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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Asian shares recover from steep loss, growth worry caps

TOKYO (Reuters) - Asian shares recouped some of the previous session's steep falls as investors reassessed fears of the Federal Reserve ending its ultra-soft monetary policy earlier than expected, but weak U.S. and European data capped Friday's recovery.

European markets are seen rebounding, with financial spreadbetters predicting London's FTSE 100 <.ftse>, Paris's CAC-40 <.fchi> and Frankfurt's DAX <.gdaxi> would open up as much as 0.6 percent. U.S. stock futures were up 0.3 percent to suggest a solid Wall Street start. <.l><.eu><.n/>

The dollar lost 0.3 percent against a basket of currencies <.dxy>, pulling away from a 5-1/2-month high hit on Thursday, as data showing weak business conditions in parts of the United States and across Europe pushed out expectations of any policy tightening.

"It's unlikely that the Fed would begin to wind down its QE (quantitative easing) program until the U.S. economic growth is improving at a faster rate than currently," said Ric Spooner, chief market analyst at CMC Global Markets in Sydney.

Most risk assets had slid to their lows for 2013 on Thursday, in part because of worries the Fed could prematurely paring back its bond buying program. But the weak data in the United States and Europe saw that view quickly reconsidered.

Gold rose 0.5 percent to $1,582.96 an ounce after having hit a seven-month high on Thursday.

Tokyo's Nikkei stock average <.n225> closed up 0.7 percent, reclaiming about half of Thursday's drop.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was up 0.2 percent. However, that was only a fraction of its 1.5 percent tumble on Thursday, and the index was set for a weekly loss of 0.8 percent.

Upbeat comments from the central bank governor helped Australian shares <.axjo> jump 0.8 percent, with investors buying back after stocks slumped 2.3 percent on Thursday.

Hong Kong shares <.hsi> bucked the regional trend and fell 0.3 percent while Shanghai shares <.ssec> inched up 0.1 percent.

"In America they're kind of revealing that actually the next thing we need to do is start tightening, and that's why global stocks are very volatile at the moment and we're going to be caught up in that," said Damien Boey, equity strategist at Credit Suisse.

The euro rose from multi-week lows hit on Thursday, gaining 0.4 percent to 123.22 yen. The dollar inched up 0.2 percent against the yen to 93.26.

London copper climbed 0.9 percent to $7,934 a metric ton, after posting its biggest single-day slide this year on Thursday.

Crude oil futures also recovered from Thursday's sell-off, with U.S. crude up 0.3 percent to $93.11 a barrel and Brent rising 0.5 percent to $114.05.

"After the Fed, people seemed to have a little less conviction that we are going to see indefinite low dollar rates, which have attracted a lot of interest in commodities, especially precious metals. But the macro picture hasn't changed tremendously and the underlying demand is still strong," a Hong Kong trader said.

U.S. 10-year Treasury yields were a tad higher in Asia, having eased in the previous session.

The German Ifo business sentiment index at 0900 GMT should offer more clues on the health of European economy, but overall sentiment is expected to remain cautious ahead of elections in Italy over the weekend.

Most investors expect a centre-left government to win and continue with reforms to tackle Italy's debt problems. But a resurgence of former leader Silvio Berlusconi has raised new worries.

(Additional reporting by Thuy Ong in Sydney and Florence Tan and Rujun Shen in Singapore; Editing by John Mair)

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Mexico security forces abducted dozens in drug war: rights group

IGUALA, Mexico (Reuters) - Dozens of people were abducted and murdered by Mexican security forces over the past six years during a gruesome war with drug cartels, Human Rights Watch said on Wednesday, urging President Enrique Pena Nieto to overhaul the military justice system.

The rights group said that since 2007 it has documented 149 cases of people who were never seen again after falling into the hands of security forces, and that the government failed to properly investigate the "disappearances."

"The result was the most severe crisis of enforced disappearances in Latin America in decades," the U.S.-based group said. (Human Rights Watch report: http://r.reuters.com/fyk26t)

It recommended reforming Mexico's military justice system and creating a national database to link the missing with the thousands of unidentified bodies that piled up during the military-led crackdown on drug cartels.

The report was a grim reminder of the dark side of the war on drug cartels that killed an estimated 70,000 people during former President Felipe Calderon's six-year presidency.

