Could Medicaid Benefits Get Pushed Off the Fiscal Cliff?

Medicaid provides benefits to more than 60 million Americans, including millions of children, who might not otherwise be able to afford medical care. This sizable government program has been sheltered from large federal cuts but is now vulnerable because of the ongoing talks in Washington to close the budget gap and avoid the fiscal cliff.Sharp cuts to Medicaid would hobble health care reform and hamper efforts to reduce overall health care spending, argues Sara Rosenbuam, a professor of health law and policy at the George Washington University School of Public Health and Health Services in Washington, DC, in an essay published online December 5 in the New England Journal of Medicine.Medicaid is relatively protected from automatic budget cuts by the Budget Control Act. The program is insulated from the across-the-board spending reduction known as sequestration which is set to take effect if Congress and the president fail to reach a compromise by the end of the year.However, there are still many ways Medicaid–and with it, some of the Affordable Care Act’s promised health care reform changes–could lose ground during the budgetary negotiations. Medicaid is a tempting target: a massive federal program that is only set to grow. Initially, the Affordable Care Act extended its coverage to some 20 million people as states expand eligibility to those who had not previously qualified but who have trouble obtaining private insurance. But in June, the U.S. Supreme Court undercut this provision, ruling that states were not required to extend additional eligibility.Rosenbaum argues that reducing coverage would mean that many millions will continue to go without medical coverage, continuing the shift of expenses on to insurers and other patients. The Congressional Budget Office has estimated that insuring people through Medicaid costs 50 percent less per person than subsidizing private insurance from a state-run health insurance exchange. “The problem is that Medicaid’s cost is driven by high enrollment, not excessive per capita spending,” Rosenbaum notes. “As a result, there’s very little money to wring out of Medicaid without shaking its structure in ways that reduce basic coverage.”Medicaid is an effective and efficient investment in health care for large numbers of people, she writes. For example, “much of the health care that Medicaid beneficiaries receive is furnished through safety-net providers such as community health centers, which are highly efficient and accustomed to operating on tight budgets.”One proposal to help trim the federal budget, as outlined by the House Budget Committee, run by Paul Ryan, would remove all of the Affordable Care Act’s Medicaid expansions in states and instead give out set grants for states to provide coverage for some qualifying residents. This option is estimated to save some $ 2 trillion in the next 10 years, but, Rosenbaum argues, it is based on “an arbitrary limit” rather than actual, changing needs. “Recent and ongoing demographic shifts…and recent tragedies, such as Hurricane Sandy, underscore the way in which uncontrollable events can cause unexpected surges in the need for government assistance,” she writes.”Such blunt force strategies would leave many poor and disabled Americans without the basic services they need to stay healthy,” Rosenbaum said in a prepared statement. Instead, she suggests redoubling efforts to increase the program’s efficiency, looking to reduce costs of caring for the most expensive patients, such as those that require long-term institutional care and use both Medicaid and Medicare.Other proposals limit states’ abilities to generate funds for Medicaid by levying taxes on hospitals or pharmacies. They also seek to reduce states’ abilities to use Medicaid funds to invest in public hospitals and other centers that care for beneficiaries. “Changing the rules would destabilize these institutions at the very time when expanded insurance coverage is creating greater demand for care,” Rosenbaum writes.But Medicaid is a plump and tempting budgetary target. And unlike Medicare, which provides coverage for seniors, Medicaid does not enjoy the same level of vocal (and financial) support. As Rosenbaum notes, often “Medicaid beneficiaries lack political clout.”

Follow Scientific American on Twitter @SciAm and @SciamBlogs.Visit ScientificAmerican.com for the latest in science, health and technology news.
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Death toll from Philippine typhoon nears 300

NEW BATAAN, Philippines (AP) — Stunned parents searching for missing children examined a row of mud-stained bodies covered with banana leaves while survivors dried their soaked belongings on roadsides Wednesday, a day after a powerful typhoon killed nearly 300 people in the southern Philippines.

Officials fear more bodies may be found as rescuers reach hard-hit areas that were isolated by landslides, floods and downed communications.

At least 151 people died in the worst-hit province of Compostela Valley when Typhoon Bopha lashed the region Tuesday, including 78 villagers and soldiers who perished in a flash flood that swamped two emergency shelters and a military camp, provincial spokeswoman Fe Maestre said.

Disaster-response agencies reported 284 dead in the region and 14 fatalities elsewhere from the typhoon, one of the strongest to hit the country this year.

