Penalty could keep smokers out of health overhaul

WASHINGTON (AP) — Millions of smokers could be priced out of health insurance because of tobacco penalties in President Barack Obama's health care law, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation.

The Affordable Care Act — "Obamacare" to its detractors — allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.

For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums.

Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration. But older smokers could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge.

Workers covered on the job would be able to avoid tobacco penalties by joining smoking cessation programs, because employer plans operate under different rules. But experts say that option is not guaranteed to smokers trying to purchase coverage individually.

Nearly one of every five U.S. adults smokes. That share is higher among lower-income people, who also are more likely to work in jobs that don't come with health insurance and would therefore depend on the new federal health care law. Smoking increases the risk of developing heart disease, lung problems and cancer, contributing to nearly 450,000 deaths a year.

Insurers won't be allowed to charge more under the overhaul for people who are overweight, or have a health condition like a bad back or a heart that skips beats — but they can charge more if a person smokes.

Starting next Jan. 1, the federal health care law will make it possible for people who can't get coverage now to buy private policies, providing tax credits to keep the premiums affordable. Although the law prohibits insurance companies from turning away the sick, the penalties for smokers could have the same effect in many cases, keeping out potentially costly patients.

"We don't want to create barriers for people to get health care coverage," said California state Assemblyman Richard Pan, who is working on a law in his state that would limit insurers' ability to charge smokers more. The federal law allows states to limit or change the smoking penalty.

"We want people who are smoking to get smoking cessation treatment," added Pan, a pediatrician who represents the Sacramento area.

Obama administration officials declined to be interviewed for this article, but a former consumer protection regulator for the government is raising questions.

"If you are an insurer and there is a group of smokers you don't want in your pool, the ones you really don't want are the ones who have been smoking for 20 or 30 years," said Karen Pollitz, an expert on individual health insurance markets with the nonpartisan Kaiser Family Foundation. "You would have the flexibility to discourage them."

Several provisions in the federal health care law work together to leave older smokers with a bleak set of financial options, said Pollitz, formerly deputy director of the Office of Consumer Support in the federal Health and Human Services Department.

First, the law allows insurers to charge older adults up to three times as much as their youngest customers.

Second, the law allows insurers to levy the full 50 percent penalty on older smokers while charging less to younger ones.

And finally, government tax credits that will be available to help pay premiums cannot be used to offset the cost of penalties for smokers.

Here's how the math would work:

Take a hypothetical 60-year-old smoker making $35,000 a year. Estimated premiums for coverage in the new private health insurance markets under Obama's law would total $10,172. That person would be eligible for a tax credit that brings the cost down to $3,325.

But the smoking penalty could add $5,086 to the cost. And since federal tax credits can't be used to offset the penalty, the smoker's total cost for health insurance would be $8,411, or 24 percent of income. That's considered unaffordable under the federal law. The numbers were estimated using the online Kaiser Health Reform Subsidy Calculator.

"The effect of the smoking (penalty) allowed under the law would be that lower-income smokers could not afford health insurance," said Richard Curtis, president of the Institute for Health Policy Solutions, a nonpartisan research group that called attention to the issue with a study about the potential impact in California.

In today's world, insurers can simply turn down a smoker. Under Obama's overhaul, would they actually charge the full 50 percent? After all, workplace anti-smoking programs that use penalties usually charge far less, maybe $75 or $100 a month.

Robert Laszewski, a consultant who previously worked in the insurance industry, says there's a good reason to charge the maximum.

"If you don't charge the 50 percent, your competitor is going to do it, and you are going to get a disproportionate share of the less-healthy older smokers," said Laszewski. "They are going to have to play defense."

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Online:

Kaiser Health Reform Subsidy Calculator — http://healthreform.kff.org/subsidycalculator.aspx

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North Korea to target U.S. with nuclear, rocket tests

SEOUL (Reuters) - North Korea said on Thursday it would carry out further rocket launches and a nuclear test that would target the United States, dramatically stepping up its threats against a country it called its "enemy".

