KARACHI: The moon of Shawal 1, 1429 has been sighted in the country on Tuesday, so Eid-ul-Fitr will be celebrated tomorrow on Wednesday October 1, Ruet-i-Hilal committee (Central Moon Sighting Committee) announced here on Tuesday night.

Addressing a press conference, Chairman of the committee, Mufti Muneeb-ur-Rehman said that the committee received the authentic evidence of moon sighting from many parts of the country.

Special arrangements were made to facilitate the committee members to gather information about moon sighting from all across the country.

The representatives of relevant departments including Meteorological department and media persons were also present on the occasion.

Muneeb-ur-Rehman said that after receiving reports from zonal Ruet-i-Hilal committees of Karachi, Quetta, Lahore, and Peshawar, it was unanimously decided that Eid-ul-Fitr would be celebrated on Wednesday October 1.

He said that the committee also received reports of moon sighting from centers of Meteorological units, adding that there was also evidence of the sighting from coastal areas and Northern Areas.

Later, the committee members prayed for the prosperity and progress of the country.

Source:geo

The term health insurance is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government.Synonyms for this usage include “health coverage,” “health care coverage” and “health benefits.” In a more technical sense, the term is used to describe any form of insurance that provides protection against injury or illness. This usage includes private insurance and social insurance programs such as Medicare, but excludes social welfare programs such as Medicaid. In addition to medical expense insurance, it also includes insurance covering disability or long-term nursing or custodial care needs.

The US market-based health care system relies heavily on private and not-for-profit health insurance, which is the primary source of coverage for most Americans. According to the United States Census Bureau, approximately 85% of Americans have health insurance; nearly 60% obtain it through an employer, while about 9% purchase it directly.Various government agencies provide coverage to about 28% of Americans (there is some overlap in these figures).

In 2007, there were nearly 46 million people in the US (over 15% of the population) who were without health insurance for at least part of that year.The percentage of the non-elderly population who are uninsured has been generally increasing since the year 2000.[3] There is considerable debate in the US on the causes of and possible remedies for this level of uninsurance as well as the impact it has on the overall US health care system.

History

Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the US by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the US effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911.

Before the development of medical expense insurance, patients were expected to pay all other health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle to late 20th century, traditional disability insurance evolved into modern health insurance programs. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and also most prescription drugs, but this was not always the case.

Hospital and medical expense policies were introduced during the first half of the 20th century. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Cross organizations.The predecessors of today’s health maintenance organizations (HMOs) originated in 1929, through the 1930s and on during World War II.

Public health care coverage

Public programs provide the primary source of coverage for most seniors and for low-income children and families who meet certain eligibility requirements. The primary public programs are Medicare, a federal social insurance program for seniors and certain disabled individuals; Medicaid, funded jointly by the federal government and states but administered at the state level, which covers certain very low income children and their families; and SCHIP, also a federal-state partnership that serves certain children and families who do not qualify for Medicaid but who cannot afford private coverage. Other public programs include military health benefits provided through TRICARE and the Veterans Health Administration and benefits provided through the Indian Health Service. Some states have additional programs for low-income individuals.

Medicare

In the United States, Medicare is a federal social insurance program that provides health insurance to elderly workers and their dependents, individuals who become totally and permanently disabled, and end stage renal disease (ESRD) patients. Some health care economists (Uwe Reinhardt of Princeton and Stuart Butler among others) assert that the third-party payment feature of this program has had the unintended consequence of distorting the price of medical procedures. As a result, the Health Care Financing Administration has set up a list of procedures and corresponding prices under the Resource-Based Relative Value Scale. Recent research has found that the health trends of previously uninsured adults, especially those with chronic health problems, improves once they enter the Medicare program.

Medicare Advantage

Medicare Advantage plans expand the health care options for Medicare beneficiaries. The option for Medicare Advantage plans is a result of the Balanced Budget Act of 1997, with the intent to better control the rapid growth in Medicare spending, as well as to provide Medicare beneficiaries more choices.

Medicare Part D (Prescription Drugs)

Medicare Part D provides a private insurance option to allow Medicare beneficiaries to purchase subsidized coverage for the costs of prescription drugs. It was enacted as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and went into effect on January 1, 2006.

Medicaid

Medicaid was instituted for the very poor in 1965. Despite its establishment, the percentage of US residents who lack any form of health insurance has increased since 1994.It has been reported that the number of physicians accepting Medicaid has decreased in recent years due to relatively high administrative costs and low reimbursements. Medicaid is a social welfare or social protection program rather than a social insurance program.

State Children’s Health Insurance Program (SCHIP)

The State Children’s Health Insurance Program (SCHIP) is a joint state/federal program to provide health insurance to children in families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance. The statutory authority for SCHIP is under title XXI of the Social Security Act. SCHIP programs are run by the individual states according to requirements set by the federal Centers for Medicare and Medicaid Services, and may be structured as independent programs separate from Medicaid (separate child health programs), as expansions of their Medicaid programs (SCHIP Medicaid expansion programs), or combine these approaches (SCHIP combination programs). States receive enhanced federal funds for their SCHIP programs at a rate above the regular Medicaid match.

Military health benefits

Health benefits are provided to active duty service members, retired service members and their dependents by the Department of Defense Military Health System (MHS). The MHS consists of a direct care network of Military Treatment Facilities and a purchased care network known as TRICARE. Additionally, veterans may also be eligible for benefits through the Veterans Health Administration.

Indian health service

The Indian Health Service (IHS) provides medical assistance to eligible American Indians at IHS facilities, and helps pay the cost of some services provided by non-IHS health care providers.