The report also illustrates the obstacles that President Pena Nieto, who took office in December, faces in trying to stem the violence, restore order over areas of the country controlled by the drug cartels and end abuses by security forces.

For nearly three years, 56-year-old shopkeeper Maria Orozco has sought to discover the fate of her son. She says he was abducted along with five colleagues by soldiers from the nightclub where they worked in Iguala, a parched town south of the Mexican capital.

She says a grainy security video, submitted anonymously, shows the moment in 2010 when local soldiers rounded up the men.

"We used to see the military like Superman or Batman or Robin. Super heroes," said Orozco. "Now the spirit of the whole country has turned against them."

Hers was one of the cases illustrated in the Human Rights Watch report.

Pena Nieto has vowed to take a different tack to his predecessor Calderon and focus on reducing violent crime and extortion rather than on going head to head with drug cartels.

The government last month introduced a long-delayed law to trace victims of the drug war and compensate the families. It says it is moving ahead with plans to roll out a genetic database to track victims and help families locate the disappeared.

"There exists, in theory, a database with more than 27,000 people on it," said Lia Limon, deputy secretary of human rights at Mexico's interior ministry. "It's a job that's beginning."

Still, impunity remains rife. The armed forces opened nearly 5,000 investigations into criminal wrongdoing between 2007 and 2012, but only 38 ended in sentencing, according to Human Rights Watch.

In its report it describes the impact of the disappearances on victims' families, a daily reality for Ixchel Mireles, a 50-year-old librarian from the northern city of Torreon, whose husband Hector Tapia was abducted by men in federal police uniforms.

Neither Mireles nor her daughter has heard from Tapia since that night in June 2010.

"I want him to be alive, but the reality just destroys me," said Mireles. "I just want them to give him back, even if he is dead."

Since her husband's disappearance, Mireles has struggled financially, having lost his 40,000 pesos ($3,143) a month salary. She has moved her daughter to a cheaper university and can barely keep up payments on her house.

"I now travel by foot," she said, noting that Mexico's social security system does not recognize the disappeared.

Some family members of the disappeared have asked for soldiers guilty of rights abuses to be judged like civilians, a move Mexico's Supreme Court has approved.

"To us it just seems that the military is untouchable," said Laura Orozco, 36, who says she witnessed her brother's military-led abduction. "They're bulletproof."

($1 = 12.73 pesos)

(Additional reporting by Michael O'Boyle,; Editing by Simon Gardner, Kieran Murray and Lisa Shumaker)

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American Idol: Women Face Sudden-Death Round

American Idol

By Jamie Bufalino

02/20/2013 at 11:00 PM EST

Mariah Carey

Mario Anzuoni/Reuters/Landov

American Idol threw yet another new twist at its 40 remaining contestants: a sudden-death round.

"One song, one chance, no mercy," Ryan Seacrest said as the first group of 10 female contestants gathered in Las Vegas to try to finally sing their way – in front of a boisterous studio audience – through to the "America votes" phase of the competition.

Five women moved on, five went home.

Kentucky high school junior Jenny Beth Willis, whose rendition of a Trisha Yearwood song earned mixed reviews from the judges, was the first up. Although Keith Urban appreciated her "effortless confidence," Nicki Minaj said her performance lacked excitement (a comment that elicited the first audience boos of the season). Final result: It was the end of the road for Willis.

Tenna Torres, 28, – who attended Mariah Carey's camp for kids as a youngster – took the stage next and impressed the judges with her take on the Natasha Bedingfield's "Soulmate." But she lost style points with Minaj, who didn't like one particular aspect of her look. "Lose the hair," said Minaj, who felt the contestant's coif aged her. Final result: She made it through to the Top 20.

The three most powerful performances of the night all made it to the next round: Nashville's Kree Harrison, who despite taking a decidedly plain-Jane approach to styling, wowed the judges with her version of Patty Griffin's "Up to the Mountain." "You sang the hell out of that song," said Carey.

Angela Miller, 18, of Massachusetts, belted out Jessie J's hit "Nobody's Perfect." But she pretty much was.

And Amber Holcomb, an assistant teacher from Texas, closed the show with a rousing (and well received) rendition of "My Funny Valentine."