The announcement by the country's top military body came a day after the United Nations Security Council agreed a U.S.-backed resolution to censure and sanction the country for a rocket launch in December that breached U.N. rules.

"We are not disguising the fact that the various satellites and long-range rockets that we will fire and the high-level nuclear test we will carry out are targeted at the United States," North Korea's National Defence Commission said, according to state news agency KCNA.

North Korea is believed by South Korea and other observers to be "technically ready" for a third nuclear test, and the decision to go ahead rests with leader Kim Jong-un who pressed ahead with the December rocket launch in defiance of the U.N. sanctions.

"Whether North Korea tests or not is up to North Korea," Glyn Davies, the top U.S. envoy for North Korean diplomacy, said in the South Korean capital of Seoul as KCNA released its statement.

"We hope they don't do it. We call on them not to do it," Davies said. "This is not a moment to increase tensions on the Korean peninsula."

The North was banned from developing missile and nuclear technology under sanctions dating from its 2006 and 2009 nuclear tests.

The concern now is that Pyongyang, whose only major diplomatic ally, China, endorsed the latest U.N. resolution, could undertake a third nuclear test using highly enriched uranium for the first time, opening a second path to a bomb.

Its previous tests have been viewed as limited successes and used plutonium, of which the North has limited stocks.

North Korea gave no time-frame for the coming test and often employs harsh rhetoric in response to U.N. and U.S. actions.

Its long-range rockets are not seen as capable of reaching the United States mainland and it is not believed to have the technology to mount a nuclear warhead on a long-range missile.

"The UNSC (Security Council) resolution masterminded by the U.S. has brought its hostile policy towards the Democratic Peoples Republic of Korea (North Korea) to its most dangerous stage," the commission was quoted as saying.

(Writing by David Chance; Editing by Raju Gopalakrishnan)

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Taiwanese activists head for Japan-controlled isles

TOKYO: A boatload of Taiwanese activists protected by the island's coastguard was on Thursday heading for Japanese-held islands at the centre of a bitter international wrangle involving Tokyo, Beijing and Taipei.

The seven activists left port in Taiwan on a fishing vessel in the early hours and were expected to arrive in the area around the uninhabited islands about noon (0400 GMT), Taiwanese coastguard spokesman Shih Yi-che said.

A coastguard official in Japan said the vessel was "sailing towards the Senkakus".

The islands in the East China Sea, whose seabed is believed to harbour valuable mineral reserves, are known as Senkaku in Japanese and Diaoyu in Chinese. Both China and Taiwan claim them.

The group said it was on its way to plant a statue of a sea goddess believed by coastal communities in the region to have the power to protect seafarers, but it was not clear if the activists would attempt to land.

It also intended to "maintain sovereignty" against Japan's control, said Hsieh Mang-lin, the Taiwanese chairman of the Chinese Association for Protecting the Diaoyutais (Diaoyu Islands), in a short statement.

Japanese broadcaster NHK reported that Taipei had dispatched six patrol boats to "monitor" the ship, adding it was the same one that had entered waters off the islands in July.

Taiwan's coastguard denied it was an organised flotilla.

"Coastguard ships that patrol the area routinely will protect the boat," said spokesman Shih, who declined to give the number of official Taiwanese vessels in the area.

"The coastguard will protect our people's voluntary actions to defend the Diaoyu islands. Coastguard vessels will go wherever the fishing boat is... to defend our sovereignty and protect our fishing rights," a statement said.

In September, coastguard vessels from Japan and Taiwan duelled with water cannon after dozens of Taiwanese boats were escorted by patrol ships into the islands' waters.

Earlier, Japanese media reports had said there were Hong Kong activists on board the boat, but a spokesman for the southern Chinese territory's main Diaoyu protest group told AFP it was not involved.

Previous activist landings have resulted in the arrest and deportation of those setting foot on what Japan says has been its indisputable territory for more than a century.

The rocky island outposts have been the scene of a diplomatic tussle between Japan and China for months.

Japan's government nationalised three of them in September by taking them out of private Japanese ownership.

