Life + Money

The New Site That Could Change Hospital Billing Forever

When the Obama administration went public with the first-ever comprehensive data on disparities in hospital billing last week, we knew it would be a game changer.

First of all, the differences are massive. A pacemaker implant that might cost a patient $36,012 in one hospital, might cost $143,124 down the road at a different hospital. There's no clear explanation as to why, and –– until now –– no simple way to go about finding out if you could get a better deal by shopping around for medical procedures first.

That's what makes the new database such a huge deal.

But there's just one problem we have with it: It's a beast to navigate.

It's basically the Mother of all spreadsheets, packed with post- and pre-insurance prices for the 100 most common procedures at over 3,300 hospitals.

Luckily, some genius has funneled all of that data into a much simpler web tool at http://www.opscost.com/.

Just punch in your city and the procedure you'd like to compare and the tool will come up with an easy-to-read list of costs at hospitals in the area.

The site is something of a side project for the developers behind the startup rentmetrics.com, a similar site for property values. "We saw the data get released and realized how important it was," co-founder George Kalogeropoulos said in an email. "But [we] also saw that it was only available in a relatively inaccessible format (160,000 row Excel sheet). The site has gained a lot of traction."

The uninsured have the most to lose from price discrepancies, since they don't have the benefit of Medicare or a private insurer to bear the brunt of the cost burden. Until now, there hasn't been a list of charges for common medical procedures anywhere near as comprehensive for consumers to sort through.

If anything, now we know that just like any consumer product, it pays to shop around for medical care — or, at the very least, try to negotiate.

By Mandi Woodruff, Business Insider

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Women Edge Out Men in Handling Credit

When it comes to managing credit, American women have a slight edge over men, according to a study of credit reports by the credit report agency Experian Plc.

Experian looked at 750,000 credit reports, a sample of what it collected nationwide, and found that while women earn 23 percent less than men, they know how to handle debt.

"When you start from there, you recognize that women have less money to spend," says Michele Raneri, Experian's vice president of analytics. "And their delinquencies are less."

When it comes to credit scores, women are in front by a tiny margin. Women averaged a credit score of 675 compared to the male average of 674, according to Experian's data. Reuters got a sneak peak of the study, which will be released Wednesday. "In terms of having a stereotype, they may spend and shop, but women also pay their bills well," Raneri says. "They are doing more with less."

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Experian found that men have 4.3 percent more debt than women. Men have a 2 percent higher credit utilization rate along with mortgage loans that are 4.9 percent higher. More men also hold mortgages that are least 60 days past due.

The average man in the study's sample carried $26,227 in debt compared to $25,095 for women. That figure includes consumer debt such as credit cards and auto loans, for example, but excludes mortgage debt.

The average mortgage held by a man is $187,245 compared to $178,140 for a woman. About 72 percent of all mortgages are held jointly, Experian found, so the analysis looked at the other 28 percent (just over half of them are held by men).

No place else in the country is close to the District of Columbia when it comes to women-held mortgages. In Washington, D.C., 47 percent of all mortgages are held individually, with 27 percent held by women, one-third more than the number of male-only mortgages. The next closest is Georgia, where 17 percent of all mortgages are held by women.

Women are least likely to be the sole mortgage holders in Idaho, Montana and North Dakota. In each of those states, women only represent 8 percent of the outstanding mortgage loans. The biggest gap in mortgage debt is in Connecticut, Experian found. The average mortgage held by a male there is $229,510 compared to the average $175,276 held by a female.

Coincidentally, men in Connecticut are also more likely to make late payments on mortgages and have more non-mortgage debt. Experian also looked at the Miami area, where both women and men are late on their mortgage payments about 13 percent of the time. But for those same women, the average debt is about 7 percent lower than the men, which Experian says is another example that women are handling their debts better.

The findings should serve to bolster the argument that women are perfectly capable of managing their finances, says money management expert Liz Weston, columnist and author of Deal with Your Debt. "I like any study that counters the notion that women are airheads about money," Weston says. "I don't think women are any more likely to be spendthrifts, for example, or any less likely to be savers."

(The author is a Reuters contributor. The opinions expressed are his own.)

Oklahoma Tornado One of the Top 5 Costliest in History

The worst of it lasted for about an hour. But the human, physical and economic toll in Oklahoma will rank among the most devastating weather events of its kind. "This is going to be one of the top five costliest tornadoes in U.S. history," said Evan Gold, vice president of client services at Planalytics, a weather consulting firm.

The full impact of the human loss was still unknown Tuesday as exhausted rescue workers searched for survivors among the piles of rubble and collapsed structures left behind in the mile-wide path of the killer storm in Moore, Oklahoma. The effort was hampered by piles of debris, damage to roadways and heavy traffic.

Local officials said 24 were confirmed dead, including eight children. Hospitals reported dozens more were being treated for injuries, at least 65 of them children.

It will take months to assess the economic damage. Preliminary estimates are often subject to wide revisions. "We're still trying to piece together what the track and intensity it was, but the early computer model estimates are $1.2 billion to $2 billion," Chuck Watson, director of research and development at Kinetic Analysis, told CNBC Tuesday.

As with most storms, the aftermath will likely produce an overall, short-term boost to the region's economy as insurance claims are paid and rebuilding begins. But many individual businesses and households may never fully recoup their financial losses. Residents of Moore are already cruelly familiar with the human and economic loss they've suffered, having survived a similar tornado strike on May 3, 1999.

That twister, with winds clocked in at 318 mph, the fastest ever recorded, left a path of destruction that killed 46 people and damaged or destroyed more than 8,000 homes. The 1999 tornado resulted in some 146,000 claims and $1.4 billion in insured losses, according to Robert Hartwig, president of the Insurance Information Institute.

The Moore tornado will most likely fall at No. 3 on the list between the Joplin, Mo., twister in 2011, which cost $3 billion, and the earlier Moore tornado in 1999 at about $1.5 billion. The most costly tornadoes were cluster of up to 100 in six Southern states on the same day in April, 2011, which cost $11 billion in damages.

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The National Weather Service said Monday's Moore twister produced winds of up to 200 mph, putting it in the second most powerful category of a tornado. Most of the economic loss was produced by the obliteration of whole neighborhoods, as thousands of homes were flattened. The destruction was so complete that local crews were installing street signs so residents could locate the site of their homes.

The town will also face the cost of rebuilding a local school and other public facilities damaged by the storm. Utilities were already at work Tuesday rebuilding damaged power lines.

Much of the cost will be offset by insurance and federal disaster assistance. President Barack Obama directed the Federal Emergency Management Agency to prepare to get "all available assistance" to the disaster-hit area. Late Monday, the president declared Oklahoma a major disaster area, making federal aid available to people in Cleveland, Lincoln, McClain, Oklahoma and Pottawatomie counties.

TORNADO CAUSES DOZENS OF DEATHS
The death toll is expected to rise, reports The Weather Channel's Jim Cantore, as the search continues for survivors after yesterday's devastating twister swept across the Midwest. While recent hurricanes have left some homeowners high and dry without insurance coverage, Hartwig said the survivors of the Moore twister are more likely to see their losses covered. That's because coverage for wind damage is more commonly included in homeowner policies than flood coverage, he said.

"It doesn't matter how a fast the wind was or if wind blew off the roof and let water in or hail damage. All of that would be covered whether it's a home or a business," he said.

Thanks to improvements in weather forecasting and warning systems storm-prone communities, death tolls from twisters have been falling in recent years. The deadliest tornado on record, which struck March 18, 1925, killed 695 people in Missouri, Illinois and Indiana. But economic losses have spiked as the frequency and severity of tornadoes and thunderstorms have surged. "Even after you adjust for inflation, the last five years have been the five most expensive years ever," said Hartwig.

About a third of those losses came in just a two-month period, in April and May, 2011, when five clusters of tornadoes swept through the south and Midwest, killing 545 people and leaving a devastating path of destruction. The total cost of rebuilding came to nearly $27 billion, according to theNational Climatic Data Center.

The severity and frequently of destructive storms is expected to continue. While some skeptics debate the causes of more frequent severe weather events, there appears to be little doubt about the economic impact.

"Whether you believe that the volatility in weather is due to natural cycles or whether its man-made, from our perspective it doesn't matter," said Gold. "The fact is there is more volatile weather today. Storms are more severe and more violent, and we have to prepare for that."

This article by John Schoen of CNBC originally appeared at CNBC.com.

5 Science Breakthroughs That Can Help Predict Tornadoes

Approximately 16 minutes before the massive twister struck Oklahoma on Monday, meteorologists used satellites and radars to issue a tornado warning in Oklahoma City.

Sixteen minutes may not be much time – but it’s certainly a major advance from 30 years ago, when the average lead time was five minutes. In the 1950s, it was even illegal to predict tornadoes because of the uncertainty and panic that could result from a false forecast. Those 11 additional minutes likely saved more lives as people burrowed into safety shelters and basements. But imagine if they had as much as 30 minutes or more? Would parents have picked up their children from school and sheltered them? Would there have been time to turn off gas sources to avoid fires? New scientific breakthroughs may soon be able to deliver those precious minutes.

Tornadoes are difficult to predict because a thunderstorm can turn into a violent tornado-producing storm within minutes, and tornados can form and disperse just as quickly – unlike hurricanes or blizzards that spend days forming and moving slowly across satellite maps. The false-alarm rate for tornadoes is still at about 75 percent, according to Joshua Wurman, a meteorologist and president of the Center for Severe Weather Research (CSWR) in Colorado.

Categorizing a tornado after it strikes on the Fujita scale from F0 to F5 is also difficult because in addition to wind speed, damage levels need to be assessed. Monday’s tornado was originally classified as an F4, but was revised to an F5 because meteorologists found one spot they thought should be in a higher category. “Even if one spot is rated F5, the tornado is deemed F5,” says Wurman. “I don’t think it’s a good system, but it’s how the weather service does it.”

The National Science Foundation (NSF) provides much of the funding for tornado research. The NSF’s current budget is $6.88 billion, $1.5 million of which goes to the CSWR. Oklahoma itself is a hub for much of the research – some $7 million of federal money goes to Oklahoma’s Department of Commerce for their National Severe Storms Lab every year, a unit of the National Oceanic and Atmospheric Administration (NOAA).

Thanks to years of research, better mathematical models of thunderstorms, and scientists who “chase” tornadoes to study them (think of the 1996 film Twister), predicting tornadoes has come a long way. Recently, there have been a few innovations in the field that could help improve the accuracy of predictions and increase warning times.

1. Multimission Phased-Array Radars (MPAR). These enhanced radars have beams that can scan faster while avoiding unwanted ground clutter – producing clearer, more readable images. Researchers at MIT’s Lincoln Laboratory, a federally funded research and development center, are trying to reduce costs in order to replace current radars on a mass scale and streamline the nation’s weather surveillance system.

2. Drones. Engineering students (with one group calling themselves “the Stormtroopers”) from Oklahoma State University have developed unmanned aerial vehicles that can penetrate the eye of a tornado and collect important meteorological data. Flying the vehicles into a thunderstorm before a tornado hits could also help predict when one will occur. Other drones have been built by an ongoing research project called the Verification of the Origins of Rotation in Tornadoes Experiment 2 (or VORTEX2) by the National Oceanic and Atmospheric Administration (NOAA) and the NSF.

3. More comprehensive radar systems. A group called the Collaborative Adapting Sensing of the Atmosphere (CASA) has been testing experimental radar systems that can provide a fresh image of a storm every minute – a big improvement from traditional radar that typically updates every five minutes. Traditional radars also have blind spots – they have trouble measuring storm activity close to the ground, where a lot of tornado-causing conditions form. The new radars are smaller, can be installed in more places, and send out waves that follow the curve of the earth, all of which helps improve coverage. The CSWR is also working on expanding its Doppler-on-Wheels project to increase the mobility in following a storm’s progress.

4. Gravity waves. Researchers at the University of Alabama, Huntsville, have been studying the effect of gravity waves on tornado formation. The waves are formed by a sudden change in the atmosphere – similar to ocean waves – and can push down on rotating thunderstorms to intensify the wind speed and form funnels. The ability to spot and predict the gravity waves sooner could increase the accuracy of a tornado prediction and save lives.

5. Supercomputing and sophisticated modeling. Supercomputers are behind the National Weather Services’ experimental warning system called Warn-on-Forecast – the researchers involved are hoping to produce accurate warnings 30 minutes to an hour before a tornado strikes. It involves taking extremely high-resolution images of a storm (that currently take too long to produce to track a storm in real-time), and comparing those with quick lower-resolution images.

Immigrants Wanted: Rust Belt Cities Need You!

Arnoldo Muller-Molina, a Costa Rican native with a PhD in artificial intelligence, could have moved his fledgling tech startup to Silicon Valley or New York City. Instead, he chose St. Louis, Missouri, a city more renowned for its sports teams than a flourishing immigrant population.

Muller-Molina says he didn’t want the high cost of establishing himself on either coast and he disdained the intense competition in those communities. He received a $50,000 grant to move his database company SimMachines to St. Louis, where he was given free legal assistance, help in obtaining an EB5 investor visa, and free mentoring services. The money and services came from Arch Grants, a global startup competition based in St. Louis that was founded in part to draw immigrant entrepreneurs to the “Gateway City.”

Immigrants have long been drawn to the vitality and economic opportunity offered by New York, Los Angeles, and Silicon Valley. And if new immigrant legislation passes, those areas will reap the benefits of attracting educated entrepreneurs.

But Rust Belt cities like St. Louis, Cincinnati, and Dayton, Ohio, don’t have the same allure. The loss of manufacturing jobs and declining populations have intensified efforts in these cities (and others like Pittsburgh and Detroit) to attract new immigrant entrepreneurs and startups to help revitalize ailing economies. A 2011 study from the American Enterprise Institute concluded that immigrants with advanced degrees as well as immigrants of any skill level on temporary visas create jobs for native-born Americans.

Facebook founder Mark Zuckerberg has recently touted the innovations that immigrant entrepreneurs bring to the economy and is a supporter of the new immigration legislation.

“It’s important to have this kind of vibrancy and talent to make for a growing economy,” said Jerry Schlichter, a St. Louis-based attorney who founded Arch Grants in 2011, and gave two of the first 15 awards to international startups (including SimMachines in June 2012). “We need to have this kind of international educated workforce to compete in a global economy.”

Schlichter and others who are trying to lure immigrant businesses to their cities recognize that it’s a daunting challenge. Since 9/11, many immigrants have been stymied by burdensome visa restrictions and anti-immigration legislation passed in Arizona, Alabama and multiple municipalities.

THE BENEFITS OF IMMIGRANT BUSINESSES
A 2012 study from the Ewing Kauffman Foundation found that the number of immigrant-founded tech companies has dropped from 25.3 percent to 24.3 percent of all tech company startups since 2005. In Silicon Valley, the percentage of immigrant-founded startups declined from 52.4 percent to 43.9 percent.

A study published by St. Louis University in June 2012 found that “increasing the number of immigrants will raise employment, grow income, boost real wages, reverse declining home prices and lower unemployment rates.” St. Louis has seen its population decline by 62.7 percent since 1950, and according to a recent report from the Brookings Institution, the city ranks 80th of 100 metropolitan areas in job growth since the recession ended. It ranks 83rd in recovery of home prices, and its unemployment rate is 7.4 percent, compared to the 6.6 percent rate for the state of Missouri.

Muller-Molina started SimMachines in his native Costa Rica in 2011, but wanted to bring his business to the U.S. Since moving to St. Louis last year, the “big data” company has secured contracts with a former NASA astronaut working on a plasma propulsion engine for the International Space Station, and is collaborating with Washington University Medical School on MRI technology.

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SimMachines, which is creating applications that analyze data for these organizations, is an example of how a small immigrant-led business can bring innovation and jobs to a mid-size city. Though the company is small with only five employees, Muller-Molina plans to hire 15 additional employees this year.

Current immigration laws, says Schlichter, make it difficult to attract innovative entrepreneurs like Muller-Molina. He also says that St. Louis and the rest of the country are losing out on a pool of Indian and Chinese graduates who are taking their life science, engineering and technology degrees back to their native countries.

New immigration legislation aims to provide more visas for specialized workers and help meet demand for both high and low-skilled employees in industries like agriculture and technology through guest worker programs.

Foreign-born entrepreneurs also “serve as bridges” to open new markets with their respective homelands, according to Dane Stangler, research director at the Kauffman Foundation. “Transnational businesses play an important role in facilitating international trade, investment and tourism,” write the authors of a 2012 report from the U.S. Chamber of Commerce and the Immigration Policy Center of the American Immigration Council.

Immigrants are more than twice as likely start a business in the U.S. as non-immigrants, according to a study by The Partnership for a New American Economy, a bipartisan group of mayors and business leaders across the country. In 2011, immigrants started 28 percent of all new business, while only accounting for 13 percent of the U.S. population.

On March 6, Cincinnati passed a resolution declaring itself an “immigrant friendly city,” in part to reverse the trend of a declining population. The Metropolitan Area Religious Coalition of Cincinnati (MARCC), an interfaith group, introduced to Southwestern Ohio a declaration of principles that “urge, local, state, and regional governments to act on a comprehensive immigration policy.”

“Immigrants develop cutting-edge technologies and companies,” said Margaret Fox, the executive director of MARCC. “Cincinnati has put out its welcome mat to receive them and their families.”

In Dayton, the city has opened its own welcome mat to immigrants in a move that municipal leaders hope will jump-start a faltering economy. The “Welcome Dayton” program seeks to attract immigrant entrepreneurs to a city of 141,000. Between 2000 and 2009, Dayton recorded a 7.2 percent decline in population.

Tim Riordan, the Dayton city manager, says the city is taking a long-term approach in hopes of drawing immigrants to a region that has a poor track record in doing so. “I don’t want you to give you the impression this is going to be easy,” Riordan said about the plan. “We did it because it was the right thing to do.”

Riordan says the city is working with the University of Dayton to retain its foreign-born graduates and help them obtain EB5 visas that will allow them to start businesses and to invest in the community. (EB5 visas are available only to those who invest $1,000,000 or at least $500,000 in a high unemployment or rural area.)

“I don’t think it’s a panacea,” said Jamie Longazel, an assistant professor of sociology at the University of Dayton and an expert in immigration policy, of the Dayton plan. “I do think they’re sending a powerful symbolic message.”

Has Fed Bond Buying Helped Everyday Americans?

While the Federal Reserve's accommodative policies have boosted stocks and helped the rich, it is unclear whether they are doing enough for the broader U.S. economy, a top central bank official said on Monday.

"We've made rich people richer...," Dallas Fed President Richard Fisher said on CNBC television. "Question is what have we done for working men and women in America?"

Fisher, who has long opposed the Fed's bond-buying program and wants to reduce it, added he expects real gross domestic product growth of more than 2.5 percent by year end.

The central bank is buying $45 billion in Treasury bonds and $40 billion in mortgage bonds each month in an effort to encourage investment, hiring and economic growth in part because the unemployment rate remains high at 7.5 percent.

The benchmark S&P 500 stock index has risen some 16 percent since the so-called quantitative easing (QE) program was launched in September, 2012.

Fisher's hawkish views have in the past few years been largely ignored by Chairman Ben Bernanke and the majority of Fed policymakers, but investors are now anxiously predicting when the bond-buying will be reduced.

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On Monday, Fisher warned that the Fed could be buying all of the gross issuance of mortgage backed securities if it keeps up the current pace. "We have to think about our fiduciary duty long term," he said.

Noting there are other Fed officials who agree with him, Fisher, who does not have a vote on policy this year, highlighted comments last week by centrist San Francisco Fed President John Williams who said the central bank could trim its purchases this summer.

"I think the odds are in favor ... of dialing this back a little bit or keeping it at its current pace," as opposed to increasing the purchases, he said. The Fed has a policy meeting set for June 18-19.

Asked who might succeed Bernanke when the chairman's term expires early next year, Fisher said: "I personally would like to see Ben stay. I think he is extraordinary and has progressed enormously on the job." Fed Vice Chair Janet Yellen "is extremely capable, there are other capable people," he said. "I can tell you one thing for certain: It won't be me."

Reporting by Jonathan Spicer of Reuters.

Millennials Hit the Brakes on 60-Year Driving Boom

Americans are driving less than they used to because of higher gasoline prices, a weak economy and changing generational preferences, according to a report released Tuesday that found a sixty-year "driving boom" had hit the brakes.

The report, by advocacy organizations the U.S. Public Interest Research Group and Frontier Group, said transportation policymakers and existing plans to expand the nation's roads and highways have not taken the decline into account.

The researchers said car use is likely to decline further as members of the Millennial generation, now in their teens to early 30s, move into cities and rely more on public transportation, while car-loving baby boomers age out of their "peak driving" years.

People aged 16 to 34 racked up 23 percent less mileage in 2009 than in 2001, the study said, demonstrating a greater decline in driving than for any other age group.

"This is a new direction - a real break, a real change, the study's co-author, Phineas Baxandall, an analyst at the U.S. PIRG, said in a briefing on Tuesday. "After 2004, on per capita basis, driving has gone down, and the number of vehicle-miles driven has also gone down each year since 2004."

This trend is reflected in vehicle ownership, which has decreased by 4 percent between the all-time high of 1.24 vehicles per driver in 2006 and now.

The percentage of driving-age Americans with licenses also fell to a 30-year low of 86 percent in 2011 from an all-time high of 90 percent in 1992.

Meanwhile, the average inflation-adjusted price of gasoline doubled between 2002 and 2011. In the short term, the study said, higher fuel prices may lead people to skip long road trips or vacations; in the longer run, sticker shock at the gas station could encourage people to lower or avoid the expense of driving by living closer to work or buying more efficient cars.

The researchers said federal and certain state governments have nevertheless continued to allocate funds to large highway expansion projects based on "obsolete" forecasts "based on assumptions forged during the driving boom," said co-author Tony Dutzik, a policy analyst at the Frontier Group.

"We invest tens of billions of dollars in our transportation systems so it's important that we're doing so with a clear understanding of what we know and don't know about the future," Dutzik said.

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The study noted that "the number of miles driven in the heaviest trucks has actually declined faster than overall vehicle travel in recent years, falling by 11 percent between 2007 and 2011." It said there was "little evidence thus far for the proposition that reductions in household driving must coincide with an increase in heavy-duty truck traffic."

Sean McAlinden, chief economist and vice president for research at the Michigan-based non-profit Center for Automotive Research, dismissed the report's findings.

"Younger buyers under 30 are listing financial problems as their reason for not buying new cars," McAlinden said. "If and when the economy recovers, will buy cars at the same rate as other generations."

The reported declines in driving coincide with weakness in the U.S. economy, which emerged from a brutal recession in June 2009 and was still in tepid recovery in 2011. However, driving did not pick up in line with the recovery, Dutzik said.

"That suggests that the recovery of the economy might not necessarily lead to the kinds of increases in driving that we saw in past decades."

The study noted that cycling, walking, light rail and other alternative methods of transportation have gained popularity in recent years: In 2011, Americans took nearly 10 percent more trips via public transportation than they had in 2005.

