Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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Conn. Victim's Father Remembers 'Loving' Daughter

(Image credit: Emilie Parker Fund/Facebook)

Emilie Parker, the little girl with the blond hair and bright blue eyes, would have been one of the first to comfort her classmates at Sandy Hook Elementary School, had a gunman’s bullets not claimed her life, her father said.

“My daughter Emilie would be one of the first ones to be standing and giving support to all the victims because that’s the kind of kid she is,” her father, Robbie Parker said as he fought back tears, telling the world about his “bright, creative and loving” daughter who was one of the 20 young victims in the Newtown, Conn., shooting.

“She always had something kind to say about anybody,” her father said.  ”We find comfort reflecting on the incredible person Emilie was and how many lives she was able to touch.”

Emilie, 6, was helping teach her younger sisters to read and make things, and she was the little girls would go to for comfort, he said.

“They looked up to her,” Parker said.

READ: Complete List of Sandy Hook Victims

Parker moved his wife and three daughters to Newtown eight months ago after accepting a job as  a physician’s assistant at Danbury Hospital. He said Emilie, his oldest daughter, seemed to have adjusted well to her new school, and he was very happy with the school, too.

“I love the people at the school. I love Emilie’s teacher and the classmates we were able to get to know,” he said.

      (Image Credit: Alex von Kleydorff/AP Photo)

The family dealt with another tragic loss in October when Emilie lost her grandfather in an accident.

“[This] has been a topic that has been discussed in our family in the past couple of  months,” Parker said. “[My daughters ages 3 and 4] seem to get the idea that there’s somebody who they will miss very much.”

Emilie, a budding artist who carried her markers and pencils everywhere, paid tribute to her grandfather by slipping a special card she had drawn into his casket, Parker said.  It was something she frequently did to lift the spirits of others.

“I can’t count the number of times Emilie would find someone feeling sad or frustrated and would make people a card,” Parker said. “She was an exceptional artist.”

The girl who was remembered as “always willing to try new things, other than food” was learning Portuguese from her father, who speaks the language.

(Image Credit: Emilie Parker Fund/Facebook)

On Friday morning, Emilie woke up before her father left for his job and exchanged a few sentences with him in the language.

“She told me good morning and asked how I was doing,” Parker said. “She said she loved me, I gave her a kiss and I was out the door.”

Parker found out about the shooting while on lockdown in Danbury Hospital and found a television for the latest news.

“I didn’t think it was that big of deal at first,” he said. “With the first reports coming in, it didn’t sound like it was going to be as tragic as it was. That’s kind of what it was like for us.”

CLICK HERE for full coverage of the Sandy Hook shooting.

Parker said he knows that God can’t take away free will and would have been unable to stop the Sandy Hook shooting. While gunman Adam Lanza used his free agency to take innocent lives, Parker said he plans to use his in a positive way.

“I’m not mad because I have my  [free] agency to use this event to do whatever I can to make sure my family and my wife and my daughters are taken care [of],” he said. “And if there’s anything I can do to help to anyone at any time at anywhere, I’m free to do that.”

(Image credit: Emilie Parker Fund/Facebook)

Friday night, hours after he learned of his daughter’s death, Parker said he spoke at his church.

“I don’t know how to get through something like this. My wife and I don’t understand how to process all of this,” he said today. “We find strength in our religion and in our faith and in our family. ”

“It’s a horrific tragedy and I want everyone to know our hearts and prayers go out to them. This includes the family of the shooter. I can’t imagine how hard this experience must be for you and I want you to know our family … love and support goes out to you as well.”

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NATO says Syrian Scuds hit "near" Turkey

BEIRUT (Reuters) - NATO accused Syrian President Bashar al-Assad's forces of firing Scud missiles that landed near to the Turkish border, in explaining why it was sending anti-missile batteries and troops to the bloc's frontier.

The Syrian government, which finds itself under attack from rebels in the capital Damascus and by a diplomatic alliance of Arab and Western powers, denies firing such long-range, Soviet-built rockets and had no immediate comment on the latest charge.

