Longer tamoxifen use cuts breast cancer deaths

Breast cancer patients taking the drug tamoxifen can cut their chances of having the disease come back or kill them if they stay on the pills for 10 years instead of five years as doctors recommend now, a major study finds.

The results could change treatment, especially for younger women. The findings are a surprise because earlier research suggested that taking the hormone-blocking drug for longer than five years didn't help and might even be harmful.

In the new study, researchers found that women who took tamoxifen for 10 years lowered their risk of a recurrence by 25 percent and of dying of breast cancer by 29 percent compared to those who took the pills for just five years.

In absolute terms, continuing on tamoxifen kept three additional women out of every 100 from dying of breast cancer within five to 14 years from when their disease was diagnosed. When added to the benefit from the first five years of use, a decade of tamoxifen can cut breast cancer mortality in half during the second decade after diagnosis, researchers estimate.

Some women balk at taking a preventive drug for so long, but for those at high risk of a recurrence, "this will be a convincer that they should continue," said Dr. Peter Ravdin, director of the breast cancer program at the UT Health Science Center in San Antonio.

He reviewed results of the study, which was being presented Wednesday at a breast cancer conference in San Antonio and published by the British medical journal Lancet.

"The result of this trial will have a major, immediate impact on premenopausal women," Ravdin said.

About 50,000 of the roughly 230,000 new cases of breast cancer in the United States each year occur in women before menopause. Most breast cancers are fueled by estrogen, and hormone blockers are known to cut the risk of recurrence in such cases.

Tamoxifen long was the top choice, but newer drugs called aromatase inhibitors — sold as Arimidex, Femara, Aromasin and in generic form — do the job with less risk of causing uterine cancer and other problems.

But the newer drugs don't work well before menopause. Even some women past menopause choose tamoxifen over the newer drugs, which cost more and have different side effects such as joint pain, bone loss and sexual problems.

The new study aimed to see whether over a very long time, longer treatment with tamoxifen could help.

Dr. Christina Davies of the University of Oxford in England and other researchers assigned 6,846 women who already had taken tamoxifen for five years to either stay on it or take dummy pills for another five years.

Researchers saw little difference in the groups five to nine years after diagnosis. But beyond that time, 15 percent of women who had stopped taking tamoxifen after five years had died of breast cancer versus 12 percent of those who took it for 10 years. Cancer had returned in 25 percent of women on the shorter treatment versus 21 percent of those treated longer.

Tamoxifen had some troubling side effects: Longer use nearly doubled the risk of endometrial cancer. But it rarely proved fatal, and there was no increased risk among premenopausal women in the study — the very group tamoxifen helps most.

"Overall the benefits of extended tamoxifen seemed to outweigh the risks substantially," Dr. Trevor Powles of the Cancer Centre London wrote in an editorial published with the study.

The study was sponsored by cancer research organizations in Britain and Europe, the United States Army, and AstraZeneca PLC, which makes Nolvadex, a brand of tamoxifen, which also is sold as a generic for 10 to 50 cents a day. Brand-name versions of the newer hormone blockers, aromatase inhibitors, are $300 or more per month, but generics are available for much less.

The results pose a quandary for breast cancer patients past menopause and those who become menopausal because of their treatment — the vast majority of cases. Previous studies found that starting on one of the newer hormone blockers led to fewer relapses than initial treatment with tamoxifen did.

Another study found that switching to one of the new drugs after five years of tamoxifen cut the risk of breast cancer recurrence nearly in half — more than what was seen in the new study of 10 years of tamoxifen.

"For postmenopausal women, the data still remain much stronger at this point for a switch to an aromatase inhibitor," said that study's leader, Dr. Paul Goss of Massachusetts General Hospital. He has been a paid speaker for a company that makes one of those drugs.

Women in his study have not been followed long enough to see whether switching cuts deaths from breast cancer, as 10 years of tamoxifen did. Results are expected in about a year.

The cancer conference is sponsored by the American Association for Cancer Research, Baylor College of Medicine and the UT Health Science Center.

___

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

Read More..

