Date: 5/27/2009
RAY HENRY
Associated Press Writer
PAWTUCKET, R.I. (AP) — Joanne Devlin needs about 20 prescription drugs to regulate her blood pressure, keep her arthritic joints limber and pain-free and control her asthma.
She counts on financial help from Rhode Island when her Medicare Part D insurance plan maxes out and no longer pays her drug bills, which can reach $3,000 every three months. But that state help may no longer be an option after Jan. 1.
The financial crisis has grown so severe that lawmakers in Rhode Island and five other states have debated whether to cut or reduce the state funding that helps seniors and disabled people like Devlin buy their drugs.
Devlin, 62, who lives off about $10,000 a year, worries she may need to stop taking her arthritis medication to make ends meet. She stocks shelves and helps distribute food as a volunteer at a Salvation Army food shelter.
“I wouldn’t be able to move a lot,” she said. “I probably wouldn’t even be able to come here. I’d probably have to stay home and some days be bedridden, probably.”
Devlin’s predicament is shared by many of the nearly 27 million people enrolled nationally in Medicare Part D, the federal insurance plan that covers prescription drugs for seniors until the total bill reaches $2,700.
Seniors then hit what’s commonly called the “doughnut hole,” and must personally pay the drug bill until their out-of-pocket costs reach $4,350, at which point Medicare coverage resumes. When seniors fall into this gap, 16 states offer financial assistance, said Thomas McCormack, a consultant for the Community Access National Network and editor of the Medicaid Watch newsletter.
Other states offer help to help defray some of the premium costs associated with Medicare.
Eliminating the program in Rhode Island would save about $700,000 and affect around 8,000 people, while a proposal to scale back benefits in South Carolina would have trimmed roughly $7 million. Officials in South Carolina have estimated about 22,000 people are eligible for the program.
Those savings aren’t huge: they amount to less than 1 percent of the total budget in both states.
Vermont’s governor proposed eliminating the funding this year, but lawmakers instead instituted co-payments that cost recipients $1 or $2. New York and Connecticut rejected plans to curtail assistance, while Massachusetts has scaled back co-payment assistance for its seniors.
Advocates for the elderly fear the cuts will force cash-strapped seniors to stop taking their medications, leading to serious health problems.
“What we repeatedly see happen is that people stop taking their medications, they get sick, they end up in emergency rooms and the they get hospitalized for more serious health problems,” said David Certner, the legislative policy director for AARP.
“In the long-term, this is going to cost more money because it’s going to lead to greater health problems,” Certner said.
Bill Flynn, executive director of the Senior Agenda Coalition of Rhode Island, believes the Rhode Island proposal is the result of across-the-board budget cuts run amok.
“The approach in hard times should not be necessarily, ‘Well, everything’s on the table so low-income seniors need to suffer along with everyone else,’” he said. “The human cost of something like this could be pretty profound.”
In January — as South Carolina grappled with worsening unemployment and $1.1 billion in cuts to its $7 billion budget — the state slashed its doughnut-hole help for seniors from 95 percent to 10 percent.
Gov. Mark Sanford vetoed nearly all of a $5.7 billion budget, including all Medicaid and prescription drug spending, in a fight over using $700 million in federal stimulus money. By overriding his veto on May 20, lawmakers raised South Carolina’s doughnut hole coverage to 40 percent.
Sanford, who says it is unconstitutional for lawmakers to require him to use the stimulus cash, has responded by filing a federal lawsuit.
He said the vote to force him to seek the cash was unconstitutional and that he would fight it in court.
In Rhode Island, which is also wrestling with high unemployment and severe budget shortfalls, Gov. Don Carcieri has proposed cutting his state’s prescription drug program for seniors.
“It was a very difficult decision, and it’s strictly a budget decision,” said Corinne Russo, director of the state Department of Elderly Affairs, which runs that program.
Carcieri’s plan would eliminate next Jan. 1 the program that pays 60 percent of drug costs for its poorest enrollees and covers all their costs beyond $1,500. The assistance, which costs $1.5 million and serves more than 8,000 people, mostly targets the poor, Russo said.
About three-quarters of the state’s funding helps the poorest people enrolled in the program, the group Russo most worries might skimp on medication to make ends meets.
“Those are the people who are most at risk either of not purchasing medication or not being compliant with their medication regimen,” she said. “If a doctor says take one a day, they may take one every other day,” she said.
Compromises may keep the assistance operating. Carcieri’s administration is investigating whether it could use federal Medicaid funding to keep the program running, or perhaps restrict it to the neediest only.
Democrats hold a veto-proof majority in the state Legislature, allowing them to rewrite the Republican governor’s spending plans. But Rep. Steven Costantino, the Democratic chairman of the House Finance Committee, said he could not commit to saving it.
Lawmakers have asked Carcieri’s administration to present them with cost-saving alternatives to totally eliminating the program.
“We’re at the point where we need to ask everybody to sacrifice on this budget,” Costantino said.
And that frightens Anne Fortin, 72, who counts on the state’s help to help her pay for drugs that control her asthma and emphysema. Without it, her monthly drug bill would easily double to $400 or more.
“I could never pay that,” Fortin said. “I’ve been thinking about it. I said, ‘My God, what am I going to do?’”
___
Associated Press Writers Jim Davenport in Columbia, S.C., and John Curran in Montpelier, Vt., contributed to this report.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
Swine flu outbreak reveals military plans, gaps
Date: 5/20/2009 7:18 AM
LOLITA C. BALDOR
Associated Press Writer
WASHINGTON (AP) — The rapid spread of swine flu from Mexico surprised Pentagon officials, who had been focused on a possible Asian-borne pandemic in a response plan that would give the military a last-resort role in helping to impose quarantines and border restrictions.