Since then, Beijing has repeatedly sent government ships into the waters. In December, a Chinese government plane flew over them, leading Japan to scramble fighter jets.

Earlier this month, both militaries had jets in the area and Japanese newspapers have reported that Tokyo is mulling allowing its pilots to fire warning shots.

While most commentators believe Asia's two largest economies will find some way to work around the problem, which has rattled relations for decades, some are warning that a mis-step could lead to armed confrontation.

- AFP/al

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Is Akbaruddin Owaisi in a bad way?

HYDERABAD: In a development which could give the government sleepless nights, doctors attending on Akbaruddin Owaisi, the jailed MIM legislator, said his health was failing and the 41-year-old leader should be moved, at least, to a prison facility which is close to a multi-speciality hospital.

Owaisi junior is being treated at the Adilabad district hospital, which doctors said did not have modern medical facilities. "According to the last ultrasound done a few months ago, several abdominal adhesions, which are basically fibrous bands between tissues and organs were found and if this is not checked, it can quickly turn into sub-acute obstruction, which would need surgery," said Dr Verghese Muthai, a colorectal surgeon at Yashoda Hospital, Somajiguda.

"If left untreated for a long time, this can lead to full intestinal obstruction which is fatal," he added. Owaisi, who has been arrested for a hate speech delivered in Nirmal town last month, has been made to travel for hundreds of kilometres across three districts to appear before different courts after doctors in Adilabad said he was fit for travel.

Off late, his lawyers are moving bail petition on health grounds, which some observers say is quite common and the fact that he had happily attended party meetings regularly before he was jailed could be a further testimony to his fitness. "His health is not bad. He is okay. The stories of his bad health are being spread to get a quick bail," said a doctor who did not want to be named.

But what is perhaps making the government nervous is the absence of quality healthcare facilities in Adilabad and sources said that perhaps prompted authorities to move him to a guest house from the subjail where he was initially lodged.

Owaisi's case-sheet

Akbar suffering from abdominal adhesions.

Is due for three surgeries: For adhesions and hernia, tendon replacement in left arm and removal of bullet in thigh

Both kidneys working at sub-optimal levels

Also suffers from uticaria, a skin infection

Prone to drug allergies

Doc says should be shifted to a prison facility which is close to a multi-speciality hospital

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Women have caught up to men on lung cancer risk

Smoke like a man, die like a man.

U.S. women who smoke today have a much greater risk of dying from lung cancer than they did decades ago, partly because they are starting younger and smoking more — that is, they are lighting up like men, new research shows.

Women also have caught up with men in their risk of dying from smoking-related illnesses. Lung cancer risk leveled off in the 1980s for men but is still rising for women.

"It's a massive failure in prevention," said one study leader, Dr. Michael Thun of the American Cancer Society. And it's likely to repeat itself in places like China and Indonesia where smoking is growing, he said. About 1.3 billion people worldwide smoke.

The research is in Thursday's New England Journal of Medicine. It is one of the most comprehensive looks ever at long-term trends in the effects of smoking and includes the first generation of U.S. women who started early in life and continued for decades, long enough for health effects to show up.

The U.S. has more than 35 million smokers — about 20 percent of men and 18 percent of women. The percentage of people who smoke is far lower than it used to be; rates peaked around 1960 in men and two decades later in women.

Researchers wanted to know if smoking is still as deadly as it was in the 1980s, given that cigarettes have changed (less tar), many smokers have quit, and treatments for many smoking-related diseases have improved.

They also wanted to know more about smoking and women. The famous surgeon general's report in 1964 said smoking could cause lung cancer in men, but evidence was lacking in women at the time since relatively few of them had smoked long enough.

One study, led by Dr. Prabhat Jha of the Center for Global Health Research in Toronto, looked at about 217,000 Americans in federal health surveys between 1997 and 2004.

A second study, led by Thun, tracked smoking-related deaths through three periods — 1959-65, 1982-88 and 2000-10 — using seven large population health surveys covering more than 2.2 million people.

Among the findings:

— The risk of dying of lung cancer was more than 25 times higher for female smokers in recent years than for women who never smoked. In the 1960s, it was only three times higher. One reason: After World War II, women started taking up the habit at a younger age and began smoking more.