Admiral James Stavridis, the American who is NATO's military commander, wrote in a blog on Friday: "Over the past few days, a handful of Scud missiles were launched inside Syria, directed by the regime against opposition targets. Several landed fairly close to the Turkish border, which is very worrisome."

It was not clear how close they came. NATO member Turkey, once friendly toward Assad but now among the main allies of the rebels, has complained of occasional bullets and artillery fire, some of which has been fatal, for many months. It sought the installation of missile defenses on its border some weeks ago.

"Syria is clearly a chaotic and dangerous situation; but we have an absolute obligation to defend the borders of the alliance from any threat emanating from that troubled state," Stavridis wrote.

Batteries of U.S.-made Patriot missiles, designed to shoot down the likes of the Scuds popularly associated with Iraq's wars under Saddam Hussein in the 1990s, are about to be deployed by the U.S., German and Dutch armies, each of which is sending up to 400 troops to operate and protect the rocket systems.

The Syrian government has accused Western powers of backing what it portrays as a Sunni Islamist "terrorist" attack on it and says Washington and Europe have publicly voiced concerns of late that Assad's forces might resort to chemical weapons solely as a pretext for preparing a possible military intervention.

In contrast to NATO's air campaign in support of Libya's successful revolt last year against Muammar Gaddafi, Western powers have fought shy of intervention in Syria. They have cited the greater size and ethnic and religious complexity of a major Arab state at the heart of the Middle East - but have also lacked U.N. approval due to Russia's support for Assad.

Moscow reacted angrily on Friday to the way U.S. officials seized on comments by a top Kremlin envoy for the Middle East as evidence that Russia was giving up on Assad. Comments by Mikhail Bogdanov on Thursday in which he conceded Assad might be ousted did not reflect a change in policy, the Foreign Ministry said.

Assad's diplomatic isolation remains acute, however, as Arab and Western powers this week recognized a new, united coalition of opposition groups as Syria's legitimate leadership. Large parts of the country are no longer under the government's control and fighting has been raging around Damascus itself.

European Union leaders who met in Brussels on Friday said all options were on the table to support the Syrian opposition, raising the possibility that non-lethal military equipment or even arms could eventually be supplied.

In their strongest statement of support for the Syrian opposition since the uprising began 20 months ago, EU leaders instructed their foreign ministers to assess all possibilities to increase the pressure on Assad.

With rebels edging into the capital, a senior NATO official said that Assad is likely to fall and the Western military alliance should make plans to protect against the threat of his chemical arsenal falling into the wrong hands.

HUNGER SPREADS

Desperation for food is growing in parts of Syria and residents of the northern city of Aleppo say fist fights and dashes across the civil war front lines have become part of the daily struggle to secure a loaf of bread.

"I went out yesterday and could not get any bread. If only the problem was just lack of food - there is also a huge shortage of fuel, which the bakeries need to run," said Ahmed, a resident of the battle-scarred Salaheddine district.

He said people get into fist fights over flour and rebels regularly have to break up fights by firing into the air.

The World Food Programme (WFP) says as many as a million people may go hungry this winter, as worsening security conditions make it harder to reach conflict zones.

Forty thousand people have now been killed in the most enduring and destructive of the Arab revolts. The government severely limits press and humanitarian access to the country.

U.N. humanitarian chief Valerie Amos said on Friday the United Nations is committed to maintaining aid operations in Syria.

"NOTHING OFF THE TABLE"

At the EU summit, Britain's David Cameron pushed for an early review of the arms embargo against Syria to possibly open the way to supply equipment to rebels in the coming months. Germany and others were more reluctant and blocked any quick move. But there was widespread agreement that whatever action can be taken under current legislation should be pursued, and the arms embargo would still be reviewed at a later stage.

"I want a very clear message to go to President Assad that nothing is off the table," Cameron told reporters at the end of a two-day summit. "I want us to work with the opposition ... so that we can see the speediest possible transition in Syria.

"There is no single simple answer, but inaction and indifference are not options."

Among factors holding Western powers back from arming the rebels is the presence in their ranks of anti-Western Islamist radicals. Following a U.S. decision this week to blacklist one such group, Jabhat al-Nusra, a "terrorist" group, thousands of Syrians demonstrated on Friday against ostracizing the movement.