Drafted and overhauled several times in recent years, the military’s closely guarded plan for an influenza pandemic assumed that officials would have more time before the flu hit U.S. shores. The Associated Press obtained briefing documents about the military’s pandemic contingency plan.
The H1N1 flu outbreak set U.S. military commanders scrambling to monitor and protect troops based near the 2,000-mile southern border and on ships nearby.
The virus spread quickly across the border into Southern California, infecting at least 27 sailors on a ship docked at San Diego, four Marines at Camp Pendleton and at least one Marine at Twentynine Palms. Several dozen Marines have been quarantined, and nearly two dozen other sailors had flu symptoms but have so far not been confirmed as having the H1N1 virus.
“We anticipated scientifically that we would have time to do different things,” said Amy Kircher, an epidemiologist with U.S. Northern Command’s surgeon general’s office. Northern Command oversees the country’s homeland defense, including coordination with Canada and Mexico.
While there are only a limited number of airports and seaports that could provide U.S. entry for the virus from overseas, the military was faced with an almost limitless number of cars, trucks and pedestrians traveling across the easily accessible, expansive border with Mexico.
In an interview with the AP, Kircher and several senior military officers from U.S. Northern Command said that since the swine flu has been far less lethal than anticipated, it has allowed the military to stop far short of the worst-case scenarios that the Pentagon prepared for in its long-range planning.
But in the event of a widespread pandemic, the Pentagon maintains standing plans to use the active-duty military as a last-resort force to help law enforcement manage quarantines, limit state-to-state travel and restrict access to government buildings.
Those plans represent “the kinds of things that the lead federal agencies might ask us to do or that we might have to do on behalf of the Department of Defense for force protection,” said Air Force Brig. Gen. Tony Rock, who until recently was deputy director for operations at Northern Command.
Officials would turn to the military for those domestic duties, Rock said, only when other authorities become overburdened and request assistance.
The requests must then be evaluated and approved by top officials, such as the defense secretary or the president.
“Some of these are in extremis, and certainly wouldn’t be the first tasks we would do,” said Army Col. Curt Torrence, a key military planner for Northern Command. He added that they would be carried out only under catastrophic circumstances and in accordance with federal laws.
Northern Command briefing documents obtained by The Associated Press include explicit assumptions that intelligence oversight laws and the Posse Comitatus Act would remain in effect.
Under that Civil War-era act, federal troops are prohibited from performing domestic law enforcement actions such as making arrests, seizing property or searching people.
In extreme cases, however, the president can invoke the Insurrection Act, also from the Civil War, which allows the use of active-duty or National Guard troops for law enforcement.
Under the military’s pandemic plan, the key goals are to defend the country, maintain the force and provide whatever support is needed to protect the national infrastructure and ensure that the government continues to function.
Rock, who recently was named commandant of the Air Command and Staff College at Maxwell Air Force Base, said states generally would turn first to police, border control officers and the National Guard under the governors’ command. Those public safety officials would be the first line of defense to stem the spread of the virus through travel restrictions at the borders and along state lines or outbreak areas.
The military, however, would be prepared to aid in establishing “mass casualty” treatment sites, provide shelter for displaced persons, dispose of dead bodies and help provide postal, power, water and sewer services and food deliveries. Troops also could provide logistics, communications and other support for law enforcement and the National Guard.
The Defense Department and Northern Command have refused to publicly release the details of their operations plan for pandemic influenza. Labeled “for official use only,” the plan lays out the active-duty military’s six-phase response to an influenza outbreak.
In interviews, Pentagon officials repeatedly expressed concerns about alarming the public, stressing that the plan would only unfold in a crisis situation and under orders from the president.
The plan also includes measures by the Pentagon to protect its own, with the understanding that if the nation’s armed services fall to the flu, it would be difficult to provide aid to those within the U.S. and defend the country in the event of a concurrent terrorist attack or other disaster.
Steps would be taken to immunize soldiers, their families, retirees and civilian workers who support the military’s mission. And, if needed, access in and out of military installations would be restricted.
The military is more vulnerable than most to the spread of disease, because of its very nature. Troops live together, eat together in mess halls, sleep together in barracks and bunk together by the thousands aboard ships.
As a result, said John Pike of GlobalSecurity.org, “The military has a long and glorious association with pandemics.”
___
Associated Press writer Pauline Jelinek contributed to this report.
___
On the Net:
Defense Department: http://www.defenselink.mil
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
LOLITA C. BALDOR
Associated Press Writer
WASHINGTON (AP) — The rapid spread of swine flu from Mexico surprised Pentagon officials, who had been focused on a possible Asian-borne pandemic in a response plan that would give the military a last-resort role in helping to impose quarantines and border restrictions.
Drafted and overhauled several times in recent years, the military’s closely guarded plan for an influenza pandemic assumed that officials would have more time before the flu hit U.S. shores. The Associated Press obtained briefing documents about the military’s pandemic contingency plan.
The H1N1 flu outbreak set U.S. military commanders scrambling to monitor and protect troops based near the 2,000-mile southern border and on ships nearby.
The virus spread quickly across the border into Southern California, infecting at least 27 sailors on a ship docked at San Diego, four Marines at Camp Pendleton and at least one Marine at Twentynine Palms. Several dozen Marines have been quarantined, and nearly two dozen other sailors had flu symptoms but have so far not been confirmed as having the H1N1 virus.
“We anticipated scientifically that we would have time to do different things,” said Amy Kircher, an epidemiologist with U.S. Northern Command’s surgeon general’s office. Northern Command oversees the country’s homeland defense, including coordination with Canada and Mexico.
While there are only a limited number of airports and seaports that could provide U.S. entry for the virus from overseas, the military was faced with an almost limitless number of cars, trucks and pedestrians traveling across the easily accessible, expansive border with Mexico.
