Personal Health: When Daily Stress Gets in the Way of Life

I was about to give an hourlong talk to hundreds of people when one of the organizers of the event asked, “Do you get nervous when you give speeches?” My response: Who, me? No. Of course not.

But this was a half-truth. I am a bit of a worrier, and one thing that makes me anxious is getting ready for these events: fretting over whether I’ve prepared the right talk, packed the right clothes or forgotten anything important, like my glasses.

Anxiety is a fact of life. I’ve yet to meet anyone, no matter how upbeat, who has escaped anxious moments, days, even weeks. Recently I succumbed when, rushed for time just before a Thanksgiving trip, I was told the tires on my car were too worn to be driven on safely and had to be replaced.

“But I have no time to do this now,” I whined.

“Do you have time for an accident?” my car-savvy neighbor asked.

So, with a pounding pulse and no idea how I’d make up the lost time, I went off to get new tires. I left the car at the shop and managed to calm down during the walk home, which helped me get back to the work I needed to finish before the trip.

It seems like such a small thing now. But everyday stresses add up, according to Tamar E. Chansky, a psychologist in Plymouth Meeting, Pa., who treats people with anxiety disorders.

You’ll be much better able to deal with a serious, unexpected challenge if you lower your daily stress levels, she said. When worry is a constant, “it takes less to tip the scales to make you feel agitated or plagued by physical symptoms, even in minor situations,” she wrote in her very practical book, “Freeing Yourself From Anxiety.”

When Calamities Are Real

Of course, there are often good reasons for anxiety. Certainly, people who lost their homes and life’s treasures — and sometimes loved ones — in Hurricane Sandy can hardly be faulted for worrying about their futures.

But for some people, anxiety is a way of life, chronic and life-crippling, constantly leaving them awash in fears that prevent them from making moves that could enrich their lives.

In an interview, Dr. Chansky said that when real calamities occur, “you will be in much better shape to cope with them if you don’t entertain extraneous catastrophes.”

By “extraneous,” she means the many stresses that pile up in the course of daily living that don’t really deserve so much of our emotional capital — the worrying and fretting we spend on things that won’t change or simply don’t matter much.

“If you worry about everything, it will get in the way of what you really need to address,” she explained. “The best decisions are not made when your mind is spinning out of control, racing ahead with predictions about how things are never going to get any better. Precious energy is wasted when you’re always thinking about the worst-case scenarios.”

When faced with serious challenges, it helps to narrow them down to specific things you can do now. To my mind, Dr. Chansky’s most valuable suggestion for emerging from paralyzing anxiety when faced with a monumental task is to “stay in the present — it doesn’t help to be in the future.

“Take some small step today, and value each step you take. You never know which step will make a difference. This is much better than not trying to do anything.”

Dr. Chansky told me, “If you’re worrying about your work all the time, you won’t get your work done.” She suggested instead that people “compartmentalize.” Those prone to worry should set aside a little time each day simply to fret, she said — and then put aside anxieties and spend the rest of the time getting things done. This advice could not have come at a better time for me, as I faced holiday chores, two trips in December, and five columns to write before leaving mid-month. Rather than focusing on what seemed like an impossible challenge, I took on one task at a time. Somehow it all got done.

Possible Thinking

Many worriers think the solution is positive thinking. Dr. Chansky recommends something else: think “possible.”

“When we are stuck with negative thinking, we feel out of options, so to exit out of that we need to be reminded of all the options we do have,” she writes in her book.

If this is not something you can do easily on your own, consult others for suggestions. During my morning walk with friends, we often discuss problems, and inevitably someone comes up with a practical solution. But even if none of their suggestions work, at least they narrow down possible courses of action and make the problem seem less forbidding. “If other people are not caught in the spin that you’re in, they may have ideas for you that you wouldn’t think of,” Dr. Chansky said. “We often do this about small things, but when something big is going on, we hesitate to ask for advice. Yet that’s when we need it most.”

Dr. Chansky calls this “a community cleanup effort,” and it can bring more than advice. During an especially challenging time, like dealing with a spouse’s serious illness or loss of one’s home, friends and family members can help with practical matters like shopping for groceries, providing meals, cleaning out the refrigerator or paying bills.

“People want to help others in need — it’s how the world goes around,” she said. Witness the many thousands of volunteers, including students from other states on their Thanksgiving break, who prepared food and delivered clothing and equipment to the victims of Hurricane Sandy. Even the smallest favor can help buffer stress and enable people to focus productively on what they can do to improve their situation.

Another of Dr. Chansky’s invaluable tips is to “let go of the rope.” When feeling pressured to figure out how to fix things now, “walk away for a few minutes, but promise to come back.” As with a computer that suddenly misbehaves, Dr. Chansky suggests that you “unplug and refresh,” perhaps by “taking a breathing break,” inhaling and exhaling calmly and intentionally.

“The more you practice calm breathing, the more it will be there for you when you need it,” she wrote.

She also suggests taking a break to do something physical: “Movement shifts the moment.” Take a walk or bike ride, call a friend, look through a photo album, or do some small cleaning task like clearing off your night table.