Young Americans in their late teens and 20's are less enthralled with the automobile than prior generations and are seen as regarding high-tech devices, including tablet computers and smartphones, as more important status symbols than cars.

That has led major automakers, including General Motors Co., Ford Motor Co. and Toyota Motor Corp. to rework their lineups with different body styles and more tech-savvy features aimed drawing young Americans' interest.

Why Angelina Jolie Paid Too Much for the Test That Saved Her Life

Angelina Jolie’s decision to undergo a preventive double mastectomy has shone the actress's megawatt starpower on the genetics of cancer and on the difficult decisions that patients, and those with family histories of the disease, face. Yet it also renewed attention on Myriad Genetics (NASDAQ: MYGN), a Salt Lake City-based biotech that developed and markets the test for the BRCA1 and BRCA2 genes linked to breast cancer. Myriad is the only company that provides that key genetic test – and it has maintained that distinction, along with the ability to charge thousands of dollars for the testing, because it holds patents on those BRCA genes.

Those controversial patents – and Myriad Genetics’ ability to profit from them – are at the heart of a legal battle that started in 2009 and is expected to be decided within weeks by the U.S. Supreme Court. At issue in the case, Association for Molecular Pathology v. Myriad Genetics, Inc., is a fundamental question in an age of rapid biotech advances: Can human genes – those sequences of DNA in your body – be patented? The Supreme Court heard arguments in the case on April 15 and is expected to issue its ruling by late June.

The plaintiffs in the case, including the Association for Molecular Pathology (AMP), the American Civil Liberties Union (ACLU), other advocacy groups and patients contend that Myriad should not be allowed to patent the genes because its researchers merely located items found in nature and did not modify them. The plaintiffs also argued that permitting companies to hold such patents has severe implications for science and for patients.

“The U.S. Patent and Trademark Office (PTO) has granted thousands of patents on human genes – in fact, about 20 percent of our genes are patented,” the ACLU argued in a press release this month. “A gene patent holder has the right to prevent anyone from studying, testing or even looking at a gene. As a result, scientific research and genetic testing has been delayed, limited or even shut down due to concerns about gene patents.”

The plaintiffs say that Myriad’s monopoly over the genes has made important medical testing more expensive than it would otherwise be. “Myriad's monopoly on the BRCA genes allows it to set the terms and cost of testing and makes it impossible for women to access alternate tests or get a comprehensive second opinion about their results,” the ACLU said in a statement released on the day the Supreme Court heard oral arguments. “It also allows Myriad to prevent researchers from even looking at the genes without first getting permission from Myriad.”

In other words, invalidating Myriad’s patents could help make the screening test available to more women who don’t have the resources of, say, an Angelina Jolie – a concern that the actress herself raised in her op-ed. “It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live,” she wrote. “The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.”

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Myriad Genetics counters that it isolated the genes in question outside their location in our cells and argues that patent protection is necessary to encourage such research and innovation. The company says that it invested some $500 million in developing the genetic test and making it available to the 1 million people who have benefitted from it so far, or some 250,000 a year now. “Countless companies and investors have risked billions of dollars to research and develop scientific advances under the promise of strong patent protection,” Myriad CEO Peter D. Meldrum said in a statement before the court hearing last month. Over the first three months of 2013, Myriad’s revenue from the BRACAnalysis test totaled $115.4 million, or 74 percent of the company’s total revenue for the period.

Myriad also says that 95 percent of patients in the U.S. have access to the testing through private insurance or other health-care coverage, and that the average out-of-pocket expense to patients is $100. Earlier this year the company heralded clarification from the government that the BRCA testing would be covered for high-risk patients as a preventive service under the Affordable Care Act.

While the Roberts court, with a reputation for being friendly to business, weighs those considerations, the debate will continue – and now, thanks to Jolie, women all across the country may be paying more attention.

The 7 Worst Job Interview Mistakes People Make

You landed a job interview for a position you really want – but the hiring manager never called you back after it was over. What happened?

It could be that the chemistry wasn’t right, of course, or that the salary didn’t align – but it's very likely you made some foolish and entirely preventable mistakes that derailed your chances.

“Given how competitive it is out there, I’m appalled at some of the interview mistakes people keep making,” says Dana Manciagli, a Seattle career expert who spent a decade at Microsoft and today runs her own executive coaching business.

She and other experts say that even job candidates at the highest professional levels make mistakes – not just those at lower or mid-level ranks. In a still-tight economy with plenty of people competing for positions of all kinds, here are some of the top job interview clunkers:

1. You leave your cell phone on.
When the ring of your phone cuts short a critical conversation about the job you covet, guess what it does to your chances?

One hiring manager in Manhattan says she sees this often – and she’s always amazed when she does. “The job candidates will say, ‘Oh, gee, I’m sorry,’ and reach to turn their phones off. But why didn’t they think of that before they walked in the door? To me, it shows a lack of preparation. It’s also inconsiderate.”

And if you actually pick up that phone or send a text during your interview, as some people do – don’t wonder why you weren’t called back.

2. You’re too focused on yourself.
If you overuse the “I” word during the interview, hiring managers may see a big ego standing in the way of a job offer. “Many candidates talk about themselves ad nauseam, with little or no relevancy to the job opening at hand,” says Manciagli. “Whether this is due to nerves, or a lack of self-awareness, or naiveté – people hurt their chances of getting the job.”

If you can’t clearly articulate how you can help the company succeed or solve its problems, you’re probably not a top candidate. “It’s critical you know the specific skills and background required,” says Manciagli. “This is basic and speaks to preparation, but plenty of people don’t do it. You should say succinctly during your interview, ‘From my understanding of the job, you’re looking for these skills. Here’s how I can help.’ Then be very specific.”

3. You’re desperate – and it shows.
Some people have been out of work so long or are so desperate for the job they’ll say almost anything. That over-eagerness and anxiety, however, is a red flag. “They’ll say, ‘Sure, I can do that,’ to just about anything that comes up during the interview,” observes Michele Woodward, a career strategist in Arlington, Virginia. “The reality is they’re thinking more about paying their mortgage or affording a summer vacation than about the staffing problem the company’s trying to solve.”

People also tend to ramble on and on when they’re anxious. It’s a much better plan to have short, concise answers to common questions prepared beforehand. Once you say them – smile, make good eye contact, and be quiet.

4. You can’t answer basic questions about your qualifications.
It’s one of the most common interview questions: “What are your strengths?” Yet hiring managers say far too many job candidates flub their answers.

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“Even at high levels, people will give a rote list of their previous jobs, or cite clichés like ‘I’m a workaholic and like to get things done.’ Not good enough,” says Dana Manciagli of Seattle.

Use this opening to your best advantage. “Companies want to know why you’re a great fit for the job they have. They want details, skill sets, accomplishments. You might say, ‘I’ve exceeded my sales goals every quarter.’ Or, ‘My division brought in five new accounts in six months,’ or ‘We created three new ad programs and drove X amount of revenue.’”

And when you hear, “What’s your biggest weakness?” that’s an opportunity to turn a negative into a positive. Rehearse it in advance. You might say, “In the past I’ve tended to take on too much, but by delegating I’ve been able to accomplish twice the amount.”

5. You’re late to the interview.
“I’ve heard every excuse in the book,” says one human resources professional. “‘I got stuck in traffic.’ ‘I couldn’t find the building.’ ‘The campus is so big I got lost.’” Whatever the case, it means you didn’t give yourself enough time. “I tell clients that if they’re not in the lobby 30 minutes before the interview, they’re late.” It bears emphasis: Allow extra time.

6. You know little or nothing about the company’s culture.
Do some research. Reach out to friends and colleagues in the business. Surf for information. Ask career coaches. Is the company ultra conservative? Do staffers dress in business casual? Learn what you can – then dress for the interview accordingly.

“I can always tell when a candidate hasn’t done basic homework about the culture,” says one seasoned hiring executive, “based on the way he or she looks.” When in doubt, dress up.

7. You badmouth a previous employer.
Negative attitudes attract no one – that’s the bottom line. It’s also a small world. Be careful what you say about previous places of employment, especially when your guard is down. No matter why you left a job or what your experience was, there are diplomatic ways to explain an unfortunate circumstance, even if the atmosphere (or boss, or pay, or company) was rotten. You can say you’re interested in new responsibilities, a variety of challenges, more authority, a different location – or simply that the current job posting appealed to you so strongly you couldn’t resist reaching out.

22 Tips Learned from 9 Years of 'The Office'

After nine seasons, more than 200 episodes, dozens of epic pranks, a watercooler-buzz-seizing romance, a worrisome change in management, and countless "that's what she said" jokes, The Office is punching its NBC timecard for the last time Thursday night.

Many fans are positively verklempt over the end of this gem of a sitcom. Others are bummed that it's gone on long enough to dull the show's once blindingly hilarious sheen. But everyone should take heart. The Office leaves behind a prodigious legacy: trailblazing comedy, an indelible performance from Steve Carell as Michael Scott, the popularization of the now-inescapable mockumentary genre, and a new generation of comedy stars in John Krasinski, Jenna Fischer, Rainn Wilson, and Mindy Kaling.

Another perk: The Office gave us a lot of advice — useful or otherwise. So as we mourn the end of this workplace comedy, let us remember some of the show's best and most hilarious workplace advice — straight from the mouths of Dunder-Mifflin's finest. Here, office tips to live by, from the sage characters of The Office:

Never trust your HR rep.
Michael: Toby is in HR which technically means he works for Corporate. So he's really not a part of our family. Also he's divorced so he's really not a part of his family.

Don't waste too much time on research.
Michael: Wikipedia is the best thing ever. Anyone in the world can write anything they want about any subject, so you know you are getting the best possible information.

Know when it's time to take a break.
Kevin: I do deserve a vacation. Sometimes Batman's gotta take off his cape.

Never trust technology.
Michael: Everyone always wants new things. Everybody likes new inventions, new technology. People will never be replaced by machines. In the end, life and business are about human connections. And computers are about trying to murder you in a lake. And to me the choice is easy.

Stand your ground against ambitious work rivals.
Gabe: Hey Andy, how about you don't steal my business strategies, and I won't dress like life is just one long brunch.

That "what are you weaknesses?" job interview question is a trick. Don't fall for it.
Michael: Guess what? I have flaws. What are they? Oh I dunno, I sing in the shower? Sometimes I spend too much time volunteering. Occasionally I'll hit somebody with my car. So sue me — no, don't sue me. That is opposite the point I'm trying to make.

Don't fraternize with the grunt workers.
Michael: There's always a distance between a boss and the employees, it's just nature's rule. It's intimidation mostly. It's the awareness that they are not me.

But make sure they still like you.
Michael: Do I want to be feared or loved? Um... easy, both. I want people to be afraid of how much they love me.

And make sure you have a social life outside of the office.
Michael: I'm friends with everybody in this office. We're all best friends. I love everybody here. But sometimes your best friends start coming into work late and start having dentist appointments that aren't dentist appointments, and that is when it's nice to let them know that you could beat them up.

Know how to work the system.
Phyllis: Yes, I put Michael in my wedding, it was the only way I could think to get six weeks off for my honeymoon. No one else has ever gotten six weeks before.

Use what you've got.
Phyllis: I wonder what people like about me. Probably my jugs.

Fight for the things that are important to you.
Creed: The only difference between me and a homeless man is this job. I will do whatever it takes to survive. Like I did, when I was a homeless man.

Know the value of company loyalty... to a point.
Dwight: Would I ever leave this company? Look, I'm all about loyalty. In fact, I feel like part of what I'm being paid for here is my loyalty. But if there were somewhere else that valued loyalty more highly… I'm going wherever they value loyalty the most.

Always take time out to teach co-workers new things.
Kelly: Look, I know the reason that you guys became accountants is because you're not good at interacting with people. But guess what? From now on, you guys are no longer losers! So give yourselves a round of applause.
Oscar: I wonder how many phone calls you're missing while you're teaching us to answer calls.
Kelly: I know, right? Probably a lot.

Crisis management is tricky.
Michael: Here's the thing. When a company screws up, best thing to do is call a press conference. Alert the media, and then you control the story. Wait for them to find out, and the story controls you. That's what happened to O.J.

Nurture your employees.
Michael: I think the main difference between me and Donald Trump is that I get no pleasure out of saying the words "you're fired." "You're fired." Oh, "you're fired." He just makes people sad. And an office can't function that way. No way. "You're fired." I think if I had a catchphrase it would be "you're hired, and you can work here as long as you want." But that's unrealistic, so...

Don't settle.
Jim: Right now this is just a job. If I advance any higher in this company, this would be my career. And, uh, if this were my career, I'd have to throw myself in front of a train.

Follow the example of American heroes.
Michael: Abraham Lincoln once said that "If you are a racist, I will attack you with the North," and those are the principles I carry with me in the workplace.

Don't take your job too seriously.
Jim: My job is to speak to clients, um, on the phone about, uh, quantities and, uh, type of copier paper. You know, uh, whether we can supply it to them, whether they can, uh, pay for it. And, um... I'm boring myself just talking about this.

Be proud of your work.
Ryan: When people see this presentation, they're gonna c** in their pants.

Know how to motivate.
Robert: There's something about an underdog that really inspires the unexceptional.

Make the most of everything.
Stanley: Life is short. Drive fast. Leave a sexy corpse. That's one of my mottos.

This article by Kevin Fallon originally appeared at TheWeek.com. Read more from TheWeek.com:

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As Home Values Rise, So Does Divorce

Couples everywhere are sighing in relief that the economy and housing market are recovering – not just because they have more money in their pocket, but because they can finally split up.

Industry experts have recently seen a spike in divorce filings, reports NBC News. Gary Silverman, a divorce lawyer in Reno, Nevada, has seen a 25 to 50 percent increase over the past year, and believes it’s due to “pent up demand.”

Alton L. Abramowitz, a New York City divorce lawyer and president of the American Academy of Matrimonial Lawyers, agrees: “There’s been an uptick in divorces in general going on over the last several months,” he told NBC News.

A few years ago, couples were sticking it out and postponing divorce while they waited for underwater mortgages to come up for air, or for their homes to sell in the sluggish market. In the same way workers felt the poor economy forced them to stay in bad jobs , spouses felt the poor housing market forced them to stay in unhappy marriages.

Richard Komaiko, co-founder of AttorneyFee.com, has been comparing housing market data, job creation trends and the number of people coming to his site for divorce advice. He told NBC News he’s seen a direct correlation between the housing curve and divorce curve. “Increased mobility – both personal and career – acts as a pressure valve for backlogged marital discontent.”

Of course, the recession itself likely fueled marital dissatisfaction. A 2011 survey from the University of Virginia found that 29 percent of couples reported the economic downturn strained their relationship. Research also shows that couples who argue frequently about money are at a higher risk of divorce.

The spike in divorce doesn’t appear to be slowing down anytime soon. Though the overall divorce rate is declining (just as marriage rates are), the divorce rate for Americans over the age of 50 has slowly been on the rise –doubling between 1990 and 2009. And with the fiscal cliff tax law that passed in January, some expect to see an increase in couples making more than $450,000 filing for divorce. Under the new law, if they divorced and filed as “single,” they could save over $27,000 a year.

Filing for divorce, however, will cost you. While many lawyers advertise bargain prices for “quick and easy” divorces for $100-$300 – that’s rarely the reality. The average divorce costs more in the range of $15,000 to $30,000, according to Sari Friedman, a matrimonial lawyer in New York City.

With the recent spike, the unhappy couples involved face long legal battles and high costs – but divorce industry professionals are likely celebrating.

Why Boomers Are Ditching Retirement to Go to Work

If you dream of retiring someday and spending every weekday golfing with your peers, an emerging trend could sabotage that vision: your friends may be at work.

Today’s older Americans are dumping retirement or at least reengineering it to include work. In a November 2012 CareerBuilder survey, 60 percent of workers age 60-plus said that they’d look for a new job after retiring from their current company, an increase from 57 percent in 2011. By 2018, 24 percent of the American workforce will be older than age 55, up from 18 percent in 2008—that will make them the largest cohort of workers in the labor pool, according to figures from the Bureau of Labor Statistics.

While some seniors are staying in jobs because they don’t have enough money saved, others continue to work by choice. Retirement Redefined, a report last spring from trend forecaster Innovaro http://innovaro.com/ notes that the majority of Baby Boomers want to keep going because they see their jobs as both financially rewarding and personally enriching. “I like the thrill of the hunt. It’s very satisfying to close a big deal,” says Ron Lanzo, an account executive at AFR Furniture Rental & Event Furnishings in New York City who turns 67 in October. He hopes to keep working until he’s at least 72.

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Others can’t hack all the free time in retirement. Art Koff talks to many older people as founder of RetiredBrains.com a job board and resource center on retirement issues. “Many choose to continue to work because they’re bored and want to fill their day with something challenging,” he says. Koff himself is 78, works 50-hour weeks, and wants to work the rest of his life.

Richard Daume, 70, sold his Missouri printing business in 2003 so that he and his wife could move to Arizona to retire. After the first few months of leisure, “I couldn’t wait to get out and do something,” he says. So the couple bought Caring Senior Service, a franchise that provides transportation, meal preparation, and other in-home services to seniors in Scottsdale and Phoenix. Daume manages the company, his wife does the marketing, and they employ 125 people. In a 2011 survey of people 55 and older by Harris Interactive, 67 percent of respondents rated “remaining productive” as the biggest benefit of a long life.

RICHER, HEALTHIER, SMARTER
In part, medical advances have made later-life work possible. Increased life expectancies mean the average man who retires at 65 can expect to live 18 years in retirement, and the average woman 20, Innovaro’s report notes. That’s up from previous generations—in 1950, when the average retirement age was about 67, men could expect to live about 11 years in retirement and women 14. “The post-age-65 life stage is getting stretched,” says Innovaro’s Chris Carbone. “People are saying, you know I actually have a good third of my life I could spend doing something.”

And it’s not just that we’re living longer—we’re healthier. Between 1983 and 2007, the share of adults ages 55 to 64 considered to be in fair or poor health declined from 25 to 19 percent and for those ages 65 to 74 from 33 to 22 percent, according to data from the Urban Institute’s Program on Retirement Policy.

It also helps that today’s older adults have finished more years of school than their parents did. Between 1989 and 2009, the share of adults age 55 to 64 with four or more years of college doubled from 16 to 32 percent, while the share not completing high school fell from 31 to 11 percent according to the Urban Institute data. All that education expands seniors’ job possibilities.

Meanwhile, structural shifts in the economy, which have devastated some cohort groups, have helped older workers. While the manufacturing sector has contracted, companies are creating more white-collar jobs. In 1971, 57 percent of American jobs were physically demanding, involving activities like heavy lifting and long periods of standing; by 2006 that was down to 46 percent.

Over the same period, the share of workers in cognitively demanding jobs—requiring skills like reasoning, writing, and decision-making increased from 26 to 35 percent. With a cell phone and a computer, Lanzo says he can continue to work for as long as he wants. But if he had a job that required regularly carrying 50 pounds, he’d be forced to quit in a few years.

Employers in and outside the knowledge industries are becoming more accommodating older workers. Pharmacy chain CVS, for example, offers a “snowbird” program that allows workers who seasonally migrate between two places to keep their jobs in both. More telework also will give people a bigger range of options, notes Innovaro’s report. Older workers will increasingly want more part-time options, or flexibility in where they can work, says Carbone.

Those could help keep experienced staff like Lanzo around even longer. Even though he loves his work, Lanzo says his ideal schedule would be a 20-hour week, working Tuesday to Thursday. With the extra time, he’d do more volunteering, go fishing with his grandchildren, and work part-time at the tasting room of a wine library.

Many older workers like Daume are building in their own flexibility by starting companies. A 2009 Kauffman Foundation study found that those ages 55 to 64 had the highest rates of entrepreneurship of any age group.

In his business, Daume said he’s delegating more than he would have when he was younger—that lets him work less than 40-hour weeks and fill in for friends on golf outings when someone drops out. He and his wife have no plans to quit working for now. “We’re taking it a couple of years at a time,” he says.

How One ‘Robin Hood’ Saved 2,000 Parking Tickets

In December James Cleaveland made an unusual New Year's resolution: to do all he could to keep police in the city of Keene, New Hampshire, from issuing parking tickets.

Cleaveland and a group of friends took to the streets with pocketfuls of change and began shadowing the city's three parking enforcement officers, stuffing coins in expired meters before they could issue $5 tickets. They call their practice "Robin Hooding," and in just over four months, the group claims to have spared motorists more than 2,000 tickets in the city of some 23,000.

"It's my philosophy," said Cleaveland, 26, a member of a group called Free Keene, which subscribes to the libertarian principle of smaller government. "I could go talk to the city council at every meeting but to me, actions speak louder than words. I can go out and try to save people and reduce the number of tickets."

The southern New Hampshire city's government does not share Cleaveland's view. This month it filed suit in state court against him and five others seeking a restraining order to keep them at least 50 feet from parking enforcement officers. The suit accuses Cleaveland and five others of videotaping, taunting and intimidating its parking meter personnel. The alleged behavior includes chasing officers on bicycles, shouting insults and accusing them of stealing people's money. One officer became so stressed that he complained of heart palpitations and began having nightmares about the group, according to court papers.

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"It's affecting the employees and it's taking a lot of time and energy to deal with it, and so the city's intent was to try to establish some clear boundaries and a little breathing room," said James Duffy, a member of the Keene City Council. "We're not saying you can't complain about the meters or plug them, it's just how that's done."

Cleaveland has vowed to continue. He said he knows each parking attendant by name. "I don't follow them home or try to find them off duty," he said. "They always use the excuse 'I'm just doing my job.' I always say ‘I'm just doing my activity too.'"

CALLING CARD
The Free Keene movement is part of the Free State Project, a group that has sought to get 20,000 libertarians to settle in New Hampshire, a state already known for its limited government and which has no sales or income tax. The Keene chapter's prior actions included publicly smoking marijuana in the city's central square to protest drug laws, and holding a protest against gun restrictions that featured a half-nude woman armed with a holstered handgun walking through downtown.

Cleaveland's compatriot Garrett Ean, 24, said he feeds meters up to five days a week in three- to four-hour shifts during the 8 a.m. to 5 p.m. period when motorists must pay to park downtown. He said he spends less than $15 a day since some of Keene's meters cost as little as 10 cents for 30 minutes of parking. Like Cleaveland, he leaves a card on the windshield of each "saved" car that says: "Your Meter Expired! However we saved you from the king's tariff! - Robin Hood & The Merry Men."

The card leaves an address for an activists' center and encourages motorists to send a donation. The group sometimes receives handwritten thank-you notes in addition to donations, which are sometimes enough not only to cover the costs of feeding meters but also to allow the group to pay the activists a small amount, said Cleaveland.

City Councilor Duffy said the city, home to Keene State College, is a progressive community whose tolerance is sometimes stretched by the group's scrutiny of even the most minor actions of local government. "In many ways this is a progressive community and also a tolerant one, but it's been going on long enough," he said. "This won't be the last issue."

This article is by Jason McLure of Reuters.

