Why Sanofi’s Zaltrap Deal Won t Help Patients
















Nurse administers chemotherapy to patient. Credit: National Cancer Institute.

I got excited when I read the New York Times story Nov. 9 (“Sanofi Halves Price of Cancer Drug Zaltrap After Sloan-Kettering Rejection)”. Zaltrap is an intravenous infusion colon cancer drug for metastatic colorectal cancer that is resistant to or has progressed with platinum-based chemotherapy. With a list price of $ 11,000 per patient per month, Zaltrap is about double the cost of Genentech’s Avastin. Sloan Kettering doctors rejected Zaltrap, claiming it offered no added value over Avastin, because it works no better than Avastin, and costs twice as much. Doctors from Sloan-Kettering Cancer Center, one the United States flagship cancer hospitals, published an op-ed in the NYTimes Oct. 14, titled “In Cancer Care, Cost Matters,” arguing that hospitals need to put their foot down when drugs are outrageously expensive with no added value. They wrote: “Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver.” The importance of getting bang for your buck, or value in healthcare, has been a huge point in health policy circles in the United States. In fact, politicians of all stripes are quick to point to health outcomes data that show that despite the United States spending in the top tier of all nations for healthcare, health outcomes are far lower. What Sanofi announced in its response Nov. 8 to Sloan-Kettering, one could have easily thought that it was a victory for patients. However, the New York Times headline stating “Sanofi halves price…” is misleading. Sadly, the Zaltrap half-off deal is not a list price reduction at all. It is just a business discount plan for hospitals and oncologists. As Lisa Jane Hubbell, who uses high-cost disease modifying drugs for a noncancerous, chronic condition told me: “It won’t help patients, will it? Our copay will be based on full price, the docs will pocket the extra from insurance companies. It doesn’t really help anyone who is in need of help paying for healthcare.” Another woman with stage IV breast cancer says that she has been deemed ineligible for any discount for her high-priced cancer drugs because she is insured. In general, drug discount plans go to the uninsured. She emailed me: “The drug I took for five years was re-patented three times while I was on it, as I recall. It was orders of magnitude more expensive than the old standby tamoxifen for only a slight advantage in efficacy.” As The Times points out, Medicare patients are unlikely to see a lower price for Zaltrap for a long while until the discount is incorporated into Medicare payment calculations for Part B, which covers physician-administered drugs. In addition, oncologists have long marked up drugs that they administer for insurers and patients. Fortunately, Sloan-Kettering doctors are on the patients’ side and question whether Sanofi’s discount will make Zaltrap more affordable for patients. Peter Bach, MD, told me: “I don’t know if they’re going through steps to ensure reimbursement goes down to follow price or not. I’m hoping that is in their plans. If not, then yes, the windfall goes to providers, and our concern is the costs passed on to patients.” Leonard Saltzman, MD, the op-ed coauthor, and gastroenterology oncologist, from Sloan Kettering also called Sanofi to task for missing the boat in making Zaltrap affordable for patients. But pharmaceutical price fixing is nothing new, according to Frederic Kaye, MD, professor of hematology and oncology at the University of South Florida in Gainesville, Florida. “I saw this happen for the first time in the late 1980s when a veterinary pill levamisole, which cost pennies for the treatment of heartworm, underwent a 100 times price escalation when it was used for treating colon cancer. There was outrage at the time over lack of regulations for price fixing, but you see almost 25 years later, it is the same.” Sanofi’s drug discount plan is clearly a business imperative. If one of the US flagship cancer treatment centers says that they will not use Zaltrap, others could follow. But the refusal to lower Zaltrap’s list price is worrisome because patient copays are based on price. More importantly, if the Sanofi plan becomes the pharmaceutical industry’s modus operandi to the era of value-based healthcare, patients will still remain out in the cold, without any added relief for the high cost of drugs. Value-based healthcare will be something for facilities and hospitals and leave patients out in the cold. These days, you have to critically review the hoopla about “patient-centered health care” and the allegedly positive partnerships shaping healthcare. Were patients included when it really mattered in drafting this drug discount program? We need to maintain a high level of skepticism about deals made strictly between drug companies and hospitals, or arrangements made between industry and physicians, or industry and health plans. It’s been said before and it must be said again: “Nothing about me [the patient] that pertains to me should be done without me at the table.”  