The latest, weekly Friday protests in rebel-held areas were held under the slogan: "The only terrorism in Syria is Assad's".

Inspired by Arab uprisings across the region, Syrian protesters were met with gunfire by Assad's security forces in March 2011. Armed revolt overtook the movement, which has become increasingly sectarian - waged by majority Sunni Muslims against forces loyal to Assad, who is from the minority Alawite sect, an offshoot of the Shi'ite Islam practiced in Assad's ally Iran.

A video posted on the Internet showed dozens of Sunni rebels dressed in camouflage gear congratulating and kissing each other outside a burning Shi'ite shrine.

A fighter holding a rifle said the group was destroying the "dens of the Shi'ites". Reuters could not independently verify the video, which was posted on YouTube on Wednesday and purports to be filmed in the northern town of Jisr al-Shughur.

(Writing by Oliver Holmes and Alastair Macdonald; Editing by Michael Roddy)

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SCDF, police conduct checks at commercial premises, Marina Square fined

SINGAPORE: A joint enforcement blitz by the Singapore Civil Defence Force (SCDF) and the police was conducted on shopping malls, hotels and public entertainment outlets on Friday night.

Marina Square Shopping Centre was issued three notices of Fire Safety Offence which carried a total fine of up to S$1,500. The shopping centre had fire safety works without approval plans at two levels of its carpark.

The SCDF statement said Marina Square changed the use of vehicle parking lots and the vicinity to a storage area which caused the existing fire safety measures to become inadequate.

In addition, the shopping centre was issued eight Fire Hazard Abatement Notices which served as a warning for not observing fire safety measures as some escape routes were obstructed.

Centrepoint Shopping Centre was issued a fine of up to S$500 for a Fire Safety Offence for changing the use of carpark area to a storage area which would cause the existing fire safety measures to become inadequate. The mall was also issued four Fire Hazard Abatement Notices for flouting fire safety measures.

Concorde Hotel received three Fire Hazard Abatement Notices; Top 5 @ Orchard Towers was issued two such notices; Peyton Place @ Orchard Towers was issued one and Ipanema @ Orchard Towers received three such notices.

- CNA/ck

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HC allows auction of 25 quarries in Punjab

CHANDIGARH: Around four months after banning all mining activities, the Punjab and Haryana high court on Friday allowed auction of 25 quarries in various districts of Punjab.

While permitting the state to initiate the process of auctioning the mining quarries under a close and strict monitoring mechanism, the court of Justice Rajive Bhalla observed that the system of issuing manual slips for lifting minerals from the quarries was being misused.

The court also issued directions to instal weighing machines at the quarries to keep a tab on each vehicle's weight to prevent contractors from extracting material in addition to the prescribed limit by over-digging and thereby harming the ecology.

In August this year, the HC had imposed complete and immediate ban on mining in the state without environmental clearance in operational quarries of up to five hectares in the state.

The court also directed that environment impact assessment committee would grant permission in each case so that there was no ecological degradation. The HC has also told the trial courts to avoid releasing vehicles and equipment used for illegal mining.

The division bench also made it clear that the HC's endeavour was only to ensure the undertaking of mining after obtaining requisite permission and following the rules, which was not being done.

Justice Bhalla was miffed over the recent statements made by the state governments that rates of building material have reached all time high because of stay on mining by the Punjab and Haryana high court.

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

Read More..

Conn. Shooter Adam Lanza: 'Obviously Not Well'

Adam Lanza of Newtown, Connecticut was a child of the suburbs and a child of divorce who at age 20 still lived with his mother.

This morning he appears to have started his day by shooting his mother Nancy in the face, and then drove her car to nearby Sandy Hook Elementary School, armed with two handguns and a semi-automatic rifle.

There, before turning his gun on himself, he shot and killed 20 children, who President Obama later described as "beautiful little kids" between five and 10 years of age. Six adults were also killed at the school. Nancy Lanza was found dead in her home.

A relative told ABC News that Adam was "obviously not well."

Family friends in Newtown also described the young man as troubled and described Nancy as rigid. "[Adam] was not connected with the other kids," said Barbara Frey, who also said he was "a little bit different ... Kind of repressed."