About 80 people survived the deluge in New Bataan with injuries, and Interior Secretary Mar Roxas, who visited the town, said 319 others remained missing.

“These were whole families among the registered missing,” Roxas told the ABS-CBN TV network. “Entire families may have been washed away.”

The farming town of 45,000 people was a muddy wasteland of collapsed houses and coconut and banana trees felled by Bopha’s ferocious winds.

Bodies of victims were laid on the ground for viewing by people searching for missing relatives. Some were badly mangled after being dragged by raging flood waters over rocks and other debris. A man sprayed insecticide on the remains to keep away swarms of flies.

A father wept when he found the body of his child after lifting a plastic cover. A mother, meanwhile, went away in tears, unable to find her missing children. “I have three children,” she said repeatedly, flashing three fingers before a TV cameraman.

Two men carried the mud-caked body of an unidentified girl that was covered with coconut leaves on a makeshift stretcher made from a blanket and wooden poles.

Dionisia Requinto, 43, felt lucky to have survived with her husband and their eight children after swirling flood waters surrounded their home. She said they escaped and made their way up a hill to safety, bracing themselves against boulders and fallen trees as they climbed.

“The water rose so fast,” she told AP. “It was horrible. I thought it was going to be our end.”

In nearby Davao Oriental, the coastal province first struck by the typhoon as it blew from the Pacific Ocean, at least 115 people perished, mostly in three towns that were so battered that it was hard to find any buildings with roofs remaining, provincial officer Freddie Bendulo and other officials said.

“We had a problem where to take the evacuees. All the evacuation centers have lost their roofs,” Davao Oriental Gov. Corazon Malanyaon said.

The International Federation of Red Cross and Red Crescent Societies issued an urgent appeal for $ 4.8 million to help people directly affected by the typhoon.

The sun was shining brightly for most of the day Wednesday, prompting residents to lay their soaked clothes, books and other belongings out on roadsides to dry and revealing the extent of the damage to farmland. Thousands of banana trees in one Compostela Valley plantation were toppled by the wind, the young bananas still wrapped in blue plastic covers.

But as night fell, however, rain started pouring again over New Bataan, triggering panic among some residents who feared a repeat of the previous day’s flash floods. Some carried whatever belongings they could as they hurried to nearby towns or higher ground.

After slamming into Davao Oriental and Compostela Valley, Bopha roared quickly across the southern Mindanao and central regions, knocking out power in two entire provinces, triggering landslides and leaving houses and plantations damaged. More than 170,000 fled to evacuation centers.

As of Wednesday evening, the typhoon was over the South China Sea west of Palawan province. It was blowing northwestward and could be headed to Vietnam or southern China, according to government forecasters.

The deaths came despite efforts by President Benigno Aquino III’s government to force residents out of high-risk communities as the typhoon approached.

Some 20 typhoons and storms lash the northern and central Philippines each year, but they rarely hit the vast southern Mindanao region where sprawling export banana plantations have been planted over the decades because it seldom experiences strong winds that could blow down the trees.

A rare storm in the south last December killed more than 1,200 people and left many more homeless.

The United States extended its condolences and offered to help its Asian ally deal with the typhoon’s devastation. It praised government efforts to minimize the deaths and damage.

___

Associated Press writers Jim Gomez, Teresa Cerojano and Oliver Teves in Manila contributed to this report.

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Syria loads chemical weapons, waits for green light

U.S. Secretary of State Hillary Clinton attends the "Friends of Syria" confernence in Paris. (AP)U.S. officials say the Syrian military has loaded active chemical weapons into bombs and is awaiting a final order from embattled President Bashar Assad to use the deadly weapons against its own people.

NBC News reports that on Wednesday the Syrian military loaded sarin gas into aerial bombs that could be deployed from dozens of aircraft.

The last large-scale use of sarin was in 1988, when former Iraqi President Saddam Hussein's forces killed 5,000 Kurds in a single attack.

However, U.S. officials told NBC that the sarin bombs had not yet been loaded onto planes but added if Assad gives the final order, "there's little the outside world can do to stop it."

The Syrian government has previously insisted that it would not use chemical weapons against its own people.

For months, the Obama administration has described the Assad regime as being on the verge of collapse. If the Syrian government were to be toppled from outside forces or from within, it would be the first nation possessing weapons of mass destruction to do so.