Follow Scientific American on Twitter @SciAm and @SciamBlogs. Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.


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Israel says prefers diplomacy but ready to invade Gaza

GAZA/JERUSALEM (Reuters) - Israel bombed dozens of targets in the Gaza Strip on Monday and said that while it was prepared to step up its offensive by sending in troops, it preferred a diplomatic solution that would end Palestinian rocket fire.


Mediator Egypt said a deal for a truce to end the fighting could be close. The leader of Hamas said it was up to Israel to end the new conflict it had started. Israel says its strikes are to halt Palestinian rocket attacks.


U.N. Secretary-General Ban Ki-moon, touring the region in hopes of helping broker a peace arrived in Cairo, where he met Egypt's foreign minister in preparation for talks with the new, Islamist president, Mohamed Mursi, on Tuesday. He also plans to meet Israeli Prime Minister Benjamin Netanyahu in Jerusalem.


Israeli attacks on the sixth day of fighting raised the number of Palestinian dead to 101, the Hamas-run Health Ministry said, listing 24 children among them. Hospital officials in Gaza said more than half of those killed were non-combatants. Three Israeli civilians died on Thursday in a rocket strike.


Militants in the Gaza Strip fired 110 rockets at southern Israel on Monday, causing no casualties, police said.


For the second straight day, Israeli missiles blasted a tower block in the city of Gaza housing international media. Two people were killed there, one of them an Islamic Jihad militant.


Khaled Meshaal, exiled leader of Hamas, said a truce was possible but the Islamist group, in charge of the Gaza Strip since 2007, would not accept Israeli demands and wanted Israel to halt its strikes first and lift its blockade of the enclave.


"Whoever started the war must end it," he told a news conference in Cairo, adding that Netanyahu, who faces an election in January, had asked for a truce, an assertion a senior Israeli official described as untrue.


Meshaal said Netanyahu feared the domestic consequences of a "land war" of the kind Israel launched four years ago: "He can do it, but he knows that it will not be a picnic and that it could be his political death and cost him the elections."


For Israel, Vice Prime Minister Moshe Yaalon has said that "if there is quiet in the south and no rockets and missiles are fired at Israel's citizens, nor terrorist attacks engineered from the Gaza Strip, we will not attack."


Yaalon also said Israel wanted an end to Gaza guerrilla activity in the neighboring Egyptian Sinai peninsula.


Although 84 percent of Israelis supported the current Gaza assault, according to a poll by Israel's Haaretz newspaper, only 30 percent wanted an invasion, while 19 percent wanted their government to work on securing a truce soon.


DIPLOMACY "PREFERRED"


"Israel is prepared and has taken steps, and is ready for a ground incursion which will deal severely with the Hamas military machine," a senior official close to Netanyahu told Reuters.


"We would prefer to see a diplomatic solution that would guarantee the peace for Israel's population in the south. If that is possible, then a ground operation would no longer be required. If diplomacy fails, we may well have no alternative but to send in ground forces," he added.


Egypt, where Mursi has his roots in the Muslim Brotherhood seen as mentors to Hamas, is acting as a mediator in the biggest test yet of Cairo's 1979 peace treaty with Israel since the fall of Hosni Mubarak.


"I think we are close, but the nature of this kind of negotiation, (means) it is very difficult to predict," Egyptian Prime Minister Hisham Kandil, who visited Gaza on Friday in a show of support for its people, said in an interview in Cairo for the Reuters Middle East Investment Summit.


Egypt has been hosting leaders of both Hamas and Islamic Jihad, a smaller armed faction.


Israeli media said a delegation from Israel had also been to Cairo for truce talks. A spokesman for Netanyahu's government declined comment on the matter.


Egypt's foreign minister, who met U.N. chief Ban on Monday, is expected to visit Gaza on Tuesday with a delegation of Arab ministers.