White House preps Plan B if debt talks fail

White House press secretary Jay Carney (Charles Dharapak/AP)President Barack Obama's budget office is preparing for the possibility that "fiscal cliff" talks will fail, triggering painful automatic cuts to domestic and defense programs that he and his Republican foes officially want to avoid. White House press secretary Jay Carney described the planning as an abundance of caution, not pessimism about the seemingly stalled negotiations.

The White House's Office of Management and Budget this week "issued a request to federal agencies" for information needed to finalize calculations on the spending cuts required under what is technically known as "sequestration," Carney told reporters at his daily briefing. OMB is "acting responsibly," he added.

"The administration remains focused on reaching agreement, as we've been discussing, on a balanced deficit-reduction plan that avoids sequestration" he said. "This action should not be read … as a change in the administration's commitment to reach an agreement and avoid sequestration."Leaders of both parties have pledged to work together in the coming weeks, and we are confident, as I just said, that we can reach an agreement. However, with less than one month left before a potential sequestration order would have to be issued, the Office of Management and Budget must take certain steps to ensure the administration is ready to issue such an order should Congress fail to act."

Carney's comments came as talks on the fiscal cliff—a series of tax hikes and government spending cuts that could plunge the economy into a new recession—seemed to be making no headway. Obama and congressional Republicans have each put a proposal on the table but do not appear to be actively involved in negotiating a compromise.

"If our offer is not acceptable to the president, then he has an obligation to show leadership by presenting a credible plan of his own that can pass both houses of Congress," Republican House Speaker John Boehner said. Boehner accused Obama of snubbing spending cuts he accepted in the past (notably in failed 2011 negotiations) and failing to lay out "serious spending cuts."

"This is preventing us from reaching an agreement," Boehner continued. "With the American economy on the brink of the fiscal cliff, we don't have time for the president to continue shifting the goal posts. We need to solve this problem."

Obama, meanwhile, flatly dismissed the idea that Republicans might use next year's vote on raising the country's debt limit as leverage in current fiscal cliff negotiations, saying it won't be entertained by the White House.

While talks between Obama and Boehner appeared to be in a deep freeze, the president and congressional leaders met separately with top executives of the Business Roundtable association in Washington. A BRT official said the group met with Republican House Majority Whip Kevin McCarthy, then Democratic Senate Finance Committee Chairman Max Baucus and Republican Sen. John Thune, who sits on the Finance and Budget committees.

BRT Chairman Jim McNerney, president and CEO of Boeing, described the discussion with Obama as "candid and constructive" and the chat with congressional leaders as "constructive."

He noted that "we encourage both sides to work around the clock, if necessary, to avoid the severe repercussions that inaction would have on U.S. economic growth and job creation."

Read More..

Powerful typhoon kills at least 74 in Philippines

MANILA, Philippines (AP) — At least 43 villagers and soldiers drowned in a southern Philippine town Tuesday when torrents of water dumped by a powerful typhoon cascaded down a mountain, engulfing emergency shelters and an army truck, officials said. The deaths raised the toll from one of the strongest storms to hit the country this year to at least 74.

Gov. Arturo Uy said rain from Typhoon Bopha accumulated atop a mountain and then burst down on Andap village in New Bataan town in hard-hit Compostela Valley province. The victims included villagers who had fled from their homes to a school and village hall, which were then swamped by the flash flood. An army truck carrying soldiers and villagers was washed away, according to Uy and army officials.

"They thought that they were already secure in a safe area, but they didn't know the torrents of water would go their way," Uy told DZBB radio.

He said the confirmed death toll in the town was likely to rise because several other bodies could not immediately be retrieved from floodwaters strewn with huge logs and debris.

Bopha slammed into Davao Oriental province region at dawn, its ferocious winds ripping roofs from homes and its 500-kilometer (310-mile) -wide rain band flooding low-lying farmland.

The storm, packing winds of 140 kilometers (87 miles) per hour and gusts of up to 170 kph (106 mph), toppled trees, triggered landslides and sent flash floods surging across the region's mountains and valleys.