—A person who never smoked was about twice as likely as a current smoker to live to age 80. For women, the chances of surviving that long were 70 percent for those who never smoked and 38 percent for smokers. In men, the numbers were 61 percent and 26 percent.

—Smokers in the U.S. are three times more likely to die between ages 25 and 79 than non-smokers are. About 60 percent of those deaths are attributable to smoking.

—Women are far less likely to quit smoking than men are. Among people 65 to 69, the ratio of former to current smokers is 4-to-1 for men and 2-to-1 for women.

—Smoking shaves more than 10 years off the average life span, but quitting at any age buys time. Quitting by age 40 avoids nearly all the excess risk of death from smoking. Men and women who quit when they were 25 to 34 years old gained 10 years; stopping at ages 35 to 44 gained 9 years; at ages 45 to 54, six years; at ages 55 to 64, four years.

—The risk of dying from other lung diseases such as emphysema and chronic bronchitis is rising in men and women, and the rise in men is a surprise because their lung cancer risk leveled off in 1980s.

Changes in cigarettes since the 1960s are a "plausible explanation" for the rise in non-cancer lung deaths, researchers write. Most smokers switched to cigarettes that were lower in tar and nicotine as measured by tests with machines, "but smokers inhaled more deeply to get the nicotine they were used to," Thun said. Deeper inhalation is consistent with the kind of lung damage seen in the illnesses that are rising, he said.

Scientists have made scant progress against lung cancer compared with other forms of the disease, and it remains the leading cause of cancer deaths worldwide. More than 160,000 people die of it in the U.S. each year.

The federal government, the Canadian Institutes of Health Research, the Bill and Melinda Gates Foundation, the cancer society and several universities paid for the new studies. Thun testified against tobacco companies in class-action lawsuits challenging the supposed benefits of cigarettes with reduced tar and nicotine, but he donated his payment to the cancer society.

Smoking needs more attention as a health hazard, Dr. Steven A. Schroeder of the University of California, San Francisco, wrote in a commentary in the journal.

"More women die of lung cancer than of breast cancer. But there is no 'race for the cure' for lung cancer, no brown ribbon" or high-profile advocacy groups for lung cancer, he wrote.

Kathy DeJoseph, 62, of suburban Atlanta, finally quit smoking after 40 years — to qualify for lung cancer surgery last year.

"I tried everything that came along, I just never could do it," even while having chemotherapy, she said.

It's a powerful addiction, she said: "I still every day have to resist wanting to go buy a pack."

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Online:

American Cancer Society: http://www.cancer.org

National Cancer Institute: http://www.cancer.gov/cancertopics/tobacco/smoking and http://www.cancer.gov/cancertopics/types/lung

Medical journal: http://www.nejm.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Al Qaeda Commander Killed for the 3rd Time

The second in command of al Qaeda's Yemen affiliate was reportedly killed in an airstrike in Yemen in December, according to a news report by Arabic television network Al Arabiya, the third time the former Guantanamo detainee has been reported dead since 2010.

According to the report, Said al-Shihri died last month after sustaining severe injuries from a joint U.S.-Yemeni airstrike that targeted a convoy in which he was riding. The al Arabiya account, based on information from "family sources," said that the airstrike left al-Shihri in a coma. He allegedly died soon after and was buried in Yemen.

On Tuesday afternoon, hours after the initial report, a Yemeni government official denied having any information regarding the death of al-Shihri, according to Arabic news site al-Bawaba.

No photos of a body have yet surfaced and no mention of his death has appeared on jihadi forums.
This is the third time al-Shihri, the second in command of al Qaeda in the Arabian Peninsula (AQAP), has been reported killed since 2009. In 2010, the Yemeni government claimed it had captured him. In September 2012, Yemeni news sites reported he was killed in an American drone strike.