U.S. Secretary of State Hillary Clinton has as recently as last week warned of the possibility that Assad could use chemical weapons against his own people. After meeting other NATO foreign ministers in Brussels last week, Clinton told the gathering, "Our concerns are that an increasingly desperate Assad regime might turn to chemical weapons, or might lose control of them to one of the many groups that are now operating within Syria."

"We have sent an unmistakable message that this would cross a red line and those responsible would be held to account," she said.

At the end of the meeting, NATO Secretary General Anders Fogh Rasmussen backed up Clinton's threat, declaring that the international community could take military action against Assad and his forces.

"The possible use of chemical weapons would be completely unacceptable for the whole international community and if anybody resorts to these terrible weapons I would expect an immediate reaction from the international community," Rasmussen told reporters.

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U.S. agency backs Apple in essential patent battle

WASHINGTON (Reuters) – Google unit Motorola Mobility is not entitled to ask a court to stop the sale of Apple iPhones and iPads that it says infringe on a patent that is essential to wireless technology, the U.S. Federal Trade Commission said on Wednesday.

In June, Judge Richard Posner in Chicago threw out cases that Motorola, now owned by Google, and Apple had filed against each other claiming patent infringement. Both companies appealed.

In rejecting the Google case, Posner barred the company from seeking to stop iPhone sales because the patent in question was a standard essential patent.

This means that Motorola Mobility had pledged to license it on fair and reasonable terms to other companies in exchange for having the technology adopted as a wireless industry standard.

Standard essential patents, or SEPs, are treated differently because they are critical to ensuring that devices made by different companies work together.

Google appealed to the U.S. Court of Appeals for the Federal Circuit. The FTC said in its court filing that Posner had ruled correctly.

The commission, which has previously argued against courts banning products because they infringe essential patents, reiterated that position on Wednesday.

“Patent hold-up risks harming competition, innovation, and consumers because it allows a patentee to be rewarded not based on the competitive value of its technology, but based on the infringer’s costs to switch to a non-infringing alternative when an injunction is issued,” the commission wrote in its brief.

The case is Apple Inc. and NeXT Software Inc. V. Motorola Inc. and Motorola Mobility Inc., in the U.S. Court of Appeals for the Federal Circuit, no. 2012-1548, 2012-1549.

(Reporting By Diane Bartz)

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Brazilian architect Oscar Niemeyer dies, aged 104

RIO DE JANEIRO (Reuters) – Oscar Niemeyer, a towering patriarch of modern architecture who shaped the look of modern Brazil and whose inventive, curved designs left their mark on cities worldwide, died late on Wednesday. He was 104.

Niemeyer had been battling kidney ailments and pneumonia for nearly a month in a Rio de Janeiro hospital. His death was confirmed by a hospital spokesperson.

Starting in the 1930s, Niemeyer’s career spanned nine decades. His distinctive glass and white-concrete buildings include such landmarks as the United Nations Secretariat in New York, the Communist Party headquarters in Paris and the Roman Catholic Cathedral in Brasilia.

He won the 1988 Pritzker Architecture Prize, considered the “Nobel Prize of Architecture” for the Brasilia cathedral. Its “Crown of Thorns” cupola fills the church with light and a sense of soaring grandeur despite the fact that most of the building is underground.

It was one of dozens of public structures he designed for Brazil’s made-to-order capital, a city that helped define “space-age” style.

After flying over Niemeyer’s pod-like Congress, futuristic presidential palace and modular ministries in 1961, Yuri Gagarin, the Russian cosmonaut and first man in space, said “the impression was like arriving on another planet.”

In his home city of Rio de Janeiro, Niemeyer’s many projects include the “Sambadrome” stadium for Carnival parades. Perched across the bay from Rio is the “flying saucer” he designed for the Niteroi Museum of Contemporary Art.

The collection of government buildings in Brasilia, though, remain his most monumental and enduring achievement. Built from scratch in a wild and nearly uninhabited part of Brazil’s remote central plateau in just four years, it opened in 1960.

While the airplane-shaped city was planned and laid out by Niemeyer’s friend Lucio Costa, Niemeyer designed nearly every important government building in the city.

BECAME NATIONAL ICON

An ardent communist who continued working from his Copacabana beach penthouse apartment in Rio until days before his death, Niemeyer became a national icon ranking alongside Bossa Nova pioneer Tom Jobim and soccer legend Pelé.

His architecture, though, regularly trumped his politics.

