St. John's in court fight over failed nurse recruitment effort

Short of hospital nurses in recent years, St. John's Health Center in Santa Monica hired a recruiter in England and flew one of its top executives to London to interview job candidates.

The recruiter's firm, Stateside Nursing, found 105 nurses and the hospital paid the company nearly $700,000 in recruiting fees and for providing "acculturation services" to help the foreigners adjust to life in Southern California.

Despite all those payments, none of the nurses ever arrived in Santa Monica.

Now the hospital is pursuing a court fight over this costly failure, saying it was the victim of fraud, bribery and unfair business practices. But the legal battle may also yield unflattering details about the inner workings of one of the area's best-known hospitals, which recently saw a high-profile management shake-up.

In the case headed to trial next month, St. John's accuses the recruiter, Lisa Taylor, of paying about $128,000 in bribes to Victor Melendez, the hospital's former vice president of human resources. The hospital is suing the pair in Los Angeles County Superior Court.

Both Melendez, through his lawyer, and Taylor deny the allegations, and they say the payments to Melendez were not bribes. He was paid for previous recruiting work unrelated to the hospital contracts, they said. Taylor says changes in U.S. immigration rules prevented the nurses from coming to work.

There's no indication that this nurse-recruitment saga prompted the recent dismissals of St. John's former chief executive, Lou Lazatin, and her chief operating officer, Eleanor Ramirez, by the hospital's owner, the Sisters of Charity of Leavenworth Health System in Denver. In November, the Catholic nonprofit escorted Lazatin and Ramirez off the hospital premises one morning and fired 15 of the hospital's 17 board members by email.

Taylor wants the two former executives to testify in this case and explain their departure. "We want to know why they aren't there anymore," she said. "It goes to their credibility." Neither Lazatin nor Ramirez could be reached for comment.

Michael Slubowski, chief executive of the Sisters of Charity, has declined to comment on the specific reasons for the St. John's dismissals, and he said the hospital "doesn't publicly discuss legal matters."

There have been discussions in recent months about selling the 266-bed hospital, which has tended to celebrities and politicians over the years. St. John's reported a loss of $13 million for 2011, the latest state data show, and patient revenue slipped 8% to $891 million.

The nursing shortage at St. John's was a common problem for many hospitals across California.

In 2006, Melendez, the hospital's newly hired human resources executive, set out to remedy that problem. He recommended three recruiting firms to the hospital, including Taylor's Stateside Nursing, according to his lawyer, Vincent S. Ammirato. In a contract that year, St. John's agreed to pay Stateside an $8,000 recruitment fee for each nurse it found.

The hospital sent Melendez to London, where he and Taylor interviewed dozens of nurses and 52 of them accepted job offers, according to the hospital's lawsuit. Stateside billed Saint John's for about $200,000 in initial fees.

Stateside then offered to provide "acculturation services" for the 52 nurses at $2,000 per nurse to help them acclimate to life in the U.S. because many were originally from the Philippines, India and other countries. In court filings, the hospital contends that Melendez didn't have the authority to approve those additional expenses because they weren't included in the contract. Rather, the hospital said, those payments were just a way for Taylor to pocket extra money for the alleged bribes.

By August 2007, even though no nurses had arrived, St. John's agreed to pay Stateside even more. The hospital boosted Stateside's recruitment fee to $13,000 per nurse from $8,000 earlier.

The hospital says Melendez wasn't authorized to sign the new contract. Ammirato, Melendez's lawyer, said that his client did not act alone and that Melendez's boss, the former chief operating officer, was involved in negotiating Stateside's agreements and approving its invoices.

In mid-2007, Melendez left St. John's for another job, so the hospital sent other human resource officials to London to interview nurses. Stateside found 53 more nurses and it billed for additional fees. Overall, according to court documents, the hospital paid Stateside $669,550 in upfront fees in 2007 and 2008.

St. John's said it became suspicious later in 2008 when Stateside's director of sales sent a letter to the hospital alleging that the recruitment firm was overcharging St. John's and paying bribes to Melendez. Based on this tip, St. John's sought to recoup its money and subpoenaed Melendez's bank records.