10 Best Jobs for Americans Over 65

Most people who continue working after retirement age don’t stay on in their current jobs, according to Boston College’s Sloan Center on Aging & Work. Instead, they leave for “bridge” jobs – the jobs that span the period between quitting a career job and leaving the labor force for good.

PHOTO GALLERY: Click Here for the 10 Best Jobs for Older Americans

A good bridge job has several key elements. A 2008 AARP survey of older workers found that 88 percent want a friendly work environment in their next position, and 74 percent a flexible schedule. A total of 38 percent say they’re looking for part-time work, while 34 percent would like to work from home.

Plenty of online resources exist to help seniors find jobs like these. In addition to Retired Brains, the resources include Retirement Jobs, Senior Job Bank, PrimeCB, Retiree Workforce, and Seniors4Hire.

To provide a snapshot of the best jobs out there for older adults, we turned to the work of Kerry Hannon, AARP’s jobs expert. Her 2012 book Great Jobs for Everyone 50+ groups the best positions for seniors into ten categories. The jobs she identified fit seniors’ needs because they tend to be more professional (research shows seniors tend to hold more professional jobs), generally don’t require long hours, and offer flexible schedules. Here are the top-paying jobs across all ten categories. The pay scales are based on data from the Bureau of Labor Statistics, though Hannon notes that pay can vary widely based on location, experience, and employer.

Boxer Knocks ‘Em Out As Top-Earning U.S. Athlete

Undefeated boxer Floyd Mayweather Jr. is the highest-paid professional athlete in the United States, with expected earnings of at least $90 million this year from just two bouts, according to Sports Illustrated magazine.

The 36-year-old welterweight, who is considered the best defensive boxer of his generation, topped the magazine's Fortunate 50 list, issued on Wednesday. Mayweather also took the top spot last year, earning an estimated $85 million, again from just two fights, the magazine reported.

Miami Heat basketball star LeBron James, 28, a four-time National Basketball Association Most Valuable Player, came in this year in the number two slot, earning a total of $56.5 million.

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The list is calculated by combining estimated salary, winnings and endorsements. Mayweather's total earnings are even more impressive considering he received no endorsement money either this year or last.

James' $56.5 million income combines a $17.5 million salary with an additional $39 million in endorsements.

Golfer Tiger Woods, the highest paid U.S. athlete from 2004, when the list was first published, through 2011, dropped to the No. 5 slot on this year's list, earning $40.8 million.

Chicago Cubs outfielder Alfonso Soriano came in as the 50th highest-paid U.S. athlete with an estimated $18.2 million.

Candidates for the list must be U.S. citizens and compete in a U.S.-based league.

Internationally, soccer great David Beckham is estimated to earn more than $48 million, landing him the top spot on the magazine's annual list of highest-paid athletes worldwide, The International 20.

Reporting by Chris Francescani of Reuters.

Obamacare Scams Rise Amid Confusion

With less than six months remaining before America's web-friendly health insurance exchanges are scheduled to open on Oct. 1, the con artists, naysayers and dooms-dayers are all busy searching for ways to profit from President Barack Obama's landmark health care reform.

Last week, AARP warned that fraud artists have expanded their familiar Medicare card scam to capitalize on the general public's unfamiliarity with the Affordable Care Act. Unfortunately, they have a lot to work with; a recent poll found that 42 percent of us don't know that health care reform is the law of the land.

The con works like this: a caller posing as a federal employee informs you that you've been chosen to be among the first to receive a health insurance card under the Affordable Care Act. To get yours, the caller will need some personal data however – including, of course, your bank account numbers.

The scam prompted the Federal Trade Commission to remind consumers that the exchanges don't open until Oct. 1, and "anyone who claims to be able to sign you up sooner is trying to scam you." You're encouraged to report such activity to the FTC at ftccomplaintassistant.gov.

The latest political bout over Obamacare kicked off last month when Health and Human Services Secretary Kathleen Sebelius testified before the Senate Finance Committee. Sebelius assured the panel that the new state exchanges will open on time and the critical consumer outreach portion of the rollout will begin this summer as scheduled.

Unfortunately, it was a minor exchange between the Secretary and Sen. Max Baucus (D-Mont.), the chief author of the Affordable Care Act, that produced the shiny thing upon which opportunists love to pounce.

Addressing the anxiety that some small businesses have expressed over the lack of specifics thus far on insurance options that will be available through the small business (or SHOP) exchanges, Baucus said, "I just see a huge train wreck coming down."

That sound bite was quickly recast by health reform's political opponents into "Baucus calls Obamacare a 'train wreck'," thus taking on a life of its own.

While Baucus later tried to extricate himself from the word snatch, President Obama weighed in on the kerfuffle last Friday, assuring an audience in Austin, Texas that health reform is on schedule and urging all Americans to be patient with the new program and keep the naysayers in perspective.

"I understand the politics of this stuff sometimes," he admitted, "but there are times when I just want people to step back and say, are you really prepared to say that 30 million Americans out there shouldn't have health insurance? Are you really prepared to say that's not a worthy goal? Because of politics?"

Well, America: Are you?

By Jay MacDonald, Bankrate.com

Jay MacDonald is a Bankrate contributing editor and co-author of "Future Millionaires' Guidebook," an e-book by Bankrate editors and reporters. Follow him on Twitter: @omnisaurus

Double Mastectomies Are Rising, Along with the Costs

After Angelina Jolie announced yesterday in The New York Times that she underwent a double mastectomy to remove both breasts to dramatically lower her chances of contracting breast cancer, women who have had the same operation have shared their stories.

Jolie’s mother died of the disease at age 56, and Jolie, 37, learned she had a gene mutation (called BRCA1 and BRCA2 genes, which account for 7 to 9 percent of all breast cancers) that put her at an 87 percent risk of developing a tumor, according to her doctors.

Approximately 100,000 women undergo mastectomies each year, according to Decision Researches, a Burlington, Massachusetts industry analysis group, and the popularity of the procedure has grown. Rates of double mastectomies more than doubled from 1.8 percent to 4.5 percent of women diagnosed with early-stage cancer between 1998 and 2003, according to a study in the Journal of Clinical Oncology. Dr. Kelly Hunt, a surgeon at Houston’s MD Anderson Cancer Center, tells CNN that she’s seen the rates of having both breasts removed increase dramatically in the past few years at the center.

But not everyone who chooses the procedure is as high risk for cancer as Angelina Jolie.

In a report last year by UK’s Independent Breast Screening Review, researchers estimated that there were around three cases of overtreatment for every death prevented from mammogram screening. Another study in Norway found that in screening 2,500 women 50 to 69 years of age, one death was prevented and 6 to 10 women were over-diagnosed.

The surgery is extremely invasive – and expensive. “The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film,” Jolie wrote in The New York Times. Costs for the full procedure – including breast reconstruction – can range from $15,000 to $50,000, depending on the location and the type of surgery. Insurance providers are not required to cover preventative mastectomies, though many do. The test alone for BRCA gene mutations can cost over $3,000. The test will be covered as preventative care under the Affordable Care Act if the patient can prove they have a family history of breast cancer.

With BRCA gene mutations, a woman’s chances of developing a life-threatening cancer are much higher and the cancer tends to progress more rapidly. While Jolie chose to have a double mastectomy to decrease her chances of ever developing the disease, a growing number of the surgeries are performed after a tumor or cancerous tissue is found in one breast. Women are opting to have both breasts removed instead of the breast-saving lumpectomy surgery. There are a few reasons for the rise.

Advances in breast reconstruction have motivated more women to choose mastectomy, and increased mammogram screening and higher quality imaging have led to more diagnoses of early-stage, or in situ, cancers – currently about 60,000 every year, compared with some 7,000-8,000 in the 1980s. While catching a cancer at an earlier stage can save lives, some of the cancers detected are not ones that would have ever caused a problem for women in their lifetime.

That’s because it’s difficult for doctors to distinguish between faster and slower-growing cancers, which can lead to high rates of over-diagnosis and over-treatment. Many in situ cancers are benign, treatable, and will never develop into life-threatening cancer. A 2011 study from New York’s Memorial Sloan-Kettering Cancer Center found that most women having mastectomies for in situ cancers were not at high risk for relapse.

Many women choose mastectomies after an in situ or BRCA gene mutation diagnosis to lower their chances of developing life-threatening cancer and give them peace of mind. A recent study from the University of Pittsburgh Medical Center found that almost all the 206 women in the study who underwent a mastectomy of a healthy breast were happy with the decision, and listed fear of cancer as well as the reconstructive surgery options as factors. “Women have this exaggerated perceived risk of getting breast cancer,” Todd Tuttle, chief of surgical oncology at the University of Minnesota told NPR. “They see breast cancer everywhere.”

The costs of treating invasive breast cancer, of course, are much higher, and can top $100,000 a year. Some 230,000 women are diagnosed with invasive breast cancer every year, and about 40,000 women die from it. As for Jolie, she says her chances of developing breast cancer have now dropped to under 5 percent. “I can tell my children that they don’t need to fear they will lose me to breast cancer.”

Crowdfunding: Why Strangers Will Pay Your Tuition

The crowdfunding economy has officially exploded – “crowds” of friends, family and strangers are funding everything from their latest film project to fertility treatments and vacations. In 2012 alone, over $274 million was raised on the popular crowdfunding site Kickstarter. Now, college students could be the latest to jump on the bandwagon.

It sounds like the perfect solution: The average high-school graduate faces thousands of dollars in debt to attend college, but if their already-working network could pool together funds and invest in their future, the student could see their debt load fall even as tuition continues to rise.

Campus Slice is the most recent startup looking to help college students raise tuition money through crowdfunding. Students set monthly funding goals and have consistent funds and payments sent directly to the schools to be used for tuition, books or fees (and not for that 12-pack of Budweiser). The founder and CEO, Tony Aguilar, says that having graduated college with over $100,000 in student loan debt, he understands the hardships recent grads face.

A number of other similar sites have launched recently, including Smartn.me, Pave and Upstart. Pave and Upstart are investment-based models, meaning that backers stand to make money from their contribution, whereas Camps Slice and Smartn.me are donation based, and backers don’t see a return on what they give.

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There are also sites like GiveCollege and GradSave, which have many parents registering their newborn or toddler to start asking family and friends to contribute to the child’s future education. And GoFundMe, a crowdfunding site that funds “personal causes” is also popular among college students looking for tuition relief.

With the passing of Jumpstart Our Business Startups, last year’s JOBS Act that loosened regulations on crowd-investing, many expect to see even more education crowdfunding launches. “There are certainly a lot of sites that trying to make a go of it,” says Mark Kantrowitz, publisher of Edvisors, but “I think they’re still searching for the right formula.”

“Pave” works by connecting investors with promising students, or “prospects,” with the expectation that one day they might be able to pay the investors back with income-based payments that are no more than 10 percent of their income for 10 years. After the 10-year time period, regardless of how much they originally raised, the agreement is over, and the prospect owes nothing more.

Backers must be accredited investors and have a net worth that exceeds $1 million. They must give at least $500 to potentially earn a financial of 5 to 8 percent annually if the student makes a decent salary. There are no interest payments or late fees for the students. Instead, Pave will maintain close contact with the prospect to create a payment plan – but there’s little recourse if donees skip out on payments. According to co-founder Oren Bass, that’s okay.

“A big motivation for backers has been the opportunity to do well by doing good,” Bass tells USA Today. “This means being part of, and having an impact on someone's entrepreneurial, creative or professional careers. Your backer is fully aligned in your success or failure.” Twenty-two backers and 8 prospects signed up for the launch last December.

A similar example is Mike Merrill, a customer service rep at a software company in Portland, Oregon, who in 2008, offered friends, family and strangers 100,000 shares in himself for $1 a share, and let the new stockholders vote on which business ideas he should pursue and how he should spend his time. Pretty soon, they were voting on personal details of his life – like if he should he move in with his girlfriend, have children, or anything else that might affect his business goals. He continues to consult with shareholders about everything from his exercise regime to his sleep schedule. Shares have gone up to as high as $20.

The donation-based sites – Campus Slice and Smartn.me – aren’t exactly seeing money roll in. On Campus Slice, out of 32 currently-live campaigns, 16 have $0 in funding, and most others have raised only $10-$30 – not exactly enough to put a dent in their tuition bills. Smarten.me only has one campaign on the site so far, featuring a student that raised $10 of her $2,200 goal.

“In practice I haven’t seen them be very effective – most people don’t get funded,” says Kantrowitz. “It’s not a very practical to raise money from strangers to help pay for your education.”

Kantrowitz sees the most promise in sites that encourage family and friends to save for a child’s college early on. Down the road, 529 college savings plans could set up their own version of crowd-saving. “There’s a lot of potential here that’s not yet realized.”

Blaire Briody is a writer and editor at The Fiscal Times and is experimenting with crowdfunding for the first time to write a nonfiction book about the oil boom in North Dakota .

How the Housing Comeback Can Help Workers

When David Pendery, a corporate public relations specialist, decided to move his family from Colorado to Illinois this year for work, his biggest worry was whether he would be able to sell his home quickly. It took just three days.

"We certainly thought selling our house would take longer," said Pendery, who started in February at Kerry Ingredients, a flavoring provider for the food and beverage industries.

Pendery's experience may be on the extreme side, but his case may be a sign of a revival in one of the historical advantages of the U.S. job market: the ability of workers to go where the jobs are.

For much of the past five years, falling house prices effectively locked people in their homes, since many were "underwater," meaning they were owing more on their mortgages than they could raise by selling. At the same time, double-digit unemployment across much of the nation meant there were few jobs to move for anyway. That may be changing. While far from their 2006 peak, home prices in major metropolitan areas have been rising since early 2012. If that persists, it should make it easier for Americans to move and for employers to match job seekers with available jobs, lowering the jobless rate and increasing overall economic productivity and growth.

"Until the real-estate market picked up, people wouldn't even consider a move without the certainty that they could sell their homes," said Jerry Funaro, vice president of global marketing for TRC Global Solutions, a domestic and international relocation service based in Milwaukee.

"Companies are now more inclined to make offers since we're seeing real estate markets across the country coming back," he said. "Last year, the pace of business started to improve and that momentum has continued in 2013."
Housing added to growth last year for the first time since 2005, and single-family home prices recently notched their biggest annual rise since mid-2006.

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Increased hiring, meanwhile, pushed the jobless rate down to 7.5 percent in April, its lowest in more than four years. In 2013, employers have added an average of 196,000 jobs per month, although economists say that is still too few to absorb the nearly 22 million Americans who have lost a job, been forced to accept a part-time position or left the workforce altogether.

SERIOUS DETRIMENT
"The lack of housing mobility has been a serious detriment these last few years and, frankly, is something we haven't seen much of since the Great Depression," said Russell Price, senior economist at Ameriprise Financial Services in Troy, Michigan. The unemployment rate reached 10 percent in late 2009, the highest in nearly three decades.

While mobility is not as robust as it was before the crisis, Price said the economic cycle is "about at the point where these types of structural employment problems start to fall away."

The U.S. Census Bureau found that the number of people who moved last year rose to 35.6 million, pushing the overall mover rate to 12 percent from 2011's record low of 11.6 percent, the first rise in four years. Long-distance moves ticked up as well. "It's not a huge gain, but when you consider that for two years, we've had the lowest migration rates since World War II, any move up is good news," said William Frey, a demographer at the Brookings Institution in Washington.

Pendery said his job offer was a "phenomenal opportunity that I just couldn't pass up," but said he feared a prolonged selling process in Colorado would make a stressful cross-country move even more harried by delaying the purchase of a new home. "No firm is going to offer unlimited temporary housing, and you don't want too much out-of-pocket expense," he said. It took about a month to close on a new home in Rockford, Illinois. According to the National Association of Realtors, it took on average 62 days to sell a home in March, compared to 91 days in March 2012.

REGIONAL VARIATIONS
Of course, housing is far from fully healed. More than 20 percent of mortgages are still underwater and foreclosure rates remain elevated. On average, home prices nationally are back at levels seen in the fall of 2003 but well off their 2006 peak.

Not all regions are booming, either. Hiring has been strong in energy-intensive industries in places such as Texas and North Dakota, said Craig Selders, president of Paragon Relocation, a global relocation firm. "I myself moved from Houston to Dallas last year and was not worried at all about selling my home," he said, noting Houston's oil and gas sector is one of the country's hottest job markets.

Florida and Las Vegas, areas hit especially hard when the housing bubble burst, still face challenges, several firms said. And while U.S. growth picked up in the first three months of 2013, some worry that higher payroll taxes and government spending cuts could slow momentum in the second quarter.

That is keeping some firms "hesitant and cautious" about moving workers, said Richard Smith, chairman and CEO of Realogy, owner of the Danbury, Connecticut-based global relocation firm Cartus, which saw a 4 percent decline in relocations in the first quarter. Companies "are still relocating employees but perhaps not as robustly as they would otherwise," Smith said on a recent conference call with investors. Cartus did see a 10 percent jump in broker referrals, suggesting things may be improving.

SKILLS MATTER
Tight bank lending standards, cost-of-living variations and a rise in two-earner families also present difficulties for job seekers, said Ellie Sullivan, vice president of consulting at Weichert Relocation Resources in Morris Plains, New Jersey.

Chirag Shah, 29, a radiation oncologist, moved to St. Louis last June when his residency at a Detroit hospital ended but pulled up roots again this year when he and his wife decided prices in the upscale St. Louis suburbs of LaDue and Clayton were too high. "A single-family detached home in a good school system was bordering on $700,000 to $800,000," said Shah, who took a new job in Akron, Ohio, and moved in with family in Cleveland while he hunts for a house. He's still paying rent in St. Louis and Detroit, where his wife is finishing her own medical training.

One of Sullivan's corporate clients has tried to address all of this by luring potential employees with cash for down payments on new homes. "But these are critical new hires, really high potential talent. That's not a trend for your average Joe."

Indeed, Joshua Shapiro, chief U.S. economist at MFR, a New York global consulting firm, noted that a lot of recent hiring has been concentrated in low-wage industries such as retail, health care and hospitality as well as temporary employment. "These are not exactly positions that get people to say, 'Oh wow, I have this fantastic $7-an-hour job with no benefits, I think I'll sell my house and move across the country,'" he said.

But Sullivan said things are moving in the right direction. "We are starting to see a pickup in activity, especially among new hires," she said. I don't know if it's contributing to hiring across the board, but I do think it improves mobility, because employees are not tethered to their houses."

Retail Sales Rise in April as Consumers Stay Resilient

U.S. retail sales unexpectedly rose in April as households bought automobiles, building materials and a range of other goods, pointing to underlying strength in the economy.

The Commerce Department said on Monday retail sales edged up 0.1 percent after a revised 0.5 percent decline in March.

Economists polled by Reuters had expected retail sales, which account for about 30 percent of consumer spending, to drop 0.3 percent last month after a previously reported 0.4 percent decline in March.

So-called core sales, which strip out automobiles, gasoline and building materials and correspond most closely with the consumer spending component of gross domestic product, increased 0.5 percent after nudging up 0.1 percent in March.

The increase in core sales, coming on the heels of relatively strong job growth over the last three months, should help to ally fears of an abrupt slowdown in the economy early in the second quarter even as government austerity is starting to put a strain on manufacturing. "Consumer spending looks to have started the second quarter off on a solid note," said Jennifer Lee, a senior economist at BMO Capital Markets in Toronto.

U.S. stock index futures trimmed losses, while the dollar rose against the yen and the euro. Prices for U.S. Treasury debt fell.

Households are spending despite incomes being pinched by the end of a 2 percent payroll tax cut on January 1. In addition, across-the-board government spending cuts kicked in on March 1.

The economy grew at a modest 2.5 percent annual rate in the first quarter. The second-quarter growth pace is seen below 2 percent.

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The tone of the retail sales report was mostly firm. Receipts at auto dealerships rose 1.0 percent after falling 0.6 percent in March. Excluding autos, sales dipped 0.1 percent after falling 0.4 percent in March. Though falling gasoline prices pushed down receipts at gasoline stations, sales excluding gasoline recorded their largest increase since December. Stripping out gasoline and autos, sales rose 0.6 percent.

Sales at building materials and garden equipment suppliers increased 1.5 percent, the largest rise since September. That reflects gains in homebuilding as the housing market recovery gains momentum.

Receipts at clothing stores rose 1.2 percent, the biggest increase since February last year.

Sales at sporting goods, hobby, book and music stores gained 0.5 percent. Receipts at electronics and appliances stores increased 0.8 percent, while sales at furniture stores were flat. Sales at restaurants and bars also increased.

However, receipts at grocery stores fell.

3D Printing: Can You ‘Ear’ Me Now?

Using 3D printing tools, scientists have created a functional ear that can “hear” radio frequencies far beyond the range of normal human capability.

The researchers’ primary purpose was to explore an efficient and versatile method of merging electronics with tissue. The scientists used 3D printing of cells and nanoparticles—with an off-the-shelf printer purchased off the Internet—followed by cell culture to combine a small coil antenna with cartilage, creating what they term a bionic ear.

“In general, there are mechanical and thermal challenges with interfacing electronic materials with biological materials,” says Michael McAlpine, an assistant professor of mechanical and aerospace engineering at Princeton University and the project’s lead researcher.

“Previously, researchers have suggested some strategies to tailor the electronics so that this merger is less awkward. That typically happens between a 2D sheet of electronics and a surface of the tissue. However, our work suggests a new approach—to build and grow the biology up with the electronics synergistically and in a 3D interwoven format.”

McAlpine’s team has made several advances in recent years involving the use of small-scale medical sensors and antennas. Last year, a research effort led by McAlpine and colleagues resulted in the development of a “tattoo” made up of a biological sensor and antenna that can be affixed to the surface of a tooth.

This project, however, is the team’s first effort to create a fully functional organ: one that not only replicates a human ability, but also extends it using embedded electronics.

CYBERNETICS
“The design and implementation of bionic organs and devices that enhance human capabilities, known as cybernetics, has been an area of increasing scientific interest,” the researchers wrote in an article published online in the scholarly journal Nano Letters. “This field has the potential to generate customized replacement parts for the human body, or even create organs containing capabilities beyond what human biology ordinarily provides.”

Standard tissue engineering involves seeding types of cells, such as those that form ear cartilage, onto a scaffold of a polymer material called a hydrogel. However, the researchers say that this technique has problems replicating complicated three-dimensional biological structures. Ear reconstruction “remains one of the most difficult problems in the field of plastic and reconstructive surgery,” they wrote.

To solve the problem, the team turned to a manufacturing approach called 3D printing. These printers use computer-assisted design (CAD) to conceive of objects as arrays of thin slices. The printer then deposits layers of a variety of materials—ranging from plastic to cells—to build up a finished product.

Proponents say the process, also called additive manufacturing, promises to revolutionize home industries by allowing small teams or individuals to create work that could previously only be done by factories.

3D PRINTED ORGANS
Creating organs using 3D printers is a recent advance; several groups have reported using the technology for this purpose in the past few months. But this is the first time that researchers have demonstrated that 3D printing is an effective strategy for interweaving tissue with electronics.