THOUSANDS MOURN FAMILY


Thousands turned out on Gaza's streets to mourn four children and five women, among 11 people killed in an Israeli strike that flattened a three-storey home the previous day.


The bodies were wrapped in Palestinian and Hamas flags. Echoes of explosions mixed with cries of grief and defiant chants of "God is greatest".


The deaths of the 11 in an air strike drew more international calls for an end to six days of hostilities and could test Western support for an offensive Israel billed as self-defense after years of cross-border rocket attacks.


Israel said it was investigating its air strike that brought the home crashing down on the al-Dalu family, where the dead spanned four generations. Some Israeli newspapers said the wrong house may have been mistakenly targeted.


In scenes recalling Israel's 2008-2009 winter invasion of the coastal enclave, tanks, artillery and infantry have massed in field encampments along the sandy, fenced-off border and military convoys moved on roads in the area.


Israel has also authorized the call-up of 75,000 military reservists, so far mobilizing around half that number.


The Gaza fighting adds to worries of world powers watching an already combustible region, where several Arab autocrats have been toppled in popular revolts for the past two years and a civil war in Syria threatens to spread beyond its borders.


In the absence of any prospect of permanent peace between Israel and Islamist factions such as Hamas, mediated deals for each to hold fire unilaterally have been the only formula for stemming bloodshed in the past.


Israel's declared goal is to deplete Gaza arsenals and force Hamas to stop rocket fire that has hit Israeli border towns for years.


Hamas and other groups in Gaza are sworn enemies of the Jewish state which they refuse to recognize and seek to eradicate, claiming all Israeli territory as rightfully theirs.


Hamas won legislative elections in the Palestinian Territories in 2006. A year later, after the collapse of a unity government under President Mahmoud Abbas, the Islamist group seized Gaza in a brief civil war with Abbas's forces.


(Writing by Jeffrey Heller, Dan Williams and Peter Graff; Editing by Alastair Macdonald)

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In Mark Cuban’s Humble Opinion, Facebook Still Kinda Sucks
















Dallas Mavericks owner and billionaire Mark Cuban has confirmed reports from last week, in a post on his personal blog today, that he has a serious beef with Facebook. But before getting into all the reasons he no longer loves the social network, he clarifies one small point: “First, I’m not recommending to any of my companies that we leave facebook,” he writes. Last week ReadWriteWeb’s Dan Lyons kind of made it seem like Cuban planned to pull out altogether because of the way Facebook’s algorithm has affected the way people see his brands’s posts. The algorithm, Edgerank, controls brand posts so that not all fans are forced to see each one in their news feeds. Because of this, he quoted Cuban saying “We are moving far more aggressively into Twitter and reducing any and all emphasis on Facebook.” And later he had him talking about all the reasons he finds it horrible for businesses. Like, mainly, that it’s too expensive, a point that GigaOm’s Mathew Ingram called naive. “Really? That surprises you? What else did you think Facebook was going to do when it gave you a giant social platform for nothing?” Cuban now explains that he isn’t bailing on Facebook, just de-emphasizing it in favor of other Internet places, like Tumblr and Twitter. But, that does not mean that he does not hate Facebook as much as everyone has been saying he hates Facebook. He does.


RELATED: Shafted Facebook Founder Is Living Like a Kardashian in Singapore













You can read the laundry list of reasons over at his personal blog, but some highlights include:


RELATED: Eduardo Saverin May Be Barred from Returning to the U.S. After Renouncing Citizenship


  • Its a time waster … FB doesn’t seem to want to accept that it’s best purpose in life is as a huge time suck. 

  • IMHO, FB really risks screwing up something that is special in our lives as a time waster by thinking they have to make it more engaging and efficient.

  • So by default you are not going to use your newsfeed as a primary source of information. It’s more like the township newspaper

  • I also think that FB is making a big mistake by trying to play games with their original mission of connecting the world.  FB is a fascinating destination that is an amazing alternative to boredom which excels in its SIMPLICITY.  One of the threats in any business is that you outsmart yourself. FB has to be careful of just that.