State risk pools

In 1976, some states began providing guaranteed-issuance risk pools, which enable individuals who are medically uninsurable through private health insurance to purchase a state-sponsored health insurance plan, usually at higher cost. Minnesota was the first to offer such a plan; 34 states now offer them. Plans vary greatly from state to state, both in their costs and benefits to consumers and in their methods of funding and operations. They serve a very small portion of the uninsurable market—about 182,000 people in the US as of 2004.In best cases, they allow people with pre-existing conditions such as cancer, diabetes, heart disease or other chronic illnesses to be able to switch jobs or seek self-employment without fear of being without health care benefits.However, the plans are expensive, with premiums that can be double the average policy, and the pools currently cover only 1 in 25 of the so-called “uninsurable” population.[14] Efforts to pass a national pool have as yet been unsuccessful, but some federal tax money has been awarded to states to innovate and improve their plans.

Private health care coverage

Private health insurance may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by individual consumers. Most Americans with private health insurance receive it through an employer-sponsored program. According to the United States Census Bureau, some 60% of Americans are covered through an employer, while about 9% purchase health insurance directly.Private health insurers have a significant economic impact in the US as employers—in 2004 they directly employed almost 470,000 people at an average salary of $61,409.

The US has a joint federal/state system for regulating insurance, with the federal government ceding primary responsibility to the states under the McCarran-Ferguson Act. States regulate the content of health insurance policies and often require coverage of specific types of medical services or health care providers.State mandates generally do not apply to the health plans offered by large employers, due to the preemption clause of the Employee Retirement Income Security Act.

Employer-sponsored

Employer-sponsored health insurance is paid for by businesses on behalf of their employees as part of an employee benefit package. Most private health coverage in the US is employment based. According to the Centers for Medicare and Medicaid Services, nearly 100% of large firms offer health insurance to their employees.The employer typically makes a substantial contribution towards the cost of coverage.In 2008 the average employee contribution was 16% of the cost of single coverage and 27% of the cost of family coverage. These percentages have been stable since 1999.Health benefits provided by employers are also tax favored. Employee contributions can be made on a pre-tax basis if the employer offers the benefits through a section 125 cafeteria plan.

Costs for employer-paid health insurance are rising rapidly: since 2001, premiums for family coverage have increased 78%, while wages have risen 19% and inflation has risen 17%, according to a 2007 study by the Kaiser Family Foundation.Employer costs have risen significantly per hour worked, and vary significantly. In particular, average employer costs for health benefits vary by firm size and occupation. The cost per hour of health benefits is generally higher for workers in higher-wage occupations, but represent a smaller percentage of payroll.The percentage of total compensation devoted to health benefits has been rising since the 1960s.Average premiums, including both the employer and employee portions, were $4,704 for single coverage and $12,680 for family coverage in 2008.

However, in a 2007 analysis, the Employee Benefit Research Institute concluded that the availability of employment-based health benefits for active workers in the US is stable. The “take-up rate,” or percentage of eligible workers participating in employer-sponsored plans, is falling. The percentage of workers actually covered has fallen somewhat, but not sharply. EBRI interviewed employers for the study, and found that others might follow if a major employer discontinued health benefits. Public policy changes could also result in a reduction in employer support for employment-based health benefits.

Although much more likely to offer retiree health benefits than small firms, the percentage of large firms offering these benefits fell from 66% in 1988 to 34% in 2002.

Small employer group coverage

According to a 2007 study, about 59% of employers at small firms (3-199 workers) in the US provide employee health insurance. The percentage of small firms offering coverage has been dropping steadily since 1999. The study notes that cost remains the main reason cited by small firms who do not offer health benefits.Small firms that are new are less likely to offer coverage than ones that have been in existence for a number of years. For example, using 2005 data for firms with fewer than 10 employees, 43% of those that had been in existence at least 20 years offered coverage, but only 24% of those that had been in existence less than 5 years did. The volatility of offer rates from year to year also appears to be higher for newer small businesses.

The types of coverage available to small employers are similar to those offered by large firms, but small businesses do not have the same options for financing their benefit plans. In particular, self-insuring the benefits (see Self-funded health care) is not a practical option for most small employers.A RAND Corporation study published in April 2008 found that the cost of health care coverage places a greater burden on small firms, as a percentage of payroll, than on larger firms.A study published by the American Enterprise Institute in August of 2008 examined the effect of state benefit mandates on self-employed individuals, and found that “the larger the number of mandates in a state, the lower the probability that a self-employed person will be a significant employment generator.”

States regulate small group premium rates, typically by placing limits on the premium variation allowable between groups (rate bands). Insurers price to recover their costs over their entire book of small group business while abiding by state rating rules.Over time, the effect of initial underwriting “wears off” as the cost of a group regresses towards the mean. Recent claim experience - whether better or worse than average - is a strong predictor of future costs in the near term. But the average health status of a particular small employer group tends to regress over time towards that of an average group.The process used to price small group coverage changes when a state enacts small group reform laws.

Insurance brokers play a significant role in helping small employers find health insurance, particularly in more competitive markets. Average small group commissions range from 2 percent to 8 percent of premiums. Brokers provide services beyond insurance sales, such as assisting with employee enrollment and helping to resolve benefits issues.

Federal employees health benefit plan (FEHBP)

In addition to such public plans as Medicare and Medicaid, the federal government also sponsors a health benefit plan for federal employees—the Federal Employees Health Benefits Program (FEHBP). FEHBP provides health benefits to full-time civilian employees. Active-duty service members, retired service members and their dependents are covered through the Department of Defense Military Health System (MHS). FEHBP is managed by the federal Office of Personnel Management.

“Portability” of group coverage

Two federal laws address the ability of individuals with employment-based health insurance coverage to maintain coverage.

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) enables certain individuals with employer-sponsored coverage to extend their coverage if certain “qualifying events” would otherwise cause them to lose it. Employers may require COBRA-qualified individuals to pay the full cost of coverage, and coverage cannot be extended indefinitely. COBRA only applies to firms with 20 or more employees, although some states also have “mini-COBRA” laws that apply to small employers.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provides for forms of both “group-to-group” and “group-to-individual” portability. When an individual moves from one employer’s benefit plan to another’s, the new plan must count coverage under the old plan against any waiting period for pre-existing conditions, as long as there is not a break in coverage of more than 63 days between the two plans. When certain qualified individuals lose group coverage altogether, they must be guaranteed access to some form of individual coverage. To qualify, they must have at least 18 months of prior continuous coverage. The details of access and the price of coverage are determined on a state-by-state basis.