PHOTOS: Terrorists Who Came Back from the Grave

READ: Gitmo Detainee turned terror commander killed: Reports

Al-Shihri, a "veteran jihadist," traveled to Afghanistan shortly after the Sept. 11, 2001 terror attacks to fight coalition troops, only to be captured weeks later, according to West Point's Combating Terrorism Center. He was sent to the U.S. prison in Guantanamo Bay, Cuba, where he stayed for six years before being released to Saudi Arabia. There, he entered a so-called "jihadi rehab" program that attempted to turn terrorists into art students by getting them to get "negative energy out on paper," as the program's director told ABC News in 2009.

READ: Trading Bombs for Crayons: Terrorists Get 'Art Therapy'

But just months after he supposedly entered the fingerpainting camp, al-Shihri reappeared in Yemen where he was suspected to have been behind a deadly bombing at the U.S. embassy there.

At the time, critics of the "jihadi rehab" program used al-Shihri as evidence that extremists would just go through the motions in order to be freed.

Click Here for the Blotter Homepage.

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Netanyahu turns to Iran after narrow election win

JERUSALEM (Reuters) - Hawkish Prime Minister Benjamin Netanyahu claimed victory in Israel's parliamentary election, shrugging off surprise losses to centre-left challengers and vowing on Wednesday to stop Iran from acquiring nuclear weapons.

However, Tuesday's vote, which also disappointed religiously inspired hardliners, may deflect the premier's focus on confronting Tehran and resisting Palestinian demands as Israel's secular, middle-class demanded new attention to domestic issues.

That, in turn, might draw Netanyahu toward a less fractious relationship with his key ally, U.S. President Barack Obama, who himself embarked on a new term this week with great ambitions.

Exit polls showed the Israeli leader's right-wing Likud and the ultra-nationalist Yisrael Beitenu would remain the biggest bloc in the 120-member assembly, but with only 31 seats, 11 fewer than the 42 the two parties held in the last parliament.

If the exit polls compiled by three local broadcasters prove correct - and they normally do in Israel - Netanyahu would be on course for a third term in office, perhaps leading a hardline coalition that would promote Jewish settlement on occupied land.

But his weakened showing in a vote which he had called nine months early in the hope of a strong mandate for his struggle with Iran, could complicate his efforts to forge an alliance with a stable and substantial majority in parliament.

"I am proud to be your prime minister, and I thank you for giving me the opportunity, for the third time, to lead the state of Israel," the 63-year-old leader told a cheering crowd in the early hours of Wednesday at his campaign headquarters.

Netanyahu said he planned to form as broad a governing coalition as possible, suggesting he would seek partners beyond his traditional ultra-nationalist and religious allies. His first call may be to Yair Lapid, a former television anchorman whose centrist, secular party came from nowhere to second place.

"The first challenge was and remains preventing Iran from obtaining nuclear weapons," Netanyahu said.

Iran denies it is planning to build an atomic bomb, and says Israel, widely believed to have the only nuclear arsenal in the Middle East, is the biggest threat to the region.

Netanyahu views Tehran's nuclear program as a threat to Israel's existence and has stoked international concern by hinting at possible Israeli military action to thwart it.

He has shunted Palestinian peacemaking well down the agenda despite Western concern to keep the quest for a solution alive.

The projections showed right-wing parties with a combined strength of 61-62 seats against 58-59 for the centre-left.

Lapid's Yesh Atid (There is a Future) party should have 18 or 19 seats, exit polls showed - a stunning result for a newcomer to politics in a field of 32 contending parties.

Lapid won support amongst middle-class, secular voters by promising to resolve a growing housing shortage, abolish military draft exemptions for Jewish seminary students and seek an overhaul of the failing education system.

He urged Netanyahu "to build as broad a government as possible so that we can bring about real change in Israel".

The once dominant Labor party led by Shelly Yachimovich was projected to take third place with 17 seats. She described Likud victory claims as "ridiculous" before final results were in.

"There is a very good chance, a very good chance, that tomorrow morning Benjamin Netanyahu will not be able to form a government," she declared at her party headquarters.

Reconciling views to build a cabinet will certainly be hard.