For the final spot of the night, it came down to Anchorage, Alaska, resident Adriana Latonio, 17, who tackled Aretha Franklin's "Ain't No Way," and Shubha Vedula, a Michigan high school senior who sang Lady Gaga's "Born This Way."

Although the judges saw potential in both contestants, they ultimately picked Lantonio's powerhouse vocals in a final emotional moment.

Thursday will bring out the guys. The first round of 10 will take the stage to try to make the top 20 – but once again, five will go home.

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Adults get 11 percent of calories from fast food

ATLANTA (AP) — On an average day, U.S. adults get roughly 11 percent of their calories from fast food, a government study shows.

That's down slightly from the 13 percent reported the last time the government tried to pin down how much of the American diet is coming from fast food. Eating fast food too frequently has been seen as a driver of America's obesity problem.

For the research, about 11,000 adults were asked extensive questions about what they ate and drank over the previous 24 hours to come up with the results.

Among the findings:

— Young adults eat more fast food than their elders; 15 percent of calories for ages 20 to 39 and dropping to 6 percent for those 60 and older.

— Blacks get more of their calories from fast-food, 15 percent compared to 11 percent for whites and Hispanics.

— Young black adults got a whopping 21 percent from the likes of Wendy's, Taco Bell and KFC.

The figures are averages. Included in the calculations are some people who almost never eat fast food, as well as others who eat a lot of it.

The survey covers the years 2007 through 2010 and was released Thursday by the Centers for Disease Control and Prevention. The authors couldn't explain why the proportion of calories from fast food dropped from the 13 percent found in a survey for 2003 through 2006.

One nutrition professor cast doubts on the latest results, saying 11 percent seemed implausibly low. New York University's Marion Nestle said it wouldn't be surprising if some people under-reported their hamburgers, fries and milkshakes since eating too much fast food is increasingly seen as something of a no-no.

"If I were a fast-food company, I'd say 'See, we have nothing to do with obesity! Americans are getting 90 percent of their calories somewhere else!'" she said.

The study didn't include the total number of fast-food calories, just the percentage. Previous government research suggests that the average U.S. adult each day consumes about 270 calories of fast food — the equivalent of a small McDonald's hamburger and a few fries.

The new CDC study found that obese people get about 13 percent of daily calories from fast food, compared with less than 10 percent for skinny and normal-weight people.

There was no difference seen by household income, except for young adults. The poorest — those with an annual household income of less than $30,000 — got 17 percent of their calories from fast food, while the figure was under 14 percent for the most affluent 20- and 30-somethings with a household income of more than $50,000.

That's not surprising since there are disproportionately higher numbers of fast-food restaurants in low-income neighborhoods, Nestle said.

Fast food is accessible and "it's cheap," she said.

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Doubt on Fed easing hits shares, commodities

LONDON (Reuters) - World share markets fell and the dollar and safe-haven assets rose on Thursday, a day after minutes of the Federal Reserve's last policy meeting cast doubts over how much longer the U.S. central bank would stick to its stimulus plan.

After the minutes were released the euro skidded to a six-week low against the dollar of $1.3235, Asian shares experienced their worst day in seven months and gold hit its lowest price since last July, at $1,554.49 an ounce.

"Disagreement over the current path is causing concern for a market that demands certainty," Ben Taylor, a trader at CMC Markets, said of evidence Fed officials were divided on policy.

MSCI's world equity index <.miwd00000pus>, which only on Wednesday had touched a 4-1/2 year high, fell 0.5 percent as the benchmark S&P 500 index <.spx> suffered its steepest daily percentage decline since mid-November.

European markets joined in the selloff with the FTSE Eurofirst 300 index <.fteu3> shedding 0.5 percent, led lower by the banks <.sxip>, which have been at forefront of recent gains. London's FTSE 100 <.ftse>, Paris's CAC-40 <.fchi> and Frankfurt's DAX <.gdaxi> were all down as much as 0.7 percent.

However, market sentiment could get some support from the release of first reading from February Purchasing Managers' Indexes (PMIs) from across Europe later in the day.

The euro-zone composite PMI is expected to have risen for a fourth consecutive month in February to around 49.0, adding to evidence that economic conditions across the recession-hit region are gradually improving.