Individually purchased

Policies of health insurance obtained by individuals not otherwise covered under policies or programs elsewhere classified. Generally major medical, short-term medical, and student policies. According to the US Census Bureau, about 9% of Americans are covered under health insurance purchased directly. The range of products available is similar to those provided through employers. However, average out-of-pocket spending is higher in the individual market, with higher deductibles, co-payments and other cost-sharing provisions.Major medical is the most commonly purchased form of individual health insurance.

In the individual market, the consumer pays the entire premium without benefit of an employer contribution.While self-employed individuals receive a tax deduction for their health insurance and can buy health insurance with additional tax benefits, most consumers in the individual market do not receive any tax benefit.

Premiums vary significantly by age.In states that allow individual medical plan underwriting, premiums also vary by health status.[36] For individuals who pass individual medical plan underwriting where it is used, the average premiums they pay are lower than the average paid for employer-sponsored coverage (this comparison is based on the entire premium for employer-sponsored coverage, including both the employee and employer contributions).Factors that may be contributing to this include: differences in age; less generous coverage in the individual market (higher beneficiary cost sharing); and a tendency for individual consumers to only buy benefits that they expect to need and use while group coverage may provide some benefits that most beneficiaries do not use.Individual policyholders are also more likely to report being in excellent health than are people covered by employer-sponsored health insurance, which may be a contributing factor.Premiums in the individual market rose less rapidly over the period 2002 through 2005 than did out-of-pocket premiums in the employer-sponsored market (17.8% versus 34.4%). The increase was larger for family policies than for single policies (25.3% for family policies; the increase for single policies was not statistically significant). Note that these comparisons did not adjust for changes in benefit levels.

Research confirms that consumers in the individual health insurance market are sensitive to price. Estimates of the demand elasticity in this market vary, but generally fall in the range of -0.3 to -0.1. It appears that price sensitivity varies among population subgroups and is generally higher for younger individuals and lower income individuals.One study found that among individuals who lack other sources of health coverage, the percentage purchasing individual insurance increases steadily with income. However, even among those with incomes four times the federal poverty level, only about a fourth buy individual coverage. The self-employed, who can tax-deduct their premiums, are more likely to purchase than other individuals. The researchers concluded that affordability appears to be a key barrier to coverage in this market, and that any premium subsidies would likely have to be substantial to be effective. The researchers note that other factors such as health status and the complexity of the market can also affect the purchase of individual health insurance, but conclude that they are unlikely to be the primary drivers of low coverage rates.

Many states allow medical underwriting of applicants for individually purchased health insurance. An estimated 5 million of those without health insurance are considered “uninsurable” because of pre-existing conditions.[14] A number of proposals have been advanced to limit the effect of underwriting on consumers and improve access to coverage. Each has its own advantages and limitations.[46] One study published in 2008 found that people of average health are least likely to become uninsured if they have large group health coverage, more likely to become uninsured if they have small group coverage, and most likely to become uninsured if they have individual health insurance. But, “for people in poor or fair health, the chances of losing coverage are much greater for people who had small-group insurance than for those who had individual insurance.” The authors attribute these results to the combination in the individual market of high costs and guaranteed renewability of coverage. Individual coverage costs more if it is purchased after a person becomes unhealthy, but “provides better protection (compared to group insurance) against high premiums for already individually insured people who become high risk.” Healthy individuals are more likely to drop individual coverage than less-expensive, subsidized employment-based coverage, but group coverage leaves them “more vulnerable to dropping or losing any and all coverage than does individual insurance” if they become seriously ill.

In August 2008 the Hartford Courant reported that competition was increasing in the individual health insurance market, with more insurers entering the market, an increased variety of products, and a broader spread of prices.

Individual health insurance is primarily regulated at the state level, consistent with the McCarran-Ferguson Act. Model acts and regulations promulgated by the National Association of Insurance Commissioners (NAIC) provide some degree of uniformity state to state. These models do not have the force of law and have no effect unless they are adopted by a state. They are, however, used as guides by most states, and some states adopt them with little or no change. The primary NAIC models affecting the individual health insurance market are:

* The Uniform Individual Accident and Sickness Policy Provision Law (UPPL);
* The Accident and Sickness Insurance Minimum Standards Model Act;
* The Advertisements of Accident and Sickness Insurance Model Regulation; and
* The Unfair Trade Practices Act.

All of these models have been implemented in one form or another by most states.

Federal laws affecting individual health insurance include:

* The Health Insurance Portability and Accountability Act (HIPAA);
* The Newborns’ and Mothers’ Health Protection Act;
* The Women’s Health and Cancer Rights Act;
* The Fair Credit Reporting Act; and
* Federal rules governing Medicare supplement policies.

Types of medical insurance

Traditional indemnity or fee-for-service

Commercial insurance companies began offering accident and sickness insurance (disability insurance) as early as the mid-1800s.Hospital and medical expense policies were introduced during the first half of the 20th century. The first group medical plan was purchased from The Equitable Life Assurance Society of the United States by the General Tire & Rubber Company in 1934.

Early hospital and medical plans offered by insurance companies paid either a fixed amount for specific diseases or medical procedures (schedule benefits) or a percentage of the provider’s fee. The relationship between the patient and the medical provider was not changed. The patient received medical care and was responsible for paying the provider. If the service was covered by the policy, the insurance company was responsible for reimbursing or indemnifying the patient based on the provisions of the insurance contract (”reimbursement benefits”). Health insurance plans that are not based on a network of contracted providers, or that base payments on a percentage of provider charges, are still described as indemnity or fee-for-service plans.