State and federal authorities believe his mother may have once worked at the elementary school where Adam went on his deadly rampage, although she was not a teacher, according to relatives, perhaps a volunteer.

Nancy and her husband Peter, Adam's father, divorced in 2009. When they first filed for divorce in 2008, a judge ordered that they participate in a "parenting education program."

Peter Lanza, who drove to northern New Jersey to talk to police and the FBI, is a vice president at GE Capital and had been a partner at global accounting giant Ernst & Young.

Adam's older brother Ryan Lanza, 24, has worked at Ernst & Young for four years, apparently following in his father's footsteps and carving out a solid niche in the tax practice. He too was interviewed by the FBI. Neither he nor his father is under any suspicion.

"[Ryan] is a tax guy and he is clean as a whistle," a source familiar with his work said.

Police had initially identified Ryan as the killer. Ryan sent out a series of Facebook posts saying it wasn't him and that he was at work all day. Video records as well as card swipes at Ernst & Young verified his statement that he had been at the office.

Two federal sources told ABC News that identification belonging to Ryan Lanza was found at the scene of the mass shooting. They say that identification may have led to the confusion by authorities during the first hours after the shooting. Neither Adam nor Ryan has any known criminal history.

A Sig Sauer handgun and a Glock handgun were used in the slaying and .223 shell casings – a round used in a semi-automatic military style rifle -- were also found at the scene. Nancy Lanza had numerous weapons registered to her, including a Glock and a Sig Sauer. She also owned a Bushmaster rifle -- a semi-automatic carbine chambered for a .223 caliber round. However, federal authorities cannot confirm that the handguns or the rifle were the weapons receovered at the school.

Numerous relatives of the Lanzas in New Jersey, Connecticut, Massachusetts, as well as multiple friends, are being interviewed by the FBI in an effort to put together a better picture of the gunman and any explanation for today's tragedy.

"I think the most important thing to point out with this kind of individual is that he did not snap this morning and decide to act out violently," said former FBI profiler Mary Ellen O'Toole. "These acts involve planning and thoughtfulness and strategizing in order to put the plan together so what may appear to be snap behavior is not that at all."

With reporting by Pierre Thomas, Jim Avila, Santina Leuci, Aaron Katersky, Matthew Mosk, Jason Ryan and Jay Shaylor

MORE: 27 Dead, Mostly Children, at Connecticut Elementary School Shooting

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U.S., rebels urge gloomy Moscow to help oust Assad

BEIRUT (Reuters) - Syria's rebel leadership and the United States seized on Russian pessimism over President Bashar al-Assad's future to urge Moscow to help push its ally into ceding power and end the battles closing in around his capital.

"We want to commend the Russian government for finally waking up to the reality and acknowledging that the regime's days are numbered," the U.S. State Department spokeswoman said after a senior Kremlin envoy conceded publicly on Thursday that Assad's opponents could win the 20-month-old civil war.

"The question now is, will the Russian government join those of us in the international community who are working with the opposition to try to have a smooth democratic transition?" U.S. spokeswoman Victoria Nuland added in Washington.

In Marrakech, where his new coalition won recognition from other international powers as the legitimate leadership of Syria, rebel political leader Mouaz al-Khatib said he believed Russia, ally and arms supplier to the Assad dynasty since Soviet times, was looking for ways out of its support for a lost cause.

"I believe that the Russians have woken up and are sensing that they have implicated themselves with this regime, but they don't know how to get out," al-Khatib told Reuters. He held them "particularly responsible" for helping Assad with arms but said Moscow need not "lose everything" in Syria if it changed tack.

Under President Vladimir Putin, wary since last year's Libyan war of what Russia sees as a Western drive to use the United Nations to overthrow national leaders it dislikes, Russia has blocked U.N. efforts to squeeze Assad, who has also had strong support from his long-time sponsor Iran.

But Mikhail Bogdanov, a deputy foreign minister and the Kremlin's special envoy for Middle East affairs, was quoted as saying in Moscow: "One must look the facts in the face."

"Unfortunately, the victory of the Syrian opposition cannot be ruled out." The Syrian government, he said, was "losing control of more and more territory" and Moscow was preparing to evacuate Russian citizens if necessary.