"YESH ATID SWEEP"

Some in Netanyahu's party acknowledged that the election had gone somewhat awry. "We anticipated we would lose some votes to Lapid, but not to this extent. This was a Yesh Atid sweep," Likud campaign adviser Ronen Moshe told Reuters.

Lapid said before the election he would consider joining a Netanyahu-led government. If that happens, the ultra-Orthodox religious parties which often hold the balance of power in parliament might lose some of their leverage.

After a lackluster campaign, Israelis voted in droves on a sunny winter day, registering a turnout of 66.6 percent, the highest since 2003. That buoyed centre-left parties which had pinned their hopes on energizing an army of undecided voters against Netanyahu and his nationalist-religious allies.

"A big majority of middle class Israelis have voted strongly against the priorities of the last government," said Dan Avnon, a political science professor at Hebrew University.

"These are the people who pay the taxes and serve in the army," he said. "I don't think they can be ignored."

Opinion polls before the election had predicted an easy win for Netanyahu, although the last ones suggested he would lose some votes to the Jewish Home party, which opposes a Palestinian state and advocates annexing chunks of the occupied West Bank.

The exit polls projected 12 seats for Jewish Home.

The biggest casualty was the centrist Kadima party, which was projected to win no seats at all. It had gained the highest number in the previous election in 2009, although its then leader Tzipi Livni failed to put together a governing coalition.

Full election results are due by Wednesday morning and official ones will be announced on January 30. After that, President Shimon Peres is likely to ask Netanyahu, as leader of the biggest bloc in parliament, to try to form a government.

WESTERN ANXIETY

Whatever permutation finally emerges, a Netanyahu-led government is likely to resist any push for a peace deal with the Palestinians that would come anywhere near satisfying the moderates who seek a viable independent state alongside Israel.

Naftali Bennet, high-tech millionaire son of American immigrants who leads the hard-right, pro-settler Jewish Home party, was projected to win 12 seats - disappointing for him but still making his group a likely member of a coalition.

Bennet, who advocates annexing West Bank land to Israel, told cheering supporters: "There is only one truth and it is simple. The Land of Israel belongs to the people of Israel."

Britain warned Israel on Tuesday it was losing international support, saying Jewish settlement expansion had almost killed off prospects for a two-state solution.

U.S.-brokered peace talks broke down in 2010 amid mutual acrimony. Since then Israel has accelerated construction in the West Bank and east Jerusalem - land the Palestinians want for their future state - much to the anger of Western partners.

Netanyahu's relations with Obama have been notably tense and Martin Indyk, former U.S. ambassador to Israel, told the BBC the election was unlikely to change that.

"President Obama doesn't have high expectations that there's going to be a government in Israel committed to making peace and is capable of the kind of very difficult and painful concessions that would be needed to achieve a two-state solution," he said.

But Aaron David Miller, once a senior U.S. adviser on the peace process, said a weakening of the right might improve ties: "The fact is, if (Netanyahu) goes with Lapid and he reaches out to the centre, you're going to end up with an American-Israeli rapprochement to a certain degree," Miller told CNN.

Tuesday's vote was the first in Israel since Arab uprisings swept the region two years ago, reshaping the Middle East.

Netanyahu has said the turbulence, which has brought Islamist governments to power in several countries long ruled by secularist autocrats, including neighboring Egypt, shows the importance of strengthening national security.

Foreign policy issues barely registered during the election campaign, with a poll in Haaretz newspaper on Friday saying 47 percent of Israelis thought social and economic issues were the most pressing concern, against just 10 percent who cited Iran.

A major problem for the next government, which is unlikely to take power before mid-March, is the stuttering economy.

Data last week showed the budget deficit rose to 4.2 percent of gross domestic product in 2012, double the original estimate, meaning spending cuts and tax hikes look certain.

(Reporting by Jerusalem bureau; Editing by Alastair Macdonald)

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US urges Bangladesh to hold free, fair trials

WASHINGTON: The United States urged Bangladesh to hold free and fair trials after a war crimes court sentenced a fugitive TV preacher to death Monday amid allegations the tribunal is politically motivated.