Blue Cross & Blue Shield plans

During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis. The first group pre-payment plan was created at the Baylor University Hospital in Dallas, Texas.This concept became popular among hospitals during the Depression, when they were facing declining revenues. The Baylor plan was a forerunner of later Blue Cross plans. Physician associations began offering pre-paid surgical/medical benefits in the late 1930s Blue Shield plans. Blue Cross and Blue Shield plans were non-profit organizations sponsored by local hospitals (Blue Cross) or physician groups (Blue Shield). As originally structured, Blue Cross and Blue Shield plans provided benefits in the form of services rendered by participating hospitals and physicians (”service benefits”) rather than reimbursements or payments to the policyholder.

Health Maintenance Organizations

The Ross-Loos Clinic, founded in Los Angeles in 1929, is generally considered to have been the first health maintenance organization (HMO).[5] Henry J. Kaiser organized hospitals and clinics to provide pre-paid health benefits to his shipyard workers during World War II. This became the basis for Kaiser Permanente HMO. Most early HMOs were non-profit organizations. The development of HMOs was encouraged by the passage of the Health Maintenance Organization Act of 1973. Benefits are provided through a network of providers. Providers may be employees of the HMO (”staff model”), employees of a provider group that has contracted with the HMO (”group model”), or members of an independent practice association (”IPA model”). HMOs may also use a combination of these approaches (”network model”).

Managed care

The term managed care is used to describe a variety of techniques intended to reduce the cost of health benefits and improve the quality of care. It is also used to describe organizations that use these techniques (”managed care organization”).Many of these techniques were pioneered by HMOs, but they are now used in a wide variety of private health insurance programs. Through the 1990s, managed care grew from about 25% US employees with employer-sponsored coverage to the vast majority.Rise of managed care in the US

Year     Conventional plans     HMOs     PPOs    POS plans HDHP/SOs

1998     14%             27%     35%     24%        ~
1999     10%             28%     39%     24%        ~
2000     8%             29%     42%     21%        ~
2001     7%             24%     46%     23%        ~
2002     4%             27%     52%     18%        ~
2003     5%             24%     54%     17%        ~
2004     5%             25%     55%     15%        ~
2005     3%             21%     61%     15%        ~
2006     3%             20%     60%     13%        4%
2007     3%             21%     57%     15%        5%

Network-based managed care

Many managed care programs are based on a panel or network of contracted health care providers. Such programs typically include:

* A set of selected providers that furnish a comprehensive array of health care services to enrollees;
* Explicit standards for selecting providers;
* Formal utilization review and quality improvement programs;
* An emphasis on preventive care; and
* Financial incentives to encourage enrollees to use care efficiently.

Provider networks can be used to reduce costs by negotiating favorable fees from providers, selecting cost effective providers, and creating financial incentives for providers to practice more efficiently.

Network-based plans may be either closed or open. With a closed network, enrollees’ expenses are generally only covered when they go to network providers. Only limited services are covered outside the network—typically only emergency and out-of-area care. Most traditional HMOs were closed network plans. Open network plans provide some coverage when an enrollee uses non-network provider, generally at a lower benefit level to encourage the use of network providers. Most preferred provider organization plans are open-network (those that are not are often described as exclusive provider organizations, or EPOs), as are point of service (POS) plans.

The terms “open panel” and “closed panel” are sometimes used to describe which health care providers in a community have the opportunity to participate in a plan. In a “closed panel” HMO, the network providers are either HMO employees (staff model) or members of large group practices with which the HMO has a contract. In an “open panel” plan the HMO or PPO contracts with independent practitioners, opening participation in the network to any provider in the community that meets the plan’s credential requirements and is willing to accept the terms of the plan’s contract.

Other managed care techniques

Other managed care techniques include such elements as disease management, case management, wellness incentives, patient education, utilization management and utilization review. These techniques can be applied to both network-based benefit programs and benefit programs that are not based on a provider network. The use of managed care techniques without a provider network is sometimes described as “managed indemnity.”

Blurring lines

Over time, the operations of many Blue Cross and Blue Shield operations have become more similar to those of commercial health insurance companies.However, some Blue Cross and Blue Shield plans continue to serve as insurers of last resort.Similarly, the benefits offered by Blues plans, commercial insurers, and HMOs are converging in many respects due to market pressures. One example is the convergence of preferred provider organization (PPO) plans offered by Blues and commercial insurers and the point of service plans offered by HMOs. Historically, commercial insurers, Blue Cross and Blue Shield plans, and HMOs might be subject to different regulatory oversight in a state (e.g., the Department of Insurance for insurance companies, versus the Department of Health for HMOs). Today, it is common for commercial insurance companies to have HMOs as subsidiaries, and for HMOs to have insurers as subsidiaries (the state license for an HMO is typically different from that for an insurance company).At one time the distinctions between traditional indemnity insurance, HMOs and PPOs were very clear; today, it can be difficult to distinguish between the products offered by the various types of organization operating in the market.

The blurring of distinctions between the different types of health care coverage can be seen in the history of the industry’s trade associations. The two primary HMO trade associations were the Group Health Association of America and the American Managed Care and Review Association. After merging, they were known as American Association of Health Plans (AAHP). The primary trade association for commercial health insurers was the Health Insurance Association of America (HIAA). These two have now merged, and are known as America’s Health Insurance Plans (AHIP).

New types of medical plans

One approach to addressing increasing premiums, dubbed “consumer driven health care,” received a boost in 2003, when President George W. Bush signed into law the Medicare Prescription Drug, Improvement, and Modernization Act. The law created tax-deductible Health Savings Accounts (HSAs). An HSA is an untaxed private bank account; withdrawals are only penalized if the money is spent on non-medical items or services. Consumers wishing to deposit pre-tax funds in an HSA must be enrolled in a high-deductible insurance plan with a number of restrictions on benefit design; in 2007, qualifying plans must have a minimum deductible of US$1,050. HSAs enable healthier individuals to pay less for insurance and bank money for their own future health care expenses.HSAs are one form of tax-preferenced health care spending account. Others include Archer Medical Savings Accounts (MSAs), which have been superseded by the new HSAs (although existing MSAs are grandfathered), Flexible Spending Arrangements (FSAs) and Health Reimbursement Accounts (HRAs). HSAs, FSAs and HRAs are most commonly used as part of an employee health benefit package.