Two entire provinces lost power and more than 100 domestic flights were canceled. About 60,000 people fled to emergency shelters.

Twenty-three people drowned or were pinned by fallen trees or collapsed houses in Davao Oriental province's coastal town of Cateel, which had the most deaths after New Bataan, Davao Oriental Gov. Corazon Malanyaon told the ABS-CBN TV network, citing police reports.

Some towns in the province were so battered that no roofs remained on buildings, Malanyaon said.

The other deaths included three children who were buried by a wall of mud and boulders that plunged down a mountain in Marapat village, also in Compostela Valley. Their bodies were wrapped in blankets by their grieving relatives and placed on a stage in a basketball court.

"The only thing we could do was to save ourselves. It was too late for us to rescue them," said Valentin Pabilana, who survived the landslide.

In Davao Oriental, a poor agricultural and gold-mining province about 1,000 kilometers (620 miles) southeast of Manila, an elderly woman was killed when her house was struck by a falling tree, said Benito Ramos, who heads the government's disaster-response agency.

The other victims either drowned or were hit by trees, he said, adding that the death toll was expected to rise.

While some 20 typhoons and storms normally lash the archipelago nation annually, the southern provinces battered by Bopha are unaccustomed to fierce typhoons, which normally hit the northern and central Philippines.

A rare storm last December killed more than 1,200 people and left many more homeless and traumatized, including in Cagayan de Oro city, where church bells pealed relentlessly on Tuesday to warn residents to scramble to safety as a major river started to swell.

Officials were taking no chances this year, and President Benigno Aquino III appealed on national TV on Monday for people in Bopha's path to move to safety and take storm warnings seriously.

In Compostela Valley, authorities halted mining operations and ordered villagers to evacuate to prevent a repeat of deadly losses from landslides and the collapse of mine tunnels in previous storms.

Bopha, a Cambodian word for flower or a girl, is the 16th weather disturbance to hit the Philippines this year. Forecasters say at least one more storm may strike the country before Christmas.

___

Associated Press writer Teresa Cerojano contributed to this report.

Read More..

Huston's "Infrared" wins Bad Sex fiction prize

LONDON (AP) — It's the prize no author wants to win.

Award-winning novelist Nancy Huston won Britain's Bad Sex in Fiction award Tuesday for her novel "Infrared," whose tale of a photographer who takes pictures of her lovers during sex proved too revealing for the judges.

The choice was announced by "Downton Abbey" actress Samantha Bond during a ceremony at the Naval & Military Club in London.

Judges of the tongue-in-cheek prize — which is run by the Literary Review magazine — said they were struck by a description of "flesh, that archaic kingdom that brings forth tears and terrors, nightmares, babies and bedazzlements," and by a long passage that builds to a climax of "undulating space."

Huston, who lives in Paris, was not on hand to collect her prize. In a statement read by her publicist, the 59-year-old author said she hoped her victory would "incite thousands of British women to take close-up photos of their lovers' bodies in all states of array and disarray."

The Canada-born Huston, who writes in both French and English, is the author of more than a dozen novels, including "Plainsong" and "Fault Lines." She has previously won France's Prix Goncourt prize and was a finalist for Britain's Orange Prize for fiction by women.

She is only the third woman to win the annual Bad Sex prize, founded in 1993 to name and shame authors of "crude, tasteless and ... redundant passages of sexual description in contemporary novels."

Some critics, however, have praised the sexual passages in "Infrared." Shirley Whiteside in the Independent on Sunday newspaper said there were "none of the lazy cliches of pornography or the purple prose of modern romantic fiction" — though she conceded the book's sex scenes were "more perfunctory than erotic."

Huston beat finalists including previous winner Tom Wolfe — for his passage in "Back to Blood" describing "his big generative jockey" — and Booker Prize-nominated Nicola Barker, whose novel "The Yips" compares a woman to "a plump Bakewell pudding."

Previous recipients of the dubious honor, usually accepted with good grace, include Sebastian Faulks, the late Norman Mailer and the late John Updike, who was awarded a Bad Sex lifetime achievement award in 2008.