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The technique allowed the researchers to combine the antenna electronics with tissue within the highly complex topology of a human ear. The researchers used an ordinary 3D printer to combine a matrix of hydrogel and calf cells with silver nanoparticles that form an antenna. The calf cells later developed into cartilage.

Manu Mannoor, a graduate student in McAlpine’s lab and the paper’s lead author, says that additive manufacturing opens new ways to think about the integration of electronics with biological tissue and makes possible the creation of true bionic organs in form and function.

Mannoor says that it may be possible to integrate sensors into a variety of biological tissues; for example, a doctor could replace a patient’s torn knee meniscus with a bionic one to monitor strain on the new cartilage during physical activities to prevent another tear.

David Gracias, an associate professor of chemical and biomolecular engineering at Johns Hopkins University and co-author on the publication, says that bridging the divide between biology and electronics represents a formidable challenge that needs to be overcome to enable the creation of smart prostheses and implants.

“Biological structures are soft and squishy, composed mostly of water and organic molecules, while conventional electronic devices are hard and dry, composed mainly of metals, semiconductors, and inorganic dielectrics,” he says. “The differences in physical and chemical properties between these two material classes could not be any more pronounced.”

THE ‘EAR’
The finished ear consists of a coiled antenna inside a cartilage structure. Two wires lead from the base of the ear and wind around a helical “cochlea”—the part of the ear that senses sound—which can connect to electrodes. Although McAlpine cautions that further work and extensive testing would need to be done before the technology could be used on a patient, he says the ear in principle could be used to restore or enhance human hearing.

He says electrical signals produced by the ear could be connected to a patient’s nerve endings, similar to a hearing aid. The current system receives radio waves, but he says the research team plans to incorporate other materials, such as pressure-sensitive electronic sensors, to enable the ear to register acoustic sounds.

The Defense Advanced Research Projects Agency, the Air Force Office of Scientific Research, National Institutes of Health, and the Grand Challenges Program at Princeton University funded the project.

This article originally appeared in Futurity.org. Source: Princeton University.

Why Wealthier Students Get More College Aid

Low-income students are increasingly bypassed when colleges offer applicants financial aid, as schools compete for wealthier students who can afford rising tuition and fees, according to a public policy institute's analysis of U.S. Department of Education data.

The study by The New America Foundation said that colleges, in their quest to advance their U.S. News & World Report rankings, are directing more financial aid to high-achieving applicants in a bid to elevate the profile of their student population. "A lot of (colleges) go for the same students from the rich suburban schools," said Stephen Burd, the foundation's education policy analyst who studied the data.

The U.S. News rankings of colleges and universities have become a popular gauge of the quality of an undergraduate and graduate institution's education and the prestige of its degrees.

As part of their strategy to compete for the best students, colleges use merit-based aid, which does not take into account financial need. Under this strategy, institutions may, for instance, give four $5,000 awards to lure four wealthy students rather than award $20,000 to one needy student, the organization said.

While the federal government issues guidelines on distribution of its grants, it doesn't regulate aid from an institution's coffers. Colleges have fiercely fought efforts by lawmakers to force greater transparency in financial aid practices.

Colleges, many under tighter budgets as they offer more amenities and hire the best professors, are under pressure to raise revenues and are using tuition prices to do so. The cost of attending a four-year public institution has gone up by 5.2 percent each year in the last decade, more than the inflation rate, according to the Consumer Financial Protection Bureau, forcing more students to take out loans to pay for tuition and fees and giving them a heavy debt burden when they graduate.

The annual cost for tuition, room, board and fees at many private colleges is between $30,000 and $45,000 a year.

NET COST OF COLLEGE
The New America Foundation analyzed net price data - the amount students paid after all grant aid was exhausted - to conclude that hundreds of colleges expect the neediest students to pay an amount equal to or even greater than their families' yearly earnings.

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For instance, of the 479 private, nonprofit colleges examined, 89 percent charged students with family incomes of $30,000 or less more than $10,000 in net prices and 22 percent expected students to pay about $20,000 or more each year.

Needy students then rely more heavily on student loans, either drop out or take on full-time jobs, which diminishes their chances of completing school, the study said. "I fear that we're going to have more social stratification and there are going to be fewer opportunities for upward mobility," Burd said.

While the practice is more predominant in private colleges, Burd said, it is increasing in public colleges, many of which are receiving less money from cash-strapped state governments.

But some schools, such as private Amherst College and Massachusetts Institute of Technology, have enrolled more lower-income students without jeopardizing their prestigious status. There is nothing illegal about this approach to doling out aid, Burd said, but it undermines the strides made in creating opportunities for the nation's needy.

Burd proposed a carrot-stick solution in which institutions that admit more low-income students receive more federal aid and those that enroll fewer low-income students but charge them higher net prices would be required to match a share of the Pell Grant aid they receive. Pell is a federal program granting aid to bright low-income college students.

"We've wanted as a country for the last 50 years or so to try to help lower-income students move themselves up the ladder of opportunity, and higher education has always been that kind of ladder. And so the idea that we may be closing these gates is very alarming," he said.

This article is by Elvina Nawaguna of Reuters.

Americans Want Washington to Focus on Jobs: Gallup

President Barack Obama flew to Texas on Thursday to put his focus back on job creation and economic growth after concentrating on gun control legislation and immigration reform in recent months. Obama is due to hold events around the country to draw attention to his efforts to boost economic growth through jobs that benefit the middle class, a White House official said.

The trip comes as a poll shows Americans say what they want most from politicians in Washington is job creation and action that will help the economy grow.

In a visit to the Austin, Texas, area, Obama was due to visit Applied Materials, which makes semiconductors and other technology, and a high school focused on math and science. He also will meet residents and entrepreneurs. The jobs tour follows some policy frustrations for Obama. He failed to persuade Congress to accept expanded background checks for gun buyers, a disappointing setback to his efforts to toughen gun rules after the December murders of 20 children and six adults at an elementary school in Newtown, Connecticut.

He also is at an impasse with congressional Republicans over a deficit reduction deal that he insists should include higher tax revenues, which Republicans oppose. The president does appear to be making headway in his efforts to change immigration laws to open a path to citizenship for a portion of the 11 million people who are in the United States without proper documentation. However, final legislation is months off.

In the meantime, a Gallup poll released Tuesday found 86 percent of those surveyed this month ranked creating jobs as their top priority for action by Congress and Obama, tied at 86 percent with helping the economy grow.

Lower on the priority list were reducing the federal deficit at 69 percent, reforming the tax code at 59 percent, reducing gun violence at 55 percent and reforming immigration at 50 percent.

The U.S. economy is recovering slowly after the deep recession of 2007-2009. Despite some encouraging signs of economic resurgence, such as stock market record highs, the jobless rate, while falling, remains at an elevated 7.5 percent.

A top Republican attacked Obama on Thursday for failing to generate stronger economic growth with his policies.

"That's the Obama economy," Senate Minority Leader Mitch McConnell said. "Well, I hope the president is traveling to Austin today because he's finally serious about turning that around - about changing course and implementing policies that might actually work to get the economy moving again."

McConnell singled out Obama's signature healthcare legislation as an obstacle he said was preventing businesses from hiring workers. He said congressional Republicans would not name members of a panel intended to achieve cost savings in the Medicare healthcare program.

"We know that will lead to access problems, waiting lists, and denied care for seniors - what most people would call rationing," McConnell said.

The president will announce a competition for locations to site three manufacturing institutes where businesses, government and educational institutions will get funding to develop new technologies, the White House official said. He will also issue an executive order requiring that newly released government data be made freely available in easily readable formats.

Obama's jobs tour also is likely to be a chance for him to argue that across-the-board spending cuts referred to as sequestration that went into effect March 1 are slowing economic growth and should be replaced. The spending reductions went into force after congressional Republicans balked at the president's insistence that any alternative spending cuts be offset by some tax increases. Some Republicans have welcomed the cuts as necessary austerity measures to check government overspending.

Millennials' Top Career Goal: To Be Inspired

In case you still thought millennials are opposed to working, it turns out the young generation tarnished as slackers has serious career aspirations.

They want to innovate at Starbucks, Abercrombie & Fitch and Apple, according to a new survey. They want to catch bad guys through FBI and CIA careers. And, hey, if that's not in the cards, drawing for DreamWorks Animation SKG would be cool too. Oh, those colorful hipsters with wide-ranging aspirations.

In a sixth annual review of high school and college students' attitudes about the workplace and employers, millennials' career goals, it turns out, reflect the economy and digital age they live in. They're intrigued by the so-called STEM fields that includes science, technology, engineering, and mathematics, according to a survey by the National Society of High School Scholars. Millennials—those between the ages of 18 and 34—also wouldn't mind job security by working for the U.S. State Department.

"These millennials are graduating from college and are expecting to be engaged, involved and inspired by their work," said Jim Lewis, president and CEO of the National Society of High School Scholars. The group recognizes academic excellence among high school and college students.

"Banking, finance, the stock market, investing—we're seeing a major shift away from that kind of career choice," he said.

I Want to Help People
A survey highlight is ranking companies that young people prefer to work at. Survey respondents were asked to rank their preferred employers from a list, which was compiled using pre-existing lists including the 2012 and 2013 Fortune 100 Best Companies To Work For. Respondents also were able to choose from popular write-in choices from prior surveys

Among the top 25 preferred employers cited by millennials, eight were health-care companies, including their local hospital and the Mayo Clinic.

Number One Employer
The number one preferred employer among the age group? St. Jude Children's Research Hospital, which replaced Google as the 2012 overall top choice. The Memphis-based facility was founded in 1962 by television legend Danny Thomas.

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Susan Thurman directs scholarships for the National Society. She reads lots of scholarship essays and a surprising number of them detail young people witnessing the devastating impact of debilitating diseases. In this context, St. Jude topping the employer list makes sense, she said.

"So here's a hospital known for outstanding research. They work with children to help find answers to some of the problems that are facing young people," Thurman said. "It's a challenge that's important to young people." As Lewis explained, millennials want to work and live by their young, evolving values.

And what about Starbucks and Abercrombie making the top 25? Brand awareness and a visible public image are key factors for job-seeking millennials, Lewis said.

Government Man
Beyond corporate visibility, the young generation isn't immune to a U.S. economy that's still recovering from a recession and steep job losses. The survey showed millennials—unlike their parents—have a strong interest in government agencies and a steady pay check, Thurman said.

"That speaks to current economic times. These younger students saw their parents laid off and the unemployment lines," she said.

Top Preferred Employers
In addition to health care, technology companies ranked high in the survey. Facebook, however, dropped to #38 in the rankings from #17 in 2012, perhaps a reflection of all the negative press around its botched IPO.

Perhaps signaling a generational shift, Bank of America and JPMorgan Chase ranked #36 and #37 respectively on the list among millennials.

The top 10 preferred employers for 2013 are:
1. St. Jude Children's Research Hospital
2. Walt Disney
3. A local hospital
4. Google
5. Apple
6. FBI
7. CIA
8. Health Care Service Corp.
9. Children's Healthcare of Atlanta
10. Microsoft

This piece by Heesun Wee originally appeared at CNBC.com.

Read more at CNBC:
Millennials Donate to Charities, Really
Ten Best States for Starting a Business
Social Media a Bust for Small Businesses

No Technology Allowed at ‘Digital Detox’ Camp

If the thought of going two minutes without checking your phone or Facebook makes you hyperventilate – then Digital Detox’s “Camp Grounded” might be for you.

The new summer camp in Anderson Valley, Calif., aims to bring over 200 adults together to spend four full days without their cellphones, computers, iPads, or any other technology. They’re even discouraged to talk about work or social media.

“So many people now don’t understand their relationship with technology,” Ben Hanna, a partner at The Digital Detox, a company that hosts numerous tech-free events throughout the year, told Mashable. “But they do know something’s wrong with how often they feel the need to check their phone.”

The camp says it’s where “grown-ups go to unplug, getaway and be kids again,” and includes activities like baking, campfires, capture the flag, pillow fights, mediation, and truth or dare games. Campers sleep in bunk beds in open-air cabins and eat together in the dining hall. The cost is $340 per person.

Though it’s a drug- and alcohol-free camp and men and women are separated into different cabins, directors say that sneaking out at night is encouraged. But if you want to capture all of your fun camp memories on camera, you’ll have to use film, polaroids, or a disposable camera – because even digital cameras are prohibited.

The first camp, from June 14 to 17, is already sold out, according to Hanna, and the list of attendees includes tech industry CEOs and venture capitalists. If networking is your goal, however, look elsewhere – campers are given nicknames and told not to share their ages.

“The most important status we’ll update is our happiness,” write the founders on the website.

10 Smart Ways to Cut College Costs

Dreading the thought of paying for college? Join the club.

According to figures from the College Board, the average total amount that students spent to attend an in-state public college (without receiving financial aid) last year topped out at $22,261. Going out of state? You’re looking at $35,312. Considering a private, four-year school? Don’t even ask.

But your wallet doesn’t have to take it on the chin. There are ways to manage college costs that don’t involve applying for a second mortgage. We spoke to some experts for creative suggestions on how to lower the giant price tag.

1. Pile on the A.P. Classes
Taking Advanced Placement classes in high school—and excelling on the official exams at the end of the course—can earn students actual credit hours at the school of their choice. Translation: The more A.P. classes that a high schooler can ace now, the fewer college courses you’ll have to pay for later. “Sometimes it won’t count toward your major, but maybe it’ll count for general requirements,” says Mark Kantrowitz, a financial aid expert and the publisher of FinAid. “You could possibly cut a semester out of your academic career.”

2. Be Creative About Scholarships
This goes without saying, but leave no stone unturned. Free money is no small thing, and your child may be able to score extra cash because she knows how to knit. (True story: It’s called the Beans for Brains Scholarship.) “It could have to do with your heritage, your personal interests or what it is you’re going to study,” says LearnVest Planning Services certified financial planner Lorrie Minor. Research what’s out there at Fastweb.com—and don’t forget to look for scholarships even after freshman year.

3. Apply for Financial Aid
Even if you think that a school won’t offer you financial aid, it doesn’t hurt to ask. You may be surprised—and you definitely won’t get anything if you don’t apply. This means filing a FAFSA (Free Application for Federal Student Aid) ideally in January of the year that your child will enter school. Communities even have FAFSA meetings for parents to help them interpret the paperwork. “Some of my clients have [attended FAFSA meetings] just to understand what type of financing and student aid is possible,” Minor says. “That’s a good thing to do a year or two in advance because sometimes you have to move assets around.”

4. Compare Net Price, Not Net Cost
Net price is “what college will cost after you subtract just the gift aid,” Kantrowitz says, “whereas net cost subtracts the entire financial aid package.” Even if a school is offering you loans, you’ll have to pay those back. (For years, in most cases.) So that’s still a cost to you, despite the fact that it’s not immediate. You can find out what individual schools dole out, on average, at such sites as U.S. News and World Report and the College Board. Look at things like the average aid package and the ratios of grants to loans or work study.

5. Consider Graduation Rates
You may think that you’re choosing the more economical school … but that’s only the case if you can snag a diploma in four years. Some 45 percent of students who go to school full-time need another year (or more) to finish. So make sure that you’re comparing apples to apples among schools by finding out what percentage of the student body graduates in four years through a site like College Results.

From the start, have your child also map out how many courses he or she plans to take each semester to graduate on time. Then consider stacking the deck with summer classes, which can be cheaper than regular semester hours, or summer classes at a community college that will transfer.

6. Look for a Closer School
When you’re considering college, the miles away matter. There are four breaks in the typical school year—Thanksgiving, winter, spring, and summer—and traveling home for each of these can add up. “It’s less expensive to drive across the state than to fly across the country,” Minor says. “I’ve known people who decided not to go across the country to school because they couldn’t afford to visit family.”

7. Seek Out No-Loan Options
Some schools have adopted “no loan” financial aid policies, meaning that students receive grants instead of loans to help them attend. Unfortunately, these tend to be the big leagues: Yale, the University of Pennsylvania, Harvard, Princeton, Columbia and Vanderbilt, for instance. If your child has the chops to get accepted to one of them, you’re set. “Princeton University started the trend,” Kantrowitz says. “And the average debt at graduation for a bachelor’s degree [from Princeton] is about $7,000.”

8. Have Your Student Work—But Not Too Much
The more money your child can earn during the school year, the less you (or your kid) will have to borrow to cover school costs. However, excessive work can torpedo academic efforts. “People who work one to 12 hours a week have a higher bachelor degree attainment rate than people who do not work,” Kantrowitz says. “But if you work more than 12 hours a week, the graduation rate lowers.” In our opinion, however, summertime is fair game!

9. Be Reasonable
“Half of your costs are going to be living expenses and miscellaneous things that come up,” Kantrowitz says. So be flexible, and remember that there are plenty of variables that will affect the final price you pay. For instance, your kid could live in student housing versus an off-campus apartment (if that’s less expensive)—or even live at home, if you’re close enough. You could also buy textbooks secondhand.

One cost-cutting tactic that’s risky: Hitting community college first, with the plan of transferring to a four-year school later. Among students who started their education at a two-year school, only about two-fifths obtained a bachelor’s degree within six years. “I don’t recommend it,” Kantrowitz says. “It’s a detour on your way to a bachelor’s degree that may ultimately cause you not to get one.”

10. Save, Save, Save
How old are your children? When are they going to school? If it’s not tomorrow, then you still have time to put money away for their education. “It’s cheaper to save,” Kantrowitz says. “Every dollar that you put away is a dollar less that you’ll have to borrow.” It generally takes about $2 to pay back every $1 in student loans, so that’s a big deal.

Plus, if you can sock money into a 529 plan, you may get a tax deduction in some states. Visit SavingForCollege.com for details in your area.

By Kate Ashford, LearnVest

More from LearnVest:
How to Do Your Taxes If You’re Paying for Tuition

Why Paying for My Daughter’s College Is My Ultimate Life Goal

15 Things to Know About Financial Aid

Home Prices Show Biggest Rise in 7 Years

U.S. home prices rose in March, marking the biggest annual increase in seven years, in the latest sign of strength for the recovering housing market, a report from CoreLogic showed on Tuesday.

CoreLogic's home price index jumped 1.9 percent from the previous month and accelerated by 10.5 percent compared to March last year.

That was the biggest year-over-year increase since March 2006, CoreLogic said.

Prices were even stronger excluding distressed sales, rising 2.4 percent from February and 10.7 percent from the year before. Distressed sales include homes that are in danger of foreclosure and properties that have already been seized by lenders.

Home prices have been rising since last year, helped by investor demand and tighter inventory. The top five states with the biggest gains in prices were Nevada, California, Arizona, Idaho and Oregon.

Prices likely continued to rise in April, CoreLogic said, though at a slower pace. Prices are seen rising 1.3 percent for the month and 9.6 percent on an annual basis.

Can Zynga Regain Its Zip with FarmVille 2?

In the past twelve months, Zynga Inc has struggled with a contracting player base, a deflated stock price and waves of layoffs. Now it is coming to terms with downsized ambitions.

As Chief Executive Mark Pincus, 47, leads the online games developer he founded in 2007 through perhaps the most crucial year of his tenure, he is pushing to restore revenues by doubling down on "FarmVille," the franchise that took Facebook users by storm four years ago and launched Zynga to stardom.

Though some industry observers had declared farm simulation games a fad and predicted FarmVille 2's early demise, the sequel to Zynga's best-known title has defied expectations at its San Francisco headquarters, Pincus said in an interview. FarmVille 2 has clung to its perch near the top of Facebook charts and the number of people who play the game each day still hovers near all-time highs of 8 million, even six months after launch.

RELATED: Can Zynga Gets Its Game Back?

Given a glaring weakness in mobile games, however, one of Zynga's current priorities is porting FarmVille 2 to mobile devices so players can move from PCs to smartphones and back without losing their data. That presented technical challenges that the company is ironing out, Pincus said. "The ideal is to make that one seamless experience between Web and mobile so you can take your farming experience from work to home," he said. "We're having to retool and reinvent around our process and technology."

Pincus badly needs a reliable hit franchise. In the past nine months, Zynga has shuttered 20 titles and closed offices in Baltimore, Boston and Tokyo. It has trimmed 5 percent of its workforce, though its headcount of nearly 3,000 still dwarfs that of fierce rivals like Supercell, a Finnish company with 100 people that claims an equivalent amount of revenue, or the 600-strong Rovio, the publisher behind the "Angry Birds" games.

Gone is the swagger that defined the early years, when Zynga's army of developers flooded the market with dozens of new titles from cooking games to bingo variations, its dealmakers splashed money to snap up smaller rivals, and its managers opened studios in cities around the world.

Wall Street is viewing Pincus' shift with cautious approval, having been singed by Zynga's abysmal stock performance — an 80 percent decline over the past year that began around the time it invested $180 million in then-promising game studio OMGPOP. "Certainly their shareholder base wants to see more discipline," said Sean McGowan, an analyst at Needham and Co. "When you have limited resources, it makes sense to start with a proven winner, then expand that franchise. But it needs to be a blend of sticking with the proven brands and realizing when people might say: 'FarmVille 4? No, I'm done with that.'"

Investors place much stock on Zynga's future prospects in Internet gambling, because of its massive poker-playing community and existing game software. But with meaningful income from real-money casino efforts likely to be months, if not years, away, it may have to risk "sequelitis" for now.

TABLES TURNED
Almost 18 months after going public, Zynga is staving off fierce competition from newer or nimbler rivals that mimic its games.

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Supercell, founded in 2010, has scored with "Hay Day," an iPad game that contains elements resembling FarmVille. With just one other game under its belt, Supercell says it is on track to make more than $800 million in revenue this year, roughly equal to the $860 million that Wall Street expects from Zynga in 2013.

Veteran video games publisher Electronic Arts Inc, one of Zynga's earliest rivals, in recent weeks said it would lay off an undisclosed number of employees and focus on core franchises like Battlefield and sports titles.

Activision Blizzard Inc, another publishing heavyweight, has fared better thanks to the strength of series like "Call of Duty," which has brought in more than $8 billion in cumulative sales since the first title launched in 2003. Yet even Activision is struggling to sustain revenue growth.

Zynga's bottom-line could be shored up through a more streamlined pipeline, Pincus argued. Since FarmVille first launched, it has gradually honed its development process to reduce the resources and development costs required for each significant update by more than 80 percent, he said. "As long as our players are interested in farming, we'll offer a Farmville," Pincus said. "It could be the Seinfeld of our era in gaming, a multi-season show that has a quality and a consistency that you can rely on."

Zynga declined to address its game pipeline. Bing Gordon, an investor at venture capital firm Kleiner Perkins Caufield & Byers and a Zynga board member, said he has repeatedly nudged the company to develop FarmVille 3. "Coca Cola has learned not to change their formula," said Gordon, a game industry veteran who formerly served as chief creative officer at Electronic Arts. "If you've got something people want, keep doing it."