Georges Pompidou, a right-wing Gaullist former French president, said Niemeyer’s design for the Communist Party of France headquarters in Paris “was the only good thing those commies ever did,” according to Niemeyer’s memoirs.

Prada, the fashion company known for providing expensive bags and wallets, thought the Communist Party building in Paris so cool it rented it for a fashion show.

Even the 1964-1985 Brazilian military government that forced Niemeyer into exile in the 1960s eventually found his buildings congenial to their dreams of making Brazil “the country of the future.”

His work is celebrated for innovative use of light and space, experimentation with reinforced concrete for aesthetic value and his self-described “architectural invention” style that produced buildings resembling abstract sculpture.

Initially influenced by the angular modernism of French-Swiss architect Le Cobusier, who worked with Niemeyer and Costa on a visit to Brazil in the 1930s, his style evolved toward rounded buildings that he said were inspired by the curves of Rio’s sunbathing women as well as beaches and verdant hills.

“That is the architecture I do, looking for new, different forms. Surprise is key in all art,” Niemeyer told Reuters in an interview in 2006. “The artistic capability of reinforced concrete is so fantastic – that is the way to go.”

Responding to criticism that his work was impractical and overly artistic, Niemeyer dismissed the idea that buildings’ design should reflect their function as a “ridiculous and irritating” architectural dogma.

“Whatever you think of his buildings, Niemeyer has stamped on the world a Brazilian style of architecture,” Dennis Sharp, a British architect and author of The Illustrated Encyclopedia of Architects and Architecture, once said of Niemeyer.

LIFELONG COMMUNIST

Niemeyer’s legacy is heavily associated with his communist views. He was a close friend of Cuba’s revolutionary leader Fidel Castro and an enemy of Brazil’s 21-year military dictatorship.

“There are only two communists left in the world, Niemeyer and myself,” Castro once joked.

Niemeyer remained politically active after returning to Brazil, taking up the cause of a militant and sometimes violent movement of landless peasants. He said in 2010 that he was a great admirer of Luiz Inacio Lula da Silva, the former labor leader who was Brazil’s president from 2003 to 2010.

Niemeyer once built a house in a Rio slum for his former driver and gave apartments and offices as presents to others.

Despite his egalitarian views, Niemeyer had no illusions that his buildings were helping to improve social justice.

Far from the model city Niemeyer had envisioned, Brasilia today is in many ways the epitome of inequality. Planned for 500,000 people, the city is now home to more than 2.5 million and VIPs keep to themselves in fenced-in villas while the poor live in distant satellite towns.

“It seemed like a new era was coming, but Brazil is the same crap – a country of the very poor and the very rich,” he said in another Reuters interview in 2001.

In a 2010 interview in his office, he was quick to blame Costa for things many dislike about Brasilia, such as its rigid ordering into homogenous “hotel,” “government,” “residential” and even “mansion” and “media” districts that can make finding a newspaper or groceries a chore.

“I just did the buildings,” he said. “All that other stuff was Costa.”

Despite Niemeyer’s atheism, one of his first significant early works was a church built in homage to St. Francis, part of a complex of modern buildings in Belo Horizonte, Brazil.

That work won the confidence of the city’s mayor Juscelino Kubitschek. When he became president, he tapped Niemeyer to help realize the dream of opening up Brazil’s interior by moving the capital from coastal Rio to the empty plains of central Brazil.

Despite years of bohemian living, Niemeyer remained married for 76 years to Annita Baldo, his first wife. He married his second wife, long-time aide Vera Lucia Cabreira, in 2006 at the age of 99. She survives him, as do four grandchildren.

Niemeyer’s only daughter, an architect, designer and gallery owner, Anna Maria, died on June 6 at the age of 82.

(Additional reporting by Brian Ellsworth; Editing by Todd Benson and Kieran Murray)

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Obama, Boehner talk; Geithner prepared to go off “cliff”

WASHINGTON (Reuters) – Republicans in Congress and President Barack Obama consumed much of Wednesday talking up their positions on the “fiscal cliff” and though Obama and Republican House Speaker John Boehner spoke by phone, neither side offered any new compromises in public.

Nor was the phone call, a rarity, followed by any immediate announcement of a face-to-face meeting that has been widely anticipated all week and was explicitly requested early in the day by House of Representatives Republican leader Eric Cantor.