Stateside wired Melendez $51,843 in February 2007 and sent him an additional $51,943 the next month, according to the hospital's lawsuit. Those wire transfers took place shortly after Melendez authorized two payments of $52,000 apiece to Stateside. Later in 2007, Taylor wrote him another check, for $25,000. Taylor and Melendez don't dispute those payments.

In October 2010, an arbitrator found that Stateside engaged in "unlawful and fraudulent business practices" by paying Melendez to gain improper advantages in its contracts. The arbitrator awarded the hospital $1 million in damages, interest and legal fees.

Stateside went through liquidation in England, Taylor said, and she couldn't defend herself at the arbitration hearing. The hospital hasn't collected any portion of the arbitration award since her company shut down.

Taylor said she had satisfied her obligations by finding the nurses and getting them licensed to work at St. John's. The U.S. had adopted a policy in 2006 that made it more difficult for some foreign nurses to obtain work visas. St. John's said in its suit that Taylor misrepresented that she could handle those immigration issues.

"We got the nurses as far as we could get them when the U.S. government ran out of visa numbers," said Taylor, 47, who now lives in Colorado. "I'm looking forward to telling my story at trial."

chad.terhune@latimes.com

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St. Gallen Journal: Swiss City Fears for Cultural Legacy in Wake of a Bank’s Fall

Daniel Auf der Mauer for The New York Times

Bach concerts sponsored by the bank Wegelin were sometimes held at the St. Laurentius church in St. Gallen.

ST. GALLEN, Switzerland — Given the modest size of its offices, a trim neo-Classical building off the marketplace, it is easy to underestimate the imprint of the bank once called Wegelin on this compact Swiss city.

It is not just that it was the oldest bank in Switzerland, founded by local textile merchants in 1741. Its senior managing partner, Konrad Hummler, was the son of a former mayor, chairman of the board of the Neue Zürcher Zeitung, the Zurich daily that is the country’s leading newspaper, and the prolific author of columns in which he often denounced the business practices of bigger Swiss banks, like UBS.

But most important, Wegelin, which closed its doors this month, was a significant sponsor of cultural institutions in the area. Among its projects, in 2006 Mr. Hummler, a passionate music lover and amateur violinist, established the Johann Sebastian Bach Foundation, with the goal of financing the performance and recording of the entire vocal works of the German composer, more than 200 cantatas, a task expected to last more than 20 years.

Moreover, the bank was dedicated to preserving the architectural substance of the town. In 2007, Wegelin paid almost $2 million for a significant part of the late Gothic convent of St. Catherine, a former nunnery with a soaring chapel and vaulted cloister that was in considerable disrepair. It then underwrote a painstaking restoration of the chapel with its 19th-century organ, and other portions of the buildings. The idea was to use them eventually for performances of Bach’s works and other music.

The bank and Mr. Hummler also had close ties to the local business school, and at any given time several dozen students might be employed in its training programs.

Now, all this is jeopardized. Last year, Wegelin was charged in the United States with illegally helping American citizens avoid taxes. Under the shock of these charges, Wegelin was split up and its valuable assets placed with another local bank, Raiffeisen. Its bad assets remained with Wegelin, though its name was changed to Notenstein Privatbank, for a medieval guild in St. Gallen.

Wegelin executives eventually pleaded guilty before a court in New York to helping Americans avoid taxes on $1.2 billion of assets between 2002 and 2010, and agreed to pay restitution and fines of almost $60 million. Entering the plea, one of Mr. Hummler’s closest associates, Otto Bruderer, told the court that Wegelin had always believed it was in compliance with Swiss law, adding that “such conduct was common in the Swiss banking industry.”

The news shook St. Gallen. “It was extremely surprising,” said Leonie Schwendimann, who runs a small bookshop across from St. Laurentius, the Protestant church where Bach concerts sponsored by the bank are occasionally held.

Ms. Schwendimann, who often attended the concerts and was a friend of Rudolf Lutz, the baroque specialist who directed the series, voiced concern for their future. “It would be a great loss,” she said. Of the bank’s disappearance, she added, “You have to take care of your business.”