Limited Medical Benefit Plans pay for routine care and do not pay for catastrophic care. As such, they do not provide equivalent financial security to a major medical plan. Annual benefit limits can be as low as $2,000. Lifetime maximums can be very low as well.

One option that is becoming more popular is the discount medical card. These cards are not insurance policies, but provide access to discounts from participating health care providers. While some offer a degree of value, there are serious potential drawbacks for the consumer.

Other types of health insurance (non-medical)

While the term “health insurance” is most commonly used by the public to describe coverage for medical expenses, the insurance industry uses the term more broadly to include other related forms of coverage, such as disability income and long-term care insurance.

Disability income insurance

Disability income (DI) insurance pays benefits to individuals who lose their ability to work due to injury or illness. DI insurance replaces income lost while the policyholder is unable to work during a period of disability (in contrast to medical expense insurance, which pays for the cost of medical care). For most working age adults, the risk of disability is greater than the risk of premature death, and the resulting reduction in lifetime earnings can be significant. Private disability insurance is sold on both a group and an individual basis. Policies may be designed to cover long-term disabilities (LTD coverage) or short-term disabilities (STD coverage).Business owners can also purchase disability overhead insurance to cover the overhead expenses of their business while they are unable to work.

A basic level of disability income protection is provided through the Social Security Disability Insurance (SSDI) program for qualified workers who are totally and permanently disabled (the worker is incapable of engaging in any “substantial gainful work” and the disability is expected to last at least 12 months or result in death).

Long-term care insurance

Long-term care (LTC) insurance reimburses the policyholder for the cost of long-term or custodial care services designed to minimize or compensate for the loss of functioning due to age, disability or chronic illness.LTC has many surface similarities to long-term disability insurance. There are at least two fundamental differences, however. LTC policies cover the cost of certain types of chronic care, while long-term-disability policies replace income lost while the policyholder is unable to work. For LTC, the event triggering benefits is the need for chronic care, while the triggering event for disability insurance is the inability to work.

Private LTC insurance is growing in popularity in the US. Premiums have remained relatively stable in recent years. However, the coverage is quite expensive, especially when consumers wait until retirement age to purchase it. The average age of new purchasers was 61 in 2005, and has been dropping.
Supplemental coverage

Private insurers offer a variety of supplemental coverages in both the group and individual markets. These are not designed to provide the primary source of medical or disability protection for an individual, but can assist with unexpected expenses and provide additional peace of mind for insureds. Supplemental coverages include Medicare supplement insurance, hospital indemnity insurance, dental insurance, vision insurance, accidental death and dismemberment insurance and specified disease insurance.

Supplemental coverages are intended to:

* Supplement a primary medical expense plan by paying for expenses that are excluded or subject to the primary plan’s cost-sharing requirements (e.g., co-payments, deductibles, etc.);
* Cover related expenses such as dental or vision care;
* Assist with additional expenses that may be associated with a serious illness or injury.

Medicare Supplement Coverage (Medigap)

Medicare Supplement policies are designed to cover expenses not covered (or only partially covered) by the “original Medicare” (Parts A & B) fee-for-service benefits. They are only available to individuals enrolled in Medicare Parts A & B. Medigap plans may be purchased on a guaranteed issue basis (no health questions asked) during a six-month open enrollment period when an individual first becomes eligible for Medicare. The benefits offered by Medigap plans are standardized.

Hospital indemnity insurance

Hospital indemnity insurance provides a fixed daily, weekly or monthly benefit while the insured is confined in a hospital. The payment is not dependent on actual hospital charges, and is most commonly expressed as a flat dollar amount. Hospital indemnity benefits are paid in addition to any other benefits that may be available, and are typically used to pay out-of-pocket and non-covered expenses associated with the primary medical plan, and to help with additional expenses (e.g., child care) incurred while in the hospital.

Scheduled health insurance plans

Scheduled health insurance plans are an expanded form of Hospital Indemnity plans. In recent years, these plans have taken the name mini-med plans or association plans. These plans may provide benefits for hospitalization, surgical, and physician services however, they are not meant to replace a traditional comprehensive health insurance plan. Scheduled health insurance plans are more of a basic policy providing access to day-to-day health care such as going to the doctor or getting a prescription drug; but these benefits will be limited and are not meant to be effective for catastrophic events. Payments are based upon the plan’s “schedule of benefits” and are usually paid directly to the service provider. These plans cost much less then comprehensive health insurance. Annual benefit maximums for a typical scheduled health insurance plan may range from $1,000 to $25,000.

Dental insurance

Dental insurance helps pay for the cost of necessary dental care. Many medical expense plans include coverage for dental expenses, and stand-alone dental insurance is also available. Discount dental programs are also available. These do not constitute insurance, but provide participants with access to discounted fees for dental work.

Vision care insurance

Vision care insurance provides coverage for routine eye care and is typically written to complement other medical benefits. Vision benefits are designed to encourage routine eye examinations and ensure that appropriate treatment is provided.

Specified disease

Specified disease provides benefits for one or more specifically identified conditions. Benefits can be used to fill gaps in a primary medical plan, such as co-payments and deductibles, or to assist with additional expenses such as transportation and child care costs.

Accidental Death and Dismemberment (AD&D) insurance

AD&D insurance is offered by group insurers and provides benefits in the event of accidental death. It also provides benefits for certain specified types of bodily injuries (e.g., loss of a limb or loss of sight) when they are the direct result of an accident.