In an interview with the AP, Kircher and several senior military officers from U.S. Northern Command said that since the swine flu has been far less lethal than anticipated, it has allowed the military to stop far short of the worst-case scenarios that the Pentagon prepared for in its long-range planning.
But in the event of a widespread pandemic, the Pentagon maintains standing plans to use the active-duty military as a last-resort force to help law enforcement manage quarantines, limit state-to-state travel and restrict access to government buildings.
Those plans represent “the kinds of things that the lead federal agencies might ask us to do or that we might have to do on behalf of the Department of Defense for force protection,” said Air Force Brig. Gen. Tony Rock, who until recently was deputy director for operations at Northern Command.
Officials would turn to the military for those domestic duties, Rock said, only when other authorities become overburdened and request assistance.
The requests must then be evaluated and approved by top officials, such as the defense secretary or the president.
“Some of these are in extremis, and certainly wouldn’t be the first tasks we would do,” said Army Col. Curt Torrence, a key military planner for Northern Command. He added that they would be carried out only under catastrophic circumstances and in accordance with federal laws.
Northern Command briefing documents obtained by The Associated Press include explicit assumptions that intelligence oversight laws and the Posse Comitatus Act would remain in effect.
Under that Civil War-era act, federal troops are prohibited from performing domestic law enforcement actions such as making arrests, seizing property or searching people.
In extreme cases, however, the president can invoke the Insurrection Act, also from the Civil War, which allows the use of active-duty or National Guard troops for law enforcement.
Under the military’s pandemic plan, the key goals are to defend the country, maintain the force and provide whatever support is needed to protect the national infrastructure and ensure that the government continues to function.
Rock, who recently was named commandant of the Air Command and Staff College at Maxwell Air Force Base, said states generally would turn first to police, border control officers and the National Guard under the governors’ command. Those public safety officials would be the first line of defense to stem the spread of the virus through travel restrictions at the borders and along state lines or outbreak areas.
The military, however, would be prepared to aid in establishing “mass casualty” treatment sites, provide shelter for displaced persons, dispose of dead bodies and help provide postal, power, water and sewer services and food deliveries. Troops also could provide logistics, communications and other support for law enforcement and the National Guard.
The Defense Department and Northern Command have refused to publicly release the details of their operations plan for pandemic influenza. Labeled “for official use only,” the plan lays out the active-duty military’s six-phase response to an influenza outbreak.
In interviews, Pentagon officials repeatedly expressed concerns about alarming the public, stressing that the plan would only unfold in a crisis situation and under orders from the president.
The plan also includes measures by the Pentagon to protect its own, with the understanding that if the nation’s armed services fall to the flu, it would be difficult to provide aid to those within the U.S. and defend the country in the event of a concurrent terrorist attack or other disaster.
Steps would be taken to immunize soldiers, their families, retirees and civilian workers who support the military’s mission. And, if needed, access in and out of military installations would be restricted.
The military is more vulnerable than most to the spread of disease, because of its very nature. Troops live together, eat together in mess halls, sleep together in barracks and bunk together by the thousands aboard ships.
As a result, said John Pike of GlobalSecurity.org, “The military has a long and glorious association with pandemics.”
___
Associated Press writer Pauline Jelinek contributed to this report.
___
On the Net:
Defense Department: http://www.defenselink.mil
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
WHO: No swine flu vaccine available for months
Date: 5/19/2009 3:57 PM
FRANK JORDANS
Associated Press Writers
GENEVA (AP) — Drug manufacturers won’t be able to start making a swine flu vaccine until mid-July at the earliest, weeks later than previous predictions, the World Health Organization said Tuesday. It will then take months to produce a new vaccine.
The disclosure that making a swine flu vaccine is proving more difficult than experts first thought came as U.N. Secretary-General Ban Ki-moon and WHO chief Dr. Margaret Chan met Tuesday with representatives from about 30 pharmaceutical companies to discuss the subject.
After the meeting, Ban declared that solidarity was the key to resolving the swine flu outbreak, urging governments to make sure all countries have access to drugs and vaccines. He also said virus samples and flu data must be shared and “self-defeating” measures like trade and travel bans should be avoided.
“We do not yet know how far and how fast it will spread, how serious the illness will be and, indeed, how many lives will be lost,” Ban told WHO’s annual assembly in Geneva. “Global solidarity must be at the heart of the world’s response.”
“(It) must mean that all have access to drugs and vaccines,” he said.
Health officials from around the world are meeting here this week to discuss the outbreak that has infected 9,830 people in over 40 countries, killing at least 79 of them.
According to vaccine experts convened by WHO, swine flu virus is not growing very fast in laboratories, making it difficult for scientists to get the key ingredient they need for a vaccine, the “seed stock” from the virus, the agency reported.
Previously, WHO officials had estimated that production could start in late May, and would take four to six months.
Experts also found no evidence that regular flu vaccines offer any protection against swine flu, it said.
Vaccine experts estimated under the best conditions, they could produce nearly 5 billion doses of swine flu vaccine over a year after beginning full-scale production.
Mass producing a pandemic vaccine would be a gamble, as it would take away manufacturing capacity for the seasonal flu vaccine that kills up to 500,000 people each year. Some experts have wondered whether the world really needs a vaccine for an illness that so far appears mild.
Chan said it would be impossible to produce enough vaccine for all 6.8 billion people on the planet — a situation that could set off a global scramble where rich countries outbid poorer nations for the vaccine.
She said some vaccine makers have offered to provide some swine flu vaccines if a worldwide outbreak is declared, but no agreements have yet been signed. Only two companies made the tentative offers.