Basically Mark Cuban thinks Facebook should stop trying to make money and stop trying to get too smart, which might work in the favor of Cuban who doesn’t want to spend too much money on something silly like social media. But,this doesn’t sound too appealing to Facebook, which as a public company needs to make money. Unless more join his cause, which could maybe happen. At least the Miami blog the 305 agrees with him. Anyone else? 


Social Media News Headlines – Yahoo! News



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Palestinian death toll in Gaza reaches 100: Health Ministry

GAZA (Reuters) - The number of Palestinians killed in Gaza during Israel's on-going offensive reached 100 on Monday, the Hamas-run Health Ministry said.


On his Facebook page, ministry spokesman Ashraf Al-Qidra listed Mohammed Tbail, killed in an air strike in Nusseirat refugee camp, as the 100th Palestinian fatality.


Qidra said the Palestinian dead included 24 children and 10 women. Ministry figures for the number of men killed in the conflict with Israel make no distinction between civilians and militants.


According to the ministry, 850 people have been wounded in Gaza since the hostilities began on Wednesday. They included 260 children and 140 women.


Israel puts its death toll since Wednesday at three civilians - two men and a woman killed by a rocket fired from Gaza. Police said more than 60 people have been wounded.


(Reporting by Nidal al-Mughrabi, Writing by Jeffrey Heller in Jerusalem, Editing by Allyn Fisher-Ilan)

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Why Sanofi’s Zaltrap Deal Won t Help Patients
















Nurse administers chemotherapy to patient. Credit: National Cancer Institute.

I got excited when I read the New York Times story Nov. 9 (“Sanofi Halves Price of Cancer Drug Zaltrap After Sloan-Kettering Rejection)”. Zaltrap is an intravenous infusion colon cancer drug for metastatic colorectal cancer that is resistant to or has progressed with platinum-based chemotherapy. With a list price of $ 11,000 per patient per month, Zaltrap is about double the cost of Genentech’s Avastin. Sloan Kettering doctors rejected Zaltrap, claiming it offered no added value over Avastin, because it works no better than Avastin, and costs twice as much. Doctors from Sloan-Kettering Cancer Center, one the United States flagship cancer hospitals, published an op-ed in the NYTimes Oct. 14, titled “In Cancer Care, Cost Matters,” arguing that hospitals need to put their foot down when drugs are outrageously expensive with no added value. They wrote: “Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver.” The importance of getting bang for your buck, or value in healthcare, has been a huge point in health policy circles in the United States. In fact, politicians of all stripes are quick to point to health outcomes data that show that despite the United States spending in the top tier of all nations for healthcare, health outcomes are far lower. What Sanofi announced in its response Nov. 8 to Sloan-Kettering, one could have easily thought that it was a victory for patients. However, the New York Times headline stating “Sanofi halves price…” is misleading. Sadly, the Zaltrap half-off deal is not a list price reduction at all. It is just a business discount plan for hospitals and oncologists. As Lisa Jane Hubbell, who uses high-cost disease modifying drugs for a noncancerous, chronic condition told me: “It won’t help patients, will it? Our copay will be based on full price, the docs will pocket the extra from insurance companies. It doesn’t really help anyone who is in need of help paying for healthcare.” Another woman with stage IV breast cancer says that she has been deemed ineligible for any discount for her high-priced cancer drugs because she is insured. In general, drug discount plans go to the uninsured. She emailed me: “The drug I took for five years was re-patented three times while I was on it, as I recall. It was orders of magnitude more expensive than the old standby tamoxifen for only a slight advantage in efficacy.” As The Times points out, Medicare patients are unlikely to see a lower price for Zaltrap for a long while until the discount is incorporated into Medicare payment calculations for Part B, which covers physician-administered drugs. In addition, oncologists have long marked up drugs that they administer for insurers and patients. Fortunately, Sloan-Kettering doctors are on the patients’ side and question whether Sanofi’s discount will make Zaltrap more affordable for patients. Peter Bach, MD, told me: “I don’t know if they’re going through steps to ensure reimbursement goes down to follow price or not. I’m hoping that is in their plans. If not, then yes, the windfall goes to providers, and our concern is the costs passed on to patients.” Leonard Saltzman, MD, the op-ed coauthor, and gastroenterology oncologist, from Sloan Kettering also called Sanofi to task for missing the boat in making Zaltrap affordable for patients. But pharmaceutical price fixing is nothing new, according to Frederic Kaye, MD, professor of hematology and oncology at the University of South Florida in Gainesville, Florida. “I saw this happen for the first time in the late 1980s when a veterinary pill levamisole, which cost pennies for the treatment of heartworm, underwent a 100 times price escalation when it was used for treating colon cancer. There was outrage at the time over lack of regulations for price fixing, but you see almost 25 years later, it is the same.” Sanofi’s drug discount plan is clearly a business imperative. If one of the US flagship cancer treatment centers says that they will not use Zaltrap, others could follow. But the refusal to lower Zaltrap’s list price is worrisome because patient copays are based on price. More importantly, if the Sanofi plan becomes the pharmaceutical industry’s modus operandi to the era of value-based healthcare, patients will still remain out in the cold, without any added relief for the high cost of drugs. Value-based healthcare will be something for facilities and hospitals and leave patients out in the cold. These days, you have to critically review the hoopla about “patient-centered health care” and the allegedly positive partnerships shaping healthcare. Were patients included when it really mattered in drafting this drug discount program? We need to maintain a high level of skepticism about deals made strictly between drug companies and hospitals, or arrangements made between industry and physicians, or industry and health plans. It’s been said before and it must be said again: “Nothing about me [the patient] that pertains to me should be done without me at the table.”  