Status of the uninsured

In 2007, more than 45 million people in the US (15.3% of the population) were without health insurance for at least part of the year. The percentage of the non-elderly population who are uninsured has been generally increasing since the year 2000.Among the uninsured population, some 37 million were employment-age adults (ages 18 to 64), and more than 27 million worked at least part time. About 38% of the uninsured live in households with incomes over $50,000.According to the Census Bureau, nearly 36 million of the uninsured are legal US citizens. Another 9.7 million are non-citizens, but the Census Bureau does not distinguish in its estimate between legal non-citizens and illegal immigrants.It has been estimated that nearly one fifth of the uninsured population is able to afford insurance, almost one quarter is eligible for public coverage, and the remaining 56% need financial assistance (8.9% of all Americans). An estimated 5 million of those without health insurance are considered “uninsurable” because of pre-existing conditions.

The costs of treating the uninsured must often be absorbed by providers as charity care, passed on to the insured via cost shifting and higher health insurance premiums, or paid by taxpayers through higher taxes.

A report published by the Kaiser Family Foundation in April 2008 found that economic downturns place a significant strain on state Medicaid and SCHIP programs. The authors estimated that a 1% increase in the unemployment rate would increase Medicaid and SCHIP enrollment by 1 million, and increase the number uninsured by 1.1 million. State spending on Medicaid and SCHIP would increase by $1.4 billion (total spending on these programs would increase by $3.4 billion). This increased spending would occur at the same time state government revenues were declining. During the last downturn, the Jobs and Growth Tax Relief Reconciliation Act of 2003 (JGTRRA) included federal assistance to states, which helped states avoid tightening their Medicaid and SCHIP eligibility rules. The authors conclude that Congress should consider similar relief for the current economic downturn.

Erin Andrews (born May 4, 1978 in Lewiston, Maine) is a television sports reporter.

Andrews joined ESPN in May 2004 as a reporter for the network’s National Hockey League coverage. Since the 2004 season, Andrews has served as sideline reporter for the ESPN College Football Saturday telecast, the Saturday Primetime college basketball game and Big Ten college basketball coverage.In 2005, she added Major League Baseball sideline reporting to her duties. She also provides reports and features on Great Outdoor Games coverage. She also covers Men’s college baseball, and is a familiar sight during the College World Series.

In 2007, she was voted “America’s Sexiest Sportscaster” by Playboy Magazine.She stands at 5′ 10″.

Andrews graduated from the University of Florida with a degree in telecommunications in 2000. While there she was a member of the Zeta Tau Alpha sorority.Andrews was also a member of the Dazzlers, the Gator basketball dance team, from 1997–2000.

She began her career with her FSN Florida as a freelance reporter from 2000–01 before serving as a Tampa Bay Lightning reporter for the Sunshine Network from 2001–02.Andrews then worked as a studio host for Turner Sports from 2002–2004, covering the Atlanta Braves and college football for TBS and Atlanta Thrashers and Atlanta Hawks for Turner South.

She is represented by the sports agency Career Sports & Entertainment in Atlanta, GA.

Infectious mononucleosis, also known as Pfeiffer’s disease, mono (in the United States of America) and more commonly known as glandular fever in other English-speaking countries, is an infectious disease. It occurs most commonly in adolescents and young adults, where it is characterized by fever, sore throat, muscle soreness, and fatigue. Infectious mononucleosis typically produces a mild illness and is often asymptomatic. Mononucleosis is predominantly caused by the Epstein-Barr virus (EBV), which infects B cells (B-lymphocytes), producing a reactive lymphocytosis predominantly consisting of atypical lymphocytes, a specific type of T-cell that gives the disease its name.

The name “kissing disease” is often applied to mono in casual speech, as in developed countries it is most common at the same age when adolescents and young adults are initiating romantic behaviour. This co-occurrence is not apparent in undeveloped countries, where poor sanitation and close living arrangements cause the causative virus to be spread at a much earlier age, when the disease is mild and seldom diagnosed. Both males and females are susceptible to mononucleosis.

Symptoms

* Fever—this varies, but is seen in nearly all cases.
* Enlarged and tender lymph nodes—particularly the posterior cervical lymph nodes.
* Sore throat—White patches on the tonsils and back of the throat are often seen
* Muscle weakness and Mental fatigue (sometimes extreme)

Additional symptoms include:

* Enlarged spleen (splenomegaly, which may lead to rupture) and/or liver (hepatomegaly)
* Petechial hemorrhage
* Abdominal pain - a possible symptom of a potentially fatal rupture of the spleen.
* Aching muscles
* Headache
* Loss of appetite
* Depression
* Diarrhea
* Dizziness or disorientation
* Inability to swallow, due to enlarged tonsils
* Dry cough
* Supra-orbital edema—the eyes become puffy and swollen—may occur in the early stages of infection

After an initial prodrome of 1-2 weeks, the fatigue of infectious mononucleosis often lasts from 1-2 months. The virus can remain dormant in the B cells indefinitely after symptoms have disappeared, and resurface at a later date. Many people exposed to the Epstein-Barr virus do not show symptoms of the disease, but carry the virus. This is especially true in children, in whom infection seldom causes more than a very mild cold which often goes undiagnosed. Children are typically just carriers of the disease. This feature, along with mono’s long (4 to 6 week) incubation period, makes epidemiological control of the disease impractical. About 6% of people who have had infectious mononucleosis will relapse.[citation needed]

Mononucleosis can cause the spleen to swell. Rupture may occur without trauma,[citation needed] but impact to the spleen is also a factor. Other complications include hepatitis (inflammation of the liver) causing elevation of serum bilirubin (in approximately 40% of patients), jaundice (approximately 5% of cases), and anemia (a deficiency of red blood cells). In rare cases, death may result from severe hepatitis or splenic rupture.

Although most cases of mononucleosis are caused by the E.B. virus, the condition is defined by the clinical presentation and laboratory findings. Cytomegalovirus can produce a similar illness, usually with less throat pain, and also generate atypical lymphocyte proliferation. In recent years, as precise virological and serological studies are more commonly done to identify the actual causative virus, some clinicians have taken to use “mononucleosis” to refer only to the E.B. virus cases. Symptoms similar to those of mononucleosis can also be caused by adenovirus, acute HIV infection and the protozoan Toxoplasma gondii

Diagnosis
Please help improve this section by expanding it. Further information might be found on the talk page or at requests for expansion. (June 2008)
Peripheral blood smear (low power) showing lymphocytosis from a 16-year-old male with pharyngitis and positive monospot test.
Peripheral blood smear (low power) showing lymphocytosis from a 16-year-old male with pharyngitis and positive monospot test.

