Insurgents Launch 4 Attacks in Afghanistan







KABUL, Afghanistan (AP) — A series of early morning attacks hit eastern Afghanistan Sunday, with three separate suicide bombings in outlying provinces and a shootout between security forces and a would-be attacker in the capital city of Kabul.




The deadliest attack was a suicide car bombing at a state intelligence site just after sunrise in the eastern city of Jalalabad. In that attack, a car approached the gate of a compound used by the National Directorate of Security and exploded, killing two guards and wounding three others, said regional government spokesman Ahmad Zia Abdulzai. The building was damaged in the attack, he added.


Taliban spokesman Zabiullah Mujahid claimed responsibility for the bombing.


Shortly before the Jalalabad attack, an assailant detonated a van packed with explosives at a highway police checkpoint in Logar province, also in the east. That explosion wounded three police officers but no one was killed, said Deputy Police Chief Rais Khan Abdul Rahimzai.


In Kabul, meanwhile, police shot and killed a would-be suicide bomber who was trying to attack an intelligence agency office downtown, according to the city's deputy police chief, Gen. Mohammad Daud Amin. Intelligence agents spotted the bomber before he could detonate the explosives in his vehicle and shot him, Amin said.


The explosives in the vehicle were later defused, he added.


Later in the morning, a man wearing a suicide vest blew himself up outside the police headquarters for Baraki Barak district in Logar province. The man was stopped by police as he tried to force his way into the building, but still managed to detonate his vest, said Din Mohammad Darwesh, the provincial government spokesman.


One policeman was wounded in the Baraki Barak attack, Darwesh said.


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Breaking Dawn - Part 2 Sweeps the Razzies









02/23/2013 at 10:00 PM EST







Taylor Lautner and Mackenzie Foy, in Breaking Dawn – Part 2


Andrew Cooper, SMPSP/Summit


Who's misérable now?

The Twilight Saga: Breaking Dawn – Part 2, Adam Sandler and Rihanna are among the "winners" of the 33rd annual Golden Raspberry Awards – the Razzies – which are not so much handed out as they are thrown at those who are voted as perpetrating Hollywood's worst achievements of the year.

Breaking Dawn – Part 2, the fifth and final installment in Stephenie Meyer's vampire saga, was recognized in seven categories, including worst picture.

The flick's Kristen Stewart was also cited as worst actress; Taylor Lautner, worst supporting actor; Lautner and 12-year-old Mackenzie Foy, worst screen couple; the entire cast, including Robert Pattinson, worst screen ensemble, and Bill Condon, worst director.

In addition, the film, which since opening last November has taken in more than $828 million at the box office, was named worst sequel.

Sandler, who last year monopolized the Razzies – and set a record by winning in 10 categories with the "comedy" Jack & Jill – this year got only two awards: for worst actor of the year and worst screenplay, both for That's My Boy.

Unlike the Oscars, which keep voting tallies a secret and will be handed out Sunday night during a very glamorous event, founder and Head RAZZberry John Wilson announced Razzie recipients Saturday night in the utilitarian Continental Breakfast Room of the Holiday Inn Express Hollywood Walk of Fame hotel, near (and yet so far from) the Dolby Theatre, home of the Academy Awards.

Wilson revealed to the press that although Rihanna, as worst supporting actress in the movie Battleship, won her Razzie by a landslide, worst screenwriter Sandler only beat the authors of Breaking Dawn by a single vote.

It's close shaves like that that really make or break the Razzies.

Breaking Dawn – Part 2 Sweeps the Razzies| Oscars 2013, The Razzies 2013, Movies, Battleship, That's My Boy, News Franchises, Individual Class, Adam Sandler, Kristen Stewart, Rihanna, Robert Pattinson

Adam Sandler, in That's My Boy, and Rihanna, in Battleship

Columbia; Universal

The 85th annual Academy Awards will air live on ABC starting at 7 p.m. ET/4 p.m. PT on Sunday, Feb. 24, from the Dolby Theatre in Hollywood.
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FDA approves new targeted breast cancer drug


WASHINGTON (AP) — The Food and Drug Administration has approved a first-of-a-kind breast cancer medication that targets tumor cells while sparing healthy ones.


The drug Kadcyla from Roche combines the established drug Herceptin with a powerful chemotherapy drug and a third chemical linking the medicines together. The chemical keeps the cocktail intact until it binds to a cancer cell, delivering a potent dose of anti-tumor poison.


Cancer researchers say the drug is an important step forward because it delivers more medication while reducing the unpleasant side effects of chemotherapy.


"This antibody goes seeking out the tumor cells, gets internalized and then explodes them from within. So it's very kind and gentle on the patients — there's no hair loss, no nausea, no vomiting," said Dr. Melody Cobleigh of Rush University Medical Center. "It's a revolutionary way of treating cancer."


Cobleigh helped conduct the key studies of the drug at the Chicago facility.


The FDA approved the new treatment for about 20 percent of breast cancer patients with a form of the disease that is typically more aggressive and less responsive to hormone therapy. These patients have tumors that overproduce a protein known as HER-2. Breast cancer is the second most deadly form of cancer in U.S. women, and is expected to kill more than 39,000 Americans this year, according to the National Cancer Institute.


The approval will help Roche's Genentech unit build on the blockbuster success of Herceptin, which has long dominated the breast cancer marketplace. The drug had sales of roughly $6 billion last year.


Genentech said Friday that Kadcyla will cost $9,800 per month, compared to $4,500 per month for regular Herceptin. The company estimates a full course of Kadcyla, about nine months of medicine, will cost $94,000.


FDA scientists said they approved the drug based on company studies showing Kadcyla delayed the progression of breast cancer by several months. Researchers reported last year that patients treated with the drug lived 9.6 months before death or the spread of their disease, compared with a little more than six months for patients treated with two other standard drugs, Tykerb and Xeloda.


Overall, patients taking Kadcyla lived about 2.6 years, compared with 2 years for patients taking the other drugs.


FDA specifically approved the drug for patients with advanced breast cancer who have already been treated with Herceptin and taxane, a widely used chemotherapy drug. Doctors are not required to follow FDA prescribing guidelines, and cancer researchers say the drug could have great potential in patients with earlier forms of breast cancer


Kadcyla will carry a boxed warning, the most severe type, alerting doctors and patients that the drug can cause liver toxicity, heart problems and potentially death. The drug can also cause severe birth defects and should not be used by pregnant women.


Kadcyla was developed by South San Francisco-based Genentech using drug-binding technology licensed from Waltham, Mass.-based ImmunoGen. The company developed the chemical that keeps the drug cocktail together and is scheduled to receive a $10.5 million payment from Genentech on the FDA decision. The company will also receive additional royalties on the drug's sales.


Shares of ImmunoGen Inc. rose 2 cents to $14.32 in afternoon trading. The stock has ttraded in a 52-wek range of $10.85 to $18.10.


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Investors face another Washington deadline

NEW YORK (Reuters) - Investors face another Washington-imposed deadline on government spending cuts next week, but it's not generating the same level of fear as two months ago when the "fiscal cliff" loomed large.


Investors in sectors most likely to be affected by the cuts, like defense, seem untroubled that the budget talks could send stocks tumbling.


Talks on the U.S. budget crisis began again this week leading up to the March 1 deadline for the so-called sequestration when $85 billion in automatic federal spending cuts are scheduled to take effect.


"It's at this point a political hot button in Washington but a very low level investor concern," said Fred Dickson, chief market strategist at D.A. Davidson & Co. in Lake Oswego, Oregon. The fight pits President Barack Obama and fellow Democrats against congressional Republicans.


Stocks rallied in early January after a compromise temporarily avoided the fiscal cliff, and the Standard & Poor's 500 index <.spx> has risen 6.3 percent since the start of the year.


But the benchmark index lost steam this week, posting its first week of losses since the start of the year. Minutes on Wednesday from the last Federal Reserve meeting, which suggested the central bank may slow or stop its stimulus policy sooner than expected, provided the catalyst.


National elections in Italy on Sunday and Monday could also add to investor concern. Most investors expect a government headed by Pier Luigi Bersani to win and continue with reforms to tackle Italy's debt problems. However, a resurgence by former leader Silvio Berlusconi has raised doubts.


"Europe has been in the last six months less of a topic for the stock market, but the problems haven't gone away. This may bring back investor attention to that," said Kim Forrest, senior equity research analyst at Fort Pitt Capital Group in Pittsburgh.


OPTIONS BULLS TARGET GAINS


The spending cuts, if they go ahead, could hit the defense industry particularly hard.


Yet in the options market, bulls were targeting gains in Lockheed Martin Corp , the Pentagon's biggest supplier.


Calls on the stock far outpaced puts, suggesting that many investors anticipate the stock to move higher. Overall options volume on the stock was 2.8 times the daily average with 17,000 calls and 3,360 puts traded, according to options analytics firm Trade Alert.


"The upside call buying in Lockheed solidifies the idea that option investors are not pricing in a lot of downside risk in most defense stocks from the likely impact of sequestration," said Jared Woodard, a founder of research and advisory firm condoroptions.com in Forest, Virginia.


The stock ended up 0.6 percent at $88.12 on Friday.


If lawmakers fail to reach an agreement on reducing the U.S. budget deficit in the next few days, a sequester would include significant cuts in defense spending. Companies such as General Dynamics Corp and Smith & Wesson Holding Corp could be affected.


General Dynamics Corp shares rose 1.2 percent to $67.32 and Smith & Wesson added 4.6 percent to $9.18 on Friday.


EYES ON GDP DATA, APPLE


The latest data on fourth-quarter U.S. gross domestic product is expected on Thursday, and some analysts predict an upward revision following trade data that showed America's deficit shrank in December to its narrowest in nearly three years.


U.S. GDP unexpectedly contracted in the fourth quarter, according to an earlier government estimate, but analysts said there was no reason for panic, given that consumer spending and business investment picked up.


Investors will be looking for any hints of changes in the Fed's policy of monetary easing when Fed Chairman Ben Bernake speaks before congressional committees on Tuesday and Wednesday.


Shares of Apple will be watched closely next week when the company's annual stockholders' meeting is held.


On Friday, a U.S. judge handed outspoken hedge fund manager David Einhorn a victory in his battle with the iPhone maker, blocking the company from moving forward with a shareholder vote on a controversial proposal to limit the company's ability to issue preferred stock.


(Additional reporting by Doris Frankel; Editing by Kenneth Barry)



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North Korea Warns U.S. Forces of ‘Destruction’ Ahead of Drills







SEOUL (Reuters) — North Korea on Saturday warned the top U.S. military commander stationed in South Korea that his forces would “meet a miserable destruction” if they go ahead with scheduled military drills with South Korean troops, North Korean state media said.




Pak Rim-su, chief delegate of the North Korean military mission to the inter-Korean truce village of Panmunjom, gave the message by phone to Gen. James Thurman, the commander of the U.S. Forces Korea, KCNA news agency said.


It came amid escalating tension on the divided Korean peninsula after the North’s third nuclear test earlier this month, in defiance of U.N. resolutions, drew harsh international condemnation.


A direct message from the North’s Panmunjom mission to the U.S. commander is rare.


North and South Korea are technically still at war after their 1950-53 conflict ended in a truce, not a peace treaty.


The U.S.-South Korean Combined Forces Command is holding an annual computer-based simulation war drill, Key Resolve, from March 11 to 25, involving 10,000 South Korean and 3,500 U.S. troops.


The command also plans to hold Foal Eagle joint military exercises involving land, sea and air manoeuvres. About 200,000 Korean troops and 10,000 U.S. forces are expected to be mobilized for the two month-long exercise which starts on March 1.


“If your side ignites a war of aggression by staging the reckless joint military exercises...at this dangerous time, from that moment your fate will be hung by a thread with every hour,” Pak was quoted as saying.


“You had better bear in mind that those igniting a war are destined to meet a miserable destruction.”


Washington and Seoul regularly hold military exercises which they say are purely defensive. North Korea, which has stepped up its bellicose threats towards the United States and South Korea in recent months, sees them as rehearsals for invasion.


North Korea threatened South Korea with “final destruction” during a debate at the U.N. Conference on Disarmament on Tuesday.


(Reporting by Sung-won Shim; Editing by Nick Macfie)


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Jobs, factory, inflation data favor easy Fed policy


WASHINGTON (Reuters) - A raft of U.S. economic data on Thursday from claims for jobless aid to factory activity and consumer prices pointed to a still tepid recovery and supported the argument for the Federal Reserve to maintain its monetary stimulus.


The Fed is currently buying $85 billion in bonds per month and has said it would keep up purchases until the labor market outlook improves substantially, although officials are increasingly divided over the wisdom of that course.


"The economy is in a holding pattern. It's not going to strengthen sufficiently to justify an end of the current program," said Millan Mulraine, senior economist at TD Securities in New York.


Initial claims for state unemployment benefits increased 20,000 last week to a seasonally adjusted 362,000, unwinding the bulk of the prior week's decline, the Labor Department said.


A second report from the department showed consumer prices were flat for a second straight month in January as gasoline prices fell and the cost of food held steady.


In the 12 months through January, consumer prices rose 1.6 percent, the smallest gain since July. That suggested there was little inflation pressure to worry the Fed.


Concerns over tepid job growth prompted the U.S. central bank last year to embark on its open-ended bond buying program.


However, minutes of the Fed's January 29-30 policy meeting published on Wednesday showed some policymakers feel the central bank may have to slow or stop the asset purchases before it sees an acceleration in job growth because of concerns over the financial risks of the program.


Those diverging views were evident on Thursday, with two Fed officials signaling support for scaling back the program, while another outlined the case for maintaining bond purchases until well into the second half of the year.


MANUFACTURING SLOWING


News on the manufacturing sector, which has supported the economy's recovery from the 2007-09 recession, was downbeat.


The Philadelphia Fed's business activity index dropped to minus 12.5 in February, the lowest level since June. The index, which measures factory activity in the mid-Atlantic region, had fallen to minus 5.8 in January.


A reading below zero indicates contraction in the region's manufacturing sector. The survey covers factories in eastern Pennsylvania, southern New Jersey and Delaware.


Another report from financial data firm Markit that tries to gauge overall national factory activity showed manufacturing growth slowed in February but remained near a nine-month peak.


"We believe manufacturing activity will continue to expand early in 2013," said Daniel Silver, an economist at JPMorgan in New York.


The claims and factory reports, as well as weak data from Europe weighed on U.S. stocks. The Standard & Poor's 500 index recorded its worst two-day loss since November.


Prices for U.S. government debt rose and the dollar touched a 5-1/2-month high against a basket of currencies.


Growth in the U.S. economy braked sharply in the fourth quarter, but it expanded at a 2.2 percent clip for the full year. Output is being hampered by lackluster demand as employment struggles to gain traction.


Job growth has been far less than the at least 250,000 per month over a sustained period that economists say is needed to significantly reduce the ranks of unemployed. The unemployment rate rose 0.1 percentage point to 7.9 percent in January.


Last week's claims data covered the survey period for the government's closely watched monthly tally of nonfarm jobs. Claims were up 27,000 between the January and February survey periods.


However, the increase probably does not suggest any material change in the pace of job growth given that claims have been very volatile since January because of difficulties smoothing the data for seasonal fluctuations.


Despite the weak factory and jobs data, there is reason for optimism about the economy. The housing market recovery is gaining momentum.


A report from the National Association of Realtors showed existing home sales rose 0.4 percent last month, pushing the supply of homes on the market to a 13-year low. The median home price rose 12.3 percent from a year earlier.


Rising home values should help to support consumer spending.


Although consumer prices excluding food and energy rose 0.3 percent - the largest gain since May 2011 - most of that reflected outsized increases in apparel and education costs.


"January is a tough month because you get a lot of price hikes at the start of the new year and the seasonals have a hard time sort of adjusting," said Omair Sharif, an economist at RBS in Stamford, Connecticut.


"I don't expect the core CPI to maintain that pace of increase in the near term."


(Additional reporting by Jason Lange in Washington and Steven C Johnson in New York; Editing by Andrea Ricci and James Dalgleish)



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Pistorius Bail Hearing Set to Resume





PRETORIA, South Africa — Oscar Pistorius, the double amputee track star accused of murdering his girlfriend, was to return to court on Friday on the fourth day of hearings this week about whether he should be granted bail in a case that has riveted the nation.




News reports said he slipped into the courthouse, his head covered by a jacket, some time before the scheduled start of hearings that have packed the courtroom with a scrum of journalists alongside legal teams, family members and onlookers.


In the latest in a series of abrupt twists in the affair on Thursday, the South African police replaced the lead investigator after revelations that he was facing seven charges of attempted murder stemming from an episode in which police officers fired at a minivan.


The change was announced a day after the investigator, Detective Warrant Officer Hilton Botha, acknowledged several mistakes in the police work and conceded that, based on the existing evidence, he could not rule out the version of events presented by Mr. Pistorius.


The prosecution says Mr. Pistorius committed the premeditated murder of Reeva Steenkamp, a 29-year-old model and law graduate, when he fired four shots through a locked bathroom door while she was on the other side in the early hours of Feb. 14.


After widespread news reports about the charges against Detective Botha, Gerrie Nel, the prosecutor, said at the start of a hearing on Thursday that he had just learned about them.


Mr. Pistorius has said that he opened fire believing there was an intruder in his home, in a gated community in Pretoria, and that he had no intention of killing Ms. Steenkamp, 29, a model and law school graduate.


But prosecutor Nel labeled Mr. Pistorius’s account “improbable.”


“What we can’t forget is the applicant is charged with murdering a defenseless, innocent woman,” Mr. Nel said.


Mr. Pistorius has said that he did not realize Ms. Steenkamp was no longer in bed as he rose to check for an intruder, shouting to her to call the police.


“You want to protect her, but you don’t even look at her?” Mr. Nel said. “You don’t even ask, ‘Reeva, are you all right?’ 


On Thursday, a police brigadier, Neville Malila, told reporters that Detective Botha was scheduled to appear in court in May on the attempted murder charges in connection with an episode in which Mr. Botha and two other police officers fired at a minivan.


“Botha and two other policemen allegedly tried to stop a minibus taxi with seven people,” Brigadier Malila said. “They fired shots.” While the charges were initially dropped, “we were informed yesterday that the charges will be reinstated,” he said.


Medupe Simasiku, a spokesman for the National Prosecuting Authority, told reporters that the decision to reinstate the charges was made on Feb. 4, long before Ms. Steenkamp was killed.


Lydia Polgreen reported from Pretoria, South Africa, and Alan Cowell from London.



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Will the PlayStation 4 Play Used Games? Maybe, Maybe Not






Ahead of Sony’s PlayStation 4 announcement Wednesday night, the rumor mill put odds on the new game console’s ability to play used games at right about zero. Bear in mind the rumors came from gossip blogs known for chasing the moon, but the notion struck a chord with gamers because it’s been happening for years over on the PC side of the biz: bigwigs like Valve and Blizzard eliminated the secondary PC games market entirely years ago by tethering Steam and Battle.net accounts to game activations, whether via digital or physical copies. Maybe you’ll make a few bucks reselling your collector’s edition of World of Warcraft: Mists of Pandaria, but the disc inside might as well be a coaster: Whoever you sell to still has to pay for a code to unlock the game itself.


That’s essentially how the rumor mill claimed Sony was planning to roll with the PS4, tethering game content to online user accounts and establishing an activation system that’d put the thumbscrews to resales, digital or physical.






Sony was mum on the subject at its PS4 press event, preferring instead to highlight the console’s graphical brawn, tease the modestly redesigned controller and talk up social interactivity, but Eurogamer managed to corner Sony Worldwide Studios president Shuhei Yoshida and pop the question “Will it or won’t it?”


Sony’s answer, concludes Eurogamer, is that the PS4 will play used games (the article’s subtitled “PlayStation 4 will not block used games”). But reading what Yoshida actually said, I’d say the answer’s still clear as mud.


“So if someone buys a PlayStation 4 game … you’re not going to stop them reselling it?” asks Eurogamer, to which Yoshida doesn’t immediately respond, eventually saying: “So, used games can play on PS4. How is that?”


Mission accomplished? Not so fast. Remember when you asked your elementary school teacher “Can I go to the bathroom?” and she/he answered “I don’t know, can you?” Silly semantics, I know, but when you’re parsing potentially game-changing corporate directives, they mean everything.


It’s possible Yoshida meant “will” play, but without clarification, who knows? Technically he’s saying “can” here, which formally means “is capable of,” not “will without restrictions” (even “will” can be employed as synonymous with “can” — headache yet?). For example, the PS3 is technically capable of playing PlayStation 2 games (with a software emulator), so it’s accurate to say “The PS3 can play PS2 games.” But it would be inaccurate to claim the PS3 actually does play PS2 games.


Will the PS4 play used games, no gotchas? All or just some? Will digitally downloaded games be resalable somehow? The Eurogamer chitchat doesn’t bring us any closer to an answer. If Sony wants us to know at this point, it needs to say so using non-evasive language. Barring that, I think it’s safe to assume the question’s either still up in the air at Sony HQ, or it’s already been decided, and not in the secondary market’s favor. If Sony’s decision involves locking down used content as originally surmised, I wouldn’t expect the company to say much at all, for the time being, in hopes of staving off the looming backlash.


Gaming News Headlines – Yahoo! News





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American Idol: Sudden-Death Round Begins for Men















02/21/2013 at 11:00 PM EST







From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj and Keith Urban


George Holz/FOX


On Wednesday, 10 women sang for five spots on American Idol's live shows. On Thursday, it was the remaining guys' turn.

The judges have their own euphemisms when they don't like a performance – it's usually easy to read between the lines: If they compliment a singer on his shoes, he won't advance. On Thursday, Nicki Minaj actually told a contestant, "Kudos to you for being really freshly, nicely groomed." They might as well have had a stagehand pull him offstage with an oversized vaudeville hook.

After several weeks of good behavior by the judges, Thursday's episode showed a spark of life when Nicki – who was wearing her very best Jan Brady wig – began rolling her eyes whenever Randy Jackson spoke. At one point, Ryan Seacrest even tried to get them to kiss and make up. There was talk about lipstick, and Mariah Carey did her best to look at anything other than the awkward air kiss that followed.

But the theatrics did not eclipsed some solid singers – and a few performances that just weren't good enough for the competition.

The Good: Curtis Finch Jr. wowed judges with his version of Luther Vandross's "Superstar." It was oversung. But there was no denying Finch's vocal talent. Charlie Askew's rendition of Elton John's "Rocketman" was interesting and well-suited to his voice. And Devin Velez pleased the crowd when he infused Spanish lyrics into Beyoncé's "Listen." The three of them advanced easily.

The Okay: Elijah Liu chose Bruno Mars's "Talking to the Moon," a song that felt current and new. Paul Jolley sang Keith Urban's "Tonight I'm Gonna Cry." Generally, it's a risky move to sing a song made popular by one of the judges, but Jolley's performance was pleasant, if a little shaky. Both advanced, although the judges were split on their assessment of Jolley.

The Others: Johnny Keiser, Kevin Harris, Chris Watson and Jimmy Smith sang unspectacular versions of various songs that everyone knows. Each of them had a decent voice, but none of their performances were all that unique, and none of them advanced. On the other side of the spectrum, J'DA performed an over-the-top rendition of Adele's "Rumor Has It." It wasn't enough for him to advance, but his performance – at one point he collapsed on the floor but continued singing – was by far the most memorable of the night.

There are ten contestants – five men and five women – who have made it to the next round. Next week, the remaining 20 contestants will complete for the remaining 10 spots – and all will hope the judges don't compliment what they're wearing.

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APNewsBreak: Govs to hear Oregon health care plan


SALEM, Ore. (AP) — Oregon Gov. John Kitzhaber will brief other state leaders this weekend on his plan to lower Medicaid costs, touting an overhaul that President Barack Obama highlighted in his State of the Union address for its potential to lower the deficit even as health care expenses climb.


The Oregon Democrat leaves for Washington, D.C., on Friday to pitch his plan that changes the way doctors and hospitals are paid and improves health care coordination for low income residents so that treatable medical problems don't grow in severity or expense.


Kitzhaber says his goal is to win over a handful of other governors from each party.


"I think the politics have been dialed down a couple of notches, and now people are willing to sit down and talk about how we can solve the problem" of rising health care costs, Kitzhaber told The Associated Press in a recent interview.


Kitzhaber introduced the plan in 2011 in the face of a severe state budget deficit, and he's been talking for two years about expanding the initiative beyond his state. Now, it seems he's found people ready to listen.


Hospital executives from Alabama visited Oregon last month to learn about the effort. And the U.S. Department of Health and Human Services announced Thursday that it's giving Oregon a $45 million grant to help spread the changes beyond the Medicaid population and share information with other states, making it one of only six states to earn a State Innovation Model grant.


Kitzhaber will address his counterparts at a meeting of the National Governors Association. His talk isn't scheduled on the official agenda, but a spokeswoman confirmed that Kitzhaber is expected to present.


"The governors love what they call stealing from one another — taking the good ideas and the successes of their colleagues and trying to figure out how to apply that in their home state," said Matt Salo, director of the National Association of Medicaid Directors.


There's been "huge interest" among other states in Oregon's health overhaul, Salo said, not because the concepts are brand new, but because the state managed to avoid pitfalls that often block health system changes.


Kitzhaber persuaded state lawmakers to redesign the system of delivering and paying for health care under Medicaid, creating incentives for providers to coordinate patient care and prevent avoidable emergency room visits. He has long complained that the current financial incentives encourage volume over quality, driving costs up without making people healthier.


Obama, in his State of the Union address this month, suggested that changes such as Oregon's could be part of a long-term strategy to lower the federal debt by reigning in the growing cost of federally funded health care.


"We'll bring down costs by changing the way our government pays for Medicare, because our medical bills shouldn't be based on the number of tests ordered or days spent in the hospital — they should be based on the quality of care that our seniors receive," Obama said.


The Obama administration has invested in the program, putting up $1.9 billion to keep Oregon's Medicaid program afloat over the next five years while providers make the transition to new business models and incorporate new staff and technology.


In exchange, though, the state has agreed to lower per-capita health care cost inflation by 2 percentage points without affecting quality.


The Medicaid system is unique in each state, and Kitzhaber isn't suggesting that other states should adopt Oregon's specific approach, said Mike Bonetto, Kitzhaber's health care policy adviser. Rather, he wants governors to buy into the broad concept that the delivery system and payment models need to change.


That's not a new theory. But Oregon has shown that under the right circumstances massive changes to deeply entrenched business models can gain wide support.


What Oregon can't yet show is proof the idea is working — that it's lowering costs without squeezing on the quality or availability of care. The state is just finishing compiling baseline data that will be used as a basis of comparison.


One factor driving the Obama administration's interest in Oregon's success is the president's health care overhaul. Under the Affordable Care Act, millions more Americans will join the Medicaid rolls after Jan. 1, and the health care system will have to be able to absorb the influx of patients in a logistically and financially sustainable way.


The federal government will pay 100 percent of the costs for those additional patients in the first three years before scaling back to 90 percent in 2020 and beyond.


"There are a lot of governors who are facing the same challenges we're facing in Oregon," Kitzhaber said. "They recognize that the cost of health care is something they're going to have to get their arms around."


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