BOLD BEATS
Even as Zynga seeks greater efficiency, it acknowledges it's been pressed to invest more to stay competitive. At the heart of the company's strategy has been its "bold beat" schedule, a roadmap laid out by Pincus in 2009 to release significant upgrades and new features to games every quarter to keep players hooked. Once criticized for low-quality graphics and rudimentary gameplay, the company's latest launches and "bold beats" have placed more emphasis on elements like visuals that were once considered superfluous, game designers said.

"Player expectations are higher than they used to be," said Zynga Senior Vice President Todd Arnold, who overseas FarmVille and FarmVille 2. "You're not able to launch a minimalist product as we used to be able to."

For its leading franchises, the company is also investing more in quantitative and analytical tools. Every week, it shuttles players into a room deep inside its offices, where they are shown minute new design features. Their reactions are recorded by video cameras as well as a team of game designers sitting behind a two-way mirror in an adjacent room.

The company also holds periodic panel discussions with its most loyal fans to solicit suggestions for new features. Linda Zoccolli, a retired daycare business owner in Moraga, California, suggested at a session in March that water was too scarce a commodity in FarmVille 2. Weeks later, she noticed the game began to feature periodic rainfall.

She has spent three hours almost daily for the past eight months tending her plot but hasn't found it repetitive. "As long as they come out with new quests, new items, it keeps it interesting," she said.

Attention Boomers: The Economy Needs You to Work Past 70

If you imagine that age 81 means shuffleboard, golf carts, and sitting on the beach, David Mintz will make you reconsider. The founder and CEO of food brand Tofutti, Mintz works 15-hour shifts, sometimes driving 500 miles a day to visit his factories. He sleeps four or five hours a night and works out every morning. “I’m working harder now than 20 years ago,” he says.

Mintz and others like him are leading a shift toward working later into life. Just 11 percent of people older than age 65 were still working in 1993, according to the Bureau of Labor Statistics. Today, that figure has reached almost 18 percent – and it’s climbing.

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Most of these workers are not just putting in a few hours: A 2008 study of people age 50 and older who retired and then went back to work found that 54 percent were employed full time and 19 percent worked more than 41 hours a week.

All of this could mean good news for the larger economy. As baby boomers move into their later years, the 65-and-over population will grow from about 13 percent in 2010 to a projected 20 percent by 2030. The rising population of seniors who work will bring stronger economic growth – if companies can retool to accommodate an older workforce, say economists and experts.

But if companies fail to plan ahead, they might also see costs mount: By one estimate, health insurance premiums for workers age 65 and older cost companies almost three times as much as those age 25.

People working in their later years could help with the country’s fiscal problems, says Gary Burtless, a Brookings Institution economist who is finalizing a study on the issue. Every additional year that a person stays on the job brings more revenue to the federal treasury in income taxes. If current trends continue, working seniors will have a positive, if small, impact on federal deficits under the most plausible budget projections.

REINFORCING THE NEST EGG
More working seniors also could lower demand for social services by cutting the number of Americans who don’t have enough money in retirement. In 2008, the federal and state governments spent nearly $15,000 per elderly person on income security and tax credits, according to a report earlier this year from the Urban Institute. Every year that a person delays taking Social Security past his or her full retirement age (anywhere from age 65 to 67, depending on the date of birth), the check amount grows by 8 percent, says Sara Rix, who focuses on the economics of aging at AARP’s Public Policy Institute.

That continues up to age 70, when everyone must draw a check. “You’re not going to get that [8-percent] return anywhere else… and it’s a guarantee,” Rix says.

It may be hard to imagine with unemployment at 7.5 percent, but more seniors on the job could help alleviate a labor shortage in the years ahead. That’s because the U.S. population is aging: While the proportion of seniors is growing, the percentage of those in their prime working age is stagnating, says Richard Johnson, an economist who directs the Urban Institute’s retirement policy program. By 2030, if people retire at age 65, the number of workers per retiree will drop from 4.5 to 3, according to a 2010 study by the Rand Corporation.

“We really need older people to stay in the labor force to provide the workers that the economy needs to continue to grow,” says Johnson. In an April 2012 survey of 430 human resource professionals, 72 percent said the loss of talented older workers poses a problem or potential problem for their organization.

If younger people worry that older colleagues staying on the job might cut into their opportunities, those fears aren’t supported by recent data. A study last fall by the Pew Economic Mobility Project found that from 1977−2011, every one percentage-point increase in the employment rate of older workers was associated with a slight decline in youth unemployment. That’s partly because employed older workers also create jobs by starting businesses themselves, or offer skills that allow companies to expand operations.

But other experts worry that later retirement could shrink company bottom lines if the workers who stay do so because they don’t have enough retirement savings. The typical household, age 55-64, had only $120,000 in their 401(k) or IRA account in 2010, according to a study last summer from Boston College’s Center for Retirement Research. The report also noted that 13 percent of those ages 60-64 had no retirement account at all.

Those who feel obligated to keep working tend to have worse health and work in jobs that are more strenuous, compared with older knowledge workers who choose to keep going. Susan Conrad of Plancorp Retirement Plan Advisors says that among this group, health care, workers’ compensation, and disability costs are higher than for others, while productivity is lower. A study by MassMutual Financial Group calculated that for companies with more than a thousand employees, increasing the portion of their workforce of those over age 60 from 10 percent to 30 percent hiked their health care and disabilities costs by about $2 million. Johnson also estimates that a company spends an average of about a thousand dollars more per year for an older worker.

Johnson argues, however, that there’s not much evidence that older workers are less productive – their productivity simply takes different forms. They may make fewer creative breakthroughs and process information more slowly, in general, but their knowledge and experience improve with age. An older telephone salesperson might make fewer calls, for example, but sell more by drawing on years of experience, he says.

A possible worker shortage in some fields is causing a number of companies to retool their operations to retain older workers. The shortage of nurses, for example, has led hospitals to redesign layouts so that work stations are closer to patients, says Jacquelyn James of Boston College’s Sloan Center on Aging & Work. And the shortage of truck drivers has some companies redesigning vehicles to create more comfortable sleeping spaces, she says. Other firms are changing work schedules: The April 2012 survey of human resource professionals found that about a quarter of companies are offering more flexible work arrangements and part-time positions to attract older workers.

With U.S. birth rates dropping and the population getting older, encouraging more companies to create incentives for older workers to delay their retirement parties could benefit us all, says Johnson.

The Real Test for Obamacare is 5 Months Away

Healthcare reform should be the signature Democratic achievement of President Barack Obama’s presidency. But with "Obamacare" five months from show time, Democrats are worried about whether enough Americans will sign up to make the sweeping healthcare overhaul a success – and what failure might mean for Congress heading into the 2016 presidential race.

Some of the law’s main advocates fear that not enough of America’s 49 million uninsured will know about health coverage offered in their own states. Even if they do, new insurance plans may not be attractive to young, healthy consumers needed to offset an expected influx of older and sicker patients.

Only a handful of states are beginning campaigns to promote the online health insurance marketplaces created by the law. Known as exchanges, the markets will offer private coverage at federally subsidized rates to individuals and families with low-to-moderate incomes, with enrollment set to begin October 1.

The federal government has kept quiet about its promotion plans, which are expected to begin in earnest over the summer. While Obama and his administration say they are working nonstop on reform, analysts believe a poor performance could make the Patient Protection and Affordable Care Act a big enough campaign issue in 2014 to jeopardize Democratic control of the Senate – particularly if insurance costs rise sharply.

"There is reason to be very concerned about what’s going to happen with young people. If their (insurance) premiums shoot up, I can tell you, that is going to wash into the United States Senate in a hurry," said Senator Ron Wyden, an Oregon Democrat.

Some Democrats are frustrated about the lack of details surrounding administration plans to promote the exchanges. Senator Max Baucus, a chief architect of the reform law, said federal outreach efforts deserve a failing grade so far and could be heading for a "huge train wreck." He criticized Health and Human Services Secretary Kathleen Sebelius for the scant information her department has provided.

FUNDING EMBARGO
"Why in late April can’t they show us any of what they’ve got planned? The rollout plan should already be in existence," an exasperated Democratic Senate aide said separately. The law is expected to cover 15 million Americans next year through the exchanges and an expansion of Medicaid. The overall number is forecast to jump to 38 million by 2022.

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Reform is facing challenges on several fronts. Big insurers appear wary of participating, raising questions about how competitive the exchanges will be. Businesses are mounting a new legal effort to stop the use of federal subsidies in exchanges run by Washington. And most states have balked at the exchanges and the Medicaid expansion.

Meanwhile, the enrollment effort is under threat from months of delay, a congressional Republican embargo on new funding and worries about how affordable the new plans will be, according to analysts, lawmakers, congressional aides and former officials.

"I don’t see how what they’re planning to do is going to be adequate. The resources are too limited, the (law’s) penalties are too weak and elite opposition in much of the country will undermine" enrollment, said Paul Starr, a Princeton professor and former health adviser to President Bill Clinton.

Add to that the challenge of reaching a public that is highly skeptical and often misinformed about the most complex social legislation since Medicare and Medicaid in the mid-1960s.

A Kaiser Family Foundation poll found that 77 percent of Americans know little or nothing about exchanges, while 40 percent erroneously think reforms create a government panel to make end-of-life decisions for people on Medicare.

An April survey of 1,003 people by HealthPocket, an online company that helps consumers find insurance, also found that the law’s penalty for not buying coverage would not induce most 25-to-34-year-olds or 18-to-24-year-olds to purchase it.

GLITCHES AND BUMPS
Obama this week defended the pace of implementation, telling reporters that the government was working hard to "make sure that we’re hitting all the deadlines and the benchmarks" even with the challenge of building the new online exchanges.

"That’s still a big, complicated piece of business," Obama said, adding the task was made harder by a dedicated Republican opposition still determined to block the law’s implementation. "Even if we do everything perfectly, there’ll still be, you know, glitches and bumps," he said.

The administration is building exchanges in 33 states that are unwilling or unable to do so on their own, and has limited funds for marketing. The remaining 17 states are building their own and have received sizable budgets for outreach.

Among states taking the lead, Vermont has launched radio advertising to raise public awareness. Colorado begins its public outreach this month, while California, Maryland and the District of Columbia will hold off until later in the year.

For the federal exchanges, HHS has a contract worth at least $8 million with public relations firm Weber Shandwick and $54 million to train and pay "navigators," or counselors who will help consumers choose a health plan. It also has a $28 million contract with General Dynamics to set up a call center and will make its Healthcare.gov website consumer-oriented.

The administration is seeking help from major U.S. insurance providers to market aggressively to consumers on the federally run exchanges and help convince healthy citizens between 26 to 45 to pay for insurance instead of a first-year penalty amounting to $95 per person or 1 percent of household income.

BLOWING UP
But reform advocates worry that the HHS budget is too small and the spigot for new funding from Congress is shut off by partisan politics. The "navigator" program allocates just $600,000 each for 13 states including Delaware, Iowa, Kansas and New Hampshire.

"There’s a limited amount of money that should be increased. But that’s subject to appropriations and Congress is not likely to appropriate additional money," said Ron Pollack of the advocacy group Families USA. "It’s going to require a very robust effort in the private sector."

Analysts say reform could be as big an issue in next year’s congressional midterm elections as it was in 2010, when dislike for the law among senior citizens helped install a Republican majority in the House of Representatives. This time, failed implementation could end Democratic hopes of recapturing the House and leave enough Senate Democrats vulnerable to give Republicans an edge in that chamber.

"We have to see how bad it is. This issue blowing up on Democrats would make the Republicans’ job a lot easier," said Jennifer Duffy of the Cook Political Report.

But Democrats believe implementation will also provide favorable coverage of deserving individuals and families finally being able to secure adequate and affordable health coverage after a long sojourn through the current marketplace.

There has been encouraging news for consumers. Vermont says 2014 premium rates will save money for residents. A family of four with an annual income of $75,000 would pay less than $600 per month for coverage with a federal subsidy, versus $900 for the cheapest small group plan available today.

Additional reporting by Sharon Begley and Caroline Humer in New York

The Shocking Cost of Being a Wedding Guest

As someone who just recently hosted a wedding, it’s a bit disconcerting to read the latest news that, according to an American Express survey, wedding guests expected to spend an average of $539 per wedding attended this year.

That’s a whole lot of money to be a guest.

The estimate, which is up $200 from last year, includes everything from what a wedding guest would shell out for clothes and a hotel room to the costs of attending the bachelorette party.

As a bridesmaid, you may be stuck with a ugly bill in addition to an ugly dress. Members of the bridal party forecasted they will spend $577 on a wedding, nearly $40 more than the average guest, according to the survey.

The buck doesn’t stop there, though. The survey also found that affluent guests—those whose household incomes were more than $100,000—estimated they would spend around $960 per wedding this year, up from the $545 estimate in 2012.

Surveyed wedding guests admitted to spending around $179 on gifts if they were a close family member, $66 if they were a coworker and $79 if they were a friend on the outside of the couple’s close-knit group.

The American Express infographic below breaks down what you can expect to pay the next time you receive that fancy wedding invitation in the mail.

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Why Employee Reward Programs Don’t Work

Incentives like employee of the month can actually reduce motivation on the job, report researchers.

The new study finds that even simple awards programs can have much broader and complex implications for employee behavior.

The researchers used field data from an attendance award program implemented at one of five industrial laundry plants. They found that awards programs could induce unintended consequences that can reduce the net value of the program.

The researchers show that two types of unintended consequences limit gains from the reward program. First, employees game the program, improving timeliness only when eligible for the award, and strategically calling in sick to retain eligibility.

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Second, employees with perfect pre-program attendance or high productivity suffered a 6 percent to 8 percent productivity decrease after program introduction, suggesting that awards for good behavior they already exhibited de-motivated them.

Overall, the results suggest the award program decreased plant productivity by 1.4 percent, and that positive effects from awards are accompanied by more complex employee responses that limit program effectiveness.

While awards programs can be powerful tools for motivating employees, companies must think carefully about the unintended consequences that can cripple their efficacy.

Lamar Pierce, associate professor of strategy at the Washington University in St. Louis Olin School of Business is an author of the study, as are Olin doctoral student Timothy Gubler and Ian Larkin, assistant professor at Harvard University.

This article originally appeared in Futurity.org. Source: Washington University in St. Louis.

How Robots Are Changing the Way We Age

When an elderly person needs dinner, “Herb” answers a command given on an iPad. He heads to the freezer, pulls out a frozen meal, microwaves it and brings it to the person – just like that. What's different about this situation is that Herb is not a person. HERB actually stands for Home Exploring Robotic Butler, and is developed out of Carnegie Melon University's Quality of Life Technology (QoLT) Center.

PHOTO GALLERY: 7 Robots That Can Help Aging Americans

The center specializes in assistive robots for older adults and people with disabilities. Robots like HERB will have a "tremendous" impact on elder care, says the 34-year-old "father" of HERB, Siddhartha Srinivasa, an associate professor at Carnegie Melon's Robotics Institute. He hopes to see the machines commercialized in the U.S. on a large scale within his lifetime.

Robots – in addition to other uses – are now being viewed as a way to meet the needs of a fast-growing aging population, with technologies that assist in daily care and provide companionship. Over the next 18 years, 78 million baby boomers will turn 65 at a rate of about 8,000 a day. And most will not be able to afford the daily help often required by age-related disability.

At the same time, health care costs are skyrocketing. Robots could help address both costs and manpower issues.

THE INDUSTRY LEADER
Japan has been leading the way in this field. For fiscal year 2013, the Japanese government provided $24.6 million to companies focusing on robotics for elder care, according to Hiro Murata, CEO for the Center for Studies on Aging Societies and a professor at Tohoku University in Sendai, Japan. Emerging technologies focus on all sorts of elder care, from assistance with manual labor to tasks that improve cognitive abilities and maneuvering with limited mobility.

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Japan has tested a variety of robotic technologies, including PARO, a seal robot that responds to an owner's touch and provides engaging companionship. Developed at MIT's Artificial Intelligence Lab, PARO was commercialized in Japan in 2005 followed by the U.S. in 2009. Early studies show that it benefits some Alzheimer’s patients, easing depression and reducing agitation. It retails for $6,000 or can be leased for $200 a month. To date, over 2,000 have been sold in Japan, with only 100 sold in the U.S.

Honda is continuing to refine a robot it developed in 2006, ASIMO, a four-foot-three robot that can help around the house or assist someone confined to a bed or wheelchair. Another Japanese product is the hybrid assistive limb, an exoskeleton suit offered by Cyberdyne, which helps those who have been paralyzed or recovering from a stroke. The robotic suit has electrodes that attach to the skin and detect nerve activation coming from the brain to the muscle. A device controls a set of motors at the joints so that the suit's arm, attached to the limbs, moves in tandem to the command given to the limbs.

Majd Alwan, executive director of the LeadingAge Center for Aging Services Technologies, says Japanese robotics technology gets more attention from private industry than in the U.S. because the Japanese are more accepting culturally of robotic technologies in general while U.S. consumers still prefer human interaction.

U.S. ROBOT REVOLUTION
But Howard Wactlar of the National Science Foundation says that while the U.S. robotics industry largely collapsed in the 1980s, advancing technology has sparked renewed interest. "I think we see it coming back," he says. DARPA spends billions annually developing cutting-edge robots for military use, and many experts expect the technology to trickle down to the consumer sector in the coming years.

The National Science Foundation, partnering with NASA, the National Institutes of Health and the Department of Agriculture, has provided $40 million in grants in the first year of its National Robotics Initiative, which focuses on co-robots that assist individuals in performing tasks. An NSF program supporting the development of health care delivery robots provided $4.5 million over the past two years, and last year, $15 million was allocated by NSF for a human/robot interaction program.

In addition to full-scale robots to assist the elderly, Wactlar says NSF is also funding smaller-scale initiatives, like a computer that plugs into a person's ear to help him or her understand how to complete a task he’s begun.

Carnegie Melon’s QoLT Center, which receives $4 million in NSF funding annually, is focusing on technologies that allow older adults to remain in their homes longer. Its work includes a system to detect cognitive decline earlier by embedding sensors into everyday home appliances, a Strong Arm that makes it easier to lift patients, and an inflatable robot arm that can assist with tooth brushing, bathing and feeding.

The Interaction Lab at the University of Southern California's Center for Robotics and Embedded Systems developed Bandit, a robot in a USC sweatshirt who sits in a chair, directing an elderly person sitting across from him on how to complete various exercises.

M.I.T.'s AgeLab has developed a robotic, autonomous wheelchair that's now being tested in partnership with The Boston Home, a clinical care facility for those who are wheelchair bound. Using voice recognition software and laser scanner technology, the wheelchair can detect how to get to a particular destination. "Any device that enables an individual with restricted physical ability to independently operate without staff, family member or paid assistant intervention has vast implications in terms of quality of life," says Don Fredette, director of Boston Home's Wheelchair Enhancement Center.

THE CHALLENGES AHEAD
Joseph F. Coughlin, who directs the AgeLab, says the new robotics products could help to address a coming workforce shortage in nursing facilities – the average age of a nurse today is 46, and 50 percent of the nurse force is scheduled to retire in 20 years, according to the BLS. "A lot of us will value the services that robots can provide to keep us independent and improve our well being," says Coughlin.

Completely autonomous robots that assist the elderly still have some challenges, says Srinivasa, HERB's developer. Robots that open doors, move objects and decide which book to pick up aren’t there yet. "That's the big challenge we're working on." He says technology will roll out in stages, appearing in smart appliances and other devices before a full-fledged robot hits the market.

Coughlin expects such robots to be available relatively soon, in a 5-to-10 year time frame. But even when the technology is full proof, the greater challenge will be getting consumers to accept it. "We need to make [these robots] cool, convenient and cost-effective," he said.

Cost is a significant hurdle. Each one of HERB's arms alone costs $200,000. Wactlar says a robot currently could be built for $50,000 to $60,000, still well outside what the average homeowner could afford. Tandy Trower, who founded Hoaloha Robotics in Seattle, Washington, expects within the next three years to have a robot on the market geared toward empowering seniors. He says a survey by Robotics Trends indicates consumers expect a price between $6,000 to $10,000 – and that's his working target. "If you consider that if the robot could defer even one month of full time paid care in the home or in a care facility, it would more than pay for itself," he said.

Kristen Sabol, a spokesperson for Carnegie Melon's Quality of Life Center, says large-scale robots like HERB will become more common over the next 10 years and costs will come down. She says many products are entering the licensing phase and Strong Arm is likely to move to industry development within the next two years. Murata says that to address the cost issue in Japan, the government is considering using public long-term care insurance to reduce costs for the user.

But if the products aren't widely accepted, costs remain high "and the technology doesn't move," says Alwan. He predicts a hybrid solution that that doesn’t entirely eliminate the need for a human caregiver. Paul DelPonte, a spokesman for the National Council on Aging, says that while robotics offer much promise and progress in caring for seniors, it "should be seen as a tool, not as a replacement for human care and compassion."

What Oregon’s Medicaid Study Means for Obamacare

Although expanding Medicaid coverage to some low-income Oregon residents substantially improved their mental health and reduced financial strains on them, it didn’t significantly boost their physical health, according to a study published Wednesday in The New England Journal of Medicine.

The findings are less upbeat than a preliminary report by the same group, which had found that Medicaid made a “big difference” in people’s lives. In the latest effort, researchers dug deeper.

They compared health status, finances and use of health services between two groups of residents: some of the 10,000 people who had been selected through a lottery drawing for health insurance coverage under a 2008 limited expansion to Oregon’s Medicaid program and those who had applied but did not get accepted.

Based on analyses of 12,229 people – 6,387 of whom gained coverage – the study’s results did not show any significant difference in the levels of high blood pressure, high cholesterol and diabetes between the two groups two years after the lottery.

The study did find improvements in other categories, including mental health. Gaining access to Medicaid, for example, reduced depression by 30 percent and also increased participants’ use of physician services, prescription drugs and preventive care. It also led to increased detection of diabetes and use of medication to control it.

Those covered by Medicaid also had lower out-of-pocket spending, the researchers reported, including a 4.5 percentage point difference in catastrophic expenditures.

“We were able to provide a multifaceted picture of what happened when people gained insurance through Medicaid, versus those who did not,” said Dr. Katherine Baicker, the study’s lead author, in an interview.

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Dr. Devon Herrick, senior fellow at the National Center for Policy Analysis, a nonpartisan research organization, said he was shocked to see so little data suggesting that Medicaid expansion improved overall health. “It didn’t seem to affect the outcome of those with diabetes,” Herrick said in an interview. “It boosted their use of medication but didn’t seem to improve their health – that’s something we would all assume.”

“The results of this indicate that states can’t just expand Medicaid and as a result, suddenly improve the health of all those that enroll – it didn’t seem to work that way,” Herrick added.

According to the study, more than 90,000 state residents participated in Oregon’s Medicaid lottery. Researchers have used that group to study the impact of expanding health coverage. Although not designed to do this, Baicker said the two groups can be seen much like a randomized controlled trial that allows researchers to evaluate the effect of Medicaid on low-income adults.

“Expanding Medicaid costs money and there has to be a way to finance the program. It doesn’t save money but it substantially improves the wellbeing of beneficiaries, although maybe not in exactly the way some people might have thought,” Baicker said, adding that “policymakers have to decide whether that set of benefits is worth the cost of the program in terms of the alternative uses of the resources.”