WHO said one company with limited production capacity has offered to share half of its vaccine doses. Another large multinational pledged to provide 50 million vaccine doses at a cheaper price for U.N. agencies to buy for poor countries.
WHO asked all flu vaccine makers to donate at least 10 percent of their production or offer reduced prices for poor countries, but is waiting for most responses.
The impact of a pandemic — a global epidemic — is expected to be worse in poor countries, where people with other diseases like AIDS and malaria are more susceptible to swine flu and national health systems are less able to respond.
U.S. Health and Human Services Secretary Kathleen Sebelius said Tuesday the U.S. felt it had a responsibility to ensure that both antiviral drugs and any new vaccine are also available to poor countries. The United States has so far refrained from reserving any new vaccine, unlike Britain, Canada, Denmark, France, Switzerland and other countries.
Sebelius said the United States is working to boost its production capacity for seasonal flu vaccines so —in the event of a global outbreak — those factories can switch to the pandemic swine flu strain.
“At this point we have not placed orders for vaccine,” Sebelius told reporters in Geneva. “There is still so much uncertainty about this virus that it is really premature for us to even make a determination of how many people would appropriately be vaccinated, in what order, how many doses would be required.”
These are the issues Ban and Chan discussed with vaccine makers, including top producers Novartis, Sanofi-Aventis, GlaxoSmithKline and Baxter International as well as drugmakers from developing countries.
One expert, however, thought the 5 billion doses estimate was too optimistic.
“We should go forward with production as quickly as possible, but we should be cautious” about predictions, said David Fedson, a vaccine expert and former medical professor at the University of Virginia.
He also wondered about the political issues involving vaccine distribution — saying countries with vaccine plants might not be willing to ship pandemic vaccines elsewhere before all of their own citizens were vaccinated.
On Monday, dozens of governments lobbied WHO to tread carefully before next raising its swine flu alert to the highest pandemic level of phase 6. The level currently stands at phase 5 — saying a global outbreak is “imminent.”
Britain, Japan, China and others said declaring a global outbreak could cause unnecessary panic and confusion, especially since the virus has turned out to be less deadly than feared.
The vaccine experts emphasized that WHO’s declaration of a pandemic should not automatically force vaccine makers to switch from making regular flu vaccine to pandemic vaccine. In addition, they said even if swine flu vaccine production began, that did not mean that countries should start immunizing large groups of people.
The experts told WHO that it should come up with targeted advice on which groups of people need the vaccine first. They also planned to meet again in several weeks to decide whether large-scale production of swine flu vaccine should begin.
Since the outbreak began last month, 79 people have died from the disease — 72 in Mexico, five in the U.S., one in Canada and one in Costa Rica, WHO says. Another U.S. death — that of a 16-month-old — is being investigated for swine flu.
Japan confirmed dozens more swine flu cases Tuesday, bringing its tally to 176, but none of the patients were in serious condition. Its 41 new cases mostly involved teenagers with no clear links to foreign travel.
Japan is the hardest-hit nation outside of North America in the swine flu outbreak. The United States has the most confirmed swine flu cases, followed by Mexico and Canada.
___
Associated Press writer Frank Jordans reported from Geneva and AP Medical Writer Maria Cheng reported from London.
___
On the Net:
WHO: http://www.who.int
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
FRANK JORDANS
Associated Press Writers
GENEVA (AP) — Drug manufacturers won’t be able to start making a swine flu vaccine until mid-July at the earliest, weeks later than previous predictions, the World Health Organization said Tuesday. It will then take months to produce a new vaccine.
The disclosure that making a swine flu vaccine is proving more difficult than experts first thought came as U.N. Secretary-General Ban Ki-moon and WHO chief Dr. Margaret Chan met Tuesday with representatives from about 30 pharmaceutical companies to discuss the subject.
After the meeting, Ban declared that solidarity was the key to resolving the swine flu outbreak, urging governments to make sure all countries have access to drugs and vaccines. He also said virus samples and flu data must be shared and “self-defeating” measures like trade and travel bans should be avoided.
“We do not yet know how far and how fast it will spread, how serious the illness will be and, indeed, how many lives will be lost,” Ban told WHO’s annual assembly in Geneva. “Global solidarity must be at the heart of the world’s response.”
“(It) must mean that all have access to drugs and vaccines,” he said.
Health officials from around the world are meeting here this week to discuss the outbreak that has infected 9,830 people in over 40 countries, killing at least 79 of them.
According to vaccine experts convened by WHO, swine flu virus is not growing very fast in laboratories, making it difficult for scientists to get the key ingredient they need for a vaccine, the “seed stock” from the virus, the agency reported.
Previously, WHO officials had estimated that production could start in late May, and would take four to six months.
Experts also found no evidence that regular flu vaccines offer any protection against swine flu, it said.
Vaccine experts estimated under the best conditions, they could produce nearly 5 billion doses of swine flu vaccine over a year after beginning full-scale production.
Mass producing a pandemic vaccine would be a gamble, as it would take away manufacturing capacity for the seasonal flu vaccine that kills up to 500,000 people each year. Some experts have wondered whether the world really needs a vaccine for an illness that so far appears mild.
Chan said it would be impossible to produce enough vaccine for all 6.8 billion people on the planet — a situation that could set off a global scramble where rich countries outbid poorer nations for the vaccine.
She said some vaccine makers have offered to provide some swine flu vaccines if a worldwide outbreak is declared, but no agreements have yet been signed. Only two companies made the tentative offers.
WHO said one company with limited production capacity has offered to share half of its vaccine doses. Another large multinational pledged to provide 50 million vaccine doses at a cheaper price for U.N. agencies to buy for poor countries.
WHO asked all flu vaccine makers to donate at least 10 percent of their production or offer reduced prices for poor countries, but is waiting for most responses.