It seemed only coincidental that posters around town advertised the latest piece at the town theater, a sharp critique of the financial world by the Swiss playwright Urs Widmer titled “The End of Money,” featuring a full-length photograph of a banker with donkey’s ears.

Madeleine Herzog, responsible for culture in the city government, called the bank’s restoration of St. Catherine’s convent “exemplary.” But she was concerned about the future without Wegelin. “It was planned for the buildings to be used for cultural events, but that lies now in the responsibility of the bank’s new owners,” she said. “What their concrete plans are, what the future of the Bach cycle is,” she said, “that is not known.”

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Baby Born with Heart Outside Her Chest Goes Home from Hospital

By Dahvi Shira

01/24/2013 at 06:40 PM EST

Ashley and Audrina Cardenas

Three-month-old Audrina Cardenas is a survivor.

The infant, delivered on Oct. 15 with a rare genetic deformity called "ectopia cordis," was born with part of her heart outside of her body. Following a successful surgery in November, Cardenas finally left the hospital on Wednesday.

At the time of her procedure, the Texas Children's Hospital in Houston released a statement explaining, "A multidisciplinary team of surgeons saved Audrina's life during a miraculous six-hour, open-heart surgery where they reconstructed her chest cavity to make space for the one-third of her heart that was outside of her body."

Cardenas's mother Ashley told ABCNews.com that she knew about her daughter's condition when she was 16 weeks pregnant.

"They gave me the option to terminate the pregnancy [or] continue with the pregnancy and do something called comfort care at the time of delivery, where instead of doing anything painful to her or do surgery, they let you spend as much time with her until she passes, or opt for a high-risk surgery to help repair the heart," Ashley Cardenas said.

Although she's been released from the hospital, Audrina will still be on oxygen and use a feeding tube, according to her mom, who spoke to HLN affiliate KTRK.

With Audrina wearing a pink chest shield made by doctors, Ashley said, "She doesn't have the sternum. She doesn't have anything over her heart besides the skin and a little muscle that they put over, so this is very important for her to wear. Especially for a car seat, the straps go right on her heart, and if she didn't have anything hard, it would damage her heart."

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Penalty could keep smokers out of health overhaul

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here's how the math would work:

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

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

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

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

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

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

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Online:

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

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'California did the impossible,' Brown says in State of the State

SACRAMENTO — Seeking to reclaim the state's identity as an innovator and engine of growth, Gov. Jerry Brown declared in a sweeping State of the State address that "California did the impossible" in emerging from financial crisis poised to lead again.

Brown outlined a vision for the state Thursday in remarks that were equal parts history lesson, lecture and rhetorical flourish. It includes major investment in water and rail systems, more robust trade and an education structure free of regulations that crush creativity.

Invoking California's "spectacular history of bold pioneers meeting every failure with even greater success," he asked a joint session of the Legislature to overhaul the way schools are funded, build a controversial bullet train and aggressively expand healthcare to millions of needy residents.

Californians "have a rendezvous with our own destiny," he said, in an allusion to Franklin Roosevelt's famous Depression-era speech.

At the same time, he sounded the familiar theme that the state should not try to live beyond its means. Drawing on the Book of Genesis, he recounted Pharaoh's dreams of well-fed cows eaten by starving cows — a warning that famine can follow plenty.

"Fiscal discipline is not the enemy of our good intentions but the basis for realizing them," he told an Assembly chamber packed with legislators, state Supreme Court justices and other dignitaries who applauded throughout the 24-minute speech.

Brown plans to take his message to Washington, D.C., next month, when he will attend a meeting of the National Governors Assn., and to China in April, when he leads a state delegation to christen California's new trade office there.

The governor is at a high point in his long political career, presiding over a Capitol now entirely controlled by his Democratic Party and having convinced voters that higher taxes would restore the state's financial footing.

He will have more influence over lawmakers than any governor has had in years. He solved for them their most immediate problem: an out-of-whack budget that has constrained their ambitions and forced them to cut deeply into programs their constituents value.

But despite Brown's proclamations that California no longer has a deficit, the state faces long-term financial problems that could stymie his agenda.