Follow Scientific American on Twitter @SciAm and @SciamBlogs. Visit ScientificAmerican.com for the latest in science, health and technology news.
© 2012 ScientificAmerican.com. All rights reserved.


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Canada pledges again to balance budget by 2015
















OTTAWA/NEW YORK (Reuters) – The Canadian government on Friday reiterated its intention to balance its budget by 2015, three days after projecting there would be deficits until 2016-17.


In separate appearances in Quebec City and New York, Prime Minister Stephen Harper and Finance Minister Jim Flaherty were at pains to say they still intended to end the red ink by 2015.













“It remains the government’s plan, intention, to balance the budget prior to the next federal election. The recent economic and fiscal update by the minister indicates we are actually very close to that objective,” Harper told reporters in Quebec City. The next election is in October 2015.


Flaherty’s fall fiscal update on Tuesday had pushed back the target date for eliminating the deficit by a year, to 2016-17, citing a weak global economy.


But the minister said in a speech in New York that the government was on track to balance the budget in the next two to three years, barring major external events, and he later clarified that he intended a balanced budget by 2015.


“The prime minister’s always correct,” he chuckled.


He sought to explain the discrepancy by saying the fiscal update had built in a C$ 3 billion ($ 3 billion) contingency cushion, meaning there was an underlying surplus of C$ 1.2 billion for 2015-16. He said the projection of a C$ 1.8 billion deficit amounted to about half a percent of the C$ 275 billion federal budget.


“There’s lots of water to go under the bridge between now and then,” he said.


The opposition New Democratic Party noted the discrepancy in a release headlined: “Stephen Harper makes stuff up about balancing the budget.”


It pointed out that balancing the budget by the next election was not the same as balancing it by 2016-17.


As it is, even the 2015-16 timetable is a year later than offered in the Conservative campaign for reelection in May 2011. They had promised a balanced budget by 2014-15, followed by major personal income tax relief before the 2015 election.


Flaherty’s timetable drew criticism this week from the Canadian Taxpayers Federation, which said the minister had become expert at kicking the can down the road.


The projections could be thrown out of whack if the United States goes off the fiscal cliff, a set of automatic tax hikes and spending cuts that are to be triggered on January 2 if legislators and the White House cannot agree on a more nuanced budget deal.


Flaherty said U.S. failure to avert the fiscal cliff would cause a significant and immediate decline in Canada’s gross domestic product, and he would counter it.


Referring to a possible economic shock from Europe or the United States, he said: “If that were to happen and if the Canadian economy were to be pushed back into recession with the resulting danger for higher unemployment and the danger always of a prolonged recession, then we would act.”