The PMI reading would still leave the composite index below the 50 mark which separates expansion from contraction and analysts estimate it would be consistent with a small fall in GDP for a fourth consecutive quarter.

In the fixed income market, German bonds, normally considered a safe haven, saw prices rise with the main Bund futures contract up 30 ticks to 142.85. The move reversed a fall seen on Wednesday but kept the contract within a narrow band before an Italian general election this weekend.

Spain was set to test market sentiment for peripheral euro zone debt with the sale of up to four billion euros of new paper.

The dollar followed up a big gain on Wednesday against a basket of major currencies to add a further 0.1 percent, although it dipped slightly against the yen to 93.41.

Among commodities, London copper struck its lowest in nearly two months, at $7,880 a metric ton, while crude oil extended losses after posting its biggest daily fall so far this year on Wednesday.

(Reporting by Richard Hubbard; Editing by Alastair Macdonald)

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Insight: Rome will burn, regardless of Italian election result

ROME (Reuters) - Regardless of who wins next weekend's parliamentary election, Italy's long economic decline is likely to continue because the next government won't be strong enough to pursue the tough reforms needed to make its economy competitive again.

Bankers, diplomats and industrialists in Rome and Milan despair at how Italians are shifting allegiances ahead of the February 24-25 vote to favor anti-establishment upstarts and show disgust with the established parties.

That makes it more likely that no bloc will have the political strength to tackle Italy's deep-rooted economic crisis, which has made it Europe's most sluggish large economy for the past two decades.

Final opinion polls predict that the vote will deliver a working majority in both houses for a centre-left coalition governing in alliance with technocrat former prime minister Mario Monti. Political risk consultancy Eurasia assigns this scenario a 50-60 percent probability.

But Italy's election for both chambers of parliament has the potential to tip the euro zone back into instability if the outcome does not produce that result.

The colorful cast of candidates includes disgraced media tycoon Silvio Berlusconi, one of the world's richest men, the bespectacled academic Monti, anti-establishment comedian Beppe Grillo who campaigns from a camper van, and Nichi Vendola, a former communist poet who is the governor of Puglia.

Investors have so far taken a relaxed view, relying on polls produced until the legal deadline for surveys of Feb 10.

One of the best indicators that they are not worried: Italian benchmark 10-year bond yields, which topped six percent during the country's worst political moments in 2011, are now trading around 4.4 percent, almost a full percentage point lower than those of Spain.

Italian stocks have performed broadly in line with the wider European market since January, despite the election and a wave of scandals which has engulfed several leading Italian groups.

But observers in Italy are increasingly nervous that the rosy election scenario favored by investors may not work out.

A jaded electorate, angry about political corruption, economic mismanagement and a national crisis that has impoverished a once-wealthy member of the G7 club of rich nations, could produce a surprise.

Pier Luigi Bersani, the standard-bearer for the centre-left, is a worthy but lackluster former minister whose party has been linked to a banking scandal in the mediaeval Tuscan town of Siena. Support for his party now seems to be fading.

Opponents have latched on to the fact that the ailing bank, Monte dei Paschi, was run by a foundation dominated by political appointees from the centre-left and accused Bersani's party of presiding over a debacle that will cost taxpayers hundreds of millions of euros.

CAMPER VAN POLITICS

Monti, dubbed "Rigor Montis" by one opponent for his austerity policies which critics say hurt growth, is stuck in fourth place and slipping. Detractors say he comes across poorly on the hustings and has been hurt because he formed an election alliance with two discredited centrist politicians who are emblematic of the traditional politics which Monti disavows.

The big gainer in the final days before the election, according to private surveys quoted by experts, is stand-up comedian Beppe Grillo and his anti-establishment 5-Star Movement. Grillo has been on a "tsunami tour" of Italy in a camper van, filling piazzas with his ringing denunciations of the country's political class. He campaigns mainly on the Internet, where his widely read blog features a list of Italy's parliamentarians convicted of a crime (it features 24 names).

"The big question is: what happens to Grillo?" said one senior banker in Milan, speaking on condition of anonymity. "He won't win but he could stop Bersani and Monti from getting enough seats to form an effective government."