The expansion of Medicaid, called for by the 2010 health care law, is being intensely debated in many states since the Supreme Court made that provision voluntary last year. Fifteen states, many in the Republican-controlled South, have already rejected the idea, while 20 have agreed to comply with the law, according to consulting firm Avalere Health.

This piece originally appeared in Kaiser Health News.

The High Cost of Killing the Next ‘Superbug’

An antibiotic-resistant strain of gonorrhea that's now considered a superbug has some analysts saying that the bacteria's effects could match those of AIDS.

"This might be a lot worse than AIDS in the short run because the bacteria is more aggressive and will affect more people quickly," said Alan Christianson, a doctor of naturopathic medicine.

Even though nearly 30 million people have died from AIDS-related causes worldwide, Christianson believes the immediate effect of the gonorrhea strain is more direct. "Getting gonorrhea from this strain might put someone into septic shock and death in a matter of days," he said. "This is very dangerous."

"It's an emergency situation," said William Smith, executive director of the National Coalition of STD Directors. "As time moves on, it's getting more hazardous."

This gonorrhea strain, HO41, was discovered in Japan two years ago in a 31-year-old female sex worker who had been screened in 2009. The bacteria has since been found in Hawaii, California and Norway. Because it resists current antibiotic treatment, the strain has been placed in the superbug category with other resistant bacteria, such as MRSA and CRE. These superbugs kill about half the people they attack, and nearly one in 20 hospital patients become infected with one, according to the Centers for Disease Control and Prevention.

Though no deaths from HO41 have been reported, efforts to combat it must continue, Smith said. "We have to keep beating the drum on this," he said. "The potential for disaster is great."

According to the CDC, about 20 million a year contract a sexually transmitted disease (STD) and result in about $16 billion in medical costs. More than 800,000 of STD cases reported are gonorrhea infections, with most occurring in people between the ages of 15 and 24.

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Gonorrhea is transmitted through unprotected sexual contact. Untreated, the disease can cause a number of health complications in women, including infertility. In men, the disease can be very painful and lead to sterility. It can also trigger other life-threatening illnesses, including heart infections.

Gonorrhea can be hard to detect. It often shows no symptoms in about half of women and in about 5 percent of men. Gonorrhea infection rates were at historic lows until two years ago, according to the CDC.

"That's what's kind of scary about this," Smith said. "We are at lows in terms of infections, but this strain is a very tricky bug and we don't have anything medically to fight it right now."

Since 1998, the Food and Drug Administration has approved only four new antibiotics of any kind, according to the Infectious Disease Society of America. The last approval was in 2010. Only seven antibiotics are in an advanced stage of development and still years away from approval and use.

Recognizing the problem, Congress passed a law last year referred to as the Gain Act (Generating Antibiotics Incentives Now) to help speed antibiotic development.

But Smith said more needs to be done. In a briefing on Capitol Hill last week, he urged Congress to target nearly $54 million in immediate funding to help find an antibiotic for HO41 and to conduct an education and public awareness campaign. "I'm hopeful we'll get the additional funds, but I can't say for sure," Smith said. "What I do know is we don't have the resources to fight this as it stands now."

Avoiding the disease completely is the best course, experts said. "People need to practice safe sex, like always," Christianson said. "Anyone beginning a new relationship should get tested along with their partner. The way gonorrhea works, not everyone knows they have it. And with this new strain it's even more important than ever to find out. "

All superbugs must be dealt with before it's too late, he said. "This is a disaster just waiting to happen," Christianson said. "It's time to do something about it before it explodes. "These superbugs, including the gonorrhea strain, are a health threat. We need to move now before it gets out of hand."

This piece originally appeared at CNBC.com.

SAT Tests: Another Drain on the Family Budget

Jeffrey Arnold’s 16-year-old daughter is a high school junior in Las Vegas, Nevada, hoping to get into pre-med programs at Johns Hopkins, Colorado State, or the University of Nevada. To help boost her SAT and ACT scores, Arnold hired a test prep tutor – at $125 an hour. They’ve done six hours so far, with another four planned – for a total of $1,250.

Another parent in New York State said she estimates she’ll spend more than $2,000 for an SAT tutor for each of her two sons. And that doesn’t include the $50 test fee each time they take the SAT.

Over 1.66 million students took the SAT (Scholastic Assessment Test) last year, and for the first time, the number of students who took the ACT (American College Testing) surpassed SAT takers by about 2,000 students. Many students take both tests, take them multiple times during their junior and senior years, and take the PSAT, SAT II subject tests, and Advanced Placement tests. These tests are an industry unto themselves, with millions of dollars spent on test fees, administration, and preparation.

The tests also carry additional fees for late registration, standby testing, registration changes, scores by telephone, and extra score reports, each of which ranges between $11 and $55. All of the costs can strain the budgets of parents before their child even sets foot on a college campus. But for most, paying to get an “edge” on standardized test scores is not only worth it, it’s necessary. Why? Because the competition is doing it.

QUEST FOR SUCCESS
The College Board and the Educational Testing Service, both private nonprofit educational testing organizations, administer the SAT. The ACT is administered by ACT, Inc, also a private non-profit.

Americans for Educational Testing Reform has criticized the organizations for collecting millions in profits while maintaining their nonprofit status and therefore avoiding federal taxes. College Board spokesperson Leslie Sepuka, says, however, that all of their profits are invested back into programs and services, including a fee waiver program for low-income students.

The executive salaries at these organizations have also come under fire in recent years. The former president of the College Board, Gaston Caperton, for example, took in $1.3 million, including deferred compensation in 2009, according to tax records – more than the president of Harvard University. He stepped down last year and his successor, David Coleman, now earns a base salary of $550,000, with total compensation of nearly $750,000. Richard Ferguson, the former CEO of ACT, Inc., received $1.1 million including retirement benefits in 2009.

“Congress should take a hard [look] at these tax-exempt testing companies that pay big-time salaries and seem to want to shake every dollar possible out of the pockets of students applying to college,” Dean Zerbe, a former senior tax counsel for the Senate Finance Committee, told Bloomberg.

According to a March report from IBISWorld, although profits fell briefly during the recession, the tutoring and test prep industry generates an average of $840.4 million every year and employs more than 115,000 people. And a 2009 report from Eduventures calculated that about 2 million students spend $2.5 billion a year on test preparation and tutoring.

Private test prep tutors, like the one Jeffrey Arnold of Las Vegas is using, range from $100 to $200 an hour, and on-site classes from companies like Kaplan and Princeton Review charge around $1,000, though less expensive online courses are available.

Daniel Riseman, 40, a full-time college test prep tutor and founder of Riseman Educational Consulting in Westchester County, New York, says he tutors about 30 students a week and demand for his services is growing – one year he took in $220,000, he says. “Sometimes I work seven days a week and it just never stops, but it’s good money,” says Riseman, who has teaching certifications in English and math and a Master’s degree in education. “One parent said, ‘If I don’t hire you, I’m doing my daughter a disservice.’”

GROWTH INDUSTRY
As the economy improves – and as college competition increases – spending from parents on test prep and tutoring is expected to rise in coming years, according to the IBISWorld report. It says the industry will grow an average of 4 percent a year for the next 10 years.

Many reports have questioned the worth of these classes, though, and the National Association for College Admission Counselors concluded in a 2009 study that test-prep activities have a “minimal positive effect on both the SAT and the ACT.” Companies like Kaplan have stopped using promotional materials that mention specific point increases. Russell Schaffer, a Kaplan spokesperson, said that they focus instead on students’ personal test goals. Riseman, however, says he’s seen students’ scores rise as much as 600 points after 3 to 6 months of tutoring.

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A handful of states – most recently North Carolina - require high school students to take the ACT, and market the test as a high school exit exam to gauge students’ college readiness. Many states test students through the ACT’s “College and Career Readiness System” to measure students’ academic development in the years before they take the official ACT. The ACT is currently developing a test for students to take in the third grade.

However, recent backlash against these college entrance exams has decreased the popularity of the SAT and ACT in some areas, and more colleges have stopped requiring the test, claiming they’re not accurate measures of students’ abilities. As of 2012, more than 800 colleges no longer require either exam, including Middlebury College in Vermont, Bowdoin College in Maine, and Wake Forest University in Winston-Salem, N.C.

Data from the College Board show that test-takers with family incomes of less than $20,000 a year consistently score lower on average than those test-takers with family incomes of over $200,000. One calculation from DOME Exam Prep showed a 40-point average score increase for every additional $20,000 in family income. “All these exams are highly coachable, advantaging students who can afford to spend $800 or more on test preparation classes,” write the authors of FairTest, an advocacy group for promoting fair evaluations of students.

Tim Tebow: Wrong Team, Wrong Town, Wrong Quarterback

“Our long National Football League nightmare is over,” Deadspin deadpanned. Yes, Tim Tebow’s short but tumultuous stint with the New York Jets officially came to an end Monday. The Jets waived Tebow some 13 months after trading with the Denver Broncos to acquire the polarizing player who had sparked a national craze and a media frenzy (yes, we’re talking about you, ESPN) while leading the Broncos to a string of comeback wins.

“I think you can never have too much Tebow,” Jets owner Woody Johnson told CNBC last summer.

“You can’t talk enough Tebow,” ESPN analyst Doug Gottleib said he was told by a producer.

Not enough quickly became too much.

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“We have a great deal of respect for Tim Tebow,” Jets coach Rex Ryan said in a statement announcing the roster move. “Unfortunately, things did not work out the way we all had hoped. Tim is an extremely hard worker, evident by the shape he came back in this offseason. We wish him the best moving forward.” With teams coming off the NFL Draft, initial reports suggest that Tebow may have a hard time catching on with another team, at least as a quarterback. Whether or not he does, here’s a look at how the Tebow phenomenon fizzled in New York:

200
Members of the media who attended the Jets news conference 13 months ago to introduce the newly acquired Tebow, according to The New York Times

$1.5 million
Salary the Jets paid Tebow. The team will save $1.055 million by releasing him now

$2.58 million
Tebow’s official salary for 2013, but that includes $1.055 million the Jets will save by releasing the quarterback

$1.531 million
The remaining portion of Tebow’s official salary – owed not to Tebow but to the Broncos. As part of the Tebow trade, the Jets agreed to split a prorated portion of the advance salary the Broncos paid the Florida quarterback after signing him in 2010

12
Games Tebow played in for the Jets

77
Offensive snaps Tebow was on the field for in 2012, according to ESPN

8
Passes Tebow attempted in the 2012 season for the Jets. He completed 6 of them for a total of 39 yards

32
Rushing attempts by Tebow for the Jets. He gained 102 yards on those runs, for an average of 3.2 yards per carry

0
Touchdowns scored by Tebow last season for the Jets

6
Quarterbacks on the Jets roster before Tebow was released. The Jets drafted former West Virginia quarterback Geno Smith in the second round of the NFL Draft last week

ER Costs Explode: Between $127 and $151 Billion

The cost of emergency care in the US may be more than two times higher than previously published estimates, a new study suggests.

“The ER has become increasingly important as a place where people go for acute unscheduled care, however there has been little rigorous analysis of its cost structure,” says Michael Lee, assistant professor of emergency medicine in the Warren Alpert Medical School of Brown University and a physician at Rhode Island Hospital and The Miriam Hospital.

Published in The Annals of Emergency Medicine, the new analysis first examines current estimates of aggregate spending on emergency department care. The Agency for Healthcare Research and Quality’s Medical Expenditure Panel Survey (MEPS) estimates $48.3 billion of spending on emergency care in 2010, or 1.9 percent of the nation’s total health care expenditures of $2.6 trillion.

With the message that “The total cost is small relative to the entire health care system,” the American College of Emergency Physicians has embraced the AHRQ figure in its “Just 2 percent” public relations campaign.

But Lee and colleagues point out that based on data from other studies, the MEPS undercounts the number of ED visits and the number of ED patients who are admitted to hospitals. Adjusting for those discrepancies using data from a variety of other published sources, the authors estimate that ED costs are between 4.9 percent to 5.8 percent of total health care spending, or between $127 billion and $151 billion.

The authors went beyond national data sets, including the National Emergency Department Sample, to review ED spending data from a different source: a major national private insurer.

The data included charges from doctors and hospitals for imaging, testing, and other procedures. But again there were accounting differences between admitted and discharged patients and a need to account fully for spending from Medicare and Medicaid. The authors’ estimate based on this data is ED spending that is 6.2 to 10 percent of total health care spending.

Much of the debate in the academic literature around the expense of ED care has to do with whether the bulk of costs are fixed (expensive equipment and continuous staffing) or marginal (flexible staff time, expendable supplies). Lee says the cost structure of the ED remains poorly understood and is significantly more complex than what is modeled in existing studies.

As with assessments of total costs, the authors report, the studies vary widely even after adjusting for inflation. Across four major studies over the last three decades, the average cost per patient of an ED visit in 2010 dollars ranged from only $134 to more than $1,000. Meanwhile, the marginal cost of an ED visit (factoring out the fixed costs), ranged from $150 to $638.

ALTERNATIVE ACCOUNTING
The authors instead argue for an accounting based approach to ED costs using a methodology known as “Time-Driven Activity Based Costing (ABC),” which has been applied to health care by Robert Kaplan and Michael Porter, professors at the Harvard Business School. The method maps all clinical, administrative, and diagnostic steps in a patient encounter and assigns costs to each activity, explicitly accounting for the time spent on each task.

ABC accounting might provide a more realistic and transparent measure of ED costs, because the emphasis on time is particularly relevant for emergency medicine, Lee says. “The real cost of providing emergency care has to do with accurately measuring the resources that are used, and time is an important variable to take into account.”

The authors envision using the methodology to measure the cost of common ED processes or chief complaints, and to compare this to alternative sites such as primary care offices or clinics. They also point out that ABC accounting gives “gives ED managers specific data they can use to improve the value of care by identifying high-cost steps in the process.”

EMPHASIZE VALUE, NOT JUST COST
The authors acknowledge that reporting higher overall costs for emergency care may invite further criticism that the expense of emergency care represents unnecessary, inefficient care.

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“However, we offer a more sanguine interpretation—the high share of spending affirms the importance of emergency medicine within the health care system,” they write. “With 130 million visits, 28 percent of all acute care visits, and accounting for nearly half of all admissions, emergency medicine should be expected to represent a large share of health care spending.”

And based on other studies, efforts by private and government payers to divert ER care may not lead to large aggregate savings, Lee says. “Diverting nonemergency care may simply shift costs onto primary care offices and clinics which may not have the infrastructure to accommodate a large volume of unscheduled care.”

Instead there may be more potential for cost savings by focusing on reducing unnecessary diagnostic testing in the ED or unnecessary admissions that originate from the ED.

The debate should include value, not just cost, they write. “More attention should be devoted to quantifying the value of specific aspects of emergency care. Rather than minimize the issue of cost, we should recognize the economic and strategic importance of the ED within the healthcare system and demonstrate that costs are commensurate with value.”

Lee acknowledges that this remains a challenge for the field of emergency medicine. “The core of our business is ruling out critical diagnoses. Many of the things we look for are low probability but highly dangerous conditions. The big question is how do you quantify value when your work is often focused on trying to demonstrate the absence of something?”

Lee, who had a prior career in economics and finance before training in emergency medicine, co-wrote the analysis with Brian Zink, professor and chair of the Dept. of Emergency Medicine at the Alpert Medical School, and Jeremiah Schuur, assistant professor at Harvard Medical School and director of quality and patient safety for the Dept. of Emergency Medicine at the Brigham and Women’s Hospital.

This article originally appeared in Futurity.org. Source: Brown University.

Why Saying ‘Yes’ Is the Key to Business Success

A colleague asks for feedback on a report. A LinkedIn connection requests an introduction to one of your key contacts. A recent graduate would like an informational interview. New research from Wharton management professor Adam Grant reveals that how you respond to these requests may be a decisive indicator of where you end up on the ladder of professional success.

Grant's findings are explored in a new book, Give and Take: A Revolutionary Approach to Success. In this interview, he delineates the differences between givers, takers and matchers; explores who gets ahead and who falls behind; and reveals how we can identify our own style and adapt it for greater success.

Knowledge@Wharton (KW): You say people differ in their preferences for reciprocity. You divide people into givers, takers and matchers. Explain.

Adam Grant (AG): You could anchor this at two extremes: the takers and the givers. The takers, in an interaction with another person, try to get as much as possible and contribute as little as they can in return, thinking that's the shortest and most direct path to achieving their goals.

At the other end of the spectrum is a strange breed of people I call "givers." It's not about donating money or volunteering, necessarily, but looking to help others by making an introduction, giving advice, providing mentoring or sharing knowledge, without strings attached. These givers prefer to be on the contributing end of an interaction. Very few of us are purely takers or givers. That brings us to the third group of people, matchers. A matcher tries to maintain an even balance of give and take. If I help you, I expect you to help me in return. These people keep score of exchanges, so that everything is fair and just.

KW: It seems logical that in fields like engineering and medicine, givers end up at the bottom of the heap. If you're focused on giving more to others than taking back, it's likely you'll end up at the bottom. But who ends up at the top of the heap, and why?

AG: Across a wide range of industries and even countries, these three styles exist everywhere. Indeed, the givers are overrepresented at the bottom. Putting other people first, they often put themselves at risk for burning out or being exploited by takers. A lot of people look at that and say, "It's hard for a taker to rise consistently to the top, because oftentimes takers burn bridges. So, it must be the matchers who are more generous than takers, but also protect their own interests." When I looked at the data, I was surprised to see those answers were wrong. It's actually the givers again. Givers are overrepresented at the top as well as the bottom of most success metrics.

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In sales, the most productive salespeople put customers' interests first. A lot of that comes from the trust and goodwill they've built, but also the reputations they create. The success of givers and the fall of takers is also driven by matchers. A matcher is somebody who believes in a just world. Matchers cannot stand to see takers get ahead by taking advantage of other people. The data suggests matchers will often try to punish them, often by gossiping and spreading negative reputational information. Matchers will also often promote, help and support givers. That's a powerful dynamic behind the rise of givers.

KW: You tell one story about a person called Peter Audet. Did being a giver help him or hurt him? What are the lessons to learn?

AG: Peter Audet, a financial advisor, goes out of his way to help everyone he meets. For years, he would interview job candidates. He would only be able to hire one, but would often give up an afternoon just trying to find jobs for [those] he couldn't hire, really opening up his personal network to do that. A lot of times, this orientation got him in trouble. He lost a ton of money in one case. He got burned by a taker in one situation.

Yet Peter has been enormously successful. His financial advisory firm [earns] well over seven figures in annual revenue. Being a giver is how he has gotten ahead. Oftentimes givers put themselves at risk in the short run. But in the long run, they end up building social capital that's really important for success in a connected world.

KW: How do successful givers approach networking? How does their approach differ from, say, takers or matchers?

AG: Takers tend to actually have incredibly broad networks. In part, because when they burn one bridge, they have to go and find new people to exploit, in order to keep the network going. Matchers tend to have much narrower networks. They will typically only exchange with people who have helped them in the past or who they expect to help them in the future. They end up restricting their universe of opportunities. Givers tend to build much broader networks than matchers, but in a very different way than takers. When they meet somebody new, givers will figure out, "How can I add value to this person's life, and what could I possibly contribute that might benefit this person?" They end up creating good will in their relationships.

KW: How do you spot a faker, or a taker in giver's clothing?

AG: Let's start with the corner office. There's a phenomenal study by Chatterjee and Hambrick that looked at over 100 computer companies and downloaded their annual reports. They tried to figure out [if] you could identify the taker CEOs without ever meeting them. They got Wall Street analysts to rate how much each CEO is a taker. These analysts who knew the CEOs and interacted with them rated the extent to which they were entitled, narcissistic and self-serving.

The first factor that correlated highly with those ratings was the gap in compensation between the CEO and the next highest-paid executive. Typically, a computer industry CEO makes about two to two and a half times as much annual compensation as the next highest-paid executive in that company. The typical taker CEO had about seven times more annual compensation than the next highest-paid executive in that company. They literally [took] more in terms of compensation.

The second cue was in their speech. The takers tended to use first-person singular pronouns, like "I" and "me," as opposed to "us" and "we," when talking about the company. The third, and my favorite, was the takers literally felt it's all about me: I am the most important figure in this company. When you looked at their photos in the company's annual reports, they actually had larger photos. They were more likely to be pictured alone.

New research by Keith Campbell and his colleagues suggests you can even spot these cues on Facebook. Look for a pattern that translates from Dutch as basically "kissing up, kicking down." Takers tend to be very careful at impression management and ingratiation when they're dealing with someone superior or more influential. But it's hard to keep up the façade in every interaction. It's often peers and subordinates who have a more direct window into this person's true motives.

KW: You say givers and takers differ quite a bit in how they approach collaboration and sharing credit. Can you give examples?

AG: One was Jonas Salk, remembered as a hero for discovering and commercializing a polio vaccine. But he never gave credit to any people in his lab who helped him discover the vaccine and actually caused the team to fracture and splinter. Salk never made a discovery that was nearly as influential again. This is a cost of appearing like a taker in a collaboration: slighting other people who might deserve credit. What givers tend to do in collaboration is assume that credit is not zero sum. If I give you credit for your contributions, that doesn't necessarily take away from my contribution. That makes it a lot easier to keep people on board in a team over time. It means, typically, that if you're a leader or a manager, people will follow you to a different job. That's powerful.

KW: A big challenge for a manager is identifying the so-called "diamonds in the rough," people who have the potential to do great things. Tell us how a legendary teacher described in your book does this.

AG: An accounting professor at the University of North Carolina and Duke by the name of CJ Skender has taught over 35,000 students in his career. He's won every teaching award on the planet. He has a remarkable gift for bringing out the best in his students. He's had many, many students win gold medals, both in his state and nationally, for accounting achievements. He's had more than three dozen students follow him to become professors of accounting. The question is, "How does he do it?" A lot of people assume he's got a great eye for talent and that he's immediately able to spot the quantitative savants and then basically work with them.

CJ says, no, it's the opposite. He sees every student as a diamond in the rough, waiting to be polished. Then he tries to make his classes as interesting as possible to bring out the best in those students. This is true of coaches and leaders and managers everywhere. If you look at research by Benjamin Bloom and his colleagues about what made somebody a world-class tennis player or a world-class musician, or even a mathematician of great acclaim, rarely were those world-class candidates superior early on in their careers. But they had in common someone who believed in them and set their aspirations very high. That often created a self-fulfilling prophecy, by inspiring them to engage and to put in the 10,000 hours that we all know are critical to achieving expertise.

KW: What can givers do to avoid burnout and to avoid becoming doormats?

AG: In a way, being a matcher is a safer strategy. Knowing that givers end up at the bottom and the top means there are some risks associated with it. But those risks actually can be mitigated with careful strategies. A lot of it comes down to setting boundaries. Many givers confuse being helpful or being generous with being available for every person and request all the time. There are other givers who confuse being generous with empathizing and dropping everything you're doing to help others. There are also plenty of givers out there who feel like it's uncomfortable or inappropriate to advocate for their own interests. We need to work with people who fall in the giving end of the spectrum to help them set clear boundaries and determine, "Okay, how am I going to help most of the people most of the time?"