___

Online: http://www.literaryreview.co.uk

Read More..

CDC says US flu season starts early, could be bad

NEW YORK (AP) — Flu season in the U.S. is off to its earliest start in nearly a decade — and it could be a bad one.

Health officials on Monday said suspected flu cases have jumped in five Southern states, and the primary strain circulating tends to make people sicker than other types. It is particularly hard on the elderly.

"It looks like it's shaping up to be a bad flu season, but only time will tell," said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

The good news is that the nation seems fairly well prepared, Frieden said. More than a third of Americans have been vaccinated, and the vaccine formulated for this year is well-matched to the strains of the virus seen so far, CDC officials said.

Higher-than-normal reports of flu have come in from Alabama, Louisiana, Mississippi, Tennessee and Texas. An uptick like this usually doesn't happen until after Christmas. Flu-related hospitalizations are also rising earlier than usual, and there have already been two deaths in children.

Hospitals and urgent care centers in northern Alabama have been bustling. "Fortunately, the cases have been relatively mild," said Dr. Henry Wang, an emergency medicine physician at the University of Alabama at Birmingham.

Parts of Georgia have seen a boom in traffic, too. It's not clear why the flu is showing up so early, or how long it will stay.

"My advice is: Get the vaccine now," said Dr. James Steinberg, an Emory University infectious diseases specialist in Atlanta.

The last time a conventional flu season started this early was the winter of 2003-04, which proved to be one of the most lethal seasons in the past 35 years, with more than 48,000 deaths. The dominant type of flu back then was the same one seen this year.

One key difference between then and now: In 2003-04, the vaccine was poorly matched to the predominant flu strain. Also, there's more vaccine now, and vaccination rates have risen for the general public and for key groups such as pregnant women and health care workers.

An estimated 112 million Americans have been vaccinated so far, the CDC said. Flu vaccinations are recommended for everyone 6 months or older.

On average, about 24,000 Americans die each flu season, according to the CDC.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

A strain of swine flu that hit in 2009 caused a wave of cases in the spring and then again in the early fall. But that was considered a unique type of flu, distinct from the conventional strains that circulate every year.

__

Online:

CDC: http://www.cdc.gov/flu/weekly

Read More..

Conservative Republicans booted from House budget panel

WASHINGTON (Reuters) - Two of the most conservative Republicans in the House of Representatives have been kicked off the House Budget Committee, a rare move that could make it easier for the panel to advance a deal with Democrats to cut fiscal deficits.

Representatives Tim Huelskamp of Kansas and Justin Amash of Michigan - both favorites of the anti-tax Tea Party movement - are among those Republicans voting most often against House Speaker John Boehner.

Huelskamp and Amash, who both will begin second terms in the House next month, voted against last year's deal to raise the federal debt limit and staunchly oppose any tax increases. Boehner has now included new revenue in his latest offer to avert the "fiscal cliff" of year-end tax hikes and automatic spending cuts. Given their voting records, winning support from Huelskamp and Amash for such a compromise seemed an uphill battle.

Huelskamp released a statement saying the Republican leadership "might think they have silenced conservatives but removing me and others from key committees only confirms our conservative convictions.

"This is clearly a vindictive move and a sure sign that the GOP establishment cannot handle disagreement," he said.

Huelskamp and Amash had said that despite sweeping changes to the Medicare and Medicaid healthcare programs, committee chairman Paul Ryan's budget did not make deep enough cuts to entitlement programs and military spending.

Boehner spokesman Michael Steel declined to be specific on the reasons for their ouster by the House Republican Steering Committee, which occurred Monday in a closed-door meeting.

"The Steering Committee makes decisions based on a range of factors," Steel said.

Huelskamp said he was given "limited explanation" for his removal from the Budget Committee, a move he called "vindictive." A spokesman for Amash could not be immediately reached for comment.

Huelskamp and Amash cast the only House Budget Committee votes against Ryan's budget plan earlier this year.

While there is often wrangling over committee chairmanships just before a new Congress takes office, it is rare for rank-and-file committee members to be stripped of their assignments.