The impact of a pandemic — a global epidemic — is expected to be worse in poor countries, where people with other diseases like AIDS and malaria are more susceptible to swine flu and national health systems are less able to respond.
U.S. Health and Human Services Secretary Kathleen Sebelius said Tuesday the U.S. felt it had a responsibility to ensure that both antiviral drugs and any new vaccine are also available to poor countries. The United States has so far refrained from reserving any new vaccine, unlike Britain, Canada, Denmark, France, Switzerland and other countries.
Sebelius said the United States is working to boost its production capacity for seasonal flu vaccines so —in the event of a global outbreak — those factories can switch to the pandemic swine flu strain.
“At this point we have not placed orders for vaccine,” Sebelius told reporters in Geneva. “There is still so much uncertainty about this virus that it is really premature for us to even make a determination of how many people would appropriately be vaccinated, in what order, how many doses would be required.”
These are the issues Ban and Chan discussed with vaccine makers, including top producers Novartis, Sanofi-Aventis, GlaxoSmithKline and Baxter International as well as drugmakers from developing countries.
One expert, however, thought the 5 billion doses estimate was too optimistic.
“We should go forward with production as quickly as possible, but we should be cautious” about predictions, said David Fedson, a vaccine expert and former medical professor at the University of Virginia.
He also wondered about the political issues involving vaccine distribution — saying countries with vaccine plants might not be willing to ship pandemic vaccines elsewhere before all of their own citizens were vaccinated.
On Monday, dozens of governments lobbied WHO to tread carefully before next raising its swine flu alert to the highest pandemic level of phase 6. The level currently stands at phase 5 — saying a global outbreak is “imminent.”
Britain, Japan, China and others said declaring a global outbreak could cause unnecessary panic and confusion, especially since the virus has turned out to be less deadly than feared.
The vaccine experts emphasized that WHO’s declaration of a pandemic should not automatically force vaccine makers to switch from making regular flu vaccine to pandemic vaccine. In addition, they said even if swine flu vaccine production began, that did not mean that countries should start immunizing large groups of people.
The experts told WHO that it should come up with targeted advice on which groups of people need the vaccine first. They also planned to meet again in several weeks to decide whether large-scale production of swine flu vaccine should begin.
Since the outbreak began last month, 79 people have died from the disease — 72 in Mexico, five in the U.S., one in Canada and one in Costa Rica, WHO says. Another U.S. death — that of a 16-month-old — is being investigated for swine flu.
Japan confirmed dozens more swine flu cases Tuesday, bringing its tally to 176, but none of the patients were in serious condition. Its 41 new cases mostly involved teenagers with no clear links to foreign travel.
Japan is the hardest-hit nation outside of North America in the swine flu outbreak. The United States has the most confirmed swine flu cases, followed by Mexico and Canada.
___
Associated Press writer Frank Jordans reported from Geneva and AP Medical Writer Maria Cheng reported from London.
___
On the Net:
WHO: http://www.who.int
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
Gov’t faces weekend deadline on polar bear rule
Date: 5/8/2009 9:34 AM
H. JOSEF HEBERT
Associated Press Writer
WASHINGTON (AP) — A decision involving the iconic polar bear could determine whether protecting endangered species might also help save the earth from global warming.
The Obama administration is approaching a weekend deadline to decide whether it should allow government agencies to cite the federal Endangered Species Act, which protects the bear, for imposing limits on greenhouse gases from power plants, factories and automobiles even if the pollution occurs thousands of miles from where the polar bear lives.
The species law that affords protection for plants, animals and fish that face possible extinction became entangled with the need to reduce pollution linked to global warming more than a year ago. The Interior Department declared the polar bear a threatened species, citing the decline of Arctic sea ice due to global warming.
Fearful that the declaration putting the bear under the federal species law might be used to force regulation of carbon dioxide, the leading greenhouse gas from burning fossil fuels, the Bush administration issued a special rule: No action outside of the bear’s Arctic habitat could be considered as endangering its survival.
The limitation, hailed by business groups, prompted lawsuits from environmentalists and action by Congress.
In March, federal lawmakers authorized Interior Secretary Ken Salazar to rescind the Bush administration’s special rule, thus avoiding any complicated and time-consuming regulatory procedures. The deadline for such action is Saturday, 60 days after Congress acted.
Salazar, who was said to be weighing the issue, scheduled a news conference for 11:30 a.m. EDT Friday to discuss it. Lobbying on the matter has been heavy, and Salazar has given little hint on whether he will rescind the Bush rule.
Environmentalists complained last week when Salazar failed to address the polar bear rule when he rescinded another Bush regulation involving endangered species consultation — one Congress also authorized to be scrapped.
“From our perspective the job is half done” without a reversal of the polar bear rule, Noah Greenwald of the Center for Biological Diversity, an advocacy group, said after last week’s action.
The special rule “significantly undercuts protections for the polar bear by omitting global warming pollution as a factor in the polar bear’s risk of extinction,” said Jane Kochersperger, a spokeswoman for Greenpeace, which delivered 80,000 petitions to the Interior Department after they were collected by the two environmental groups.
Environmentalists also circulated a letter to Salazar, signed by 49 law professors, that urges him to reverse the Bush rule, arguing that its restrictions are so broad as to be illegal under the Endangered Species Act.
Business groups have expressed concern about the Endangered Species Act being used to regulate greenhouse gases, especially industrial and power plant emissions.
On Thursday, Rep. Doc Hastings of Washington, the ranking Republican on the House Natural Resources Committee, urged Salazar to keep the Bush rule in place.