One of my favorite concepts is what's called the five-minute favor. Instead of helping everyone all the time, [ask], "Can I offer something of unique value to this other person that will take me five minutes or less?" It's about finding high benefit to others, but low cost to the self.

KW: Normally people believe that the alternative to being selfish, a trait that takers usually have, is being selfless. But you've come up with another term, called "otherish." What is the difference?

AG: Takers tend to be purely selfish. There's one group of givers, who are purely selfless, who constantly put other people's interests ahead of their own. But there's this other group of givers I call "otherish." They are concerned about benefitting others, but they also keep their own interests in the rearview mirror. They will look for the "win-win," as opposed to win-lose. Here's the irony. The selfless givers might be more altruistic because they constantly elevate other people's interests ahead of their own. But my data, and research by lots of others, show they're actually less generous: They run out of energy, time and resources, because they basically don't take enough care of themselves. The "otherish" givers are able to sustain their giving by looking for ways that giving can hurt them less or benefit them more.

KW: What practical advice could you offer those who want to start applying these principles to their own lives?

AG: The first question is, what is your own style? On the Give and Take website, Giveandtake.com, there's a self-assessment you can take. There's also a 360 assessment, both available for free, where you can get other people to rate you. The second step is, there are surprising opportunities for success and for meaning in operating like a giver. I would ask, "What are the types of giving that you find most energizing or most consistent with your skills?" For some, it's making introductions. For others, it's sharing credit. For others, it's mentoring. Finding your own giver style is powerful. The real meaning and purpose associated with that is that even if givers don't always do better than takers or matchers, they manage to succeed in ways that make others better and lift others up, instead of cutting them down.

This article, which has been edited, originally appeared in Knowledge@Wharton.

A ‘Fake’ Nickel from 1913 Sells for $3.1 Million

It’s like a scene from the Twilight Zone.

In 1962, a man named George Walton wanted to find out what his 1913 Liberty Head nickel coin was worth. But on his way to the coin show, his car crashed and burst into flames, killing him – while the coin emerged unscathed. Appraisers gave it to his sister, Melva Givens, but told her it was fake.

RELATED: 15 Shocking Auction Sales

For some reason, though, Givens kept it, passing it down to her heirs in a padded envelop with the words “It’s not real” scrawled on it after she died in 1992.

In 2003, her heirs wanted to validate Givens’ claim and had it reappraised.

As it turns out, the coin is authentic – and one of only five 1913 Liberty Head nickels ever made. The U.S. officially stopped making Liberty Head nickels in 1912, but one rebellious worker at the U.S. Mint made five more in 1913 to create collectors’ items and sold them for $500 each.

At an auction in Schaumburg, Illinois, last week, the heirs were shocked when their coin sold for $3,172,500. They couldn’t believe Givens had kept it in a closet for 40 years, thinking the whole time it was a fake. “She died … never knowing she had the real thing,” one of the four heirs, Cheryl Myers, told the Chicago Tribune.

Myers and her brother, Ryan Givens, celebrated their new fortune with dinner and told the AP they plan to invest the money.

“We started with a nickel yesterday morning and now we have $2.7 million.”

Will Home Care Industry Exert Political Power on Pay?

As a home health aide, Nicole Fletcher, 40, provides personal assistance to the elderly, disabled and those living with chronic conditions in their own homes. She assists them with activities of daily living – including bathing, dressing and eating – and, on occasion, she often stays to help them overnight.

"Sometimes there will be 24-hour cases because the client needs care and cannot be left alone depending on their condition," she said.

Working for a District of Columbia-based company, she earns more than the minimum wage and is paid time-and-a-half for every hour she works beyond her usual 40 per week. But unlike Fletcher, close to 2 million in-home care workers and personal care aides in the United States don’t always get paid for overtime work or receive minimum wage, according to the U.S. Department of Labor. They are explicitly excluded from a key federal wage law that carved out exceptions for causal babysitters and companions for people who are sick or disabled.

The average yearly salary for home health aides in 2012 was $21,830, according to the Labor Department. Only 21 states and the District of Columbia extend minimum wage guarantees to at least some in-home care workers. Among them, 12 states have a minimum wage that is higher than the federal standard – $7.25 an hour.

The administration wants to change that, however. In December, 2011, President Barack Obama proposed a revision to the Fair Labor Standards Act that would extend both overtime and minimum wage protections to home-care workers employed by third parties, such as home care agencies. "They work hard and play by the rules and they should see that work and responsibility rewarded," Obama said.

The proposal has been under protracted review by regulators and is now being analyzed by officials at the Office of Management and Budget. Thousands of comments have been filed with the government on the plan.

When a 90-day review window came and went on April 15, key supporters of the proposal organized a conference call urging the Obama administration to expedite the change. Bruce Vladeck, who ran Medicare and Medicaid under President Bill Clinton and is now a senior adviser at the consulting firm Nexera, pointed in that call with reporters to the political power of the home care industry, which is opposing the proposal. In a subsequent interview, he said, "Based on my understanding, the OMB folks have met with industry representatives who have raised concerns publicly about the impact on them with the proposal." He added, "It will take until somebody at the political level
decides to either issue a regular order or bury it. There’s absolutely no telling."

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The plan has been criticized by some Republican lawmakers and Medicaid directors. In addition, some disability advocacy groups have complained it will increase the health care costs for people who want to remain in their homes and avoid moving to institutional care. If finalized, the proposal would redefine "domestic service employment" to include home health aides and personal care aides as domestic workers. It would also narrow the definition of "companionship services" and clearly outline what duties would qualify for overtime pay. For example, medically related tasks that generally require prerequisite training, such as wound care and blood pressure testing, would become eligible.

"The (current) rules don’t really reflect the job being done by home health aides and home care aides," said Steven Edelstein, the national policy director of PHI National, a nonprofit group that aims to improve working conditions for direct-care workers. "When the (companion services) exception was first created, they were looking to provide an exception to friends and neighbors who would be helping out, not a situation where people are making their livelihood by providing long term services and support."

The key stakeholders in the home care industry, however, have been less optimistic about the proposed revision, raising concerns that include higher labor costs and reduced affordability for consumers. "Pretty much no one is not getting paid minimum wage unless it’s somebody working under the table," said William Dombi, the vice president of the National Association for Home Care & Hospice.

According to Dombi, Medicare and Medicaid pay for most of the services but they would not reimburse the businesses for overtime pay. Businesses may respond by restricting the work hours of home health aides so they would stay under the overtime threshold, potentially lowering their gross income and raising the potential for higher turnover among workers.

Peter Ross, the CEO and co-founder of Senior Helpers, an in-home senior care staffing agency based in Maryland, says paying his workers minimum wage isn’t the issue. He is more worried about the potential impact on consumers who, as a result of businesses not wanting to pay overtime, may end up having multiple caregivers.

"You want to keep consistency and continuity of care with the client because they're most comfortable with that caregiver," he said. "The challenge the government has to understand is if the families can no longer pay, because the government has basically put in a rule that is going to drive the costs up, then they’re going to have no choice but to go into a facility."

The demand for home health aides is expected to increase by 69 percent between 2010 and 2020, PHI estimates, and is potentially fueled by ongoing efforts to keep seniors and the disabled out of nursing homes. In an April 8 letter to the OMB, leaders from the National Association of Medicaid Directors said the proposal may "jeopardize" existing Medicaid delivery system models that give consumers options when hiring potential caregivers. They urged OMB to "examine the unintended consequences, costeffectiveness, and alternatives to this complicated and burdensome rule." According to NAMD, Medicaid was the single largest payer of spending on long-term care services and supports for home-based care in 2009 – paying more than $126 billion that year.

Edelstein and his colleagues at PHI, however, disagree. "The truth is that these protections have been provided to workers in some states already under state law," said Edelstein, "There isn't an issue in terms of the affordability of these services. It's not causing more people with long-term care needs to have to get their care in nursing homes rather than at home." According to a PHIreport, rates of institutionalization are not higher in states that currently extend minimum wage and overtime protections to home care workers.

Marla Lahat is the executive director at Home Care Partners, the agency that employs Fletcher. Lahat says that employers arguing against minimum wage and overtime protections are missing the bigger picture and said her agency’s home health aides are paid for overtime work even though the District of Columbia only extends minimum wage provisions and not overtime to in-home care workers.

"This is a job that requires training, it requires skills, it requires compassion, it requires the ability to work independently," she said. "It's a very challenging, demanding, yet gratifying job but at a minimum should be getting minimum wage and overtime protection.

This article originally appeared in Kaiser Health News.

6 Career-Killing Phrases to Quit Using Now

Whether making an important presentation to potential clients or trying to motivate a room full of entry-level employees, your words carry weight at work. This is especially true in an age of instant tweets, texts and social media streams.

Darlene Price, an executive coach in Atlanta and founder of Well Said, a communications training firm, tells The Fiscal Times, “Whether you want to pass a budget, win votes, or seal the deal, effective leaders use language to influence others in order to achieve a certain result. That’s one reason they’re seen as leaders – their words compel people to follow.”

Price, whose latest book is Well Said! Presentations and Conversations That Get Results, suggests that just as words empower others and lead to results-based leadership, so, too, words can “jeopardize your message and credibility” in work-based situations.

Here’s a handy reference guide to what not to say in today’s competitive job environment:

1. Avoid, ‘I’ll try.’
These words imply the possibility of failure. “In 1962, John F. Kennedy did not say, ‘We’ll try to go to the moon,’” argues Price. “He said, ‘We will go to the moon … because that challenge is one that we are willing to accept.’”

Price says that when the goal is to communicate strength and inspire confidence in others, “replace the word ‘try’ with the word and intention of ‘will.’ The comments, ‘I understand the urgency, John. I’ll have it on your desk by 10 a.m.,’ are much more powerful than, ‘I’ll try to have it done.’”

2. Avoid playing the blame game. Do not say, ‘You should have…’
No one likes to be on the raw end of finger pointing. “Ideally, today’s workplace fosters equality, collaboration and teamwork. Instead of making someone feel guilty – even if they are – take a more productive and non-judgmental approach” to managing others, she says.

She suggests trying these words: “Next time, please bring this to my attention immediately.” Or, “In the future, I recommend…”

3. Avoid, ‘That’s not my job.’
As a team player, no matter what your field, one of your jobs is to care about the team’s success. So if someone asks you to do something, “it’s because it’s important to that person,” says Price.

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“That doesn’t mean you have to say yes, but it does mean you need to be considerate and tactful if you say no.” Price advises that if you’re hit with “another work-intensive project by your boss, reply by saying, ‘I’ll be glad to help. Given my current tasks, which of these should I put aside while I work on the new assignment?’ This conveys priority, reminds the boss of your current work load, and shares realistic expectations.”

4. Avoid, ‘I think …’
Why risk coming across as unsure of your message? “Consider the difference between these two sentences: ‘I think our company might be a good partner for you,’ versus, ‘I’m confident our company will be a good partner for you,’” says Price. “The conviction communicated in the second sentence is profound. It’s assertive and certain. To convey a command of content and passion for your subject, say, ‘I believe,’” says Price, not, ‘I think.’”

5. Avoid, ‘This may be a dumb question, but …’
There’s no reason on God’s green earth to diminish your point before you’ve even made it. “Your spoken words reveal the value you place on yourself and your message. Why lessen the significance of what you contribute? Instead, assert your recommendation: ‘To reduce travel costs and increase time efficiency, I recommend we conduct the quarterly meeting online.’”

6. Avoid, ‘I may be wrong,’ or ‘Okay?’
“Imagine an investment banker saying, ‘This is a good way to invest your money, though I may be wrong.’” Hedge – and you could lose the deal. Instead, take charge verbally, advises Price. “Say, ‘This strategy is a wise investment with long-term benefits. With your approval, I’ll move forward by 5 p.m. today.’”

Gaming Twitter: How Newt Gingrich and 50 Cent Score

What do Newt Gingrich, Russian Prime Minister Dmitry Medvedev, Louis Vuitton, and Diddy all have in common? According to a social media watchdog group, they all may have bought their way to Twitter fame, purchasing small armies of followers to boost their digital profiles.

A report in The New York Times takes a look at the murky weirdness of Twitter and Facebook's fake follower problem. Brands, celebrities, and regular ol' you can purchase hundreds — even thousands — of Twitter followers for the right price.

Now, I know what you're thinking: Why would anyone do such a thing?

"For some people, it simply feeds the ego," says The Times’ Nicole Perlroth. "For people and brands, a large Twitter following or Facebook fan base helps increase their visibility. If followers are constantly clicking on links to a brand’s landing page, it also lifts the brand's position in Google's search results."

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According to Altimeter Group, which has been tracking the activity of high-profile accounts, it's all about generating buzz.

But as anyone with an inkling of marketing know-how will tell you, quantity doesn't necessarily equate quality, especially when the followers in question, well, aren't real.

Take the Twitter account of Rep. Jared Polis (D-Colo.), which, for two years, was gaining an average of 15 new followers every day. Then last July, his account exploded with 19,705 new Twitter users, mostly egg avatars. One day a few months later, 13,000 of his followers suddenly evaporated, likely a zap-job by the Twitter mothership.

"Many brands struggle to measure the top line value of social media," Susan Etlinger, an analyst with Altimeter Group, tells The Times. "So there is a thirst to show momentum in different ways, one of which is to show that the brand has a bigger audience today than it did yesterday."

So how exactly does one build a fake online following?

If you're so inclined, you can head over to websites like Fiverr, which functions as a digital billboard for dubious online services. For $5, you can purchase anything from 200 Facebook "likes" to 10,500 "REAL looking Twitter followers."

As Gizmodo notes, writing a script that will add thousands of bots to an account doesn't take any technological wizardry, either. As a "reputable hacker friend" explains it: Generally they use compromised accounts or create them in batches with some kind of captcha bypassing exploits, or by simply creating a bunch of accounts, manually filling those captchas.

But yeah, mostly compromised twitter accounts acquired with botnets, they run a script to make those accounts to follow the profile in question... Nothing complicated really. [Gizmodo]

For the average user, falsely inflating your follower count is more of a vanity project than anything. It's not technically illegal, either — it's just kind of sad. As Mary C. Long at Mediabistro's All Twitter blog notes, "You're a fraud," for starters, and more importantly, possessing an account loaded with dubious #SocialMediaMavens, Beliebers, and sexbots is an obvious "credibility killer."

And on Twitter, where information flies fast and furious,credibility is the one of the rare currencies still worth valuing.

Buyer beware.

This article by Chris Gayomali originally appeared at TheWeek.com

Read more from TheWeek.com:

E-Cigarettes: Could They Change the Tobacco Industry Forever

Why Apple is Purposely Going into Debt

Google’s Anti-Trust Battle: Are the Search Giant’s Proposed Concessions Enough?

3 Things You Need to Know About Traveling This Summer

A week at the beach? A Caribbean cruise? Europe by train?

If you’re like most Americans, you’ve already begun to daydream about your big summer trip. But before you pack your bags, make sure that you’re getting the most for your money—no matter where you’re planning to go.

To help you plan wisely, we’ve rounded up the major industry changes in hotel rewards, cruises and transportation that will affect summer travel this year—some may have you jumping to book that getaway, while others might make a staycation look better and better.

1. Hotels That Aren’t So Hospitable
If there were a Sad-Trombone Award for summer travel, this year’s first-place prize would go to hotel rewards points. Three major brands—Marriott, Hilton and Starwood—have increased the amount of points needed to book a free hotel room.

Marriott
Marriott Hotels, which includes Ritz Carlton and Fairfield Inn & Suites, among others, has moved 36% of its properties (more than 1,000 hotels) into higher rewards categories. This means that some hotels that used to require 15,000 points per night to book a free room now require 20,000 points; others that used to require 30,000 points now demand 35,000. What’s more, 13 of the brand’s properties have been placed in Category 9—a new designation requiring 45,000 points for a free room.

If you have points to redeem, and want to get the best deal, book your room now. The changes go into effect on May 15, but all rewards points bookings made before that date will be honored at the price point at which they were booked.

Hilton
Hilton’s most significant changes come in the form of what they’re calling Seasonal Pricing. Previously, the amount of rewards points needed to book a free room was the same throughout the year, but it now varies based on demand. This is good news for people who want to travel during the shoulder season, when demand for rooms is low, explains public relations executive Matt Kochis. “For example, you had to use the same amount of points to stay in Park City, Utah, in the summer as in the winter,” he says. “With seasonal pricing, members have the opportunity to book at a number of hotels using [fewer] points, depending on the time of year.”

Although this is true, for those traveling during the summer months when demand peaks, seasonal pricing means shelling out significantly more rewards points as was previously required. The changes span the entire brand, including Waldorf Astoria, Doubletree, Hampton Inn and more.

Starwood
Members of Starwood Hotels and Resort’s loyalty program—including Sheraton, Westin and W Hotels—will notice that 20% to 25% more points and cash are required to book rooms via the brand’s Cash & Points program. For example, before the change, a room in a category 6 hotel, like the W New York in Times Square, would have required 8,000 points, plus $150. Now the same room requires 10,000 points, plus $180. On the upside, the new model lets members use their points for upgraded rooms and suites, an option that wasn’t available before.

Thankfully, not all the news is bad. Last month, Hilton introduced a 5th Night Free benefit for Silver, Gold and Diamond elite members who use their points to book Standard Rooms for five consecutive nights or more. And Starwood and Delta Airlines recently announced a partnership called Crossover Rewards that gives reciprocal benefits to Delta Skymiles Medallion Members and Starwood’s SPG elite members.

For example, an SPG elite member flying to Tokyo would earn SPG points plus SkyMiles—and would enjoy all the benefits a SkyMiles member would, like a free checked bag. Likewise, a Delta SkyMiles member staying at a Starwood property would be treated as an elite SPG member, with priority check-in, late check-out and free in-room Internet. “It’s the first partnership of its kind in hotel-airline history,” says Maire Griffin, who’s in charge of public relations for Starwood’s SPG program.

2. Cruise Control
For the past several years, major cruise lines have lured summer travelers with rock-bottom prices. This year they’re making a different appeal to customers, says Carolyn Spencer Brown, editor-in-chief of Cruise Critic. “This is something I’ve never seen before,” she explains. “There aren’t a lot of bargain-basement prices, but cruise lines are throwing in a lot more extras, like free cocktails and free gratuities.”

These freebies may sound trivial, but when you consider that it’s easy to pay more for extras than for the cruise itself, they add up to significant savings. “If you do the math, the cruise can actually turn out to be cheaper this way,” Brown says.

You can also score great deals on European cruises this summer. “Cruise lines saw that Europe was becoming more popular with their customers, so they overcommitted ships,” says Brown. Since there are now more cabins than customers, prices have been slashed. European cruises don’t always include airfare, so you have to factor that into the cost. But even with that, says Brown, it can still work out to be an excellent bargain.

Perhaps the greatest deal to be had—this or any summer—is a repositioning cruise. At the end of every season, cruise ships make one-way trips back to their home ports, and they’re always looking for customers to fill the boats. The trips are one way, and they can mean a lot of time at sea because they don’t stop at as many ports as a standard cruise, but the prices can be as low as $30 a day—an unheard-of price for any other type of cruise.

3. Planes, Trains and Automobiles
There’s been a lot of media buzz about the airline industry adopting what it’s calling a New Distribution Capability—a benign way of saying that customers will be charged different amounts for seats depending on whether they’re flying for business or pleasure, where they’re flying from and how often they fly.

The bad news: The rumors are true. The good news: The changes won’t affect travel for summer 2013. “We will begin pilot projects in 2013-2014, but these will not be broad-based trials,” says Perry Flint, head of corporate communications for the International Air Transport Association (IATA). “We anticipate deployment could begin in 2015-2016.”

If you’re hoping to travel Europe by train this summer, choose your Eurail pass carefully. As of this year, the Eurail Select Pass no longer includes train travel within France. To visit that country, you’ll need a Eurail Global pass. On the upside, Turkey became a Eurail pass member this year, and the country is accessible with both the Select and the Global passes.

Road trippers won’t be quite as hard hit as in the past few summers. Gas prices, of course, tend to follow demand, peaking during summer months. This year doesn’t look to be any different, but according to the U.S. Energy Department, the overall predicted median price for 2013 is lower than last year—an estimated $3.56 per gallon versus $3.63 in 2012. Gasbuddy.com’s annual forecast looks promising too. Last year’s predicted summer prices ranged from $3.80 to $3.91, while this summer’s fall between $3.60 and $3.73. A small savings, perhaps, but with hotel rewards points losing value, and airlines threatening to charge more in the future, any silver lining is a welcome one.

By Beth Collins, LearnVest

More from LearnVest:
Checklist: I Want to Plan a Trip

13 Free Travel Apps Everyone Should Know About

Take Your Dream Trip: 5 Surprisingly Affordable Destinations for 2013

Commencement Redux: Inspiring an Indebted Generation

There were blue skies over the National Mall, and it was packed with jubilant George Washington University grads in caps and gowns and a bevy of appropriately dressed parents sitting on folding chairs on the lawn. So sunny, we moved our chairs under the shade of a tree. My husband, my children and I had flown to Washington, D.C., from Los Angeles as my son Ethan Harari is a proud member of the G.W. graduating class.

As Brian Williams stepped up to the podium to deliver the commencement speech, the skies turned dark. He smiled and said something like, “Perfect,” as it in some way mirrored his chequered collegiate past. He’d managed to amass 18 credits (at three colleges) before dropping out of the very same George Washington University’s night school. He had a good excuse — he was an intern at the White House and had an access-all-areas pass.

And he couldn’t afford college. He was, also, wearing a cap and gown (with a brilliant black and white diagonally striped tie peeking out from his collar) as G.W. was giving him an honorary doctoral degree.

I want one. Like Brian Williams, I didn’t go to college. I finished high school during a winter session and when fall came around I was a working journalist, my family was somewhat dysfunctional, and, at the time, not going to college was a legitimate choice. I always wanted to start a society of people who didn’t go to college, kind of like that society of people who went to Harvard or G.W. Not that either Brian Williams or I am advocating not going to college.

I love Brian Williams. He makes me feel calm. He seems appropriately astonished and interested in the news he delivers, which may have as much to do with the pitch of his eyebrows as the tenor of his voice. I feel the same way about him that my mother felt about Walter Cronkite.

Curiously, Walter Cronkite delivered my high school commencement speech. I attended a small boarding school in Vermont, and his daughter was in my graduating class. Everyone was excited that Walter Cronkite was giving our high school commencement speech. He talked to us about robots. The entire class’s eyes glazed over.

He told us that by the time our children graduated from college, the world would be run by robots. We wanted him to tell us that the world was our oyster, that we had infinite possibilities. And he was talking to us about robots.

The girls in the class wanted him to talk about equality, how we could break the glass ceiling, and that there was a place for us in the work force. And he was talking to us about robots. He wasn’t wrong in some ways; he wasn’t entirely right. I’m still missing that robot that was supposed to bring me coffee in the morning.