Asked in an interview with CNBC if the administration was ready to go over the so-called fiscal cliff if Republicans don’t come around on taxes, Obama‘s chief negotiator, Treasury Secretary Timothy Geithner, responded: “Oh, absolutely.”

Facing spending cuts and tax increases that start to take effect in January unless Congress acts, Republicans on Capitol Hill were privately acknowledging that they were taking a public relations thrashing at the hands of the White House, which has marshaled a campaign-style offensive that involves some of the very “job-creators” Republicans say they are protecting.

Obama met with another such corporate group on Wednesday, The Business Roundtable, renewing his call to include tax hikes on the wealthiest 2 percent of Americans as part of the final resolution and for including an increase in the nation’s borrowing limit.

U.S. stocks rose on Wednesday after Obama also said a deal to avert the fiscal cliff was possible within a week, though he expressed it as a hope not a prediction.

The confrontation has become an endless loop of familiar talking points and well-worn positions. Republican leaders have balked at raising any tax rates, and Democrats have resisted Republican calls for cuts in entitlements like the Medicare and Medicaid healthcare programs.

Obama said there could be a quick deal if Republican leaders dropped their opposition to raising tax rates for those making more than $ 250,000 a year in exchange for spending cuts and entitlement reforms.

“If we can get the leadership on the Republican side to take that framework, to acknowledge that reality, then the numbers actually aren’t that far apart,” Obama told The Business Roundtable.

“Another way of putting this is we can probably solve this in about a week. It’s not that tough, but we need that conceptual breakthrough,” he said.

Geithner reiterated that there would be no deal without higher tax rates on the wealthy and without a change in congressional rules making it harder to block an increase in the U.S. debt ceiling.

“There is no prospect (for) an agreement that doesn’t involve rates going up on the top 2 percent of the wealthiest Americans,” he told CNBC.

The two sides have submitted proposals to cut deficits by more than $ 4 trillion over the next 10 years, but differ on how to get there. Republicans propose $ 1 trillion more in spending cuts than Obama, while the president wants $ 800 billion more in tax increases and $ 200 billion to boost the sluggish economy.

Republicans have shown cracks in their solidarity on taxes, however, with some saying they would be willing to let rates rise on the wealthiest 2 percent in exchange for extending low rates for the other 98 percent of taxpayers.

‘WE HAVE TO RAISE REVENUE’

Republican Senator Tom Coburn of Oklahoma said he could accept some higher tax rates as part of a long-term solution to the threat posed by spiraling U.S. debt. He said the path to prosperity would require at least a $ 9 trillion package of spending cuts and tax increases over 10 years, rather than the $ 4 trillion being discussed now.

“Personally I know we have to raise revenue. I don’t really care which way we do it. Actually, I would rather see the rates go up than do it the other way because it gives us a greater chance to reform the tax code and broaden the base in the future,” Coburn said on MSNBC.

With no resolution in sight and the fiscal cliff looming, the White House budget office has told all federal agencies to begin planning for possible automatic spending cuts that will start taking effect in January without a deal, the White House said.

White House spokesman Jay Carney said the Office of Management and Budget needed to take certain steps to be ready if an agreement is not reached and asked federal agencies for information so it could complete calculations on the required cuts.

Economists have predicted that failure to reach an accord could trigger another recession, and business executives and investors in the financial markets have watched the back and forth anxiously.

Jim McNerney, chairman of the Business Roundtable and chairman and chief executive officer of Boeing Co., called for non-stop negotiations to break the stalemate.

“We encourage both sides to work around the clock, if necessary, to avoid the severe repercussions that inaction would have on U.S. economic growth and job creation,” McNerney said in a statement after Obama’s appearance before the executives.

Obama’s call for including an increase in the debt ceiling in a final package seemed likely to complicate the negotiations.

In his speech to executives, Obama said it was a “bad strategy” for Republicans to believe they would have more leverage next year to extract concessions from the White House by threatening to let the United States default.

A debt ceiling standoff between the White House and House Republicans in 2011 brought the country perilously close to default and resulted in an embarrassing debt rating downgrade.

“I want to send a very clear message to people here: We are not going to play that game next year,” Obama told the executives.

The focus on the debt ceiling is already raising concerns among market watchers.

“The more the Republicans talk about raising or not raising the debt limit, that really makes the market nervous, and makes the White House more nervous than Congress,” said John Brady, managing director at R.J. O’Brien & Associates in Chicago. “The cliff can be punted into the future, but the debt ceiling can’t be.”