Laboratory findings usually include an elevated white blood cell count and abnormal liver function tests. The white cell count elevation is predominantly in the lymphocyte portion, and of those the majority is often of the atypical form characteristic of the disease.

Specific tests for EBV include:

* A monospot test (positive for infectious mononucleosis)
* Epstein-Barr virus antigen by immunofluorescence (positive for EBV)
* Epstein-Barr virus antibody titers to help distinguish acute infection from past infection with EBV

Transmission

Mononucleosis is typically transmitted from asymptomatic individuals through saliva, earning it the name “the kissing disease”, or by sharing a drink, or sharing eating utensils. As with many viral infections, such as chickenpox, antibodies are developed by individuals who become infected with the disease and recover. In most individuals, these antibodies remain in their system, creating lifelong immunity to further infections.

Atypical presentations of mononucleosis/EBV infection

In small children, the course of the disease is frequently asymptomatic. Some adult patients suffer fever, tiredness, lassitude (abnormal fatigue), depression, lethargy, and chronic lymph node swelling, for months or years. This variant of mononucleosis has been referred to as chronic EBV syndrome or chronic fatigue syndrome (CFS), although CFS is a distinct condition from IM. Still, current studies suggest there is an association between infectious mononucleosis and CFS.[3] In case of a weakening of the immune system, a reactivation of the Epstein-Barr virus is possible; in CFS there is evidence of immune activation also. “Chronic fatigue states” as defined by the CDC criteria for CFS, appear to occur in 10% of those who contract mononucleosis.Chronic fatigue may then be a rather common side effect of infectious mononucleosis. On the other hand, studies conducted by the CDC[citation needed] and others[who?] have discounted a link between EBV and CFS.

Perhaps a majority of chronic post infectious “fatigue states” appear not to be caused by a chronic viral infection, but are triggered by the acute infection.[citation needed] Direct and indirect evidence of persistent viral infection has been found in CFS, for example in muscle and via detection of an unusually low molecular weight RNase L enzyme, although the commonality and significance of such findings is disputed. Hickie et al contend that mononucleosis appears to cause a hit and run injury to the brain in the early stages of the acute phase, thereby causing the chronic fatigue state. This would explain why in mononucleosis, fatigue very often lingers for months after the Epstein Barr virus has been controlled by the immune system. Just how infectious mononucleosis changes the brain and causes fatigue (or lack thereof) in certain individuals remains to be seen. Such a mechanism may include activation of microglia in the brain of some individuals during the acute infection. Microglia may remain activated or “damaged” for months following infection, thereby causing a slowly dissipating fatigue. Secondary infections can occur. Such infections include mild swelling of the cartilage between the sternum and ribs occurring approximately one month after initial diagnosis.

Treatment

Infectious mononucleosis is generally self-limiting and only symptomatic and/or supportive treatments are used.Rest is recommended during the acute phase of the infection, but activity should be resumed once acute symptoms have resolved. Nevertheless heavy physical activity and contact sports should be avoided to abrogate the risk of splenic rupture, for at least one month following initial infection and until splenomegaly has resolved, as determined by ultrasound scan.

In terms of pharmacotherapies, acetaminophen/paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) may be used to reduce fever and pain.

Intravenous corticosteroids, usually hydrocortisone or dexamethasone, are not recommended for routine use but may be useful if there is a risk of airway obstruction, severe thrombocytopenia, or hemolytic anemia.

There is little evidence to support the use of aciclovir, although it may reduce initial viral shedding.However, the antiviral drug valacyclovir has recently been shown to lower or eliminate the presence of the Epstein-Barr virus in subjects afflicted with acute mononucleosis, leading to a significant decrease in the severity of symptoms.Antibiotics are not used as they are ineffective against viral infections. The antibiotics amoxicillin and ampicillin are contraindicated in the case of any coinciding bacterial infections during mononucleosis because their use can frequently precipitate a non-allergic rash. In a small percentage of cases, mononucleosis infection is complicated by co-infection with streptococcal infection in the throat and tonsils (strep throat). Penicillin or other antibiotics (with the exception of the two mentioned above) should be administered to treat the strep throat. Opioid analgesics are also contraindicated due to risk of respiratory depression.

Morbidity and mortality

Fatalities from mononucleosis are nearly impossible in developed nations. Uncommon, nonfatal complications exist, including various forms of CNS and hematological affection:

* CNS: Meningitis, encephalitis, hemiplegia and transverse myelitis. EBV infection has also been proposed as a risk factor for the development of multiple sclerosis (MS), but this has not been affirmed.
* Hematologic: EBV can cause autoimmune hemolytic anemia (direct Coombs test is positive) and various cytopenias.

Erin Brockovich-Ellis (born June 22, 1960) is an American legal clerk and environmental activist who, despite the lack of a formal law school education, was instrumental in constructing a case against the $28 billion Pacific Gas and Electric Company (PG&E), of California in 1993. Since the release of the movie that shares her story and name, she has hosted Challenge America with Erin Brockovich on ABC and Final Justice on Lifetime. She is the president of Brockovich Research & Consulting, a consulting firm. She is currently working as a consultant for the New York law firm Weitz & Luxenberg, which has a focus on personal injury claims for asbestos exposure.

Biography

Background

Brockovich was born Erin L. E. Pattee in Lawrence, Kansas to Frank Pattee, an industrial engineer and Betty Jo O’Neal-Pattee, a journalist. She attended Lawrence High School then Kansas State University in Manhattan, Kansas. She worked as a management trainee for Kmart in 1981 but quit after a few months and entered some potentially lucrative beauty pageants. After winning Miss Pacific Coast in 1981, she soon gave up pageant life because she found it shallow. She has lived in California since 1982.