The International Crimes Tribunal, a domestic body with no international oversight, ordered Maolana Abul Kalam Azad to be hanged for genocide and murder during the bloody 1971 liberation war against Pakistan.

"The United States supports bringing to justice those who commit such crimes," State Department spokeswoman Victoria Nuland said in a statement.

"However, we believe that any such trials must be free, fair and transparent, and in accordance with domestic standards and international standards Bangladesh has agreed to uphold through its ratification of international agreements."

Azad, who for years presented a widely watched show on Islam on private and state-run television channels, is a former leading light of Bangladesh's largest opposition Islamic party Jamaat-e-Islami.

The 63-year-old TV host has been on the run for about a year.

In total, 11 top opposition figures -- nine from Jamaat and two from the main opposition Bangladesh Nationalist Party (BNP) -- stand accused of war crimes.

Both Jamaat and the BNP have called the cases "politically motivated and farcical" and international rights groups have questioned the proceedings and found loopholes in the war crime laws.

The Bangladeshi government says the trials are fair and meet international standards.

"The United States urges the government of Bangladesh to adhere to the due process standards that are part of its treaty obligations, and to fully respect the rule of law" as it addresses atrocities committed during the liberation war, Nuland said.

-AFP/fl

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Log on for clean governance

GWALIOR: Amarjeet Singh Rathore, 60, didn't think he'd see a day when he could walk into a sarkari office and get his work done without having to grease palms. "Tracking a patwari or getting a land records copy took several days and money," says the farmer from Simiria Taka village, Gwalior.

The Janmitra Samadhan Kendra (JSK) has changed that experience. "I just file an application and things get done," says Rathore, who was at the local JSK centre to apply for renewal of his BPL card. The JSK is the showpiece e-governance project of the Gwalior Administration . Started in September 2009 by then collector Akash Tripathi, the IT-driven initiative based on a biometric attendance system has today brought effective grassroots governance to 600 villages. For the aam aadmi, it offers single-window access to 74 public services, saving them the bother and expense of travelling to the district HQ. Delivery — whether it's a request for a hand pump or for a vet to attend to a sick cow — is time-bound.

By 2012-end, the 73 JSKs had got more than seven lakh applications and disposed of 95.5%. Several state and central schemes, such as NREGS, are being executed through this project. Recently, it's been linked to the Centre's e-panchayat scheme. The biometric system has compelled babus to be more regular. Bahadur Singh Gurjar, a Congress worker at Naugaon village, says sarkari buildings like schools and health centres have come to life. "Now you can see babus at work," says Rathore of Simiria Taka village.

District collector P Narhari — who carried forward his predecessor's task — says action against absenteeism has improved "on-field availability" of functionaries. Attendance and work delays, highlighted by the system, are reviewed weekly. Around 60 babus have been served notices on complaints from JSKs; 22 penalized and one sacked. About 400 have suffered salary cuts. This has made some unhappy. Randhawa Khatri, district president of MP Patwari Sangh, wants patwaris to be exempted from daily attendance. "It should be reduced to three days. It's difficult for them to move around with files," he says.

Applicants aren't complaining, though. Dinesh Jatav, 22, from Hastinapur village is physically challenged. His trips to the city 35km away for a disability certificate stopped after a JSK came up at the panchayat bhavan. "I got the certificate immediately. Then I went to collect a new tricycle," he says. Given the response, local netas of all hues want the project extended across the state. It's not a question of politics, says BSP MLA Madan Kushwah. "This project helps my people and I support it."

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Flu season fuels debate over paid sick time laws

NEW YORK (AP) — Sniffling, groggy and afraid she had caught the flu, Diana Zavala dragged herself in to work anyway for a day she felt she couldn't afford to miss.

A school speech therapist who works as an independent contractor, she doesn't have paid sick days. So the mother of two reported to work and hoped for the best — and was aching, shivering and coughing by the end of the day. She stayed home the next day, then loaded up on medicine and returned to work.

"It's a balancing act" between physical health and financial well-being, she said.