(Additional reporting by Kim Dixon, Alina Selyukh, David Alexander, Richard Cowan, Steve Holland and Rodrigo Campos; Writing by John Whitesides; Editing by Eric Beech)

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WestJet embraces tech to woo business travelers

TORONTO (Reuters) – WestJet Airlines Ltd will use technological innovation, including a new Internet ticket booking system, to help it transform from a no-frills carrier to a lower-cost full-service airline courting lucrative corporate travelers, its chief executive said on Monday.

Canada’s second-biggest airline plans to launch a series of technology systems, most notably the new online booking engine, which will sell three tiers of tickets, in the next two months.

“Companies evolve or they die,” Chief Executive Gregg Saretsky told Reuters in a phone interview from the company’s Calgary head office.

“We’re 16 and going on 17 years old and we can’t stay just as we were 17 years ago. The world has changed. And we are changing to be more relevant for a broader segment of guests.”

The new Internet booking system, which WestJet hopes to launch in late January, will sell economy, mid-tier and premium tickets. That is a major shift from its current system, which sells only the lowest-priced ticket available.

Economy tickets under the new system will continue to sell the lowest available fare, but the cancellation fee for them will jump to C$ 75 ($ 75.48) from C$ 50. Mid-tier tickets will have a C$ 50 cancellation fee.

Premium tickets, unavailable until late March when WestJet finishes reconfiguring its 100 Boeing 737 planes to allow more leg room, will include priority screening and boarding, free cancellations and flexibility on ticket changes.

Pricing for those tickets, which may include free meals and drinks and an extra baggage allowance, has not yet been determined. Fares will be well below half the price for business class at WestJet’s bigger competitor, Air Canada, Saretsky said.

“It’s time for us to be more serious with respect to going after business travelers because frankly, they’re the ones who are booking last-minute and are happy to pay for the conveniences,” Saretsky said.

WestJet will launch its premium economy service with 24 seats per plane, but will consider expansion if it proves “wildly successful,” he added.

POISED FOR CHANGE

WestJet, which has spent about C$ 40 million over the past two years on technology projects, is poised for major changes in 2013 as it readies to launch a new regional airline, Encore.

Saretsky hopes that WestJet’s switch in coming weeks to a new Internet phone system will allow ticket reservation agents to work from home and help make room for Encore staff.

Some 750 reservation agents work at WestJet’s Calgary offices, which house about 2,400 staff. Space will be needed for Encore employees over the next 18 months while their office, hangars and maintenance stores are constructed at the WestJet campus.

Encore will be launch in the second half of 2013, “probably closer to July than December,” Saretsky said, with seven Bombardier Q400 planes.

While WestJet won’t announce Encore’s schedule until Jan 21, the carrier will initially serve only “a handful” of new cities, with ticket prices up to 50 percent below Air Canada’s, he added.

Over the next two months, WestJet will also roll out a guest notification system that alerts travelers via email about their flights, allowing them to check in remotely.

Such self-service technology will be critical as WestJet faces increasing labor costs, Saretsky said.

Wage and benefit costs, which represent about a third of operating costs, have climbed 50 percent since WestJet was founded in 1996.

“You can see that creates a little bit of drag on earnings,” Saretsky said. “We’ve got to find ways of reducing our component costs.”

If WestJet can increase self service options for travelers, that could limit the need for new employees, Saretsky said. Management also wants to improve attendance management, so that fewer employees book off sick around long weekends, and more quickly clean and process planes between flights, he said.

(Reporting By Susan Taylor; Editing by Peter Galloway)

(This story was corrected to show that WestJet is replacing its Internet booking engine, not entire reservation system, in the first and second paragraphs)

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100,000 protest at presidential palace

CAIRO (AP) — More than 100,000 Egyptians protested outside the presidential palace in Cairo on Tuesday, fueling tensions over Islamist leader Mohammed Morsi's seizure of nearly unrestricted powers and the adoption by his allies of a controversial draft constitution.

The outpouring of anger across the Egyptian capital, the Mediterranean port of Alexandria and a string of other cities pointed to a prolonged standoff between the president and a newly united opposition.

Morsi's opponents, long fractured by bickering and competing egos, have been re-energized since he announced decrees last month that place him above oversight of any kind, including by the courts, and provide immunity to two key bodies dominated by his allies: The 100-member panel drafting the constitution and parliament's upper chamber.