When you have a clear head and are feeling less overwhelmed, you’ll be better able to figure out the next step.


This is the first of two columns about anxiety.

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U.S. and U.K. Propose Plan to Deal With Bank Failures


LONDON — Regulators in the United States and Britain introduced a plan on Monday for averting threats to financial stability when large, cross-border financial institutions fail.


The plan, devised by the U.S. Federal Deposit Insurance Corporation and the Bank of England, would allow the regulators to fire executives, force shareholders to take losses and move a company’s operations into full private ownership without taxpayer support.


The steps are intended to minimize costs for taxpayers and limit the risk that the troubles would spread, the regulators said.


“These strategies have been designed to enable large, complex cross-border firms to be resolved without threatening financial stability and without putting public funds at risk,” the F.D.I.C. and the Bank of England said in a joint paper published on the British central bank’s Web site. “To be successful, such an approach will require close cooperation between home and foreign authorities.”


Ever since the financial crisis that began in 2007, national regulators have been working together to find ways to allow large financial institutions to fail in an orderly manner rather than forcing the respective governments to bail them out at huge costs.


At a time when the business of large financial institutions reach across borders, one of the central questions considered by the regulators was how to avoid the failure of a bank in one country spreading to another. Another question centered on how best to limit the disruption to healthy subsidiaries of a failing institution.


The strategy for large financial firms that are failing “should assign losses to shareholders and unsecured creditors, and hold management responsible for the failure of the firm,” the two regulators said in the paper.


“The unsecured debt holders can expect that their claims would be written down to reflect any losses that shareholders cannot cover, with some converted partly into equity in order to provide sufficient capital” for the sound parts of the firm, according to the paper.


The paper affects the world’s 28 so-called systematically important financial institutions, 12 of them based in the United States or Britain, Martin Gruenberg, the F.D.I.C. chairman, and Paul Tucker, deputy governor for financial stability at the Bank of England, wrote in The Financial Times on Monday.


“Because many of these institutions have operations that are concentrated in our two jurisdictions, we have a shared interest in ensuring that, when such a business fails, it can be resolved at no cost to taxpayers and without placing the financial system at risk,” they wrote.


The United States and Britain had to bail out some of their financial institutions as a result of the financial crisis. The countries have since worked on separate but similar new rules for their banking sectors.


“Developing an effective strategy for the orderly failure of a systemic financial institution could hardly be more important,” Mr. Gruenberg and Mr. Tucker wrote in The Financial Times. “The joint paper marks a significant step in that endeavor.”


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India Ink: A Conversation With: Human Rights Activist Binayak Sen

Binayak Sen, 62, is no ordinary doctor. Few doctors, after all, spend three decades working in a region threatened by what Prime Minister Manmohan Singh called the “single biggest internal security challenge ever faced” by the country. And that was before Dr. Sen was jailed on charges of “waging a war against the state,” which prompted a group of Nobel laureates to petition for his release.

Dr. Sen was released in 2009, after spending two years in jail, but still faces charges of supporting the Maoists, also referred to as Naxalites, which he denies.

The Maoists have been leading an armed movement to capture political power in 13 states in India over four decades, and claim to be fighting for the poor, dispossessed and marginalized. Dr. Sen ran mobile clinics in the interior of Chhattisgarh, one of the states most affected by the Maoist insurgency. In 2005, he led a 15-member team that published a report criticizing the Salwa Judum, which  Human Rights Watch calls “a state-supported vigilante group aimed at eliminating Naxalites.”

The Chhattisgarh state government alleged that his work, and in particular his association with the Maoist leader Narayan Sanyal,  amounted to helping wage “a war against the state.” Although that charge was dismissed, he was found  guilty of sedition and conspiracy, and sentenced to life imprisonment by a lower court in Chhattisgarh in 2010. He was granted bail by the Supreme Court in 2011 and an appeal against the conviction is pending in the Chhattisgarh High Court.

A group of 40 Nobel laureates described him as “an exceptional, courageous, and selfless colleague, dedicated to helping those in India who are least able to help themselves,” in a 2011 letter appealing for his life sentence to be overturned.

India Ink had several conversations with Dr. Sen, both over the phone and e-mail, to discuss how human rights activism grew from his work as a doctor.

Describe your journey from being a doctor in rural areas to being labeled a Maoist sympathizer.

My work in Chhattisgarh was with village communities, some of the poorest in India, and training health workers to look after their needs. Earlier, I had helped establish a hospital for mine workers in the area. As a logical outcome of my work, I was involved with human rights work, and was the general secretary of the state unit of the Peoples’ Union for Civil Liberties.

In this capacity I was instrumental in documenting and exposing deaths due to hunger and malnutrition, and to the displacement of over 600 tribal villages by the state-sponsored militia called Salwa Judum, or S.J., in southern Chhattisgarh. Last year, the S.J. was banned by the Supreme Court of India.

But it was in 2007 that I was labeled a Maoist supporter, for reasons best known to the Chhattisgarh state government. I was arrested in 2007 and charged with sedition, as well as under internal security acts, spent two years in jail during the trial, was released on bail by the Supreme Court,  convicted and sent to jail again, before again being released on bail in 2011. My appeal against the conviction is still pending in the state high court.