The 34-member Republican steering committee is headed by Boehner and includes members of House leadership, committee chairs and other lawmakers representing different regions of the country.

The same group last week recommended that Ryan, the conservative former Republican vice presidential candidate, be renewed as Budget Committee chairman.

(Editing by Bill Trott)

Read More..

Gunman severely wounds Swedish woman in Pakistan

LAHORE, Pakistan (AP) — A gunman on a motorcycle shot and severely wounded an elderly Swedish woman who worked at a church in eastern Pakistan on Monday, officials said.

The woman, who was identified by Pakistani police as Bargetta Emmi, was getting out of her car in front of her home in the city of Lahore when she was shot in the neck by an unknown assailant. Her servants reported the incident to police, said Pakistani police officer Malik Awais.

She was a director of FGA Church (Full Gospel Assemblies of Pakistan), Awais said.

Swedish Foreign Ministry spokesman Teo Zetterman confirmed en elderly Swedish woman was shot and severely wounded in Lahore. He said she was a volunteer worker in her 70s, but did not provide her name or where she worked.

The woman is a Swedish citizen but has lived and worked in Pakistan for several years, said Zetterman.

The gunman who shot Emmi escaped, and the motive was unclear.

Also in Lahore, gunmen on Monday desecrated over 100 graves of Ahmadis, members of a persecuted religious sect in Pakistan, said Awais, the police officer. More than a dozen gunmen held the caretakers of the graveyard hostage while they defaced the graves.

"You can't inscribe verses from the holy Quran on the graves. You are Ahmadis. You are not Muslims," one of the attackers told the caretakers, according to Awais.

Parliament amended Pakistan's constitution in 1974 to declare that Ahmadis were not considered Muslims under the law.

Ahmadis believe their spiritual leader, Hadrat Mirza Ghulam Ahmad, who died in 1908, was a messiah — a position rejected by the government in response to a mass movement led by Pakistan's major Islamic parties.

The Ahmadis' plight — along with that of Pakistan's other religious minorities, such as Shiite Muslims, Christians and Hindus — has deepened in recent years as hard-line interpretations of Islam have gained ground and militants have stepped up attacks against groups they oppose. Most Pakistanis are Sunni Muslims.

Also Monday, a roadside bomb ripped through a police van as it was patrolling on the outskirts of the northwestern city of Peshawar, killing two officers and wounding two others, said senior police officer Javed Khan.

Peshwar is on the edge of Pakistan's tribal region, the main sanctuary for Taliban militants in the country, and has been hit by frequent bombings over the past few years.

In the southern city of Karachi, a gunman riding on a motorcycle killed the leader of an Islamic seminary, sparking a riot by hundreds of seminary students, who stoned shops and set vehicles on fire, said police officer Azhar Iqbal.

Karachi has a long history of political, sectarian and ethnic strife, which has been on the rise this year.

____

Associated Press writers Louise Nordstrom in Stockholm, Adil Jawad in Karachi, Pakistan and Sebastian Abbot in Islamabad contributed to this report.

Read More..

Costas gun control commentary gets notice

NEW YORK (AP) — Bob Costas' "Sunday Night Football" halftime commentary supporting gun control sparked a Fox News Channel debate Monday on whether NBC should fire him and a Twitter storm involving Ted Nugent, Rosie O'Donnell, Herman Cain and many more.

The NBC sportscaster, who frequently delivers commentary at halftime of the weekly NFL showcase, addressed the weekend's murder-suicide involving Kansas City Chiefs linebacker Jovan Belcher.

Costas said that the shooting has invoked the "mindless sports cliche" that "something like this really puts it all in perspective."

"Please," he said. "Those who need tragedies to continually recalibrate their sense of proportion about sports would seem to have little hope of ever truly achieving perspective."

He then paraphrased and quoted extensively from a piece by Fox Sports columnist Jason Whitlock.

After praising the column, Costas said: "In the coming days, Jovan Belcher's actions and their possible connection to football will be analyzed. Who knows? But here, wrote Jason Whitlock, is what I believe. If Jovan Belcher didn't possess a gun, he and Kasandra Perkins would both be alive today."