The decrees have led to charges that Morsi's powers turned him into a "new pharaoh."

The large turnout in Tuesday's protests — dubbed "The Last Warning" by organizers — signaled sustained momentum for the opposition, which brought out at least 200,000 protesters to Cairo's Tahrir Square a week ago and a comparable number on Friday to demand that Morsi rescind the decrees.

The huge scale of the protests have dealt a blow to the legitimacy of the new constitution, which Morsi's opponents contend allows religious authorities too much influence over legislation, threatens to restrict freedom of expression and opens the door to Islamist control over day-to-day life.

What the revived opposition has yet to make clear is what it will do next: campaign for a "no" vote on the draft constitution in a nationwide referendum set for Dec. 15, or call on Egyptians to boycott the vote.

Already, the country's powerful judges have said they will not take on their customary role of overseeing the vote, thus robbing it of much of its legitimacy.

Morsi was in the presidential palace conducting business as usual as the protesters gathered outside. He left for home through a back door as the crowds continued to swell, according to a presidential official who spoke on condition of anonymity because he was not authorized to speak to the media.

The official said Morsi left on the advice of security officials to head off "possible dangers" and to calm the protesters. Morsi's spokesman, however, said the president left the palace at the end of his normal work day, through the door he routinely uses.

The protest was peaceful except for a brief outburst when police used tear gas to prevent demonstrators from removing a barricade topped with barbed wire and converging on the palace.

Soon after, with the president gone, the police abandoned their lines and the protesters surged ahead to reach the palace walls. But there were no attempts to storm the palace, guarded inside by the army's Republican Guard.

Protesters also commandeered two police vans, climbing atop the armored vehicles to jubilantly wave Egypt's red, white and black flag and chant against Morsi. The protesters later mingled freely with the black-clad riot police, as more and more people flocked to the area to join the demonstration.

The protesters covered most of the palace walls with anti-Morsi graffiti and waved giant banners carrying images of revolutionaries killed in earlier protests. "Down with the regime" and "No to Morsi," they wrote on the walls.

"He isn't the president of all Egyptians, only of the Muslim Brotherhood," said protester Mariam Metwally, a postgraduate student of international law. "We don't feel like he is our president."

A giant poster emblazoned with an image of Morsi wearing a Pharaonic crown was hoisted between two street light posts outside the presidential palace. "Down with the president. No to the constitution," it declared.

"The scene at Itihadiya palace is a stab at the president's legitimacy and his constitutional declaration," opposition leader Hamdeen Sabahi told a private TV network. "The scene sends a message to the president that he is running out of time."

The massive gathering was reminiscent of the one outside the palace on Feb. 11, 2011 — the day authoritarian president Hosni Mubarak stepped down in the face of an 18-day uprising that ended his 29-year regime.

Shouts of "Erhal! Erhal!" — Arabic for "Leave! Leave!" — and "The people want to topple the regime!" rose up from the crowd, the same chants used against Mubarak. This time, though, they were directed at his successor, Egypt's first democratically elected president.

"The same way we brought down Mubarak in 18 days, we can bring down Morsi in less," Ziad Oleimi, a prominent rights activist, told the crowds using a loudspeaker.

In Alexandria, some 10,000 opponents of Morsi gathered in the center of the country's second-largest metropolis, chanting slogans against the leader and his Islamic fundamentalist group, the Muslim Brotherhood.

The protests fueled Egypt's worst political crisis since Mubarak's ouster, with the country clearly divided into two camps: Morsi, his Muslim Brotherhood and their ultraconservative Islamist allies, versus an opposition made up of youth groups, liberal parties and large sectors of the public.

Tens of thousands also gathered in Cairo's downtown Tahrir Square, miles away from the palace, to join several hundred who have been camping out there for nearly two weeks. There were other large protests around the city.

Smaller protests by Morsi opponents were staged in the Islamist stronghold of Assiut, as well as in Suez, Luxor, Aswan, Damanhour and the industrial city of Mahallah, north of Cairo.

"Freedom or we die," chanted a crowd of several hundred outside a mosque in Cairo's Abbasiyah district. "Mohammed Morsi, illegitimate! Brotherhood, illegitimate!" they yelled.

Earlier Tuesday, several hundred protesters also gathered outside Morsi's residence in an upscale suburb. "Down with the sons of dogs. We are the power and we are the people," they chanted.

Morsi, who narrowly won the presidency in a June election, appeared to be in no mood for compromise.

A statement by his office said he met Tuesday with his deputy, his prime minister and several top Cabinet members to discuss preparations for the referendum. The statement suggested business as usual at the palace, despite the mass rally outside its doors.

Asked why Morsi did not address the crowds, Muslim Brotherhood spokesman Mahmoud Ghozlan said the protesters were "rude" and included "thugs and drug addicts."

The Islamists responded to the mass opposition protests last week by sending hundreds of thousands of supporters into Cairo's twin city of Giza on Saturday and across much of the country. Thousands also besieged Egypt's highest court, the Supreme Constitutional Court.

The court had been widely expected to declare the constitutional assembly that passed the draft charter illegitimate and to disband parliament's upper house, the Shura Council. Instead, the judges went on strike after they found their building under siege by protesters.

Morsi's Nov. 22 decrees were followed last week by the constitutional panel rushing through the draft constitution in a marathon, all-night session without the participation of liberal and Christian members. Only four women, all Islamists, attended the session.

The charter has been criticized for not protecting the rights of women and minority groups, and many journalists see it as restricting freedom of expression. Critics also say it empowers Islamic religious clerics by giving them a say over legislation, while some articles were seen as tailored to get rid of the Islamists' enemies.

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Associated Press writer Maggie Michael contributed to this report.

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iOS users generate double the Web traffic of Android users

According to the latest numbers from Chitika Insights, iOS users generate more than twice the amount of Web traffic as Android users. The six-month study found that while the two operating systems were nearly tied when it came to smartphone Web traffic, Apple (AAPL) has a substantial lead with its iPad tablet. Despite Android’s commanding share of the overall mobile market, the Cupertino-based company’s platform totaled 67% of Web traffic measured in the past six months, compared to Android’s 35% share.

“Despite all the new Android and Apple devices that have been released over the past six months, little has changed in the overall Web traffic distribution between iOS and Android,” the research firm wrote. “iOS’s share has hovered around 65%, while Android largely has stayed around 35%, the OS hit a peak of 40% in late August thanks partially to strong Samsung Galaxy S III sales. Apple then regained some share with the release of the iPhone 5 in the September timeframe.”

To qualify for the study Chitika Insights analysed billions of ad impressions coming from iOS or Android devices from May 27th to November 27th.

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Huston’s “Infrared” wins Bad Sex fiction prize

LONDON (AP) — It’s the prize no author wants to win.

Award-winning novelist Nancy Huston won Britain’s Bad Sex in Fiction award Tuesday for her novel “Infrared,” whose tale of a photographer who takes pictures of her lovers during sex proved too revealing for the judges.

The choice was announced by “Downton Abbey” actress Samantha Bond during a ceremony at the Naval & Military Club in London.

Judges of the tongue-in-cheek prize — which is run by the Literary Review magazine — said they were struck by a description of “flesh, that archaic kingdom that brings forth tears and terrors, nightmares, babies and bedazzlements,” and by a long passage that builds to a climax of “undulating space.”

Huston, who lives in Paris, was not on hand to collect her prize. In a statement read by her publicist, the 59-year-old author said she hoped her victory would “incite thousands of British women to take close-up photos of their lovers’ bodies in all states of array and disarray.”

The Canada-born Huston, who writes in both French and English, is the author of more than a dozen novels, including “Plainsong” and “Fault Lines.” She has previously won France’s Prix Goncourt prize and was a finalist for Britain’s Orange Prize for fiction by women.

She is only the third woman to win the annual Bad Sex prize, founded in 1993 to name and shame authors of “crude, tasteless and … redundant passages of sexual description in contemporary novels.”

Some critics, however, have praised the sexual passages in “Infrared.” Shirley Whiteside in the Independent on Sunday newspaper said there were “none of the lazy cliches of pornography or the purple prose of modern romantic fiction” — though she conceded the book’s sex scenes were “more perfunctory than erotic.”

Huston beat finalists including previous winner Tom Wolfe — for his passage in “Back to Blood” describing “his big generative jockey” — and Booker Prize-nominated Nicola Barker, whose novel “The Yips” compares a woman to “a plump Bakewell pudding.”

Previous recipients of the dubious honor, usually accepted with good grace, include Sebastian Faulks, the late Norman Mailer and the late John Updike, who was awarded a Bad Sex lifetime achievement award in 2008.

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Online: http://www.literaryreview.co.uk

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