"It was a springtime speech, but California is more likely to be in Indian summer," said John J. Pitney, professor of politics at Claremont McKenna College. "The good economic times are probably temporary."

The governor's budget does not address hundreds of billions of dollars in debt the state has accumulated. And in his speech, Brown acknowledged the cost of healthcare for more Californians, in line with the new federal law that expands coverage next year, is unclear.

"Ignoring such known unknowns would be folly," he said.

In addition, his general call for restraint may collide with plans by legislative leaders to restore sizable programs slashed or eliminated in recent years.

After the speech, state Senate leader Darrell Steinberg (D-Sacramento) seemed eager to do just that.

"If the economy grows, and if there is opportunity, and if there is headroom to restore some of what's been lost, of course we are going to," Steinberg said.

It also remains to be seen whether Brown's alliance with the state's influential teachers unions and other school groups can withstand his proposals to shift resources from wealthier school districts to poorer ones and eliminate or ease some popular state mandates, such as restrictions on class size.

Brown vowed to do away with mandates that inhibit school flexibility and creativity and to shift more control from Sacramento to local districts. He said the system for funding education is "overly complex, bureaucratically driven and deeply inequitable" and called for a new formula that would give a financial boost to districts "based on the real-world problems they face."

He prodded leaders of public colleges and universities to work harder to control costs, graduate students in four years and make it easier for them to transfer from community colleges to universities.

"Tuition increases are not the answer," he said to a standing ovation. "I will not let the students become the default financiers of our colleges and universities."

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The Making of Yair Lapid, Israel’s New Power Broker

Oliver Weiken/European Pressphoto Agency

Yair Lapid spoke to reporters in Tel Aviv on Wednesday, a day after his centrist party became the second-largest faction in Parliament.

TEL AVIV — They pitched tents along Rothschild Boulevard and took to the streets in unprecedented numbers, hundreds of thousands demonstrating against the rising costs of gas, apartments, even cottage cheese.

Back on the genteel boulevard on Wednesday, many of those middle-class protesters from 2011 said they had taken their grievances to the ballot box the day before, helping to catapult Yair Lapid, a suave, handsome journalist-turned-populist-politician, into Israel’s newest power broker.

“He spoke out the strongest about how everything in this country is upside down,” said Elad Shoshan, 28, who works with computers and rents an apartment on a cheaper street off the boulevard.

Echoing his candidate’s mantra, Roni Klein, 52, an accountant, said, “My wife and I work, and still it is very hard for us to finish the month.”

Mr. Lapid’s new, centrist Yesh Atid party shocked the political establishment by winning 19 of Parliament’s 120 seats, becoming Israel’s second-largest faction and a crucial partner for Prime Minister Benjamin Netanyahu, whose relatively poor showing left him scrambling to form a stable coalition.

While Mr. Netanyahu remains all but assured of serving a third term — Mr. Lapid said Wednesday that he would not unite with Arab lawmakers to stop him — Yesh Atid’s ascendance promises to shift the government’s focus to pocketbook concerns despite the pressing foreign policy issues Israel faces.

Mr. Lapid’s campaign hardly challenged Mr. Netanyahu’s policies on the Iranian nuclear threat, the tumult in the Arab world or the Israeli-Palestinian conflict. This was the first election in memory in which such existential security issues were not emphasized, as a growing majority of Israelis see them as too tough to tackle. Even Mr. Netanyahu barely spoke about Iran, his raison d’être.

Instead, voters and analysts alike said Mr. Lapid had captured the hearts of Israel’s silent majority with his personal charm and a positive, inclusive message that harnessed the everyday frustrations that fueled the huge social justice protests in 2011.

One pollster found that about 40 percent of Mr. Lapid’s supporters defined themselves as right-leaning, and in Israel’s coalition system, many saw his success as a tactical move by voters not to oust Mr. Netanyahu but to nudge him to broaden the agenda.

On Wednesday, the prime minister embraced Mr. Lapid’s platform, promising a government “as broad as possible” that would bring change on three fronts: affordable housing, government reform and forcing ultra-Orthodox Jews to “share the burden” of military service and taxes.