What was your association with the Maoist leader Narayan Sanyal?

I was approached by Narayan Sanyal’s family to help him with his legal cases and his health needs. In my capacity as a P.U.C.L. activist, I visited him in jail several times in the presence of senior jail officials, as they testified at my trial.

Could you tell us about your time in prison?

My time in prison was a time of deep despair, as I was unable to figure out the logic of the juridical action against me. At the same time it gave me an opportunity to know the stories of many fellow prisoners who were undergoing the same trauma as myself.

I came across many such instances where people had spent substantial amounts of time and were later let go. In some instances the judges have indicted the police for fabrication of evidence and illegal detention, but nothing has happened.

I did not do anything that was, to the best of my knowledge, wrong or illegal.  I didn’t expect anything like this happen to me; I had in fact worked with the government to provide essential services in these areas. After coming out of jail, I have been part of a nationwide process for the repeal of unjust and oppressive laws.

There was no physical intimidation that I faced in jail. However, I was kept in solitary confinement. Life in jail is itself a form of mental intimidation.

Do you consider yourself fortunate that you received a great deal of media attention when you were arrested?

I faced a virulent media trial in Chhattisgarh in the print and electronic media, as well as on the Internet. The ordinary journalist in Chhattisgarh relies to a large extent on government (including police) handouts. It was the contribution of dedicated national journalists who turned their spotlight on the real story.

It was only over a period of time that a campaign against the patent injustice in my case built up, and many prominent citizens at the national and international levels besides sections of national media took a positive view about me.

What is your understanding of the Maoist problem in India? Does their use of violence overshadow the issues they are fighting for?

It is surprising that so much of the public discourse is about the issue of violence. Large sections of the population in the “affected areas” are living in a state of perpetual hunger, to the point of famine, and lack appropriate and basic health care. Their access to common property resources, essential for their survival, is denied to them as a result of state action, to a point where the very survival of entire communities is called into question – but this does not become the center of the discourse.

I have clarified on many occasions that I do not condone the violence either of the agencies of the state or of those who oppose the state.

You were recently part of a conference called “Resist the Silent Emergency” in Delhi; what is the “silent emergency” in India?

The conference to which you refer was mainly devoted to documenting and chronicling widespread fabrication of cases and the use of sedition-like laws to suppress dissenting voices across the country. The silent emergency refers to the suppression of fundamental rights to freedom of thought and expression, without the declaration of an actual internal emergency as in 1975.

You have spoken about the need to establish alternative agencies and systems. What has given rise to the need?

First of all, I want to clarify that I have always engaged with the state to help it function better. I was recently part of the steering committee for health in the 12th five-year plan, and earlier part of the advisory group on structural reforms in health care for government of Chhattisgarh.

However, recent developments make it plain that the planning commission is unlikely to carry out its stated commitments to the universalization of health care. The alternative strategies that most public health workers are advocating, is the universalization of health care and for increased resource allocation in the health and nutrition sector.

Some suggest we need to involve international bodies in improving health care. Does that signal a lack of faith in the country’s own systems of checks and balances?

The distress due to chronic hunger, lack of health care and widespread displacement of the people, who constitute one sixth of mankind, cannot be constrained only by questions of national identity. These are matters of concern for the entire world community.

(This interview has been lightly edited and condensed.)

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RIM offers biggest clients incentives to adopt BB10






TORONTO (Reuters) – Research In Motion Ltd on Thursday outlined a program of incentives to encourage its biggest customers to run its soon-to-launch line of BlackBerry 10 devices, seeking to persuade corporations and government users to stick with its secure smartphones.


RIM is betting that the devices, to be launched on January 30, will revive its fortunes. That will depend to a large extent on the response from RIM’s enterprise customers — the business users who value BlackBerry’s strong security features.






Waterloo, Ontario-based RIM, once a smartphone pioneer, has bled market share to Apple Inc’s iPhone and devices powered by Google’s market-leading Android operating system, even among the business customers who once used BlackBerry exclusively.


RIM says its new devices will be faster and smoother than previous BlackBerry phones and will have a large catalog of apps, which are crucial to the success of any new line of smartphones.


It now plans to phase in a BlackBerry 10 Ready Program for enterprise customers, initially offering online training and webcasts, and then providing free trade-ups of licenses and services.


“We will be aggressively reaching out to our customers to make sure they are aware of this program,” said Bryan Lee, senior director of enterprise at RIM. “We see this as really the linchpin for helping our customers to transition to BB10.”


Early adoption of BlackBerry 10 by government and corporate clients will go a long way in easing the concerns of both RIM’s clients and investors. Many fear that a lackluster market reception to BB10 could seal RIM’s fate.


RIM, which does not say what percentage of its business comes from the enterprise customers, said its online training and webcast series are already in place. Trade-ups, including free upgrades on the licenses for BB10 operating system, will be available ahead of the January 30 launch.


Evercore Partners analyst Mark McKechnie said RIM’s step-by-step program to woo enterprise customers was a positive move, though it highlights the challenges RIM faces.