He added: “We would not stand by and let that happen. The kinds of measure we can take: there are various tax measures we can take, there are measures with respect to stimulus we can take, these are things that we have done before and we can do again.”


On Tuesday, Flaherty spoke of having prepared various contingency plans.


(Additional reporting by Louse Egan; Editing by David Gregorio)


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Rock band AC/DC releases entire catalog on iTunes
















NEW YORK (AP) — AC/DC is finally releasing its music digitally on iTunes.


Columbia Records and Apple announced Monday that the classic rock band’s music will be available at the iTunes Store worldwide. Sixteen studio albums will be released, including “High Voltage” and “Back in Black.”













AC/DC was one of the few acts that would not release music through the digital outlet. The Beatles and Kid Rock were also against selling music on iTunes, but have since jumped onboard. Country star Garth Brooks has yet to release his music on iTunes.


Four of AC/DC’s live albums and three compilation records are also available. The statement said the songs have been mastered for iTunes “with increased audio fidelity.”


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Israel, Gaza fighting rages on as Egypt seeks truce
















GAZA/JERUSALEM (Reuters) – Israel bombed Palestinian militant targets in the Gaza Strip from air and sea for a fifth straight day on Sunday, preparing for a possible ground invasion though Egypt saw “some indications” of a truce ahead.


Militant rocket fire into Israel subsided during the night but resumed in the morning with three rockets fired at the nearby coastal city of Ashkelon, the Israeli army said.













“As of now we have struck more than 1,000 targets, so Hamas should do the math over whether it is or isn’t worth it to cease fire,” Israeli Vice Prime Minister Moshe Yaalon, over Twitter.


“If there is quiet in the South and no rockets and missiles are fired at Israel’s citizens nor terrorist attacks engineered from the Gaza Strip, we will not attack.”


Forty-eight Palestinians, about half of them civilians, including 13 children, have been killed in Israel’s raids, Palestinian officials said. More than 500 rockets fired from Gaza have hit Israel, killing three people and injuring dozens.


Israel unleashed intensive air strikes on Wednesday, killing the commander of the Hamas Islamist group that governs Gaza and spurns peace with the Jewish state. Israel’s declared goal is to deplete Gaza arsenals and press Hamas into stopping cross-border rocket fire that has plagued Israeli border towns for years.


Air raids continued past midnight into Sunday, with warships shelling from the sea. A Gaza City media building was hit, witnesses said, wounding 6 journalists and damaging facilities belonging to Hamas’s Al-Aqsa TV as well as Britain’s Sky News.


An Israeli military spokeswoman said the strike had targeted a rooftop “transmission antenna used by Hamas to carry out terror activity”.


Two other predawn attacks on houses in the Jabalya refugee camp killed two children and wounded 13 other people, medical officials said.


These attacks followed a defiant statement by Hamas military spokesman Abu Ubaida, who told a news conference: “This round of confrontation will not be the last against the Zionist enemy and it is only the beginning.”


The masked gunman dressed in military fatigues insisted that despite Israel’s blows Hamas “is still strong enough to destroy the enemy”.


An Israeli attack on Saturday destroyed the house of a Hamas commander near the Egyptian border.


Casualties there were averted however, because Israel had fired non-exploding missiles at the building beforehand from a drone, which the militant’s family understood as a warning to flee, and thus their lives were spared, witnesses said.


Israeli aircraft also bombed Hamas government buildings in Gaza on Saturday, including the offices of Prime Minister Ismail Haniyeh and a police headquarters.


Among those killed in air strikes on Gaza on Saturday were at least four suspected militants riding motorcycles, and several civilians including a 30-year-old woman.


ISRAELI SCHOOLS SHUT


Israel said it would keep schools in its south shut on Sunday as a precaution to avoid casualties from rocket strikes reaching as far as Tel Aviv and Jerusalem in the past few days.


Israel’s “Iron Dome” missile interceptor system destroyed in mid-air a rocket fired by Gaza militants at Tel Aviv on Saturday, where volleyball games on the beach front came to an abrupt halt as air-raid sirens sounded.