Along with the recent ruling by the Environmental Protection Agency that carbon dioxide is a health hazard, “withdrawing this rule would give the federal government vast new climate change power to regulate any federal or federally permitted activity in our country that emits greenhouse gases,” said Hastings. “This reaches far beyond the scope of polar bears in the Arctic and could put jobs and economic activity across the entire nation at risk.”
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
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H. JOSEF HEBERT
Associated Press Writer
WASHINGTON (AP) — A decision involving the iconic polar bear could determine whether protecting endangered species might also help save the earth from global warming.
The Obama administration is approaching a weekend deadline to decide whether it should allow government agencies to cite the federal Endangered Species Act, which protects the bear, for imposing limits on greenhouse gases from power plants, factories and automobiles even if the pollution occurs thousands of miles from where the polar bear lives.
The species law that affords protection for plants, animals and fish that face possible extinction became entangled with the need to reduce pollution linked to global warming more than a year ago. The Interior Department declared the polar bear a threatened species, citing the decline of Arctic sea ice due to global warming.
Fearful that the declaration putting the bear under the federal species law might be used to force regulation of carbon dioxide, the leading greenhouse gas from burning fossil fuels, the Bush administration issued a special rule: No action outside of the bear’s Arctic habitat could be considered as endangering its survival.
The limitation, hailed by business groups, prompted lawsuits from environmentalists and action by Congress.
In March, federal lawmakers authorized Interior Secretary Ken Salazar to rescind the Bush administration’s special rule, thus avoiding any complicated and time-consuming regulatory procedures. The deadline for such action is Saturday, 60 days after Congress acted.
Salazar, who was said to be weighing the issue, scheduled a news conference for 11:30 a.m. EDT Friday to discuss it. Lobbying on the matter has been heavy, and Salazar has given little hint on whether he will rescind the Bush rule.
Environmentalists complained last week when Salazar failed to address the polar bear rule when he rescinded another Bush regulation involving endangered species consultation — one Congress also authorized to be scrapped.
“From our perspective the job is half done” without a reversal of the polar bear rule, Noah Greenwald of the Center for Biological Diversity, an advocacy group, said after last week’s action.
The special rule “significantly undercuts protections for the polar bear by omitting global warming pollution as a factor in the polar bear’s risk of extinction,” said Jane Kochersperger, a spokeswoman for Greenpeace, which delivered 80,000 petitions to the Interior Department after they were collected by the two environmental groups.
Environmentalists also circulated a letter to Salazar, signed by 49 law professors, that urges him to reverse the Bush rule, arguing that its restrictions are so broad as to be illegal under the Endangered Species Act.
Business groups have expressed concern about the Endangered Species Act being used to regulate greenhouse gases, especially industrial and power plant emissions.
On Thursday, Rep. Doc Hastings of Washington, the ranking Republican on the House Natural Resources Committee, urged Salazar to keep the Bush rule in place.
Along with the recent ruling by the Environmental Protection Agency that carbon dioxide is a health hazard, “withdrawing this rule would give the federal government vast new climate change power to regulate any federal or federally permitted activity in our country that emits greenhouse gases,” said Hastings. “This reaches far beyond the scope of polar bears in the Arctic and could put jobs and economic activity across the entire nation at risk.”
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
Obama to crack down on business taxes
Date: 5/4/2009 7:50 AM
PHILIP ELLIOTT
Associated Press Writer
WASHINGTON (AP) — President Barack Obama plans changes to tax policy certain to be unpopular with corporations with international divisions and individuals who use tax havens.
Obama’s two-part plan, which he is slated to unveil at the White House on Monday, also calls for 800 new federal tax agents to enforce the system.
The president’s proposal would eliminate some tax deductions for companies that earn profits in countries with low tax rates, as well as consider U.S. citizens who use tax havens in the Bahamas or Cayman Islands guilty of violating U.S. tax laws. If Obama wins congressional approval for the changes — and he faces a challenge on Capitol Hill — it could deliver $210 billion in tax revenue over the next decade.
Treasury Secretary Timothy Geithner was to join Obama for the 11 a.m. comments.
Officials described the administration’s plan ahead of the announcement on the condition of anonymity so they wouldn’t upstage the president’s remarks. However, they acknowledged the political challenges facing the plan. The administration won’t seek a complete repeal of overseas tax benefits and, although the rule changes are narrower than some anticipated, business leaders still oppose them as a tax hike. Obama aides countered that the plan is a step toward a massive overhaul of international financial regulations the president has promised.
In exchange, Obama said he was willing to make permanent a research tax credit that was to expire at the end of the year and is popular with businesses. Officials estimate that making the tax credits permanent would cost taxpayers $74.5 billion over the next decade.
But administration aides said 75 percent of those tax credits paid workers’ wages; given the struggling economy, aides were reluctant to do anything that could add more Americans to the unemployment rolls.
It was small comfort. Companies who shelter profits in international accounts stand to lose billions if Obama’s plan becomes law. Under the existing regulation, those companies pay taxes only if they bring the profits back to the U.S. If they keep the profits offshore, they can defer paying taxes indefinitely — and many do.
Obama’s plan wouldn’t go into effect until 2011; Obama has said he does not want to tinker with tax revenues until his $787 billion stimulus plan has run its course. The proposals, however, were far from complete, and aides said this was just one piece of the administration’s plan for sweeping overhaul.
First up: Companies won’t be able to write-off domestic expenses for generating profits abroad. For instance, administrative tasks performed in New York for a London office would not be tax deductible in the United States.
Administration officials depicted the move as a way to close unfair tax loopholes that encouraged companies to send jobs overseas. They argued that if it costs the same amount to do business in, say, Ireland as in Iowa, why not do it entirely in Des Moines? Officials said Obama would characterize the move as a way to keep jobs in the United States and fight a system that is rigged against U.S. companies who keep their entire business operation domestic.