“We are encouraged with an ‘all out’ marketing campaign with the right incentives to motivate enterprises to upgrade,” he said in a note to clients. “Our take is that this will remove a roadblock for those already planning to upgrade, but likely won’t push too many who prefer to wait.”


McKechnie, who has an “equal-weight” rating on RIM’s stock, said the move is unlikely to tempt back customers who have already abandoned the BlackBerry in favor of iPhones and Android devices. RIM offers support for the rival devices, but needs corporates to update to Blackberry Enterprise Service 10 so they can power and run BB10 devices on their networks.


BB10 READY


RIM’s Lee said he sees tremendous excitement from enterprise customers who want to use the new platform, but he would not speculate on how many would be ready to transition to the new platform come launch day.


RIM said last month that its BlackBerry Enterprise Server 10, which runs the devices on corporate networks, is in beta testing with around 20 key government agencies and corporates.


Feedback on the BB10 devices and platform has been largely positive from both carriers and developers. Financial analysts remain divided.


Some have upgraded their ratings and targets on RIM’s share price in anticipation of a successful launch of BB10, while others believe the new platform has little chance of succeeding.


TD Securities analyst Scott Penner on Wednesday raised his price target on RIM to $ 12 from $ 9.50, but said RIM still faces significant hurdles.


RIM’s stock has surged over the last two months from multi-year lows around $ 6 as the launch date for the new devices nears. The stock is still more than 90 percent below the 2008 all-time high around $ 148.


The latest TSX data indicates that short positions in RIM shares have fallen dramatically in the last two weeks. The total short positions in RIM, a bet that the stock price will fall, on the TSX fell to 15.2 million as of November 30, down from 20.6 million in the prior two weeks.


RIM shares slipped 0.4 percent to $ 11.89 on the Nasdaq on Thursday. The Toronto-listed shares ended down 0.3 percent at C$ 11.81.


(Reporting by Euan Rocha; Editing by Jeremy Laurence, Janet Guttsman and Leslie Adler)


Gadgets News Headlines – Yahoo! News


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New tragedy rocks NFL's regularly scheduled world


The games go on.


For the second straight weekend, tragedy rocked the regularly scheduled world of the NFL. It left families, friends, teammates and coaching staffs grieving over yet another senseless loss of life. It also left the league facing questions not only about efforts to safeguard players on the field but whether it's doing enough to help them stay out of harm's way once they step outside the white lines.


In the early-morning hours Saturday in Irving, Texas, 24-year-old Dallas Cowboys nose tackle Josh Brent got behind the wheel of his Mercedes alongside teammate Jerry Brown and sped off, the prelude to a one-car accident that would leave Brown dead at 25 and Brent sitting in jail facing a felony charge of intoxicated manslaughter.


All this happened little more than three years after Brent was sentenced to probation and 60 days in jail in a plea agreement following his drunken driving arrest while playing football at the University of Illinois, where he and Brown were teammates as well.


That it happened just a week after Kansas City linebacker Jovan Belcher shot his girlfriend to death, then drove to the Chiefs' training facility and took his own life with the same gun, raised questions about the league's responsibility to the young men it empowers and enriches — in some cases, almost overnight.


"I don't know that anybody has the answer, to be honest. They're human beings, kids in most of the cases like this, and they're going to make mistakes," said Dan Reeves, who played seven years for the Cowboys before launching an NFL coaching career that included four stops over four decades.


"As a coach, you've got more than 50 players, if you count practice squad guys, that you're trying to keep an eye on. And both the league and the team invest an awful lot of time and money trying to educate them about the opportunities and pitfalls that are set out in front of them. ...


"But no matter what you do, some are going to believe the bad stuff will never happen to them. And teams spend so much time together, they become like families. It's easy to get lulled into thinking you know which ones need a pat on the back and which ones a kick in the behind. Yet this shows we don't always learn the real strengths and weaknesses of some until it's too late. Everybody deals with that knowledge in their own way.


"But if you're going to play," Reeves said finally. "I don't know any other way to honor that person than to play as hard as you can."


The emotional scene that roiled Kansas City in the wake of Belcher's murder-suicide a week earlier shifted to Cincinnati, where the Cowboys arrived Saturday night to complete preparations before Sunday's kickoff against the Bengals.


The team cut short its regular two-hour meeting and made sure counselors were on hand to speak to players afterward. But when owner Jerry Jones spoke with a Fox interviewer outside the locker room shortly before the game, his eyes were rimmed red and he spoke haltingly about Brown.


"Our team loved him. They certainly are conscious of him and want his family to know and have as much of them as they can give. At the same time," he added, "they know that one of the best things they can do for him and his memory is to come to the game today, is go out and play well."


How the NFL responds to this latest tragedy remains to be seen. Earlier this summer, cognizant of both the rising number of domestic violence and DUI incidents involving players, Commissioner Roger Goodell pledged to address both problems.


"We are going to do some things to combat this problem because some of the numbers on DUIs and domestic violence are going up and that disturbs me," he told CBS Sports. "When there's a pattern of mistakes, something has got to change."