An unusually early and vigorous flu season is drawing attention to a cause that has scored victories but also hit roadblocks in recent years: mandatory paid sick leave for a third of civilian workers — more than 40 million people — who don't have it.

Supporters and opponents are particularly watching New York City, where lawmakers are weighing a sick leave proposal amid a competitive mayoral race.

Pointing to a flu outbreak that the governor has called a public health emergency, dozens of doctors, nurses, lawmakers and activists — some in surgical masks — rallied Friday on the City Hall steps to call for passage of the measure, which has awaited a City Council vote for nearly three years. Two likely mayoral contenders have also pressed the point.

The flu spike is making people more aware of the argument for sick pay, said Ellen Bravo, executive director of Family Values at Work, which promotes paid sick time initiatives around the country. "There's people who say, 'OK, I get it — you don't want your server coughing on your food,'" she said.

Advocates have cast paid sick time as both a workforce issue akin to parental leave and "living wage" laws, and a public health priority.

But to some business owners, paid sick leave is an impractical and unfair burden for small operations. Critics also say the timing is bad, given the choppy economy and the hardships inflicted by Superstorm Sandy.

Michael Sinensky, an owner of seven bars and restaurants around the city, was against the sick time proposal before Sandy. And after the storm shut down four of his restaurants for days or weeks, costing hundreds of thousands of dollars that his insurers have yet to pay, "we're in survival mode."

"We're at the point, right now, where we cannot afford additional social initiatives," said Sinensky, whose roughly 500 employees switch shifts if they can't work, an arrangement that some restaurateurs say benefits workers because paid sick time wouldn't include tips.

Employees without sick days are more likely to go to work with a contagious illness, send an ill child to school or day care and use hospital emergency rooms for care, according to a 2010 survey by the University of Chicago's National Opinion Research Center. A 2011 study in the American Journal of Public Health estimated that a lack of sick time helped spread 5 million cases of flu-like illness during the 2009 swine flu outbreak.

To be sure, many employees entitled to sick time go to work ill anyway, out of dedication or at least a desire to project it. But the work-through-it ethic is shifting somewhat amid growing awareness about spreading sickness.

"Right now, where companies' incentives lie is butting right up against this concern over people coming into the workplace, infecting others and bringing productivity of a whole company down," said John A. Challenger, CEO of employer consulting firm Challenger, Gray & Christmas.

Paid sick day requirements are often popular in polls, but only four places have them: San Francisco, Seattle, Washington, D.C., and the state of Connecticut. The specific provisions vary.

Milwaukee voters approved a sick time requirement in 2008, but the state Legislature passed a law blocking it. Philadelphia's mayor vetoed a sick leave measure in 2011; lawmakers have since instituted a sick time requirement for businesses with city contracts. Voters rejected a paid sick day measure in Denver in 2011.

In New York, City Councilwoman Gale Brewer's proposal would require up to five paid sick days a year at businesses with at least five employees. It wouldn't include independent contractors, such as Zavala, who supports the idea nonetheless.

The idea boasts such supporters as feminist Gloria Steinem and "Sex and the City" actress Cynthia Nixon, as well as a majority of City Council members and a coalition of unions, women's groups and public health advocates. But it also faces influential opponents, including business groups, Mayor Michael Bloomberg and City Council Speaker Christine Quinn, who has virtually complete control over what matters come to a vote.

Quinn, who is expected to run for mayor, said she considers paid sick leave a worthy goal but doesn't think it would be wise to implement it in a sluggish economy. Two of her likely opponents, Public Advocate Bill de Blasio and Comptroller John Liu, have reiterated calls for paid sick leave in light of the flu season.

While the debate plays out, Emilio Palaguachi is recovering from the flu and looking for a job. The father of four was abruptly fired without explanation earlier this month from his job at a deli after taking a day off to go to a doctor, he said. His former employer couldn't be reached by telephone.

"I needed work," Palaguachi said after Friday's City Hall rally, but "I needed to see the doctor because I'm sick."

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Associated Press writer Susan Haigh in Hartford, Conn., contributed to this report.

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Follow Jennifer Peltz at http://twitter.com/jennpeltz

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