Phillip Phillips looks at life beyond “American Idol”

LOS ANGELES (Reuters) – Like the 10 winners before him, Phillip Phillips faces the uneven road from “American Idol” victor to pop-chart mainstay.

After the success of his Top 10 hit, “Home,” the Georgia native is facing a new challenge – to replicate the mainstream successes of past “Idol” winners Carrie Underwood and Kelly Clarkson on his debut album, “The World from the Side of the Moon,” released on Monday by Interscope Records.

Phillips, 22, spoke to Reuters about making his first proper studio album, what he might do differently on a second one, and whether he could have won “Idol” with this season’s panel of judges.

Q: How do you plan to transition from “American Idol” winner to a mainstream music career?

A: “It’s pretty funny that you mention that because the majority of the people I meet don’t even know that I was on ‘Idol.’ It’s really cool to hear that. When I go home, people ask, ‘What’ve you been doing? I’ve heard your song,’ but they don’t even know that I’ve been on ‘Idol.’”

Q: Your first single “Home” has gone twice platinum. You’ve said that it isn’t a song you would have written yourself. What’s your relationship now with your first hit?

A: “It’s amazing how well it has done, and I look at all the stories that I hear like how it has helped families out with their situation, or something’s happened with their kid, mom or dad, or if their child’s overseas in the war. Something like that’s pretty amazing how many different stories come out of it.”

Q: Did you have any ideas on how you wanted to develop your sound finally getting into a big-time studio?

A: “I already had the songs written, and it was just a matter of throwing in ideas and then just trimming it down to what felt right, because we only had three weeks to do this album. So it was kind of pressured, but that kind of helped out as well. It didn’t make us overthink anything.”

Q: Was there anything in particular you wanted to achieve?

A: “I wanted to make it similar to what I did on the show – a horn section and some rock. I tried to be a little artistic. I just wrote what came from my heart and what felt right.”

Q: Unlike many of the other contestants, you went into “Idol” as a songwriter, how many of the album’s songs did you write?

A: “I think five. Some of the co-writes, (the writers) really just kind of pushed me, so I kind of wrote most of those myself. But it was a lot of fun; it was a great experience.”

Q: Would you do anything differently next time?

A: “It’s still early, but I’d definitely want a little more time to do it. But that’s really about it, because three weeks is just really quick, and also I have just so many other things going on. … It was very kind of stressful and hopefully for the next record I’ll have a little more time.”

Q: What would that time allow you to do in the studio?

A: “Just being able to listen to it a little more. We all knew that it sounded really good but also having to listen to, like 17 songs in a row. You say, ‘Yeah that sounds great’ but you listen to it more and more and (say) ‘Maybe I would’ve brought this instrument down a little bit or brought it up a little bit more.’”

Q: Would you have fared any differently on ‘Idol’ with the current judges Nicky Minaj and Mariah Carey?

A: “I don’t know. I’m curious to see how they’re going to judge. It’s a completely different panel this year. … I don’t really know how I would’ve turned out. Maybe I’ll have to go out and audition again (laughs).”

Q: Would you have had to change your roots-y style?

A: “Naw, I would’ve still been the same dude. If they wouldn’t have sent me through, they wouldn’t have sent me through. And if they did, that’d be awesome.”

(Reporting By Eric Kelsey, editing by Jill Serjeant and Gunna Dickson)

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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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“Last Resort,” “666 Park Avenue” Dropped by ABC

LOS ANGELES (TheWrap.com) – ABC’s freshman submarine drama “Last Resort” has been sunk, and the network has shuttered “666 Park Avenue” while it’s at it.

The network has declined to pick up its freshman drama “Last Resort,” which starred Ande Braugher as a submarine commander whose crew is declared rogue enemies after he ignores a suspicious order.

Likewise, freshman drama “666 Park Avenue,” which starred Terry O’Quinn and Vanessa Williams, will also not go forward. That drama centered around a young couple who manage a New York City apartment building that’s plagued by supernatural occurrences.

Though the network says it will air the remaining episodes of both series, they have not been picked up for additional episodes.

“Last Resort,” which aired Thursdays at 8 p.m., dipped to a 1.3 rating/4 share in the advertiser-cherished 18-49 demographic, tying the lowest performance in the series’ short existence.

“666 Park Avenue,” which aired Sundays at 10 p.m., drew a 1.3/3 for its final airing, which also tied a series low.

Earlier Friday, CBS canceled its freshman comedy “Partners.”