In several important ways, player conduct has already improved significantly since Goodell took over from Paul Tagliabue.


In 2006, Goodell's first season, 68 players were arrested for crimes more severe than a traffic violation. Since then, arrests for crimes including domestic violence, drunken driving and gun possession are down 40 percent.


Yet, as Goodell noted, the number of incidents in the last year have climbed at an alarming rate — according to one study, 21 of the league's 32 teams had at least one player charged with domestic violence or sexual assault — and the tragedies involving players on successive weekends has already prompted accusations that the league isn't doing nearly enough.


On Saturday in Kansas City, a dozen members of the Chiefs' organization attended a memorial service for Kasandra Perkins. Among them was general manager Scott Pioli, whom Belcher spoke with in the parking lot of the Chiefs facility to thank before turning the gun on himself. A day later, just as the Chiefs did against the Panthers last Sunday, the Cowboys rallied to win their game against the Bengals.


The team has already canceled its annual Christmas party, scheduled for Monday at Cowboys Stadium, and instead began planning a memorial service for Brown.


"From here on, they're in uncharted waters," Reeves said. "No one can point the best way forward. I was lucky in that sense: We never had to deal with the nightmare of losing a friend and teammate. One thing I'm certain of, though — it's going to haunt some of them for a long time to come."


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Interest Groups Push to Fill Margins of Health Coverage





The chiropractors were out in force, lobbying for months to get their services included in every state’s package of essential health benefits that will be guaranteed under the new health care law.




“We’ve been in constant contact with our state chapters, just telling them, ‘Look, you’ve got to get in the room,’ ” said John Falardeau, senior vice president of government relations at the American Chiropractic Association.


The acupuncturists were modest by comparison, ultimately focusing on a few states, like California, where they had the best odds of being included.


“Our profession really didn’t have a million dollars to spend on a lobbyist,” said Jeannie Kang, the immediate past president of the American Association of Acupuncture and Oriental Medicine. Instead, they mobilized 20,000 acupuncturists and their patients in a letter-writing campaign.


Both efforts seem to have shown results. Most of the roughly two dozen states that have chosen their essential benefits — services that insurance will have to cover under the law — have decided to include chiropractic care in their package. Four states — California, Maryland, New Mexico and Washington — included acupuncture for treating pain, nausea and other ailments. It is also likely to be an essential benefit in Alaska and Nevada, according to the Department of Health and Human Services.


“To me, six is huge,” said Ms. Kang, an acupuncturist in Los Angeles, who helped coordinate the lobbying effort.


The main goal of the health care law has always been to guarantee medical coverage to nearly all Americans, but as states finalize their benefits packages, it is becoming clear that what is received will depend partly on location.


According to proposals that the states have submitted to the Department of Health and Human Services, insurance plans will have to cover weight-loss surgery in New York and California, for example, but not in Minnesota or Connecticut. Infertility treatment will be a required benefit in Massachusetts, but not in Arizona.


Over all, the law requires that essential health benefits cover 10 broad categories, including emergency services, maternity and newborn care, hospitalization, preventive care and prescription drugs. But there is room for variation in those categories. Whether insurance will pay for hearing aids, foot care, speech therapy and various medications will vary significantly by state.


The Obama administration originally planned to impose a single set of essential benefits nationwide, so groups like Ms. Kang’s lobbied federal officials at first. But last year, amid accusations that the health care law was too rigid, it decided to allow each state to choose its own guaranteed benefits within the 10 broad categories.


The law stipulates that starting in January 2014, the essential benefits will have to be covered by insurance plans offered in individual and small-group markets. These are the plans that people will shop for to comply with the law’s mandate that almost everyone have health coverage or pay a penalty. They will be available through health insurance exchanges, online markets where the uninsured can shop for coverage, often with federal subsidies to help pay for it.


The essential benefits will not be guaranteed to people who get coverage through large employers, but such plans already tend to be relatively generous. In comparison, many plans currently sold on the individual market do not cover maternity care, for example, or mental health services.


For the most part, states are defining their essential benefits as those provided by the largest health plan in their small-group insurance market. In Washington State, for example, that plan covers 12 acupuncture visits and 10 chiropractic visits per year. It does not cover in vitro fertilization, weight-loss programs or routine foot care for anyone except diabetics.


“Everybody really was conscious of the cost impact that the plan was going to have,” said Stephanie Marquis, a spokeswoman for the state’s insurance commissioner. “That’s something we’re working very hard at keeping an eye on and making sure we’re not adding benefits unnecessarily.”


Alan Weil, executive director of the National Academy for State Health Policy, said that while the essential benefit packages vary at the margins, they are similar over all. Every state’s package will cover visits to primary care doctors and specialists, for example, and diagnostic tests like X-rays and blood work.


“To people who care about particular diseases or conditions or provider groups, these don’t feel like the margins,” Mr. Weil said. “But at the end of the day, the core benefits are very standardized, and the differences are at the periphery.”


Some states have declined to choose an essential benefits package, saying that the law does not give them enough latitude. In those states, the default will be the largest plan available in their small-group insurance market, according to the Department of Health and Human Services.


