anniversary of the U.S. financial crisis on Monday in an effort to move back to his domestic agenda after weeks of dealing with Syria.

When Wall Street came to a near collapse in 2008, the resulting economic crisis helped propel then-Democratic presidential nominee Obama to the White House.

But the economy's slow recovery from the recession has been a difficult challenge for Obama, who in recent weeks has been focused largely on foreign policy in trying to mount an international response to a chemical weapons attack in Syria.

A White House official said Obama will deliver remarks in the White House Rose Garden on Monday to mark the fifth anniversary of the financial crisis, which was accelerated on September 15, 2008 when the Lehman Brothers firm filed for bankruptcy protection.

The Democratic president will focus on the positive, discussing progress made and highlighting his prescriptions for boosting job creation amid budget battles expected with Republicans in Congress in the weeks ahead.

He is also expected to urge his Republican opponents in Congress not to threaten to shut down the government over the budget and to support raising the debt limit. Without new spending authority, most U.S. government agencies would have to close their doors on October 1 in a replay of politically painful shutdowns during the mid-1990s.

(Reporting By Steve Holland; Editing by Doina Chiacu)


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Pennsylvania to unveil proposal on extending Medicaid access

Pennsylvania Governor Tom Corbett speaks at a news conference on the Penn State campus in State College, Pennsylvania January 2, 2013. REUTERS/Craig Houtz

Pennsylvania Governor Tom Corbett speaks at a news conference on the Penn State campus in State College, Pennsylvania January 2, 2013.

Credit: Reuters/Craig Houtz

By Daniel Kelley

PHILADELPHIA | Fri Sep 13, 2013 5:18pm EDT

PHILADELPHIA (Reuters) - Governor Tom Corbett is expected to propose early next week that Pennsylvania extend Medicaid benefits to more low-income residents, likely helping them purchase private insurance using Medicaid funds, a Republican state representative said on Friday.

State Representative Gene DiGirolamo, chairman of the House Human Services Committee, Corbett's proposal probably will look similar to plans in Iowa and Arkansas, other states where officials have resisted the outright expansion of the Medicaid program under President Barack Obama's healthcare reform law.

The model these states are considering would allow them to extend health coverage to more of their poor when the law takes full effect on January 1. Such plans require a waiver from the U.S. Department of Health and Human Services.

"The people covered by the expansion are people with no disposable income to buy private insurance," DiGirolamo said. "These people will still be out there, and their only alternative is the ER."

Corbett spokeswoman Lynn Lawson says that the administration has begun meeting with legislators this week to explain the proposal, but provided no details.

Corbett "has been very clear about the need for reform," the governor's office said in a statement. "There are a number of interesting options under review and consideration as he develops a plan that ensures quality and accessibility for all Pennsylvanians. He will have more to say on this issue sometime next week."

Corbett had long opposed the Medicaid expansion. But local organizations, including hospitals, have pressured elected officials not to forfeit the additional federal funds that come with extending the program. Twenty-six states have so far refused to expand Medicaid under "Obamacare."

The Hospital and Health System Association of Pennsylvania estimates that roughly 350,000 low income, non-elderly state residents would be covered by the Medicaid expansion outlined in the new law.

HHS, which has sought to keep an open door to states that initially rejected Medicaid expansion, said it was "eager" to work with Pennsylvania on coverage options.

"HHS is committed to supporting state flexibility, within the confines of the law," the department said in a statement.

Under Obama's 2010 Patient Protection and Affordable Care Act, as many as 9 million Americans are expected to obtain health coverage next year by raising the income threshold for Medicaid eligibility to 138 percent of the federal poverty level in states that accept the expansion.

The federal government will cover the entire cost of new beneficiaries for the first three years, and then lower its participation to 90 percent over the remaining decade.

Uninsured people with higher incomes will be able to shop for subsidized private insurance in new online marketplaces being set up in each state under the law.

(Additional reporting by David Morgan in Washington; Editing by Michele Gershberg and David Gregorio)


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