Belcher shot and killed Perkins, the mother of his 3-month-old daughter, on Saturday morning, then drove to Arrowhead Stadium and committed suicide in the parking lot of the team's practice facility.

Quickly, Costas' comments renewed one of society's most contentious debates, made more intense by people who believe that a football halftime show was not the right place for Costas to be speaking on the issue.

"You tune in for a football game and end up listening to Bob Costas spewing sanctimonious dreck," tweeted Herman Cain, the former GOP presidential candidate.

Above a headline "Advocacy Gone Awry?" the hosts of Fox's morning show "Fox & Friends" read letters from viewers criticizing Costas' stance. On Megyn Kelly's afternoon show, there was a debate on whether Costas should be fired.

Rock star and gun advocate Nugent was quick to criticize via Twitter: "Hey Bob Costas we all kno (sic) that obesity is a direct result of the proliferation of spoons and forks. Get a clue."

Former talk show host Rosie O'Donnell, however, tweeted "way to go, Bob Costas." His former NBC colleague, Keith Olbermann, observed that it was "amazing that all those ripping my friend Bob Costas would, had he taken opposing view, be defending him for using the 1st."

There was no immediate comment on Monday from NBC Sports or from Costas.

Before the Olympics this summer, Costas criticized the International Olympic Committee's decision not to hold a moment of silence to mark the deaths of 11 Israeli athletes and coaches killed by Palestinian gunmen in Munich in 1972. But he stopped short of repeating that criticism on the air.

___

Online:

http://nbcsports.msnbc.com/

Read More..

Fossil fuel subsidies in focus at climate talks

DOHA, Qatar (AP) — Hassan al-Kubaisi considers it a gift from above that drivers in oil- and gas-rich Qatar only have to pay $1 per gallon at the pump.

"Thank God that our country is an oil producer and the price of gasoline is one of the lowest," al-Kubaisi said, filling up his Toyota Land Cruiser at a gas station in Doha. "God has given us a blessing."

To those looking for a global response to climate change, it's more like a curse.

Qatar — the host of U.N. climate talks that entered their final week Monday — is among dozens of countries that keep gas prices artificially low through subsidies that exceeded $500 billion globally last year. Renewable energy worldwide received six times less support — an imbalance that is just starting to earn attention in the divisive negotiations on curbing the carbon emissions blamed for heating the planet.

"We need to stop funding the problem, and start funding the solution," said Steve Kretzmann, of Oil Change International, an advocacy group for clean energy.

His group presented research Monday showing that in addition to the fuel subsidies in developing countries, rich nations in 2011 gave more than $58 billion in tax breaks and other production subsidies to the fossil fuel industry. The U.S. figure was $13 billion.

The Paris-based Organization for Economic Cooperation and Development has calculated that removing fossil fuel subsidies could reduce carbon emissions by more than 10 percent by 2050.

Yet the argument is just recently gaining traction in climate negotiations, which in two decades have failed to halt the rising temperatures that are melting Arctic ice, raising sea levels and shifting weather patterns with impacts on droughts and floods.

In Doha, the talks have been slowed by wrangling over financial aid to help poor countries cope with global warming and how to divide carbon emissions rights until 2020 when a new planned climate treaty is supposed to enter force. Calls are now intensifying to include fossil fuel subsidies as a key part of the discussion.

"I think it is manifestly clear ... that this is a massive missing piece of the climate change jigsaw puzzle," said Tim Groser, New Zealand's minister for climate change.

He is spearheading an initiative backed by Scandinavian countries and some developing countries to put fuel subsidies on the agenda in various forums, citing the U.N. talks as a "natural home" for the debate.

The G-20 called for their elimination in 2009, and the issue also came up at the U.N. earth summit in Rio de Janeiro earlier this year. Frustrated that not much has happened since, European Union climate commissioner Connie Hedegaard said Monday she planned to raise the issue with environment ministers on the sidelines of the talks in Doha.