Gov. Dave Heineman, Republican of Nebraska, chose an insurance plan with a high deductible as his state’s benchmark, reasoning that such lower-cost plans were popular in the state. But the Obama administration recently informed him that the plan did not meet the requirements of the law, he said.


“The point we were trying to make is that the minimum coverage should not be above what people need,” Mr. Heineman said. “The overriding concern is that the cost will be too great.”


Other states delayed choosing a benchmark plan on the grounds that the Obama administration had not provided enough guidance. Last month, the administration published a proposed rule that sought to answer outstanding questions.


The rule makes clear, for example, that insurers can substitute one covered service for another as long as they are in the same broad category and “substantially equal.” It clarifies that pediatric services, one of the 10 required categories, must be provided to everyone 18 and under.


States can still change or choose a benchmark plan, but they are running out of time. They generally have until Dec. 26, when the comment period for the proposed rule will end. So far, 23 states and the District of Columbia have chosen plans, according to Avalere Health, a consulting company.


Interest groups that did not succeed in getting a particular service covered may have another chance to do so. States will most likely be able to change their benchmark plans after 2015. So groups like the Obesity Action Coalition will keep making their case.


“There’s going to be a great deal more effort on this issue,” said Chris Gallagher, a policy consultant for the coalition. “At a minimum, if plans are going to try to exclude obesity treatment services, there must be some kind of exception for medically necessary treatment. It’s a serious medical condition that affects one in three Americans.”


Likewise, Ms. Kang’s group will keep presenting state decision makers with patient testimonials and research studies on the benefits of acupuncture. Its next targets are New York and Florida, which have more licensed acupuncturists than any state except California.


The chiropractors, meanwhile, are focused on California, where the essential benefits package that Gov. Jerry Brown signed into law in September does not include chiropractic services. Mr. Falardeau said the American Chiropractic Association was still hoping for a change.


“We’re ready, if we have to, to go to war on it,” he said.


This article has been revised to reflect the following correction:

Correction: December 10, 2012

An article on Thursday about the way in which benefits under the new health care law will vary from state to state, using information from the Department of Health and Human Services, misidentified a state that has proposed making infertility treatment a required benefit. It is Massachusetts, not New Hampshire.



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Bloomberg Weighs Making a Run for Financial Times





Not long ago, The Financial Times would have been the crown jewel of any media company, instantly conferring prestige and influence on its owner. Now, given the likely bidders, one of the world’s most respected and distinctive financial newspapers could end up as a trophy to help sell more computer terminals.




Michael R. Bloomberg is weighing the wisdom of buying The Financial Times Group, which includes the paper and a half interest in The Economist, according to three people close to Mr. Bloomberg who spoke on the condition of anonymity to divulge private conversations.


Mr. Bloomberg has long adored The Economist, and his affinity for the paper, at least as a reader, has deepened lately. Its bisque-colored pages, once rarely seen in the thick stack of newspapers Mr. Bloomberg carries under his arm all day, have become a mainstay. Friends say he favors its generally short, punchy and to-the-point articles, which match his temperament.


In October, Mr. Bloomberg visited the London headquarters of The Financial Times, a few blocks away from Bloomberg L.P.’s giant new London complex, which is still under construction. When an editor asked if he would buy the paper, Mr. Bloomberg replied, “I buy it every day.”


He has spoken openly with friends and aides about the potential benefits and pitfalls of making such a costly acquisition in an industry he admires deeply as a reader but sneers at as a businessman, these same people said. And he has recently taken to rattling off circulation figures and “penetration” rates for the paper.


“It’s the only paper I’d buy,” he has said to one associate. “Why should I buy it?” he has asked another.


His ambivalence speaks to the troubles facing the newspaper business, and to the complex motivations of the mayor himself. Drawn to power and prominence, Mr. Bloomberg is wrestling with his affection for the paper as its potential publisher and his wariness of an investment that could mar his company’s reputation for achieving outsize profits. Pearson, the parent company of The Financial Times Group, does not break out separate financial results for the paper, but analysts estimate that it loses money. A spokesman for the mayor declined to comment on his conversations about the paper.


For Thomson Reuters, the other likely bidder, the calculation is somewhat different. Unlike Mr. Bloomberg, who started his financial information company in 1982, James C. Smith, president and chief executive of Thomson Reuters, came up through Thomson’s regional newspapers and has ink in his veins. A replica of an old-fashioned printing press is on display in his corner office overlooking Times Square.


But the company has been hurt financially after its newest desktop terminal product struggled to catch on. In the first nine months of 2012, the company reported revenue of $9.88 billion, a 3 percent decrease from the period a year earlier. A company spokesman declined to comment.


The Financial Times could expand the Thomson Reuters brand and give its reporters additional exposure since, unlike Bloomberg, which bought Businessweek in 2009, the company does not own a regular magazine. Thomson Reuters, partly a British company, and The Financial Times also have large footprints in Asia.