Hamas claimed responsibility for the attack on Tel Aviv, the third against the city since Wednesday. It said it had fired an Iranian-designed Fajr-5 at the coastal metropolis, some 70 km (43 miles) north of Gaza.


In the Israeli Mediterranean port of Ashdod, a rocket ripped into several balconies. Police said five people were hurt.


Israel’s operation has drawn Western support for what U.S. and European leaders have called Israel’s right to self-defense, but there was also a growing number of calls from world leaders to seek an end to the violence.


British Prime Minister David Cameron “expressed concern over the risk of the conflict escalating further and the danger of further civilian casualties on both sides,” in a conversation with Israeli Prime Minister Benjamin Netanyahu, a spokesperson for Cameron said.


London was “putting pressure on both sides to de-escalate,” the spokesman said, adding that Cameron had urged Netanyahu “to do everything possible to bring the conflict to an end.”


Ben Rhodes, a deputy national security adviser to President Barack Obama, said the United States would like to see the conflict resolved through “de-escalation” and diplomacy, but also believes Israel has a right to self-defense.


Egyptian President Mohamed Mursi said in Cairo as his security deputies sought to broker a truce with Hamas leaders, that “there are some indications that there is a possibility of a ceasefire soon, but we do not yet have firm guarantees.”


Egypt has mediated previous ceasefire deals between Israel and Hamas, the latest of which unraveled with recent violence.


A Palestinian official told Reuters the truce discussions would continue in Cairo on Sunday, saying “there is hope,” but it was too early to say whether the efforts would succeed.


In Jerusalem, an Israeli official declined to comment on the negotiations. Military commanders said Israel was prepared to fight on to achieve a goal of halting rocket fire from Gaza, which has plagued Israeli towns since late 2000, when failed peace talks led to the outbreak of a Palestinian uprising.


Diplomats at the United Nations said Secretary-General Ban Ki-moon is expected to visit Israel and Egypt in the coming week to push for an end to the fighting.


POSSIBLE GROUND OFFENSIVE


Israel, with tanks and artillery positioned along the frontier, said it was still weighing a ground offensive.


Israeli cabinet ministers decided on Friday to more than double the current reserve troop quota set for the Gaza offensive to 75,000 and around 16,000 reservists have already been called up.


Asked by reporters whether a ground operation was possible, Major-General Tal Russo, commander of the Israeli forces on the Gaza frontier, said: “Definitely.”


“We have a plan. … It will take time. We need to have patience. It won’t be a day or two,” he added.


A possible move into the densely populated Gaza Strip and the risk of major casualties it brings would be a significant gamble for Netanyahu, favored to win a January election.


The last Gaza war, a three-week Israeli blitz and invasion over the New Year of 2008-09, killed 1,400 Palestinians, mostly civilians. Thirteen Israelis died in the conflict.


But the Gaza conflagration has stirred the pot of a Middle East already boiling from two years of Arab revolution and a civil war in Syria that threatens to spread beyond its borders.


One major change has been the election of an Islamist government in Cairo that is allied with Hamas, potentially narrowing Israel’s maneuvering room in confronting the Palestinian group. Israel and Egypt made peace in 1979.


(Writing by Allyn Fisher-Ilan; Editing by Douglas Hamilton)


World News Headlines – Yahoo! News



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DirecTV strikes deal to carry Time Warner Cable’s sports channels
















LOS ANGELES (TheWrap.com) – Los Angeles Lakers fans who subscribe to DirecTV will finally be able to watch their team again.


DirecTV, has struck a deal to carry Time Warner SportsNet, which now almost exclusively airs the Lakers games, along with Time Warner‘s Spanish-language Deportes.













The agreement ends a carriage dispute that left DirecTV viewers in Southern California out in the cold as the NBA season began last month. DirecTV, along with other carriers, had protested the price of the recently formed regional-sports networks, which would have cost an additional $ 3.95 per subscriber. Other carriers, such as Dish and Cox Communications, eventually reached agreements with Time Warner Cable, with DirecTV holding out the longest.


Under the agreement, DirecTV subscribers in Southern California will also have access to games from the LA Galaxy and Los Angeles Sparks.