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Who Are the ‘Anti-Israel’ Press Behind Rupert Murdoch’s Twitter Attack?

Rupert Murdoch can apologize (as he sort of did) about his “Jewish-owned press” tweet, but he still can’t take it back. And because that tweet is out there, the big question now—after “Why is he still on there?” and “Wow, that’s really offensive, right?”—is which press, exactly, he was referring to. Here’s the tweet that Murdoch sent out on Saturday night: 

Why Is Jewish owned press so consistently anti- Israel in every crisis?

— Rupert Murdoch(@rupertmurdoch) November 18, 2012

After an avalanche of Twitter blowback, Murdoch soon faux-apologized…

“,Jewish owned press” have been sternly criticised, suggesting link to Jewish reporters.Don’t see this, but apologise unreservedly.

— Rupert Murdoch(@rupertmurdoch) November 18, 2012

…”don’t see this” being Murdochian for faux-apology.

RELATED: Rupert Murdoch Brightens Every Newsroom He Enters

As the initial round of shock wears off (The Daily Beast’s Peter Beinart eloquently wrote about how stupid and offensive this tweet was), journalists and editors are now actually trying to make some kind of sense of which outlet or outlets Murdoch may have gotten all drunk-uncle-at-Thanksgiving over. So, with the help of journalists on the case, here’s our best attempt at “Murdoch Whispering“: 

RELATED: How U.K. Tabloids Are Getting Around Prince Harry’s Nudity Warning

He Is Talking About The New York Times Foreign Policy’s Blake Hounshell put it succinctly: 

FWIW Murdoch was probably referring to the NYT with that weird tweet.

— Blake Hounshell (@blakehounshell) November 18, 2012

And it was shared be Buzzfeed’s Ben Smith:

Wolff also assumes, as I did, that Murdoch’s Jewish-owned press meant the Times guardian.co.uk/commentisfree/…

— Ben Smith (@BuzzFeedBen) November 19, 2012

The reason Smith, Hounshell, and The Guardian‘s Michael Wolff all think it’s a Times-centered attack isn’t just because of an anti-Semitic slam against the Sulzbergers (more on this in a tiny bit) but because of Murdoch’s various “wars” and his rivalry with The New York Times. Back in 2010, as Vanity Fair pointed out, Murdoch was warring with executive editor Bill Keller, and he was seen tweeting dissing the well-liked Times‘s public editor, Margaret Sullivan, not too long ago: 

Amusing fuss over NYT public editor.We see all two million daily subscribers as our very public editors.

— Rupert Murdoch(@rupertmurdoch) November 8, 2012

So maybe this tweet was another pot shot, albeit with more anti-Semitic tone. But as Wolff points out, being Jewish-owned doesn’t even apply to The Times anymore, which kinda makes it even more anti-Semitic if he was just going by the Sulzberger surname:

To describe the Times this way is both quizzical, and we can assume, pointed. Because, as it happens, the Times isn’t, per se, “Jewish”. True, the Sulzbergers, who control the company, were once a prominent Jewish family. But the Times’ chairman and publisher, Arthur Sulzberger, is half-Jewish (on his father’s side) and was raised as an Episcopalian. Murdoch knows this full well. So what he is saying is something more like “Jewish-tainted press”, which, all in all, seems more, not less, antisemitic.

He Was Talking About CNN and the AP If you go to the New York Times report on the whole thing that might be referring to The Times, they point to CNN and the AP. “In an earlier message he had said, “CNN and AP bias to point of embarrassment,” writes The Times‘s Amy Chozick.

RELATED: New York Times Devours Gothamist

He Was Channeling Wendi’s Broken English and Trolling His ‘Minders’ “Curiously, Murdoch’s wife Wendi often uses the word ‘Jewish’in an atonal context – ‘You Jewish, right? I know you Jewish!’– that makes Murdoch’s minders jump.  He may even become more retrograde to bedevil his minders.” wrote Wolff. Based on a life experience which includes very blunt Asian relatives and a large extended family, there is a definite possibility that Wendi might not know how harsh  ”You Jewish, right?” comes off. It’s hard to say the same for Rupert.

RELATED: The Vatican Gets Trendy: Puts Newspaper Online, Plans a Paywall

He Wasn’t Talking About Mother Jones‘s Adam Weinstein: 

*I* don’t own any media. You laid me off in 2008. RT @rupertmurdoch: Why Is Jewish owned press so consistently anti-Israel in every crisis?

— Adam Weinstein (@AdamWeinstein) November 18, 2012

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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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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? 

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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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