Nuland said Bogdanov's comments demonstrated that Moscow now "sees the writing on the wall" on Syria and said Russia should now rally behind U.N. efforts to prevent a wider bloodbath.

"They can withdraw any residual support for the Assad regime, whether it is material support (or) financial support," she said. "They can also help us to identify people who might be willing, inside of Syria, to work on a transitional structure."

DIPLOMACY

International envoy Lakhdar Brahimi, who has met Russian and U.S. officials twice in the past week, is seeking a solution based on an agreement reached in Geneva in June that called for the creation of a transitional government in Syria.

But Russia has repeated warnings that recognition of al-Khatib's coalition, notably by the United States, is undermining diplomacy, and rejected U.S. contentions that the Geneva agreement sent a clear message that Assad should step down.

Nuland said the Brahimi meetings could lay the framework for a political structure to follow Assad:

"We've said all along to the Russians that we are concerned that the longer that this goes on, and the longer it takes us to get to an alternative political path for Syria, the only path is going to be the military one and that is just going to bring more violence.

"We all ought to be working together."

Bogdanov, whose government has suggested that Assad himself should be allowed to see through a transition he has promised, suggested the rebels and their allies were set on a military solution and he gave little hint of detente with Washington.

"The fighting will become even more intense and (Syria) will lose tens of thousands and, perhaps, hundreds of thousands of civilians," Bogdanov was quoted as saying. "If such a price for the removal of the president seems acceptable to you, what can we do? We, of course, consider it absolutely unacceptable."

The head of NATO, Anders Fogh Rasmussen, said elsewhere: "I think the regime in Damascus is approaching collapse."

A U.S. official said: "Assad probably still believes that Syria is his and illusions can die hard. But Assad and those closest to him have got to be feeling the psychological strain of fighting a long war that is not going their way."

DAMASCUS BATTLES

But Al-Khatib, who played down Western concerns of sectarian Sunni Islamists in rebel ranks, warned that the fighting was far from over, even as it has begun to rattle the heart of Assad's power in Damascus. On Wednesday, a car bomb killed at least 16 people in a nearby town which is home to many military families.

"The noose is tightening around the regime," al-Khatib said.

"(But) the regime still has power. People think that the regime is finished, but it still has power left, but it is demoralized and however long it lasted its end is clear."

Day and night, Damascenes can hear the thunderous sound of bombardment aimed at rebel-held and contested neighborhoods.

The city's streets have now turned into a labyrinth of checkpoints and road blocks, with several major roads permanently closed off to traffic by concrete barriers.

"We escape from one place and trouble follows," said one grandmother, Um Hassan, as she described to Reuters her family's flight from one neighborhood to another as fighting seeps into the capital. "I don't know where we can keep running to."

Nonetheless, al-Khatib played down demands for their allies to provide heavier weaponry - a request long resisted by governments wary of anti-aircraft missiles and other hardware reaching Islamist rebels who might turn them against the West.

"The Syrian people ... no longer need international forces to protect them," he said, not specifying whether he meant a no-fly zone, arms supplies or other military support.

The opposition chief said he was willing to listen to proposals for Assad to escape with his life - "The best thing is that he steps down and stops drinking the blood of the Syrian people" - and outlined three scenarios for a change of power:

Al-Khatib ruled out the Russian proposal suggesting Assad hand over power to a transitional government while remaining president, saying it was "disgraceful for a slaughtered nation to accept to have a killer and criminal at its head".

The British-based Syrian Observatory said war planes bombed rebel-held eastern suburbs of Damascus on Thursday and artillery was hitting Daraya and Moadamiyeh, southwestern areas near the centre where rebels have been fighting for a foothold.

Syria has relied on war planes and helicopters to bombard rebel districts but Damascus denied accusations by U.S. and NATO officials that it had fired Scud missiles in recent days. The foreign ministry said the long-range missiles were not used against "terrorist groups," a term it uses for the rebels.

At least 40,000 people have been killed in Syria's uprising, which started in March 2011 with street protests which were met with gunfire by Assad's security forces, and which spiraled into the most enduring and destructive of the Arab revolts.