But first, the paper needs to be put on the block. Pearson is about to lose two of its top executives, raising speculation the paper could be for sale. Analysts value The Financial Times Group at about $1.2 billion, well within the reach of Bloomberg L.P., which in 2011 had revenue of $7.6 billion, and Thomson Reuters, which posted revenue of $13.8 billion.


The paper has a successful digital strategy, and analysts have said that its strict online pay wall is considered a financial success. But like most newspapers, it is struggling in an industrywide decline in print advertising revenue. In the three months ending Oct. 1, the paper’s total paid circulation exceeded 600,000, more than half of which was from digital subscriptions. In its most recent earnings report, Pearson said it expected profit to decline because of a sluggish advertising market and “the shift from print to digital.”


Marjorie Scardino, Pearson’s longtime chief executive, who once said the paper would be sold “over my dead body,” is departing on Dec. 31. Rona Fairhead, chief executive of The Financial Times Group, will leave at the end of April. Both executives had championed the print businesses. A successor to Ms. Fairhead has yet to be named, though one person close to the company pointed to John Ridding, the chief executive of the paper.


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Syrian Rebels Tied to Al Qaeda Play Key Role in War


Sana Handout, via European Pressphoto Agency


In May in Damascus, Syrian workers removed debris from two car bombs that were linked to the Qaeda-backed Nusra Front.







BAGHDAD — The lone Syrian rebel group with an explicit stamp of approval from Al Qaeda has become one of the uprising’s most effective fighting forces, posing a stark challenge to the United States and other countries that want to support the rebels but not Islamic extremists.




Money flows to the group, the Nusra Front, from like-minded donors abroad. Its fighters, a small minority of the rebels, have the boldness and skill to storm fortified positions and lead other battalions to capture military bases and oil fields. As their successes mount, they gather more weapons and attract more fighters.


The group is a direct offshoot of Al Qaeda in Iraq, Iraqi officials and former Iraqi insurgents say, which has contributed veteran fighters and weapons.


“This is just a simple way of returning the favor to our Syrian brothers that fought with us on the lands of Iraq,” said a veteran of Al Qaeda in Iraq, who said he helped lead the Nusra Front’s efforts in Syria.


The United States, sensing that time may be running out for Syria’s president, Bashar al-Assad, hopes to isolate the group to prevent it from inheriting Syria or fighting on after Mr. Assad’s fall to pursue its goal of an Islamic state.


As the United States pushes the Syrian opposition to organize a viable alternative government, it plans to blacklist the Nusra Front as a terrorist organization, making it illegal for Americans to have financial dealings with the group and most likely prompting similar sanctions from Europe. The hope is to remove one of the biggest obstacles to increasing Western support for the rebellion: the fear that money and arms could flow to a jihadi group that could further destabilize Syria and harm Western interests.


When rebel commanders met Friday in Turkey to form a unified command structure at the behest of the United States and its allies, jihadi groups were not invited.


The Nusra Front’s ally, Al Qaeda in Iraq, is the Sunni insurgent group that killed numerous American troops in Iraq and sowed widespread sectarian strife with suicide bombings against Shiites and other religious and ideological opponents. The Iraqi group played an active role in founding the Nusra Front and provides it with money, expertise and fighters, said Maj. Faisal al-Issawi, an Iraqi security official who tracks jihadi activities in Iraq’s Anbar Province. 


But blacklisting the Nusra Front could backfire. It would pit the United States against some of the best fighters in the insurgency that it aims to support. While some Syrian rebels fear the group’s growing power, others work closely with it and admire it — or, at least, its military achievements — and are loath to end their cooperation.


Leaders of the Free Syrian Army, the loose-knit rebel umbrella group that the United States seeks to bolster, expressed exasperation that the United States, which has refused to provide weapons throughout the conflict that has killed more than 40,000 people, is now opposing a group they see as a vital ally.


The Nusra Front “defends civilians in Syria, whereas America didn’t do anything,” said Mosaab Abu Qatada, a rebel spokesman. “They stand by and watch; they look at the blood and the crimes and brag. Then they say that Nusra Front are terrorists."


He added, “America just wants a pretext to intervene in Syrian affairs after the revolution.”


The United States has been reluctant to supply weapons to rebels that could end up in the hands of anti-Western jihadis, as did weapons that Qatar supplied to Libyan rebels with American approval. Critics of the Obama administration’s Syria policy counter that its failure to support the rebels helped create the opening that Islamic militants have seized in Syria.


The Nusra Front’s appeals to Syrian fighters seem to be working.


At a recent meeting in Damascus, Abu Hussein al-Afghani, a veteran of insurgencies in Afghanistan, Iraq and Libya, addressed frustrated young rebels. They lacked money, weapons and training, so they listened attentively.


He told them he was a leader of Al Qaeda in Iraq, now working with a Qaeda branch in Syria, and by joining him, they could make their mark. One fighter recalled his resonant question: “Who is hearing your voice today?”


On Friday, demonstrators in several Syrian cities raised banners with slogans like, “No to American intervention, for we are all Jebhat al-Nusra,” referring to the group’s full name, Ansar al-Jebhat al-Nusra li-Ahl al-Sham, or Supporters of the Front for Victory of the People of Syria. One rebel battalion, the Ahrar, or Free Men, asked on its Facebook page why the United States did not blacklist Mr. Assad’s “terrorist” militias.


Another jihadist faction, the Sahaba Army in the Levant, even congratulated the group on the “great honor” of being deemed terrorists by the United States.


Tim Arango reported from Baghdad, and Anne Barnard and Hwaida Saad from Beirut, Lebanon. Reporting was contributed by Hania Mourtada from Beirut; Duraid Adnan and Yasir Ghazi from Baghdad; employees of The New York Times from Mosul, Iraq, and the provinces of Anbar and Diyala; and Michael R. Gordon from Dublin.



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Marquez knocks out Pacquiao in 6th round


LAS VEGAS (AP) — No need for Juan Manuel Marquez to impress the judges. No need for the referee to count to 10.


Marquez took care of all of his business Saturday night with a thunderous right hand that left Manny Pacquiao face first on the canvas with his remarkable career in question.


Unable to win a decision in their first three fights, Marquez won the old-fashioned way with a huge right hand that put Pacquiao down for the second time in the fight at 2:59 of the sixth round.


Referee Kenny Bayless never bothered to count as Marquez leaped into his handlers' arms in celebration and Pacquiao's wife broke into tears at ringside.


"I threw a perfect punch," Marquez said. "I knew Manny could knock me out at any time."


It was a stunning end to a thrilling fight, the fourth one in the last eight years between the two men. It could also be the end of the Filipino's career, though he said in the ring afterward he would like to fight Marquez for a fifth time.


"If you give us a chance, we'll fight again," Pacquiao said. "I was just starting to feel confident and then I got careless."


Pacquiao had been down in the third round but knocked Marquez down in the fifth and the two were exchanging heavy blows in the sixth round before Marquez threw a right hand that flattened Pacquiao face down on the canvas.


"I thought I was getting him in the last couple of rounds but I got hit by a strong punch," Pacquiao said. "I never expected that punch."


Pacquiao was down for about two minutes before his handlers managed to get him up as Marquez celebrated and the sold-out crowd at the MGM erupted.


After being helped to his corner, Pacquiao sat on a stool, blew his nose and stared vacantly ahead as his handlers cut his gloves off. It was a stunning end to a furious fight, and Pacquiao was later taken to a hospital for precautionary examination.


"We always worked on that punch," Marquez said. "We knew he was going to come out aggressive so we had a fight plan that was more technical. We were able to capitalize on it."


Marquez had vowed to finally beat Pacquiao after losing two close fights and settling for a draw in the first fight. But after Pacquiao knocked him down in the fifth round and was landing big left hands, it looked like it would be Pacquiao's night.


The two came out for the sixth round and the pace was just as relentless. Both were landing big punches and both were brawling when suddenly as the round came to close Marquez shot out a right hand that landed flush to the jaw of Pacquiao, who crumpled to the canvas in a heap.


"I felt he was coming to knock me out the last three rounds and I knew he was going to be wide open," Marquez said.


It was the second loss in a row for Pacquiao, who dropped a decision to Timothy Bradley in June and who had vowed to regain his prominence in the ring.


Pacquiao was aggressive from the opening bell, but paid the price in the third round when he got caught by a Marquez right hand that put him down. Pacquiao got back up and seemingly took control of the fight, dropping Marquez in the fifth round and landing the bigger punches until he was dropped.


"I got hit by a punch I didn't see," Pacquiao said.


Pacquiao, who earned more than $20 million for the fight, was ahead 47-46 on all three scorecards after the fifth round.


There was no title at stake in the 147-pound fight, but that didn't stop 16,348 fans from filling the MGM Grand Arena and roaring in unison from the opening bell as the two fighters went after each other.


Ringside punching stats underscored the ferocity of the bout, showing Pacquiao landing 94 of 256 punches to 52 of 246 for Marquez. But it was the one big right hand from Marquez that counted more than anything, knocking Pacquiao out for the first time in a career that goes back 17 years.


"He was in charge," Pacquiao's trainer, Freddie Roach said. "He just got a little too careless and got hit with a punch he didn't see."


Promoter Bob Arum immediately said he could see a fifth fight between the two boxers, and a dazed Pacquiao seemed to agree.


"Why not?" he said.


Pacquiao weighed the class limit of 147 pounds, but it was Marquez who looked like the stronger fighter entering the ring after having bulked up with the help of a strength conditioner, though he weighed in at 143 pounds. In their earlier fights, Pacquiao had been the bigger puncher, knocking Marquez down a total of four times, but on this night it was Marquez who had the biggest punch.


The stunning knockout was the first real loss by Pacquiao in seven years. He lost a close decision to Bradley in his last fight, but most ringside observers believed he had won it fairly convincingly.


Marquez improved to 55-6-1 with 40 knockouts, while Pacquiao fell to 54-5-2.


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New Taxes to Take Effect to Fund Health Care Law





WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.




The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.


Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.


To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.


The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.


Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.


Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.


Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.


Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.


In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.


Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.


Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.


The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.


David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.


The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.


Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.


Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.


In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.


Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.


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