Some saw the results as a victory for secular Jews at a time of conflict with the ultra-Orthodox over resources and religious pluralism. Mr. Lapid’s stronghold was here in coastal Tel Aviv and its bourgeois suburbs, where he won about 1 in 4 votes cast, and Modiin, a fast-growing bedroom community halfway between here and Jerusalem.

Tamar Hermann, a political scientist and vice president of Israel’s Open University, called Mr. Lapid “the epitome of the Israeli dream” and described his voters as “the mainstream of the mainstream.”

“This is the kind of voting you can take your kids to and teach them a lesson in civic fulfillment without taking any risks,” Professor Hermann said. “They are complaining, but this is a kind of the zeitgeist, not real agony, not real suffering, not real dissatisfaction with the basic cornerstone of the system. It’s just polishing here and there.”

The election results were widely seen as a rebuke to the status quo, but not necessarily a call for change in approach to contentious questions like what to do about the Palestinians. While Mr. Lapid has called for a return to negotiations, he shares Mr. Netanyahu’s skepticism about the lack of a partner, saying this week, “I don’t think the Arabs want peace.” He opposes division of Jerusalem and made his foreign policy speech in Ariel, a sprawling Jewish settlement 12 miles into the West Bank that the Palestinians see as problematic for the viability of their state.

“The majority of Israelis came to the conclusion that there will be no new Middle East,” Mr. Lapid said over cappuccino here last month. “What we want is not a happy marriage, but a decent divorce.”

Instead, the change voters were seeking was more about the nature of politics itself.

Irit Pazner Garshowitz contributed reporting.

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Women have caught up to men on lung cancer risk

Smoke like a man, die like a man.

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

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

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

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

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

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

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

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

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

Among the findings:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Online:

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

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

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

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

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As Bell corruption trial nears, city faces uncertain future

When Doug Willmore became Bell's city manager last June, one of his first questions was about the padded black chair behind his desk. Had it been occupied by the man he was replacing, Robert Rizzo?

No. To his relief, that one had been chucked.

"I'd sit on a folding chair instead of his chair, or a stool," Willmore said.

In the seat of power for 17 years, Rizzo became the face of a salary scandal in 2010 that sent the city to the edge of insolvency. Bell, just 2½ square miles in southeast Los Angeles County, became the butt of jokes everywhere and a rallying cry for reformers.

Now, six former Bell council members are facing trial in Los Angeles County Superior Court on corruption charges related to their lavish compensation during Rizzo's reign as city administrator. The council members made $100,000, mostly for sitting on boards that rarely, if ever, met.

The trial is expected to bring new attention to a scandal that former Dist. Atty. Steve Cooley famously described as "corruption on steroids." But there has been significantly less focus on the small city's slow recovery from the scandal.

"Everybody suspected that the city of Bell would go under immediately, but we haven't two years later," said Ana Maria Quintana, a councilwoman who won office in the wake of the revelations.

The city's general fund has been slashed to $12 million from $16 million, largely because a handful of highly paid employees are now gone, and the budget is balanced. Council meetings are streamed online in a city where the workings of government were once opaque. The city has cut fees for trash pickup, building permits and business licenses that had ballooned under Rizzo.

But it is too soon to tell how well the city will ultimately emerge from the scandal. It faces a tangle of scandal-related lawsuits, with $1.5 million in legal fees a year, and the possibility of fiscal calamity.

"If all the litigation stuff were solved today, I'd tell you Bell has a bright future, and we can pay our bills," said Willmore, who estimates he spends a third of his time on lawsuits. "There are all these things that could happen that could bankrupt the city."

Among the worries, he said, is that Bell will be made to pay the legal fees of the former city leaders, who claim the city should foot the bill because their alleged misdeeds occurred as part of their official duties.

"That's probably $5 million easily," Willmore said.

Rizzo and the other officials have pleaded not guilty and deny any wrongdoing. James Spertus, Rizzo's attorney, described his client as "a good administrator who turned the city around," and attributed its financial woes to a bad economy. He said the city has refused to negotiate on Rizzo's legal fees.