DirecTV is pleased that Los Angeles Lakers, LA Galaxy and Los Angeles Sparks games and programming will now be seen by so many people whose loyalty remains the life’s blood to each team,” DirecTV chief content officer Dan York said. “We appreciate our customers’ patience and are happy to have arrived at an outcome that benefits everyone involved. We know that our customers will enjoy the great programming of these three franchises for many years to come.”


“Our partners at DirecTV value Southern California sports as much as we do and we’re thrilled to work with them to bring Lakers, Galaxy and Sparks games and programming to our viewers,” Time Warner Cable Sports’ senior vice president Dan Finnerty added. “Time Warner Cable SportsNet and Time Warner Cable Deportes will help bring DirecTV customers closer to these teams than they have ever been before.”


SportsNet will air on channel 691, while Deportes will run on channel 458.


TV News Headlines – Yahoo! News



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Questions of Blame Linger 34 Years After Jonestown
















From the age of 13, Leslie Wagner Wilson had been indoctrinated in the California-based Peoples Temple, led by the charismatic Jim Jones, whose mission was to foster racial harmony and help the poor.


But on Nov. 18, 1978, she and a handful of church members fought their way through thick jungle in the South American country of Guyana, escaping a utopian society gone wrong where followers were starved, beaten and held prisoner in the Jonestown compound.













She walked 30 miles to safety with her 3-year-old son, Jakari, strapped to her back and a smaller group of defectors. But just hours later, the mother, sister and brother and husband she left behind were dead.


“I was so scared,” said Wagner, now 55. “We exchanged phone numbers in case we died. I was prepared to die. I never thought I would see my 21st birthday.”


Today, on the 34th anniversary, Wilson said it’s important to remember the California-based Peoples Temple Jonestown massacre, especially the survivors who have wrestled with their consciences for decades.


PHOTOS: Jonestown Massacre Anniversary


Nine members of her family were among the 918 Americans who died that day, 909 of them ordered by Jones to drink cyanide-laced Kool-Aid in the largest ritual suicide in history.


Her husband, Joe Wilson, was one of Jones’ top lieutenants who helped assassinate congressman Leo Ryan and his press crew when they tried to free church members who were being held against their will.


After arriving back in the United States, Wilson said she “went through hell” — three failed marriages, drug use and suicidal thoughts she describes in her 2009 book, “Slavery of Faith.”


“I was like Humpty Dumpty, but you couldn’t put me back together again,” she said.


Survivors, many of them African-American like Wilson, say they felt guilt and shame and faced the most agonizing question surrounding the nation’s single largest loss of life until 9/11: Was it suicide or murder?


Full Coverage: Jonestown Massacre


In the now-famous “death tape,” supporters clapped and babies cried as Jones instructed families to kill the elderly first, then the youngest in protest against capitalism and racism. Mothers poisoned 246 children before taking their own lives.


“We really can’t understand the Peoples Temple without looking at the historical time period when it arose,” said Rebecca Moore, a professor of religious studies at San Diego State University.


“With the liberation movements of the ’60s and ’70s, the collapse of the black-power movement, the Peoples Temple was the main institution in the San Francisco Bay area that promoted a message of integration and racial equality.”


Moore lost her two sisters and her nephew, the son of Jim Jones. “They were hardcore believers,” she said of her siblings.


Jim Jones, who was white, came from a “wrong side of the tracks,” poor background in Indiana where in the 1950s he became known as a charismatic preacher with an affinity for African-Americans.


“A number of survivors, including those who defected, believe to this day he had paranormal abilities,” said Moore, who met him years later. “He could heal them and read their minds.”


In the 1960s, Jones moved to San Francisco, where at the height of the Peoples Temple there were about 5,000 members.


WATCH: A Look Back at Jonestown Massacre


“They wanted my parents to join,” she said. “Like most outsiders, we didn’t have any idea what was happening outside closed doors.”


Jones ingratiated himself with celebrities and politicians, mobilizing voters to help elect Mayor George Moscone in 1975 and becoming chairman of the city’s housing authority.


Health News Headlines – Yahoo! News



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