Many developing countries are positive toward phasing out fossil fuel subsidies, not just to protect the climate but to balance budgets. Subsidies introduced as a form of welfare benefit decades ago have become an increasing burden to many countries as oil prices soar.

"We are reviewing the subsidy periodically in the context of the total economy for Qatar," the tiny Persian gulf country's energy minister, Mohammed bin Saleh al-Sada, told reporters Monday.

Qatar's National Development Strategy 2011-2016 states it more bluntly, saying fuel subsides are "at odds with the aspirations" and sustainability objectives of the wealthy emirate.

The problem is that getting rid of them comes with a heavy political price.

When Jordan raised fuel prices last month, angry crowds poured into the streets, torching police cars, government offices and private banks in the most sustained protests to hit the country since the start of the Arab unrest. One person was killed and 75 others were injured in the violence.

Nigeria, Indonesia, India and Sudan have also seen violent protests this year as governments tried to bring fuel prices closer to market rates.

Iran has used a phased approach to lift fuel subsidies over the past several years, but its pump prices remain among the cheapest in the world.

"People perceive it as something that the government is taking away from them," said Kretzmann. "The trick is we need to do it in a way that doesn't harm the poor."

The International Energy Agency found in 2010 that fuel subsidies are not an effective measure against poverty because only 8 percent of such subsidies reached the bottom 20 percent of income earners.

The IEA, which only looked at consumption subsidies, this year said they "remain most prevalent in the Middle East and North Africa, where momentum toward their reform appears to have been lost."

In the U.S., environmental groups say fossil fuel subsidies include tax breaks, the foreign tax credit and the credit for production of nonconventional fuels.

Industry groups, like the Independent Petroleum Association of America, are against removing such support, saying that would harm smaller companies, rather than the big oil giants.

In Doha, Mohammed Adow, a climate activist with Christian Aid, called all fuel subsidies "reckless and dangerous," but described removing subsidies on the production side as "low-hanging fruit" for governments if they are serious about dealing with climate change.

"It's going to oil and coal companies that don't need it in the first place," he said.

___

Associated Press writers Abdullah Rebhy in Doha, Qatar, and Brian Murphy in Dubai, United Arab Emirates, contributed to this report

____

Karl Ritter can be reached at www.twitter.com/karl_ritter

Read More..

Boehner makes counteroffer on debt talks

WASHINGTON—House Republicans on Monday unveiled a counterproposal to a Democratic plan to avoid the so-called fiscal cliff that includes $800 billion in new government revenue by eliminating write-offs in the tax code while extending current tax rates for all income levels.

In a letter sent to the White House, Republican leaders outlined a plan that they said would provide $2.2 trillion in deficit reduction over the next decade. On top of the $800 billion in new revenue from a tax code overhaul, Republicans estimated they could save $300 billion by cutting discretionary spending, $600 billion in "health savings," $200 billion in changes to the consumer price index and another $300 billion in mandatory spending.

The White House last week sent Republicans a proposal that estimated $1.6 trillion in new tax revenue over 10 years and about $400 billion in savings for entitlement programs. It also included new spending for infrastructure projects. Republicans rejected it outright and put forth their own plan on Monday.

The President
The White House
1600 Pennsylvania Avenue, Northwest
Washington, DC 20500

Dear Mr. President,

After a status quo election in which both you and the Republican majority in the House were re-elected, the American people rightly expect both parties to come together on a fair middle ground and address the nation's most pressing challenges.

To that end, shortly after the election, we presented you with a balanced framework for averting the fiscal cliff by coupling spending cuts and reforms with new tax revenue. We then welcomed Secretary Geithner to the Capitol on November 29 with every expectation that he would lay out a similarly reasonable path.

Regrettably, the proposal he outlined on behalf of your Administration contains very little in the way of common ground. The proposal calls for $1.6 trillion in new tax revenue, twice the amount you supported during the campaign. The proposal also includes four times as much tax revenue as spending cuts, in stark contrast to the "balanced approach" on which you campaigned. While administration officials are claiming that this proposal contains 2.5 dollars of spending cuts for each dollar in new revenue, counting as part of this ratio previously enacted savings — as if these were new spending reductions — only confuses the public debate. What's worse, the modest spending cuts in this offer are cancelled out by the additional 'stimulus' measures the Administration is requesting. And, this proposal would remove any and all limits on federal borrowing.

We cannot in good conscience agree to this approach, which is neither balanced nor realistic. If we were to take your Administration's proposal at face value, then we would counter with the House-passed Budget Resolution. It assumes an overhaul of our tax code with revenue remaining at historically normal levels and proposes structural reforms to preserve and protect the Nation's entitlement programs, ensuring they are sustainable for the long-term rather than continuing to grow out of control. Some of its key reforms include:

The House-passed Budget Resolution assumes enactment of structural Medicare reform that offers future beneficiaries guaranteed coverage options, including a traditional fee-for-service Medicare plan. This proposal is based on recent bipartisan efforts and would provide greater support for the poor and the sick and less support for the wealthy. We achieve these reforms in Medicare without affecting current seniors or those nearing retirement. This would slow the projected explosive spending growth in this program and eventually maintain Medicare spending as a share of the economy at 4.75 percent, thus saving the program for future generations.
The House-passed Budget Resolution reforms Medicaid and provides states with greater flexibility to better deliver health security to beneficiaries, saving the federal government nearly $800 billion over 10 years.
Separate from savings in our proposal for the 2010 health care law, the House-passed Budget Resolution envisions hundreds of billions in savings in other mandatory spending, including reforms to Federal employee compensation and the Supplemental Nutrition Assistance Program.

These reforms are, in our view, absolutely essential to addressing the true drivers of our debt, and we will continue to support and advance them. At the same time, mindful of the status quo election and past exchanges on these questions, we recognize it would be counterproductive to publicly or privately propose entitlement reforms that you and the leaders of your party appear unwilling to support in the near-term.

With the fiscal cliff nearing, our priority remains finding a reasonable solution that can pass both the House and the Senate, and be signed into law in the next couple of weeks. The best way to do this is by learning from and building on the bipartisan discussions that have occurred during this Congress, including the Biden Group, the Joint Select Committee, and our negotiations leading up to the Budget Control Act.

For instance, on November 1 of last year, Erskine Bowles, the co-chair of your debt commission, presented the Joint Select Committee with a middle ground approach that garnered praise from many fiscal watchdogs and nonpartisan experts. He recommended that both parties agree to a balanced package that includes significant spending cuts as well as $800 billion in new revenue.

Notably, the new revenue in the Bowles plan would not be achieved through higher tax rates, which we continue to oppose and will not agree to in order to protect small businesses and our economy. Instead, new revenue would be generated through pro-growth tax reform that closes special-interest loopholes and deductions while lowering rates. On the spending side, the Bowles recommendation would cut more than $900 billion in mandatory spending and another $300 billion in discretionary spending. These cuts would be over and above the spending reductions enacted in the Budget Control Act.

This is by no means an adequate long-term solution, as resolving our long-term fiscal crisis will require fundamental entitlement reform. Indeed, the Bowles plan is exactly the kind of imperfect, but fair middle ground that allows us to avert the fiscal cliff without hurting our economy and destroying jobs. We believe it warrants immediate consideration.

If you are agreeable to this framework, we are ready and eager to begin discussions about how to structure these reforms so that the American people can be confident that these targets will be reached.

Again, the American people expect their leaders to find fair middle ground to address the nation's most pressing challenges. To achieve that outcome, we respectfully request that you respond to this letter in a timely fashion and hope that you will refrain from any further action that would undermine good-faith efforts to reach a reasonable and equitable agreement in this critical matter.

Sincerely,

John Boehner, Speaker
Eric Cantor, Majority Leader
Kevin McCarthy, Majority Whip
Cathy McMorris Rodgers, Republican Conference Chairman
Dave Camp, Chairman, Committee on Ways and Means
Paul Ryan, Committee on the Budget
Fred Upton, Committee on Energy & Commerce

Read More..