"The public outrage creates a political environment where they can't compromise [on] anything, and that's economic disaster," Spertus said. "The city should be trying to conserve resources, heal and move forward."

Willmore said that when he arrived, the city hadn't reconciled a bank statement in two years. "Under Rizzo, the lack of accounting was just staggering," he said. "I've inherited scandals before, but certainly nothing like this." He said the city's handbook of ethics policies — which new employees are given — still bore Rizzo's name when he took office. He quickly changed that.

The city is also posting its audits online. The most recent, for the fiscal year that ended in June 2010, found widespread flaws in the city's financial bookkeeping under Rizzo, with shoddy documentation and a lack of clear policies regarding license fees and loans to employees.

Bell still has the second-highest property tax in Los Angeles County, after only Beverly Hills, and a 10% utility tax, about twice that of most cities.

In contrast to Rizzo, who made a salary of $800,000, Willmore earns $175,000 for the same job — now making him the city's highest-paid employee.

Drive the city's main streets — Gage, Florence and Atlantic avenues — and the sight of boarded-up storefronts is a common one. Willmore attributes that in part to the way Rizzo allegedly squeezed local businesses for fees. For years, the Chamber of Commerce was perceived as a bloc of Rizzo stooges and received $7,000-a-month payments from the city — a practice Willmore said he hasn't seen elsewhere. The new City Council has stopped the payments.

Jose Vazquez, a tire shop owner and head of the Bell Business Assn. — formed because the Chamber of Commerce was so distrusted — said the atmosphere for businesspeople is "100% better" than it was.

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Exit Polls in Israel Suggest Netanyahu’s Showing Is Weaker Than Expected

Pool photo by Uriel Sinai

Prime Minister Benjamin Netanyahu of Israel touched the Western Wall on Tuesday in Jerusalem.

TEL AVIV — A weakened Prime Minister Benjamin Netanyahu emerged Wednesday from Israel’s national election likely to serve a third term, according to preliminary results and political analysts after voters on Tuesday gave a surprising second place to a new centrist party founded by a television celebrity who emphasized kitchen-table issues like class size and apartment prices.

Baz Ratner/Reuters

A polling station on Tuesday in the West Bank Jewish settlement of Elon Moreh, near Nablus.

For Mr. Netanyahu, who entered the race an overwhelming favorite with no obvious challenger, the outcome was a humbling rebuke as his ticket lost seats in the new Parliament. Overall, the prime minister’s conservative team came in first, but it was the center, led by the political novice Yair Lapid, 49, that emerged newly invigorated, suggesting that at the very least Israel’s rightward tilt may be stalled.

Mr. Lapid, a telegenic celebrity whose father made a splash with his own short-lived centrist party a decade ago, based his campaign on issues that resonated with the middle class, including the need to integrate the ultra-Orthodox into the army and the work force.

Perhaps as important, he also avoided antagonizing the right, having not emphasized traditional issues of the left, like the peace process. Like a large majority of the Israeli public, he supports a two-state solution to the Israeli-Palestinian conflict, but is skeptical of the Palestinian leadership’s willingness to negotiate seriously; he has called for a return to peace talks but has not made it a priority.

On Tuesday, Mr. Netanyahu implored his supporters to turn out, reading signs that voters were not embracing his message of security and his party’s conservative agenda. The day ended with Mr. Netanyahu reaching out again —this time to Mr. Lapid, offering to work with Israel’s newest kingmaker as part of the “broadest coalition possible.”

Israel’s political hierarchy is only partly determined during an election. The next stage, when factions try to build a majority coalition, decides who will rule, how they will rule and for how long. While Mr. Lapid has signaled a willingness to work with Mr. Netanyahu, the ultimate coalition may bring together parties with such different ideologies and agendas that the result is neither a shift to the right nor the left, but paralysis.

Still, for the center, it was a time of celebration.

“The citizens of Israel today said no to politics of fear and hatred,” Mr. Lapid told an upscale crowd of supporters that had welcomed him with drums, dancing and popping Champagne corks. “They said no to the possibility that we might splinter off into sectors, and groups and tribes and narrow interest groups. They said no to extremists, and they said no to antidemocratic behavior.”