Obama also planned to ask Congress to crack down on tax havens and implement a major shift in the way courts view guilt. Under Obama’s proposal, Americans would have to prove they were not breaking U.S. tax laws by sending money to banks that don’t cooperate with tax officials. It essentially would reverse the long-held assumption of innocence in U.S. courts.
If financial institutions cooperate with Washington and disclose details when asked, Americans could invest anywhere they like.
Obama officials also said they would close a Clinton-era provision that would cost $87 billion over the next decade by letting U.S. companies “check the box” and treat international subsidiaries as mere branch offices. Officials said it was meant as a paperwork shortcut that is now a widely used and perfectly legal way to avoid paying billions in taxes on international operations.
___
On the Net: www.whitehouse.gov
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
PHILIP ELLIOTT
Associated Press Writer
WASHINGTON (AP) — President Barack Obama plans changes to tax policy certain to be unpopular with corporations with international divisions and individuals who use tax havens.
Obama’s two-part plan, which he is slated to unveil at the White House on Monday, also calls for 800 new federal tax agents to enforce the system.
The president’s proposal would eliminate some tax deductions for companies that earn profits in countries with low tax rates, as well as consider U.S. citizens who use tax havens in the Bahamas or Cayman Islands guilty of violating U.S. tax laws. If Obama wins congressional approval for the changes — and he faces a challenge on Capitol Hill — it could deliver $210 billion in tax revenue over the next decade.
Treasury Secretary Timothy Geithner was to join Obama for the 11 a.m. comments.
Officials described the administration’s plan ahead of the announcement on the condition of anonymity so they wouldn’t upstage the president’s remarks. However, they acknowledged the political challenges facing the plan. The administration won’t seek a complete repeal of overseas tax benefits and, although the rule changes are narrower than some anticipated, business leaders still oppose them as a tax hike. Obama aides countered that the plan is a step toward a massive overhaul of international financial regulations the president has promised.
In exchange, Obama said he was willing to make permanent a research tax credit that was to expire at the end of the year and is popular with businesses. Officials estimate that making the tax credits permanent would cost taxpayers $74.5 billion over the next decade.
But administration aides said 75 percent of those tax credits paid workers’ wages; given the struggling economy, aides were reluctant to do anything that could add more Americans to the unemployment rolls.
It was small comfort. Companies who shelter profits in international accounts stand to lose billions if Obama’s plan becomes law. Under the existing regulation, those companies pay taxes only if they bring the profits back to the U.S. If they keep the profits offshore, they can defer paying taxes indefinitely — and many do.
Obama’s plan wouldn’t go into effect until 2011; Obama has said he does not want to tinker with tax revenues until his $787 billion stimulus plan has run its course. The proposals, however, were far from complete, and aides said this was just one piece of the administration’s plan for sweeping overhaul.
First up: Companies won’t be able to write-off domestic expenses for generating profits abroad. For instance, administrative tasks performed in New York for a London office would not be tax deductible in the United States.
Administration officials depicted the move as a way to close unfair tax loopholes that encouraged companies to send jobs overseas. They argued that if it costs the same amount to do business in, say, Ireland as in Iowa, why not do it entirely in Des Moines? Officials said Obama would characterize the move as a way to keep jobs in the United States and fight a system that is rigged against U.S. companies who keep their entire business operation domestic.
Obama also planned to ask Congress to crack down on tax havens and implement a major shift in the way courts view guilt. Under Obama’s proposal, Americans would have to prove they were not breaking U.S. tax laws by sending money to banks that don’t cooperate with tax officials. It essentially would reverse the long-held assumption of innocence in U.S. courts.
If financial institutions cooperate with Washington and disclose details when asked, Americans could invest anywhere they like.
Obama officials also said they would close a Clinton-era provision that would cost $87 billion over the next decade by letting U.S. companies “check the box” and treat international subsidiaries as mere branch offices. Officials said it was meant as a paperwork shortcut that is now a widely used and perfectly legal way to avoid paying billions in taxes on international operations.
___
On the Net: www.whitehouse.gov
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney
Pakistan peace deal under fire amid attacks
Date:
ZARAR KHAN
Associated Press Writer
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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ZARAR KHAN
Associated Press Writer
ISLAMABAD (AP) — Clashes in a northwestern region covered by an increasingly fragile peace pact killed seven militants and one soldier Monday, authorities said, adding to strains on an agreement seen in the West as a capitulation to extremists.
Washington has said it wants Pakistan to fight the militants, not talk to them, and is unlikely to mourn the three-month-old deal in the Malakand region if it breaks down. Still, many in the staunchly Islamic region have welcomed the pause in hostilities even though it did not lead to the eviction of the Taliban.
The deal will feature in talks between Pakistani President Asif Ali Zardari and President Barack Obama later this week in Washington where Zardari is also expected to ask for more money to help his country’s battered economy and under-equipped security forces.
Under the deal, the government agreed to impose Islamic law in the districts that make up Malakand in hopes that the militants would lay down their arms. But the Taliban in Swat, the movement’s stronghold, did not lay down their weapons and were emboldened, soon entering the adjacent Buner district to impose their harsh brand of Islam.
The proximity of Buner to the capital of Islamabad raised alarms domestically and abroad. Pakistan’s military went on the offensive over the past week to drive the Taliban out. On Monday, security forces killed seven insurgents in an attack on a hide-out there, the military said in a statement, bringing to almost 90 the number of insurgents slain since the operations began. Thousands of civilians have fled the region.
The military have so far not extended their campaign into Swat, saying the deal still held there.
But in violence in the former tourist region Monday, militants killed one solider and injured two others in an attack on a convoy, the statement said.