Under the electoral law in force for this poll, which almost all Italians agree is in need of reform, voters cast ballots for a party list. The coalition with the most votes is awarded top-up seats in the lower house to give it a 55 percent majority. But in the Senate, the top-up premium applies by region.

Pollsters say the race is too close to call in a few battleground regions but there is a good chance the centre-left will fall short of a majority in the Senate, which has equal law-making powers to the lower house.

A substantial vote for Grillo's movement - and some experts suggest he could top 20 percent - could mean the new parliament is filled with new, inexperienced, anti-establishment deputies who may refuse to do deals with other politicians and block legislation. Bersani and Monti could find themselves without a workable majority in the Senate even in alliance - a scenario which Eurasia believe has a 20-30 percent probability.

"It's hard to see Grillo's movement as a source of stability," said one diplomat, speaking off the record. "There is no chance they would be part of a coalition."

CONVICTION POLITICIAN

Ironically Grillo himself will not be entering parliament regardless of how well his movement does. The shaggy-haired 63-year-old was convicted of manslaughter after three passengers died when a jeep he was driving crashed in 1981, making him ineligible for election under his own party's rules barring convicted criminals from parliament.

"Grillo's agenda is just silly," said one leading Italian columnist, speaking anonymously because his publication did not allow him to be quoted in other media before the vote.

"It's a fuck off policy. He wants to leave Europe, set up people's tribunals, halve public employees. It's the most visible symptom of Italy's political crisis."

The 5-Star Movement is not the only anti-establishment force threatening to make Italy ungovernable. The federalist Northern League, which favors greater autonomy for northern Italy, is polling around five percent nationally. Its leader Roberto Maroni told Reuters last week he would use his seats in parliament in alliance with the centre-right to block a centre-left coalition and prevent it from governing.

The League is particularly important in the Senate as its home region of Lombardy, where the party polls about 15 percent, returns by far the most senators - 49 out of a chamber of 319.

Should Grillo's movement and the Northern League win enough seats to deprive a centre-left coalition with Monti of an overall majority, the most likely outcome is a "grand coalition" of left and right, experts say.

Such a result would unsettle investors because it would be likely to bring centre-right leader former premier Berlusconi, 76, back into government in a key role and Monti would be unlikely to join it.

Berlusconi's own party has boosted its standing in polls over the past month, helped by the former premier's veteran campaigning skill and his dominance of the country's private TV channels. But nobody apart from his own supporters believes he is likely to win this time.

POPE FACTOR

Pope Benedict's unexpected resignation this month has pushed the parliamentary election off the front pages in Italy, giving Berlusconi less print space and TV air time to press his populist message. The main beneficiary appears to be Grillo, whose strategy of ignoring mainstream media and campaigning on the Internet has been unaffected by the news from the Vatican.

Investors above all want a government which will tackle the reasons for Italy's lackluster performance. Italy has hardly grown since the birth of the euro in 1999 and its economy has slumped faster since the 2007 financial crisis than any other in Europe except Greece. Last year, Italy contracted by 2.2 percent, according to official statistics.

Businessmen complain of three main obstacles: stifling bureaucracy, labor laws which offer workers so much protection that they encourage slack performance, and a dysfunctional court system which makes it hard to enforce contracts and collect debts. All are deep-rooted problems and none is likely to be tackled effectively by a weak and divided government.

"Nobody in Italy is ready to make the reforms our country needs right now," said the chief executive of a major Italian company, speaking off the record.

"I am deeply convinced that without a major change in labor flexibility, we will not be able to increase productivity. My personal experience is that Italian labor is fantastic. But if you take a very good worker and tell him his job is completely safe, you will turn him into a slacker."

Italy's byzantine court system - where cases can languish for years - and its legendary bureaucracy are major obstacles to foreign investment and competitiveness, business people and diplomats say. "Foreign companies are surprised by how hard it is to get things done here which we all thought had been agreed in Brussels 20 years ago," said one senior European diplomat.

Monti's technocratic government won plaudits from business for reforming Italy's pension system but its efforts to reform labor laws did not enjoy similar success. Monti's government lasted 13 months until Berlusconi's bloc triggered its collapse by withdrawing support. Some observers in Italy don't believe that the next parliament's make-up will be nearly as conducive to reform as the outgoing one.