We weren’t really sure about Walter Cronkite’s politics. He didn’t make regular appearances on nightly talk shows. In those days, newscasters were supposed to keep their opinions to themselves. But the one thing we knew about Walter Cronkite was that he loved the moon. He loved the space program.

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The first Apollo mission was set to launch in August the year I graduated from high school. And the most searing, powerful robot image I’ve ever seen, which reminded me of Walter Cronkite, was of the Mars rovers. They almost had personalities. They had names. Two of them were called Spirit and Opportunity. We lost contact with Spirit in 2010. Opportunity is still operational. A third rover, Curiosity, was expected to land on Mars in August 2012. (Update: It did.) And I suspect Walter Cronkite loved them as much as I do.

Brian Williams, who is the anchor of the NBC Nightly News and the host of the news magazine show “Rock Center,” has pitch-perfect comedic timing, as evidenced by his appearances on “The Daily Show,” and whose politics seem slightly more transparent from same, also loves the space program, but more about that later. He also knows a little bit about the potential difficulties for recent college grads, the difficulties of being in your early 20s in 2012.

Allison Williams, his 23-year-old drop-dead-beautiful daughter, who graduated from Yale, is one of the stars of the Lena Dunham-created HBO series “Girls.” The world is somewhat divided on “Girls.” Girls are divided on “Girls.” You either think it’s hysterically funny or deeply depressing. There doesn’t seem to be much in between. (Note to all: Do not pretend it’s “Breaking Bad” and watch five episodes in a row.)

But just the fact of “Girls,” the fact that it’s on the air — in what has been a banner year for women and female-driven entertainment that is not the lighthearted norm (“Hunger Games” comes to mind) — is an extraordinary achievement. But it sort of gets under your skin and I can’t help but tune in to see what horrible thing Lena Dunham’s character is going to do this week, what “out there” thing Jemima Kirke’s character will do or what silly thing will happen to the frozen virgin. Allison Williams, following in her father’s footsteps, is in some way the anchor of “Girls,” the most stable one, but she’s probably about to do something really dumb, too.

Brian Williams elegantly did not mention “Girls” in his commencement speech, but he did segue to a more serious tone, practically a Jimmy Stewart impression, midway through. He talked about the stalemate in Washington and how the Constitution was based on compromise.

He urged the students at G.W., which has a curiously diverse political population unlike most liberal arts colleges, to introduce themselves to one another, to try to get along, to have a dialogue, to try not to stay on two opposing sides of the fence. He also, curiously, talked about the Smithsonian National Air and Space Museum on the other side of the National Mall, where the bullet-shaped Bell X-1 is on exhibit. The one that Chuck Yeager flew (having no idea if he would succeed or not) and broke the sound barrier for the first time.

He talked about how John Glenn hummed “The Battle of the Hymn of the Republic” as he was about to re-enter the earth’s atmosphere with flames shooting around him as he was certain he was going to die. (Not certain that would have been my song choice, but he’s John Glenn.)

As Williams talked about the moon missions, he, of course, reminded me of Walter Cronkite. He talked about how sad it was that we had to ask the Russians last week to fly our astronauts to the space station because we no longer have the ability. He talked about how pollsters were saying for the first time that people in this nation are feeling that they are not leaving the next generation a better world and better possibilities. (I wondered how the graduating class of G.W. felt about that.)

And then, with the eye of the Washington Monument a beacon behind him, Williams congratulated the students on their achievement. “You don’t actually have to build a rocket,” he said, “but please take us somewhere. Please keep us moving. Push us, lift us up.”

And the thing about being 22 and a college graduate (and the thing about Brian Williams, and Chuck Yeager, and John Glenn, and Walter Cronkite in his time) is that you feel, despite any evidence to the contrary, despite the pollsters and “Girls” and the changing face of NASA, that the world is full of infinite possibilities and even though there are no guarantees, it doesn’t occur to you that you won’t succeed. Here’s to this year’s graduating class.

This piece was originally published in The New York Times’ T Magazine online in Amy Ephron’s column L.A. POV.

How a $2 Trillion Shadow Economy Fuels the U.S.

The growing underground economy may be helping to prevent the real economy from sinking further, according to analysts.

The shadow economy is a system composed of those who can't find a full-time or regular job. Workers turn to anything that pays them under the table, with no income reported and no taxes paid — especially with an uneven job picture.

"I think the underground economy is quite big in the U.S.," said Alexandre Padilla, associate professor of economics at Metropolitan State University of Denver. "Whether it's using undocumented workers or those here legally, it's pretty large."

"You normally see underground economies in places like Brazil or in southern Europe," said Laura Gonzalez, professor of personal finance at Fordham University. "But with the job situation and the uncertainty in the economy, it's not all that surprising to have it growing here in the United States."

Estimates are that underground activity last year totaled as much as $2 trillion, according to a study by Edgar Feige, an economist at the University of Wisconsin-Madison. That's double the amount in 2009, according to a study by Friedrich Schneider, a professor at Johannes Kepler University in Linz, Austria.

The study said the shadow economy amounts to nearly 8 percent of U.S. gross domestic product. Much of that money goes into cash registers, said Gonzalez, as personal consumption has risen since the recession. "There is consumer spending in the short term, with people having money even if it's not reported, and that's boosting the economy," she said. "But in the long run, an underground economy is telling us that things have to change."

Shadow economies are usually associated with illegal activity, such as drug dealing. But anecdotal evidence indicates that off-the-books work in today's job market includes personal and domestic workers, such as housekeepers and nannies.

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"The jobs are in service industries from small food establishments to landscaping," said David Fiorenza, an economy professor at Villanova University. "Even the arts and culture industry is not immune to working off the books in areas of music and entertainment."

It also includes firms that hire hourly or day construction labor, information technology specialists and Web designers. Many who have a job that doesn't pay enough take another one that pays under the table.

"We've always had people who make income without recording it, so it's not really new," said Peter McHenry, an assistant professor of economics at William & Mary College. "But the fact that more and more people are doing it shows how bad the job picture is," he added.

The reasons behind the underground economy's growth are fairly simple, according to Gonzalez. "There's a lot of uncertainly about immigration changes and who will be legal, and about paying for Obamacare," she said, adding that most workers in the shadow economy are in the country illegally. "Government rules are keeping businesses from hiring."

A report from ADP Research states that many employers, especially in low-wage businesses such as retail and food service, plan to reduce workers' hours to less than 30 a week to avoid having to offer health benefits through Obamacare (or pay a fine). "This type of regulation could put more people out of work and into an underground economy," McHenry said.

But employers have their own agenda, according to Padilla. "Businesses are not angels, and they exist to make a profit," Padilla said. "They are going to do everything they can to keep costs down, and if that means paying people off the books, they will do it. The government doesn't really have the resources to track down every business that does this."

What the government is keeping track of is lost revenues. According to the Internal Revenue Service, about $500 billion in taxes were lost last year because of unreported wages, versus $384 billion in 2001. "The effects of the underground economy are larger than we think," said David Fiorenza. "The result is less tax money paid to the various levels of government."

"Those working and not paying the taxes puts the burden on those who pay the tax," added Fiorenza. "Taxes could be lower if the government where able to capture the underground economy instead of raising taxes on those currently paying the various income and payroll taxes."

But the dangers of a shadow economy go beyond dollars and cents, analysts said. Workers who aren't on the books don't get Social Security or health benefits, and worse. "People who do these types of jobs run the risk of getting exploited with lower pay or not being paid at all," Gonzalez said. "There could be more exploitation if more people are forced into this type of economy."

"Some income is better than none, but there is a reason we have certain regulations in place to protect workers and what they do," McHenry said.

In the end, what's happening below the normal economy should not come as too much of a shock, according to Gonzalez. "People are running out of patience when it comes to finding a job and losing income," she said. "So it's not that surprising to have workers take jobs that are in the shadow economy. But it's a sign of how bad things are and how we have to get the real economy moving again."

This article originally appeared in CNBC.com.

10 Golf Items to Make You Green with Envy

It has been said that golf is a rich man's sport, but times have changed.

A Google search of the term "cheap golf" returns hundreds of thousands of results, some of which lead to courses with green fees as low as $17 a player.

SLIDE SHOW: 10 High-End Golf Goodies You Can't Live Without

Clearly, the game is no longer the exclusive province of the wealthy. But that doesn't mean that sellers of golf-related luxury items have gone all wobbly, nor does it mean that their customers have, either.

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Golfers with extravagant tastes are still vital to the game's culture, and upmarket brands such as MGM Resorts and Ferrari have the goods to sell them, at top dollar.

Here is a list of 10 high-end extravagances for the golfer who demands the best and for whom money is no object.

Read ahead to see what they are and, more important, what they cost.

Click here for 10 High-End Golf Goodies You Can't Live Without

This article originally appeared in CBNC.com .

Why a Part-Time Workforce Is the New Normal

Darrell McCall, 29, worked full time as a salesperson at Juicy Couture’s flagship store in New York City for two and a half years. He had health insurance and a 401(k). “It was one of the few good jobs on Fifth Avenue,” he says. “I was able to get by.”

That changed last year when Juicy started letting full-time workers go and replacing them with part-timers who accepted lower pay and no benefits, McCall says. According to Yana Walton of the Retail Action Project (RAP), an organization of retail workers dedicated to improving labor conditions, nearly half the employees at the Juicy flagship used to be full-timers. Now, only 19 of the store’s 128 employees work full-time. Juicy Couture could not be reached for comment.

Last Thursday, RAP staged a protest outside of Juicy Couture’s flagship store in response to the widespread “part-timing” of workers. In addition to Juicy Couture, other retailers like DSW, J.C. Penney and Abercrombie & Fitch have adopted similar policies, says Walton.

The “part-time only” trend picked up steam during the recession. Analysts say one reason is the passage of the Affordable Care Act—commonly called Obamacare—and the mandate that businesses with 50 full-time employees or more must provide health insurance, which has become even more expensive. In January 2006, there were about 4.6 million involuntary part-time workers. In January of 2013, there were about 8.6 million—almost double, according to the BLS.

“Many employers are looking to make the employment relationship more flexible, and so are increasingly relying on part-time work and a variety of arrangements known as ‘contingent work,’” said Federal Reserve Governor Sarah Bloom Raskin in a speech last month. “[It’s] a sensible response to today’s competitive marketplace…and allows firms to maximize workforce flexibility in the face of seasonal and cyclical forces.”

Before Obamacare, there was no legally accepted definition of full- or part-time. Under the new act, which takes effect on January 1, 2014, a worker is considered full-time if he or she works at least 30 hours per week.

The practice isn’t limited to the retail industry: Many fast food franchisees of chains such as Burger King, McDonalds and Taco Bell are considering a shift in hiring structures to circumvent the new rules. A 2012 study by the Mercer consulting firm found that of retail and wholesale firms that don’t currently offer insurance coverage, 67 percent “are more inclined to change their workforce strategy so that fewer employees meet that [30 hour a week] threshold” specified in the ACA.

Low-wage jobs have been growing at a particularly fast clip during the economic recovery, with eating and drinking establishments accounting for almost one in 13 of all American jobs in March. The retail sector employs an additional 14.8 million people, and about 654,000 new retail jobs are expected to be created between 2008 and 2018, according to the National Retail Federation. If more employers reevaluate their workforce strategy, as the Mercer study suggests, more workers will be affected.

More part-time workers could also mean fewer employment protections, notes Raskin. Part-time often receive less pay and fewer benefits than traditional workers, and are much less likely to benefit from labor and employment laws. “[They] often have no real pathway to upward mobility in the workplace,” she said.

Although Obamacare doesn’t take effect until 2014, Walton explains that there’s a “look back” period to determine eligibility for employees starting in January of next year. Employers can decide to use the past 3 months, 6 months or year to measure their number of full-time employees. It makes financial sense for many retailers to start tracking the data now, when shopping is relatively slow. That way, when their workers’ hours are eventually averaged out, few will average more than 30 per week, even if they work extra during the holidays.

“Operators can’t be as casual about workers’ total hours as they could before because there are fines and penalties and costs associated with it,” Scott DeFife, executive vice president for policy and government affairs for the National Restaurant Association, told The New York Times. “You can’t accidentally let them become full-time without a specific purpose.”

Joe Olivo, co-owner of the family business Perfect Printing in Morristown, New Jersey, has 49 full-time employees. He provides high-deductible plans to his employees already, but has seen insurance rates rise as much as 40 percent in recent years. He’s worried because Obamacare, he says, “is doing everything it can to discourage high deductible plans.” As a result, his current plan will no longer be an option, and he doesn’t have a sense of how much an alternative plan will cost. The recent insurance rate hikes “have certainly hurt my employees,” Olivo says, “and have taken the place of a lot of wage increases I’d typically give. Since I’m paying more for their insurance, it’s definitely affected my ability to give raises.”

With the new legislation, Olivo is desperately trying to stay under the 50 employee mark: “I’m doing everything I can to avoid that—hiring temps, part-timers, keeping them under 20 hours a week. It’s a nightmare to manage a business that way.” Olivo has been hiring temporary employees from staffing agencies, so they don’t count toward his total.

Similarly, Bob Bellagamba of Concorde Worldwide, a ground transportation business in Freehold, New Jersey, says with Obamacare, he has no idea what his costs are going to be next year. Concorde Worldwide offers health insurance to its roughly 75 full-time employees, but only about 20 employees have chosen to be on the company plan. Bellagamba anticipates that after Obamacare takes effect, more employees will choose to accept the company’s insurance—but he has no idea how many that will be. Currently, he is paying about $60,000 a year for his employees’ insurance coverage. “What happens if that amount goes up to $100,000?” he asks. To prepare for the new legislation, he’s cut staff as people have left or been terminated and redistributed work. “We’re trying to do more with less.”

Although it’s tempting for some employers like Olivo to take their workforce more part-time to avoid Obamacare’s requirements, Christine Pollack, the vice president of governmental affairs at the Retail Industry Leaders Association says that in many cases, shifting to a workforce of part-timers wouldn’t be prudent. For example, that would mean hiring far more workers, training them and managing all of their schedules, all of which have overhead and problems of their own.

Last year, the Florida-based Darden Restaurants – owner of Olive Garden and other national chains – experimented with reducing hours at some of its restaurants in response to rising health care costs. After trying it out, Darden Restaurants reversed the policy and announced that it wouldn’t cut hours from any full-timers in response to the Affordable Care Act. According to Entrepreneur magazine, Darden’s CEO Clarence Otis cited declining guest satisfaction and employee engagement when they had more part-time workers.

“[Obamacare]has changed the way all employers are thinking about their benefits structure and how they will grow as a business. There are a lot of business implications, but it isn’t as cut-and-dry as cutting everyone’s hours,” says Pollack.

Blaire Briody contributed reporting.

‘Air and Water’ No Longer Free at Cooper Union

There wasn’t much chance at all that any of my children would one day go to Cooper Union, the Manhattan-based scholarship college with highly regarded programs in art, architecture and engineering – my kids don’t want urban.

But the mere fact that there was a prestigious and free college in the heart of a great city – an apple ripe for the picking – was just good to know.

It was refreshing, somehow, in an age of budget-busting, backbreaking costs.

But that was yesterday. Cooper Union has just announced that beginning in the fall of 2014, it will charge tuition to undergraduates.

Why? Budget troubles, of course. The school has been operating at a $12 million annual deficit, administrators say. Fundraising drives haven’t yielded the goods. The college’s expenses, including rent payments, have ballooned over the years, while loan payments and health care costs have also been swelling.

Not one undergraduate has paid for an education at Cooper Union in more than 100 years.

“The time has come to set our institution on a path that will enable it to survive and thrive well into the future,” the school’s chairman of the board, Mark Epstein, said in a statement. “Under the new policy, the Cooper Union will continue to adhere to the vision of Peter Cooper, who founded the institution specifically to provide a quality education to those who might not otherwise be able to afford it.”

Using a slide scale, the school says it will now charge those it deems able to pay approximately $20,000, while others – including those “with the greatest needs” – will pay zero.

Some of the students and faculty were so distraught by the decision they decided to give the school a giant “symbolic hug,” as The New York Times called it, literally joining hands and wrapping themselves around one of the school buildings after the news broke.

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There are, of course, still a few other schools in the country that don’t charge for tuition. The College of the Ozarks, a Christian-based work college in Branson, Missouri, requires students to work 15 hours a week and do two 40-hour work weeks during the academic year.

The work hours are then “applied to the cost of education (tuition),” the college says, which in the 2011-2012 academic year totaled $17,600. “Earnings from participating in the work program, plus any federal and/or state aid for which students qualify, plus a College of the Ozarks ‘cost of education scholarship,’ combine to meet each student’s full tuition charge,” the college states on its site.

The service academies in this country are generally “free,” too, although graduates must, in return, give several years of their lives to active military duty. The United States Military Academy at West Point, for example, still requires five years of active duty. Students graduate as commissioned officers in the Army.

Then there’s Macaulay Honors College at The City University of New York in Queens. Founded in 2001, the school provides free tuition for in-state residents. Students are also given a $7500 fund “to pursue global research, study, service and internships,” as well as a laptop and “a cultural passport” that gives access to arts and cultural venues in the city.

The Curtis Institute of Music in Philadelphia, which educates “exceptionally gifted young musicians for careers as performing artists on the highest professional level,” has had an all-scholarship policy since 1928, providing “merit-based full-tuition scholarships to all undergraduates and graduate students, regardless of their financial situation,” the school says. Its total enrollment for the 2012-2013 academic year? Just 166 students.

Still and all, there was something about the iconic Cooper Union, whose education was long revered as “free as air and water” (as its unofficial motto put it) that stood out.

Mourning the loss of a free college is directly proportional to the angst about the high costs of a college education. Since 1978, college tuition has increased 1,120 percent, says CourseSmart, an e-textbook provider. The average debt total at graduation is about $27,500. And nearly one in five households in this country is paying off student loan debt, according to the Pew Research Center.

What happens when a child doesn’t even graduate in four years – but stretches the experience to five years or more? That’s a whole other (pricey) story.

6 Signs You’re Ready to Retire Early

No. 1: You are emotionally ready to quit working
Both the big picture and the fine details of your financial and emotional states are important to consider when assessing your readiness for early retirement. If you're not emotionally ready to quit working, you may not be ready to retire.

"What are you planning on doing that will continue to allow you to enjoy your life, allow you to stay active mentally, emotionally and spiritually?" asks Richard Reyes, a CFP professional and coach with The Financial Quarterback in Maitland, Fla. "In retirement, every day is Saturday."

Being ready financially is a no-brainer. Jeff Currie, an adviser with Icon Financial Services in Boise, Idaho, offers this quick assessment of financial readiness: "no debt, a good pension that includes health insurance benefits, good savings and low expenses. All of these factors can lead to a person retiring early. In most cases, the early 50s is about the most realistic and early I have seen. It usually involves an inheritance to boost a person's normal assets."

While some tend to associate retirement with a specific age, "It's really about getting your budget and liabilities under control, then having a clear understanding of the resources available to create the desired and consistent retirement income you need," says Sean Lee, a financial adviser with SPL Financial in Salt Lake City.

No. 2: You followed a retirement budget for 6 months
Expenses may drop in retirement, but not as much as you might think. That's why crafting a post-retirement budget and living off that budget for six months before you retire can help you decide whether your budget is realistic and whether you can stick with it.

Treat this exercise as a serious trial run, says Amy Rose Herrick, an investment adviser in St. Croix, U.S. Virgin Islands. "If you can't do this for six months without raiding savings or tapping credit cards to live, you are not ready yet," she says.

To put that post-retirement budget together, you need to understand what your cash flow will be like after retirement, says Helen Hogan, an investment adviser with Sunset Financial Services in Red Bank, N.J. "How much money do you need every month, including the quarterly and annual expenses, the unexpected and hidden expenses?" she asks.

It's important to factor inflation into your budget, says Jamie Patrick Hopkins, an assistant professor of taxation at The American College of Financial Services in Bryn Mawr, Pa. "Inflation is low now, but it could easily go up to 5 percent," he says. "Fifteen or 20 years of that type of inflation can really eat into savings and increase expenses."

No. 3: You have reliable health insurance coverage
Because Medicare doesn't kick in until age 65 and health insurance costs are rising faster than inflation, it's important to have a reliable, consistent source of health insurance. While health care reform will make health insurance more widely available, that coverage may get expensive. For many would-be early retirees, affordable coverage is most likely to come from a former employer.

"Having adequate health insurance and other insurance coverage including life, disability and long-term care is a factor in whether you can retire early," says Harrine Freeman, CEO of H.E. Freeman Enterprises in Bethesda, Md. A policy with low deductibles and copays that covers prescriptions, doctor visits, hospitalization, dental and vision will help keep out-of-pocket expenses as low as possible.

No. 4: Your children are financially independent
Children, especially in their college years, are expensive. To retire with children who are still financially dependent, there needs to be enough savings to cover college expenses, says Don Cummings, a financial adviser with Blue Haven Capital LLC in Geneva, Ill.

"Are there children with special needs who may be living in the household or perhaps on their own who will continue to be an expense?" he asks. "What about parents with similar needs?"

Hopkins notes that divorce can torpedo the most well-crafted retirement plan, leaving both parties with fewer assets, more expenses -- including legal fees -- and an extended period of financial uncertainty. While it's not possible to necessarily predict divorce, marital harmony about retirement dates, goals and spending lends stability to the family situation as retirement is contemplated.

No. 5: Your debts are paid off or nearly paid off
One big sign that you are not ready to retire early: You still owe money to creditors.

Paying debt from a retirement budget cuts into what you can spend in retirement on doing the fun things that you've waited years to do, not to mention paying for necessary items such as utilities, taxes, food and home maintenance.

"My guidelines for early retirement include asking clients first whether their home is paid off," says Curtis Chambers, a financial adviser with Chambers Financial Group in Clearwater, Fla. "If it is not, then retirement is not on the radar screen. Second, do they have debt? If they have debt, they are probably not ready to retire."

No. 6: Your portfolio is big enough to withstand losses
Because everyone's standard of living is different, there's no magic amount that automatically qualifies you for early retirement. That being said, a portfolio that is large and diversified by asset class can protect you in bad markets. If it's composed of different types of tax-deferred and tax-free assets, your portfolio is more likely to throw off enough income to sustain a long retirement than one that isn't.

"I tend to look at income that can be generated from a portfolio and use a 4 percent withdrawal rate. And I look at things like rental properties or business ownership that may generate other income," says Cummings. "In addition to that, we look at the potential for additional funds from business sales or inheritances and the size of the 401(k), deferred compensation plans, 403(b), pension, and guesstimate the amount of income that will generate when an individual turns 59 ½."

One gauge of whether or not you are ready to retire is the amount you have saved as a multiple of your income. According to Fidelity Investments, you should have saved at least eight times your pre-retirement income by age 67 to ensure a secure retirement. If you want to retire earlier than that, you should probably shoot for more.

By Amy E. Buttell, Bankrate.com