“We set up Islamic courts, we gave them Islamic judges, yet they do not accept this. They have some other agenda,” said Northwest Frontier Province Information Minister Mian Iftikhar Hussain, who helped negotiate the pact and had been one of its strongest defenders. “We will fight them and, God willing, these handful of miscreants will be defeated and the nation will prevail.”
Hussain does not have the authority to order a military operation in Swat. By singling out a “handful” of militants as opposed to all of them, he appeared to be suggesting that only those he considered to be spoiling the deal should be attacked.
Army spokesman Maj. Gen. Athar Abbas said the army would not launch an offensive in Swat unless the government formally abandoned the truce.
Taliban spokesman Muslim Khan claimed responsibility for the convoy attack, saying the attack was in response to the alleged strengthening of military positions in the region in violation of the peace deal.
“Why do you think we should remain silent if they come heavy on us? … We will attack them too,” he told The Associated Press.
On Sunday, the army accused the insurgents of “gross violations” of the deal in Swat by looting and attacking infrastructure. At least three other security officials have been reported killed in recent days, and the Taliban have resumed armed patrols in the main city of Mingora.
Swat is just one part of the Afghan border region where Pakistan is facing Islamist insurgents. However, it is of special concern because it is meant to fall fully under government control, unlike tribally ruled areas along the frontier which have more autonomy.
The provincial government, whose ministers were coming under frequent insurgent attack, signed the deal with militants after security forces were unable to defeat them after two years of clashes that killed hundreds and displaced up to one-third of its 1.5 million residents.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Once welcoming, Pakistan city fears Taliban rise
Date: 5/3/2009 12:06 PM
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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EDITOR’S NOTE — Kathy Gannon has written about Afghanistan and Pakistan for The Associated Press for more than two decades. She lived in Peshawar from 1987 to 1988 and has visited countless times since.
| By KATHY GANNON |
|---|
| Associated Press Writer |
PESHAWAR, Pakistan (AP) — At the entrance to Peshawar, a young man on the side of the road offers a prayer, while on the bridge overhead three men videotape him.
They could be friends in Peshawar for the first time, perhaps from a nearby village. But that isn’t my first thought.
My first thought is, maybe he is a suicide bomber setting off on a mission.
I make a mental note of his appearance — maybe 5 feet, eight inches, brownish-beige shalwar kameez, mustache, no beard, maybe 20 years old, maybe younger. They say most suicide bombers are 18- and 19-year-olds, poor, disaffected.
I decide to quietly, gently roll down my window, just an inch, thinking that if there’s an explosion — from the young lad I just saw or any number of other directions — the opening will reduce the effect of the concussion. It could perhaps prevent the windows from shattering into deadly shards, unless of course the explosion is right next to the car, and then I guess it doesn’t matter.
It has been 22 years since I lived in Peshawar, a city of one million people close to the border of Afghanistan. In the early morning traffic, noisy diesel-belching rickshaws weave past screeching buses with people hanging off the side. Horns blare as cars bump up against horse-drawn carts straining under the weight of half a dozen people crammed onto a seat made for three.
But what strikes me most is the palpable fear that now hangs over the city.
The Taliban insurgency is spreading from the wild, ungoverned border region close to Afghanistan into urban Pakistan. Peshawar, the commercial and cultural hub of the frontier province, is on the front line. Some say it is under siege. It has that feel to it.
Bit by bit the militants are creeping farther into Pakistan. Last month they dumped the headless body of a police officer on the road to Peshawar. This month they blew up a mosque frequented by security men who stood guard at a post across the street. The men had just knelt in prayer when the bomb ripped through the building and killed dozens.
That’s how they start, with the police and the security officers. Then they go after the people — the businessmen, the musicians, the teachers and children in the schools.
Just last week, a powerful bomb flattened 30 shops on the edge of Peshawar. The owners of theaters and music shops have received letters warning them to close or be destroyed.
Even former friends are frightened. One former Taliban from a small gunmaking town barely 20 miles from Peshawar says he is terrified of his one-time colleagues.
“I don’t mind being blown up, but it’s the beheadings that scare me,” he says. “And no one, not the police, no one can stop them.”
Women who used to wear large shawls now rarely emerge without the all-enveloping burqa. Musicians have fled. Schools have been blown up, and young men roam the Peshawar University campus to harass girls seeking education.
In a posh neighborhood of Hayatabad, an Iranian diplomat was kidnapped and the Afghan ambassador-elect taken by armed men. Residents are under self-imposed lockdown after dark. Belligerent young men from nearby religious schools knock on doors at prayer time, telling people to go to the mosque.
Peshawar’s people used to be the most hospitable around — they would stop you on the street and invite you into their homes for tea. It doesn’t happen today. Foreigners are targeted, and that makes locals nervous to be around them.
Peshawar has always been linked to Afghanistan through trails in the mountains that run like a jagged spine between the two countries. When I first came here in 1986, the trails were used by Afghan mujahedeen fighting the Soviet Red Army that had invaded their country. Then, Russia was the Soviet Union and the mujahedeen were Cold War heroes, helped by U.S. money.
In those days, heavily armed, praying young men, their Kalashnikov rifles slung over their shoulders, weren’t looked on with suspicion and fear. No, they were seen with admiration and even a little romanticism, because they were fighting the good fight.
The enemy was the communist Russians. The friends — or, as President Ronald Reagan liked to call them, the freedom fighters — were the religious young men taking up arms. The sight of them praying five times a day was a comforting image, a symbol of a battle between holy warriors and godless communists.
Not any more.
The bearded men with guns have become a nightmare, and now their prayer is a reminder of the terror they are willing to inflict in the name of their harsh brand of Islam.
My thoughts return to the young man praying on the outskirts of Peshawar, his clothes covered in dust from a nearby construction site. And I think, my, how times have changed.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.
http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney