White House seeks quick vote on healthcare overhaul but hurdles remain

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By Yasmeen Abutaleb and Susan Heavey| WASHINGTON

Top aides to President Donald Trump on Monday predicted the House of Representatives would move this week to overhaul the U.S. healthcare system, though Republicans remained divided on how to protect sick Americans from insurance price hikes.

The White House is eager to move forward on legislation to repeal and replace the Affordable Care Act, commonly called Obamacare, to make good on a key campaign promise. Republicans tried but failed to pass a replacement bill in March in an embarrassing setback for the Trump Administration.

Lawmakers are considering a bill that would allow states to opt out of Obamacare protections for people with pre-existing medical conditions – provisions that force insurers to charge sick people and healthy people the same rates. It was unclear when or if a vote would be scheduled.

Trump told Fox News Channel that he would not set a deadline for the vote, and indicated he was open to improvements. “We’re either going to have a great plan or I’m not signing it,” he said in the interview.

In a separate interview with Bloomberg News, Trump insisted that the new bill would maintain protections for pre-existing conditions.

“I want it to be good for sick people. It’s not in its final form right now,” he told Bloomberg. “It will be every bit as good on pre-existing conditions as Obamacare.”

Ten major patient advocacy groups said they opposed the reworked healthcare bill, including the American Heart Association and American Diabetes Association.

Other major medical groups such as the American Medical Association have also expressed concerns over coverage losses and unaffordable insurance for those with pre-existing conditions.

HOUSE DIVIDED

Republican lawmakers have struggled to unite around legislation, with moderates and conservatives within the caucus divided over key provisions.

Once a plan passes the Republican-controlled House, it is expected to face a tough fight in the Senate, where Republicans have a narrower majority and where some party senators have expressed misgivings about the House bill.

White House Chief of Staff Reince Priebus and White House economic adviser Gary Cohn on Monday said in separate interviews with CBS’ “This Morning” that they thought there were enough votes to pass the bill this week.

House Republican leaders were more cautious. As of Monday afternoon, no vote had been scheduled and backers of the healthcare proposal had not released legislative language.

Representative Cathy McMorris Rodgers, chair of the House Republican conference, said Republican members needed time to understand new tweaks to the bill.

“We are having those member-to-members conversations right now,” McMorris Rodgers told Fox News.

Vice President Mike Pence made his way to Capitol Hill late on Monday to make the case to members who are on the fence, a Republican aide said on condition of anonymity, noting leaders are believed to be within five or six votes of having enough support to pass the bill.

The Freedom Caucus, which brought down the previous effort to pass a healthcare bill, has endorsed the new measure. The Republican aide told Reuters all but one or two members of the group will support the reworked plan.

“This bill doesn’t get all the way there but it’s a good step and is … the best we can get out of the House right now,” Representative Jim Jordan, chairman of the group, told CNN.

But several moderate Republicans were either undecided or opposed the bill for fear that it would not protect those with pre-existing conditions and cause millions to lose health insurance.

Representative Charlie Dent, a moderate Republican from Pennsylvania, said he still had problems with the latest plan and suspected there were not enough votes to pass it.

“Too many Americans are going to be without coverage,” Dent told MSNBC, adding that the plan could make things even worse for vulnerable Americans.

(Additional reporting by Doina Chiacu and Mark Hosenball; Writing by Roberta Rampton; Editing by Caren Bohan and Dan Grebler)

Japan wrestles over smoking ban as Olympics loom

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By Elaine Lies and Kwiyeon Ha| TOKYO

Tokyo risks being one of the unhealthiest Olympic Games hosts in years, as an anti-smoking law exposes deep rifts over tobacco tax revenue, personal freedom and the dangers of passive smoking, which kills thousands of Japanese each year.

There is pressure on the Japanese capital ahead of the 2020 Summer Games, including from the International Olympics Committee (IOC), to follow Rio de Janeiro and other recent Olympic venues in banning smoking in all public places to create a healthy sporting environment.

But an initial proposal for a blanket ban on smoking indoors across Japan was opposed by pro-smoking politicians, restaurateurs and Japan Tobacco, which is one-third government-owned and paid the state $700 million in dividends in 2015.

The health ministry scaled back its plan, to allow smoking indoors in spaces around 30 square metres (323 square feet) as long as adequate ventilation is installed.

But opponents say this will still hurt Japan’s many eateries, restrict individual freedom, and dent tobacco tax revenues – which topped 2 trillion yen ($18 billion) in 2014-15.

Natsuko Takami, who runs a Tokyo pub that is small enough to allow smoking under the revised bill, fears losing money as she can’t afford new ventilation, and could be fined 500,000 yen if a customer lit up. The smoker could be fined 300,000 yen.

“I think people would stop coming,” she said, adding that being able to smoke and drink helps reserved Japanese open up.

The ruling Liberal Democratic Party’s (LDP) health committee, whose support is essential to introducing the bill in parliament, won’t meet ministry officials, saying the revised bill is too strict.

The committee chair, Naomi Tokashiki, acknowledges there should be a law that protects against second-hand smoke, but says Japan’s cultural emphasis on good manners and sensitivity to others should suffice.

“I believe Japanese people really are considerate of others,” she said. “It’s more important for us to trust people than enact a really repressive law.”

Not so, say health authorities, pointing to 15,000 deaths a year from second-hand smoke, mostly women and children.

“It’s not a question of manners, we’re looking at the impact on health,” said a ministry official involved in crafting the bill who declined to be named due to the issue’s sensitivity.

“We’ve basically allowed people their independence, but the situation hasn’t changed,” he said. “Something more is needed.”

It now seems unlikely the law will be put to a vote in the current parliamentary session, which ends on June 18.

PATCHWORK LAWS

Fifty years ago, around half of Japanese smoked. That’s now dropped to 18 percent, and smoking areas have been dramatically restricted, but smoking laws vary from city to city and, within Tokyo, from ward to ward. Penalties are low and enforcement lax.

A 2003 law “encourages” restaurants and other public areas to separate smoking and non-smoking areas, but there is no penalty for non-compliance. Smoking is still possible on the grounds of schools and hospitals, though not inside, and there is a cigarette vending machine in a health ministry annex.

Japan ranks bottom globally in anti-smoking regulations, as measured by the types of public places entirely smoke-free, according to the World Health Organization. The revised proposal would raise Japan to the second-lowest of four rungs.

The WHO has teamed up with the IOC to guarantee smoke-free Games venues, though IOC Vice President John Coates has said the body can’t force a ban beyond the venues and the Olympic Village.

Brazil passed a blanket indoor smoking ban before the Rio Olympics in 2016, and bans were in place for the 2010 Winter Olympics in Vancouver, Canada as well as for the 2012 London Games. In Russia, Sochi had only a limited city ban for the 2014 Winter Olympics, but an extensive national ban was introduced a few months later. Beijing had a limited, temporary ban in 2008, but enforcement was patchy. It passed a tougher ban in 2015, when it hosted the athletics World Championships.

GLOBAL IMAGE

The issue could affect Japan’s image as it looks to attract more tourists. Many travelers from Europe and North America are used to smoking being banned indoors.

“A recent newspaper described Japan as a ‘paradise for smokers,’ and I’m sure it wouldn’t want that title,” said Douglas Bettcher, WHO’s director for prevention of non-communicable disease. “It’s not a good impression to give … as Japan is preparing and investing so much for the 2020 Summer Olympics.”

Many politicians have proposed a temporary smoking ban for the Olympics, says Toshiharu Furukawa, an LDP lawmaker and a doctor who supports an indoor ban, noting some colleagues’ concern about a drop in government tax revenues from cigarettes at a time when Japan’s taxpaying population is shrinking.

“Tobacco is a very important tax resource,” he said. Some of those lawmakers “are smokers, but some are backed by farming groups that produce tobacco, and some are backed by tobacco companies.”

Japan Tobacco spokesman Masahito Shirasu says the company shares concerns about passive smoking, but the health ministry’s proposal is too strict.

The 80,000-strong National Food and Drink Association favors having establishments display stickers showing if they are non-smoking, segregated, or allow smoking – letting customers decide.

“Only 18 percent of people may smoke, but the percentage of smoking customers in smaller restaurants is much higher – nearly half,” said Tetsuro Kojo, head of the association. “We must take care of them.”

Public opinion varies. A poll by the liberal Asahi Shimbun newspaper found that 64 percent supported the revised proposal, while the conservative Sankei Shimbun found only 37 percent in favor.

Kazuo Hasegawa, a 46-year-old non-smoker diagnosed with lung cancer in 2010, believes pressure related to the Olympics is essential for achieving a ban.

“The tobacco issue is something that can’t really be solved in a Japanese manner,” he said. “Without outside pressure, Japan won’t move on this.”

(Additional reporting by Ami Miyazaki and Chris Gallagher; Editing by Malcolm Foster and Ian Geoghegan)

AstraZeneca immunotherapy wins first approval in bladder cancer

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By Ben Hirschler and Divya Grover

<span class="articleLocation”>U.S. regulators have approved AstraZeneca’s key immunotherapy drug durvalumab as a treatment for bladder cancer, marking the first commercial green light for a product the company hopes will go on to sell billions of dollars.

The approval, while expected, marks a milestone for the British company, which expects new cancer drugs to help revive its fortunes following patent losses on older blockbuster products like cholesterol pill Crestor and Nexium for heartburn.

Bladder cancer itself is a relatively small initial market, where AstraZeneca is lagging behind rivals Bristol-Myers Squibb and Roche whose immunotherapies are already approved for the condition.

Durvalumab’s big commercial opportunity lies in previously untreated lung cancer, where key clinical trial results, including with combination therapy, are due in June or July.

Leerink analyst Seamus Fernandez sees durvalumab capturing a modest 10 percent of the estimated $2.3 billion global bladder cancer market, while AstraZeneca in 2014 put the drug’s peak sales in all cancers at $6.5 billion, including combination use.

The U.S. Food and Drug Administration (FDA) said late on Monday it granted accelerated approval to AstraZeneca’s drug to treat advanced bladder cancer in patients whose disease had progressed despite chemotherapy.

The drug, which will have the brand name Imfinzi, works by helping the body’s immune cells kill cancer, offering an alternative to toxic chemotherapy. While not without side effects, such immuno-oncology treatment has the potential of longer-lasting efficacy, although it comes at a high price.

AstraZeneca said the average wholesale acquisition cost of durvalumab would be around $15,000 a month.

“This first approval for Imfinzi is an important milestone in our return to growth,” said AstraZeneca Chief Executive Pascal Soriot.

The drug belongs to a new class of medicines called PD-L1 inhibitors that block a mechanism tumors use to evade detection from the immune system.

It was approved by the FDA for use in patients with locally advanced or metastatic urothelial carcinoma, by far the most common form of bladder cancer, regardless of their status for the amount of PD-L1 protein on their cancer cells.

Durvalumab won accelerated approval, which enables the use of therapies for serious conditions to fill an unmet medical need based on data the FDA believes is likely to predict a clinical benefit. AstraZeneca is required to conduct trials to confirm actual benefit to patients.

The FDA also approved a complementary diagnostic from Roche that can be used with the drug to assess PD-L1 levels. Studies have shown patients with high PD-L1 are more likely to do well on durvalumab, although such a test is not required for its use.

Durvalumab is being tested on its own and also in combination with another immune system-boosting therapy called tremelimumab in various cancers.

The medicine is the latest immunotherapy to be approved by the FDA, after nods for treatments developed against various cancers by Bristol-Myers Squibb, Merck & Co, Roche, and a collaboration between Germany’s Merck KGaA and Pfizer.

AstraZeneca shares were up 0.3 percent in early London trading on Tuesday.

(Editing by Susan Thomas and Jason Neely)

Powerful storm front that killed 16 threatens eastern United States

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By Ian Simpson

<span class="articleLocation”>A powerful storm system bore down on the eastern United States on Monday after spawning tornadoes and torrential rains that killed at least 16 people and shut down hundreds of roads over the weekend, forecasters said.

The storm that tore through the central United States from Texas to Illinois could spawn damaging winds, hail and tornadoes as it heads into parts of the Middle Atlantic and Northeast, the National Weather Service said.

The front, described as a “powerhouse of an upper level system,” could pack downpours of more than an inch (2.5 cm) an hour as it hammers Pennsylvania and New York state, the weather agency said.

Flooding that could be record breaking in eastern Oklahoma, northern Arkansas, Missouri and Illinois was expected to take several days to recede, it said.

High water in Missouri on Monday forced about 330 roads to close, including a stretch of Interstate 44 near Rolla, the state transportation department said on its website. More than 100 highways also were shut in neighboring Arkansas, state officials said.