With three-quarters of the votes counted by 3 a.m. Wednesday, Israel Radio reported that Mr. Netanyahu’s conservative Likud-Beiteinu ticket was poised to take 31 of Parliament’s 120 seats, with Mr. Lapid’s party, There Is a Future, coming in second with 19, far more than polls had predicted. The right wing and religious parties that make up Mr. Netanyahu’s current coalition garnered a thin majority of perhaps 62 seats, pushing him to try to join with Mr. Lapid instead and possibly embrace other center and left-leaning groups. Labor took 15 seats in early returns and Jewish Home, a new religious-nationalist party, 11

The prime minister called Mr. Lapid shortly after the polls closed at 10 p.m. Tuesday and, according to Israeli television reports, told him that they had great things to do together for the country. In his speech to a rowdy crowd of supporters here Wednesday morning, he said, “I see many partners.”

Mr. Lapid said he was open to working with Mr. Netanyahu, saying the only way to face Israel’s challenges was “together.” But he added: “What is good for Israel is not in the possession of the right, and nor is it in the possession of the left. It lies in the possibility of creating here a real and decent center.”

The results were a blow to the prime minister, whose aggressive push to expand Jewish settlements in East Jerusalem and the West Bank has led to international condemnation and strained relations with Washington. The support for Mr. Lapid and the left-leaning Labor Party showed voters responded strongly to an emphasis on domestic, socioeconomic issues that brought 500,000 people to the streets of Tel Aviv in the summer of 2011.

Jodi Rudoren reported from Tel Aviv, and Isabel Kershner from Jerusalem. Myra Noveck contributed reporting from Jerusalem.

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Google’s fourth quarter results shine after ad rate decline slows

SAN FRANCISCO (Reuters) – Revenue from Google Inc’s core Internet business outpaced many analysts’ expectations during the crucial holiday quarter and advertising rates fell less than in previous periods, pushing its shares up more than 4 percent.

The world’s largest Internet search company introduced new product listings during the fourth quarter – typically its strongest – and also benefited from business growth in international markets, analysts said.

Excluding traffic-acquisition costs, the business generated net revenue of $ 9.83 billion, up from $ 8.13 billion a year earlier, Google reported on Tuesday. That surpassed a $ 9.6 billion average forecast from six analysts polled by Reuters.

“Business looked really strong, especially from a profitability perspective. They really grew their margins in the core business,” said Sameet Sinha, an analyst with B. Riley Caris. “Most of that strength seems to be coming from international markets which grew revenues quite substantially: up 23 percent year over year, versus the 15 percent growth in the third quarter.”

Average cost-per-click, a critical metric that denotes the price advertisers pay Google, declined 6 percent from a year ago, the fifth consecutive quarter of decline.

Google executives told analysts on a conference call that the company had focused on improving the metric – shoring up margins – while lowering the overall growth rate of paid clicks in the holiday quarter.

“Click prices are still declining, but it’s better than expected,” said BGC Partners analyst Colin Gillis.

MOTOROLA MOBILITY “STILL LOSING MONEY”

Consolidated net income in the fourth quarter was $ 2.89 billion or $ 8.62 per share, compared with $ 2.71 billion, or $ 8.22 per share, in the year-ago period when Google had not yet acquired Motorola.

Excluding certain items, Google said it earned $ 10.65 per share in the fourth quarter.

“The core business is a great business and the fourth-quarter is always a time for Google to shine. However, Motorola is still losing money and click rates still declined. They only declined 6 percent, but go back four or five quarters and click prices were improving. So mobile is still pressuring click prices,” Gillis said.

The company posted consolidated revenue – which includes its Motorola Mobility mobile phone business but not the television set-top box business it recently agreed to sell – of $ 14.42 billion on Tuesday.

Motorola Mobility had an operating loss of $ 353 million during the quarter.

Shares of Google were up roughly 4.5 percent at $ 734.46 in after-hours trading on Tuesday.

(Reporting By Alexei Oreskovic; Editing by Bernard Orr)

Tech News Headlines – Yahoo! News

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