MUDDLE-THROUGH OUTCOME

"I want to be optimistic but my best guess is that they will keep to this muddle-through scenario in the next parliament with lackluster results for the economy," said a second senior diplomat. "This country needs a new generation of political leaders."

Key among the concerns of diplomats and business people is the disparate nature of the centre-left coalition leading in polls.

Bersani's election alliance is made up of four main parties, stretching from the former communist Vendola through the Christian left to socialists and centrists. If it is unable to govern alone, as most polls predict, it will need the support of Monti's bloc - itself made up of three parties.

Bankers fear that a government made up of seven different groups of widely varying political hues is highly unlikely to agree on the tough, radical reform measures the country needs.

"If we have a government made up of Bersani, Monti and Vendola, they will argue all the time," said the chief executive. "Bersani and Vendola's capacity for reform is almost zero." Comparing the present Italian centre-left candidate to the former German chancellor whose successful labor reforms belied his socialist roots, he added: "Bersani is no Schroeder".

Bersani's economic spokesman Stefano Fassina insists that the centre-left fully understands the urgency of Italy's economic plight and is committed to deliver on measures to stop the rot. But he puts the emphasis on making the public sector more efficient and persuading Berlin to tone down budget austerity at a European level rather than pursuing labor reform in Italy. Fassina insists that public commitments by Bersani and Vendola on an agreed program will minimize disagreements but he does admit to concern about how a centre-left administration could work with Grillo's unpredictable forces.

"It's impossible to have any discussions with Grillo as a party," he said. "We hope that in parliament some of his MPs will be pragmatic enough to agree on reasonable measures."

With so much uncertainty about the election and the chances fading of it returning a strong, stable reformist government, it is hard to avoid the conclusion that Italy's slow, steady economic decline will continue regardless of the result.

"We've seen a steady economic decline in Italy over the past 20 years and it's very hard to see any outcome from this election which will reverse that. The reforms which would really get the country going again are out of reach," concluded the European diplomat.

(Editing by Peter Millership and Giles Elgood)

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What's Next for Mindy McCready's Two Young Boys?

By Steve Helling

02/19/2013 at 07:00 PM EST

Mindy McCready's apparent suicide on Sunday has left her two young sons in custodial limbo.

The boys – Zander, 6, and Zayne, 10 months – had been in state custody since Feb. 7, when McCready called police to ask for help in making her father and stepmother leave her home. When police arrived, McCready appeared to be intoxicated, according to a Department of Human Services report.

In a subsequent petition, the singer's father, Tim McCready, asked the court to order her to undergo mental health and substance abuse evaluation and treatment, alleging that his daughter, who had recently lost her boyfriend, "hasn't had a bath in a week ... screams about everything ... [is] very verbally abusive to Zander."

After a judge granted the petition, the children were quickly removed and placed into foster care. Although McCready was released from treatment, the boys remained in state custody.

At the time, Zander's father, Billy McKnight, requested custody of his son. "My son needs me," he told PEOPLE on Feb. 8. "I'm married, working and successful. I'm on the right track and proud of it. I've been sober for years. I just want my son."

But McCready's mother and stepfather, Gayle and Michael Inge, also want custody of the children – and authorities seem to agree.

In a proposed order sent to Circuit Judge Lee Harrod, the Department of Human Services proposed that the Inges might be a better fit for the children, claiming that they have "a substantial relationship." The Inges had custody of Zander for much the past few years, during McCready’s rehab and jail stints.

With McCready's death, the judge will have to determine what is in the children's best interest. A custody hearing has been scheduled for April 5.

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Drug overdose deaths up for 11th consecutive year

CHICAGO (AP) — Drug overdose deaths rose for the 11th straight year, federal data show, and most of them were accidents involving addictive painkillers despite growing attention to risks from these medicines.

"The big picture is that this is a big problem that has gotten much worse quickly," said Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, which gathered and analyzed the data.

In 2010, the CDC reported, there were 38,329 drug overdose deaths nationwide. Medicines, mostly prescription drugs, were involved in nearly 60 percent of overdose deaths that year, overshadowing deaths from illicit narcotics.

The report appears in Tuesday's Journal of the American Medical Association.