(Additional reporting by Steve Gutterman in Moscow and Andrew Quinn in Washington; Writing by Alastair Macdonald; Editing by Michael Roddy) For an interactive look at the uprising in Syria, please click on http://link.reuters.com/rut37s

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More land released for sale in early 2013

SINGAPORE: The Ministry of National Development (MND) has announced the Government Land Sales Programme for the first half of 2013 (1H2013).

In a statement issued on Friday, MND said it will provide an adequate supply of private housing to meet continued demand from home buyers.

There will be 12 private residential sites, including five executive condominium (EC) sites and a commercial and residential site on the Confirmed List.

These sites can yield about 6,900 private residential units, including 3,100 EC units and 33,000 square metre gross floor area (GFA) of commercial space.

MND said most of the private residential sites, including the five EC sites, are located in the suburban areas or in the city fringe where more affordable private housing is expected to be built.

In addition to the sites on the Confirmed List, MND said 19 sites will be available under the 1H2013 Reserve List.

These include 11 private residential sites, one commercial and residential site, two commercial sites, one "white" site and four hotel sites.

"White" sites are those which developers are allowed to decide on a mix of uses for the site and respective quantum of floor space for each use, as long as the total permissible GFA for the whole development is not exceeded.

Sites on the Reserve List can yield about 7,100 private residential units, 281,000 square metre GFA of commercial space and 1,740 hotel rooms.

In all, the programme is expected to yield about 14,000 private residential units, including 3,100 EC units.

- CNA/xq

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Anna’s crusade gets a Gen Singh boost

VARANASI: Aimed at mobilising the country's youth against corruption, Anna Hazare and former Army chief General VK Singh will begin a campaign from Patna's Gandhi Maidan on the occasion of martyrs' day on January 30.

Anna and Gen Singh announced the schedule of their proposed one and a half year long campaign to create awareness among youth while addressing an impressive gathering of students at Bharat Mata Mandir premises here on Wednesday. On finding an enthused crowd, Hazare announced that the campaign will begin on the day the father of the nation Mahatma Gandhi attained martyrdom. "The campaign will be aimed at creating awareness among youngsters for their active participation in nation-building. We will be travelling across the country to hold meetings with youths in this regard. Around four to five such meetings will also be held in the districts of UP," he said.

A huge gathering of students and student leaders from various universities and colleges of eastern UP districts was present at this meeting. Before addressing the crowd, Anna along with Singh offered prayers at Bharat Mata Mandir. Hinting that the campaign will be held in view of the 2014 Lok Sabha elections, he said that until the youth of the country realize the importance of their vote, the wrong people would continue reaching the parliament. One must have the right to reject wrong people contesting the election, said Anna, encouraging youngsters to be ready for a massive agitation during which they may face brutality and also go behind the bars.

He said that it was easier to fight for freedom against British rule than it is to fight with our own corrupt people, but the task is not impossible. He said that in last 65 years, the country has witnessed immense increment in cases of loot, cheat and corruption. Expressing concern over the existing education system, he said that the poor are still deprived of their right to education and rich people are busy in trading of education for commercial gains.

Reacting over FDI in retail, Anna said that inviting foreign companies and snatching land from farmers, selling rivers, forests and natural resources can't be termed development. Development can't be ensured at the cost of nation, nature and countrymen, he said. It is really unfortunate to see that a majority of the people are struggling for three square meals while some people are living to eat, he added. Anna also appealed to the gathering to stay in touch with the campaign by sending SMS on 9923599234.

Meanwhile, Gen Singh emphasised on generating employment opportunities for youngsters. He said that over 200 districts of the country are Naxal-affected due to lack of employment and development in their areas. He said around 71 percent of India's population is young, but this is not reflected in the Parliament. "We are being divided on the basis of caste, creed and religion. Common man's participation has completely vanished from our democracy. Youngsters should come forward to remove those people who have been exploiting the country for 65 years. Like Army personnel, everyone should consider their country as the first priority, he said, and called upon youngsters to join their campaign which will be launched from Patna.

After addressing this meeting, the two left for Sarva Sewa Sangh, Rajghat to take part in a meeting with activists of India Against Corruption (IAC).

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