In North Carolina, Governor Roy Cooper urged residents to remain on their guard, especially in areas already hit by flooding. Almost 30 roads were closed from high water and washouts, his office said in a statement.

Tornadoes from the storm system killed four people on Saturday in Canton, Texas, about 60 miles (95 km) east of Dallas. The National Weather Service said Canton was hit by four tornadoes, with two packing winds of 136 miles to 165 miles (219 km to 265 km) per hour.

Five people died in Arkansas, with two still missing, said state emergency management spokeswoman Melody Daniels. She could not confirm news reports that the missing were children who were in a car swept off a bridge.

In Mississippi, one man was killed when a tree fell on his home, and a 7-year-old boy was electrocuted when he unplugged an electric golf cart in standing water, said Greg Flynn, a spokesman for the state’s emergency agency.

Two people were killed in Tennessee in storm-related incidents, authorities said. They included a Florence, Alabama, woman struck by a falling tree on Sunday, the Lincoln County Sheriff’s Department said in a statement.

In Missouri, a 72-year-old Billings woman was swept away by high waters on Saturday, and two men ages 18 and 77 drowned in separate incidents on Sunday, emergency management spokesman Mike O’Connell said.

(Reporting by Ian Simpson in Washington; Editing by Colleen Jenkins and Andrew Hay)

Fire in Georgia wildlife refuge could take months to fight: U.S. officials

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<span class="articleLocation”>A wildfire that has burned more than 100,000 acres (40,469 hectares) at the Okefenokee National Wildlife Refuge in southern Georgia could take until November before it is put out, the U.S. Fish and Wildlife Service said on Monday.

The fire has burned about one-fourth of the wildlife refuge, and the blaze is considered only eight-percent contained, said Mark Davis, spokesman for the service.

“November is the worst-case scenario,” said Davis. “The firefighters’ plan is to contain the fire as best they can, hoping that nature will cooperate with some rainfall.”

Helicopters, bulldozers and 500 firefighters are involved in fighting the blaze, Davis said.

No homes have been burned or threatened, but smoke has reached some cities including Waycross, Georgia, Davis said.

While much of the wildlife refuge is marshland and swamp, parts of it are prairie and wooded land. The refuge is home to black bears, alligators and sandhill cranes. Davis said wildlife knows to avoid the flames.

Six years ago, a wildfire burned more than 300,000 acres (12,1406 hectares)of the 407,000-acre (16,4707-hectare)refuge, Davis said.

(Reporting by Bernie Woodall; Editing by Sandra Maler)

UK will not appeal court ruling on air pollution plan: PM May's spokesman

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The British government will not appeal a court ruling on its plans to tackle air pollution and will meet a deadline for May 9 to detail its efforts to improve air quality, Prime Minister Theresa May’s spokesman said on Tuesday.

The government had sought to extend an April 24 deadline to submit its plan to improve air quality and comply with EU nitrogen dioxide limits, but a court ordered a draft plan to be submitted by May 9 and a full report by July 31. [nL8N1HZ9IB]

“We have looked at the judgment from last week and we will not be appealing,” the spokesman told reporters.

“The court deadline was I believe the 9th of May and we will be meeting that deadline.”

(Reporting by Elizabeth Piper, Writing by Kylie MacLellan; editing by Stephen Addison)

Twin polar bear cubs born at Sea World in Australia

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Two polar bear cubs born a week ago at Sea World in Australia’s Gold Coast are expected to make their public debut in three months time, but staff have seen the blind and toothless pair suckling milk from their mother inside their den.

Sixteen-year-old mother Liya delivered her second litter on April 26, and the cubs, which have still to be named, weigh about 600 grams and are 15 centimeters long. Fully grown they could stand as tall as standing as tall as 11 feet (3.35 meters) and weigh up to 1,400 pounds (635 kg).

“Liya and the cubs will spend the majority of these early months in the maternity den at Sea World,” said Sea World Director of Marine Sciences Trevor Long.

The cubs are expected to leave the den in July.

Polar bears currently number about 26,000, but their population is expected to fall by a third over the next 35 to 40 years due to melting sea ice in the Arctic, scientists said at a meeting of the American Geophysical Union last December.

(Writing by Karishma Singh, Editing by Darren Schuettler & Simon Cameron-Moore)

German minister to try to persuade U.S. to remain in climate pact

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German Environment Minister Barbara Hendricks said on Tuesday she would seek to convince the administration of U.S. President Donald Trump to remain part of the Paris Climate Agreement during her trip to the United States later this month.

Trump, elected in November, had vowed during his campaign to withdraw from the Paris accord within 100 days of becoming president, part of a broader plan to sweep away Obama administration environmental protections that Trump said were hobbling the economy.

Hendricks said the United States was an important partner so she wanted to engage in a direct dialogue about climate protection.

“I will especially campaign for the United States to remain part of the Paris climate agreement and to make its contribution to implementing it,” Hendricks said in a statement.

She is due to meet with U.S. Environmental Protection Agency Administrator Scott Pruitt and non-governmental organizations during her trip from 15 to 17 May. She is also due to meet California Governor Jerry Brown, with whom she will discuss the role of cooperation between states, towns and regions in pushing ahead with climate protection.

(Reporting by Markus Wacket; Writing by Michelle Martin; Editing by Larry King)

Kendrick Lamar's 'Damn' holds steady atop Billboard 200 chart

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LOS ANGELES Rapper Kendrick Lamar’s latest album “Damn.” held onto the top spot of the weekly U.S. Billboard 200 album chart on Monday, holding off Drake and Ed Sheeran.

Lamar’s “Damn.,” which debuted atop the chart last week, sold a total of 238,000 album units in its second week of release, according to figures from Nielsen SoundScan.

Canadian rapper Drake’s “More Life” climbed one spot to No. 2, while British singer Sheeran’s “Divide” climbed one spot to No. 3.

The Billboard 200 album chart tallies units from album sales, song sales (10 songs equal one album) and streaming activity (1,500 streams equal one album).

New albums in the top 10 of the Billboard 200 chart this week include rockers Incubus at No. 4 with “8” and the soundtrack to the upcoming Marvel superhero film “Guardians of the Galaxy Vol. 2” at No. 8.

On the Digital Songs chart, which measures online single sales, Puerto Rican singer Luis Fonsi’s “Despacito” climbed from No. 8 to No. 1 with 86,000 downloads sold.

(Reporting by Piya Sinha-Roy; Editing by Jonathan Oatis)

Fox News reporter says she was shunned over article about health condition

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By Daniel Wiessner

<span class="articleLocation”>A Fox News contributor said in a lawsuit filed on Monday that she was taken off the air after writing an article about a medical condition that would likely leave her infertile, in the latest of a series of discrimination claims against the network.

Diana Falzone, 34, said in the lawsuit in New York state court that despite writing many popular articles for Fox News’ website and routinely being praised for on-air appearances, she was abruptly sidelined in January, three days after the article about her struggle with endometriosis was published.

Falzone said Fox, a unit of Twenty-First Century Fox Inc, discriminated against her on the basis of sex and disability in violation of New York City law.

The network did not immediately respond to a request for comment.

Fox News has faced mounting legal claims that it ignored employees’ complaints of sexual harassment and gender and race discrimination.

Bill O’Reilly, the network’s most popular anchor, and former Fox News chief Roger Ailes both have been ousted over harassment claims by several women, which they deny.

In Monday’s lawsuit, Falzone said she was not given a reason for being taken off the air. She said she complained internally using an employee hotline, but did not bring her concerns to network executives because they had, for years, been “complicit in covering up and enabling a hostile and harassing environment for women at Fox News.”

“Once Diana disclosed her condition, Fox executives decided she no longer conformed to their image of on-air women as ‘physically perfect,’” Nancy Smith, Falzone’s attorney, said in a statement.

Smith and Martin Hyman filed a sexual harassment lawsuit last year against Ailes on behalf of former Fox News anchor Gretchen Carlson. The lawsuit, which was settled for $20 million, led to Ailes’ resignation after two decades as one of the most influential executives in cable television.

Last week, Fox News anchor Kelly Wright, who is black, and several other non-white employees filed a lawsuit seeking class action status, claiming they were mocked and humiliated because of their race and paid less than white coworkers. Fox has denied the claims.

Fox News announced on Monday that Bill Shine, co-president of the network since August, has resigned. A Fox News contributor sued Shine last month, accusing the executive of failing to investigate her claims of sexual harassment.

(Reporting by Daniel Wiessner in Albany, New York; Editing by Jonathan Oatis and Dan Grebler)