It details which drugs were at play in most of the fatalities. As in previous recent years, opioid drugs — which include OxyContin and Vicodin — were the biggest problem, contributing to 3 out of 4 medication overdose deaths.

Frieden said many doctors and patients don't realize how addictive these drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs.

They're useful for cancer, "but if you've got terrible back pain or terrible migraines," using these addictive drugs can be dangerous, he said.

Medication-related deaths accounted for 22,134 of the drug overdose deaths in 2010.

Anti-anxiety drugs including Valium were among common causes of medication-related deaths, involved in almost 30 percent of them. Among the medication-related deaths, 17 percent were suicides.

The report's data came from death certificates, which aren't always clear on whether a death was a suicide or a tragic attempt at getting high. But it does seem like most serious painkiller overdoses were accidental, said Dr. Rich Zane, chair of emergency medicine at the University of Colorado School of Medicine.

The study's findings are no surprise, he added. "The results are consistent with what we experience" in ERs, he said, adding that the statistics no doubt have gotten worse since 2010.

Some experts believe these deaths will level off. "Right now, there's a general belief that because these are pharmaceutical drugs, they're safer than street drugs like heroin," said Don Des Jarlais, director of the chemical dependency institute at New York City's Beth Israel Medical Center.

"But at some point, people using these drugs are going to become more aware of the dangers," he said.

Frieden said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" — doctor offices and pharmacies that over-prescribe addictive medicines.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be subjected to the same restrictions as other narcotic drugs like oxycodone and morphine. Meanwhile, more and more hospitals have been establishing tougher restrictions on painkiller prescriptions and refills.

One example: The University of Colorado Hospital in Aurora is considering a rule that would ban emergency doctors from prescribing more medicine for patients who say they lost their pain meds, Zane said.

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Stobbe reported from Atlanta.

___

Online:

JAMA: http://www.jama.ama-assn.org

CDC: http://www.cdc.gov

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com

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European shares steady awaiting further growth signals

LONDON (Reuters) - European share markets were little changed on Wednesday, awaiting further signs of improving global economic recovery after a big rise in the previous session fuelled by encouraging German data.

The FTSE Eurofirst <.fteu3> index of top European shares was down 0.1 percent in early trading, having gained 1.1 percent on Tuesday, its best day for three weeks <.fteu3>.

London's FTSE 100 <.ftse>, Paris's CAC-40 <.fchi> and Frankfurt's DAX <.gdaxi> were all close to flat. <.eu/>

"I see no reason why we can't consolidate the gains and possibly move higher," said Michael Hewson, an analyst at CMC Markets.

Global share markets surged on Tuesday after forecast-beating German sentiment data pointed to an accelerating recovery in Europe's largest economy.

The data comes ahead of more important euro zone flash Purchasing Managers Indexes on Thursday and a German business sentiment survey on Friday that could show whether the region's recovery is taking hold.

The rising hopes of recovery have been supported on Wall Street by a surge in merger activity that has sent U.S. benchmark shares indexes close to record highs. <.n>.

In Asia, share markets outside Japan are at 18-month highs <.miapj0000pus>, as the relatively stronger growth outlook compared with Europe and the United States has drawn in foreign investors.

The rise in equities has weighed on assets perceived as safe havens, with German Bund futures down 25 ticks in early trade to 142.57, though news that Spain may be about to issue a U.S. dollar bond supported sentiment.

In the currency markets the euro rose 0.2 percent to $1.3413 but sterling fell to its lowest in nearly 16 months against a trade-weighted basket of currencies.

Currency traders have their eyes on central banks and the minutes of policy meetings at the Bank of England and the U.S. Federal Reserve that are due to be published later in the day.

The Bank of England minutes at 0930 GMT may reiterate a tolerance for higher inflation or greater disagreement among policymakers over the value of restarting the bank's asset purchase program.

Commodities markets mostly followed equities higher, with spot gold inching up 0.2 percent to $1,605.90 an ounce but stuck near a six-month low.

London copper edged up 0.2 percent to $8,067.75 a metric ton, off Tuesday's three-week lows but Brent crude was little changed at $117.47 a barrel.

(Additional reporting by Masayuki Kitano in Singapore and Thuy Ong in Sydney; Editing by Eric Meijer)

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