Brockovich was involved in a car accident in Reno and was seriously injured. Her case was settled out of court for $17,000.

Brockovich received an Honorary Doctorate of Humane Letters, Honoris Causa Degree and was Commencement Speaker at Loyola Marymount University in Los Angeles, CA on May 5, 2007.

Pacific Gas litigation

The case alleged contamination of drinking water with hexavalent chromium, also known as chromium (VI), in the southern California town of Hinkley. At the center of the case is a facility called the Hinkley Compressor Station, part of a natural gas pipeline connecting to the San Francisco Bay Area and constructed in 1952. Between 1952 and 1966, PG&E used hexavalent chromium to fight corrosion in the cooling tower. The wastewater disolved the hexavalent chromium from the cooling towers and was discharged to unlined ponds at the site. Some of the wastewater percolated into the groundwater affecting an approximately two miles long and nearly a mile wide area near the plant.The case was settled in 1996 for $333 million, the largest settlement ever paid in a direct action lawsuit in U.S. history.

Chromium (VI) is known to be toxic and carcinogenic,and the 0.58 ppm in the groundwater in Hinkley exceeded the Maximum Contaminant Level of 0.10 ppm currently set by the United States Environmental Protection Agency.However, while it has long been known that chromium (VI) is carcinogenic when ingested via inhalation, drinking water laced with chromium (VI) is widely believed to be less toxic; some experts argue that the exposures at Hinkley were too low to cause health effects, while others respond that there were too many gaps in the data on chromium to dismiss the Hinkley residents’ case.When Harvard’s School of Public Health gave Brockovich an award in 2005, scientists were divided on the merits of her work.National Institutes of Health researchers announced May 16, 2007 there is strong evidence that hexavalent chromium causes cancer in laboratory animals when it is consumed in drinking water. The two-year study conducted by the National Toxicology Program (NTP) shows that animals given hexavalent chromium for three months developed malignant tumors on their pituitary gland.The report warns that extrapolation of these results to other species, including characterization of hazards and risks to humans, requires analyses beyond the intent of the report. Nevertheless, health care professionals agree that the current data on Chromium (VI) are sufficient to justify strict legal limits on the hexavalent Cr concentration in water, and that neglect of these limits imposes a major health threat on the affected population.

Working with Thousand Oaks, California-based lawyer Edward L. Masry, Brockovich went on to participate in other anti-pollution lawsuits. One accuses Whitman Corporation of chromium contamination in Willits, California. Another lawsuit, which lists 1,200 plaintiffs, alleges contamination near PG&E’s Kettleman Hills Compressor Station in Kings County, California, along the same pipeline as the Hinkley site. After experiencing problems with mold contamination in her own home in the Conejo Valley, Brockovich became a prominent activist and educator in this area as well. Today, Brockovich is a noted speaker in demand all over the U.S.
Biopic

Her story is the topic of a feature film, Erin Brockovich, starring Julia Roberts in the title role. The film was nominated for five Academy Awards, including Best Actress in a Leading Role, Best Actor in a Supporting Role, Best Director, Best Picture, and Best Writing in a Screenplay Written Directly for the Screen. Roberts won the Academy Award for Best Actress for her portrayal of Erin Brockovich. Erin Brockovich herself had a cameo role as a waitress named Julia (in reference to Julia Roberts playing Erin).

Recently she was featured in an advertising campaign for Noel Leeming, a homeware chain from New Zealand.

After the success of the film about her, Brockovich was the target of a blackmail attempt by her old boyfriend, George (played by Aaron Eckhart in the film), one of her ex-husbands, and an attorney who threatened to smear her reputation as a parent. She called the police, who later arrested the three for extortion after conducting a sting operation.

She did a cameo appearance as herself in The Simpsons Movie, but the scene ended up being cut.

Paul Leonard Newman (January 26, 1925 – September 26, 2008) was an American actor, film director, entrepreneur, humanitarian and auto racing enthusiast. He won numerous awards, including an Academy Award, two Golden Globe Awards, a Screen Actors Guild Award, a Cannes Film Festival Award, an Emmy award, and many honorary awards. He also won several national championships as a driver in Sports Car Club of America road racing and his race teams won several championships in open wheel IndyCar racing.

Newman was a co-founder of Newman’s Own, a food company from which Newman donated all profits and royalties to charity.As of May 2007, these donations had exceeded US$220 million.

On September 26, 2008, Newman died at his long-time home in Westport, Connecticut, of complications arising from cancer.

Early life

Newman was born in Shaker Heights, Ohio (a suburb of Cleveland), the son of Theresa (née Fetzer or Fetsko)and Arthur S. Newman, who ran a profitable sporting goods store.His father was Jewish and his mother was born to a Slovak Catholic family at Ptičie (formerly Peticse) in the former Kingdom of Hungary, now in Slovakia,and converted to Christian Science when Paul was five.Newman had described himself as Jewish, stating that, “it’s more of a challenge”.Newman’s mother worked in his father’s store, while raising Paul and his brother Arthur (who later became a producer and production manager).

Newman showed an early interest in the theater, which his mother encouraged. At the age of seven, he made his acting debut, playing the court jester in a school production of Robin Hood. Graduating from Shaker Heights High School in 1943, he briefly attended Ohio University in Athens, Ohio, where he was initiated into the Phi Kappa Tau fraternity.

Military service

Newman served in the Navy in World War II in the Pacific theater.Newman was sent to the Navy V-12 program at Ohio University, with hope of being accepted for pilot training, but this plan was foiled when it was discovered he was color blind.He was sent instead to boot camp and then on to further training as a radioman and gunner. Qualifying as a rear-seat radioman and gunner in torpedo bombers, in 1944, Aviation Radioman Third Class Newman was sent to Barber’s Point, Hawaii, and subsequently assigned to Pacific-based replacement torpedo squadrons (VT-98, VT-99, and VT-100). These torpedo squadrons were responsible primarily for training replacement pilots and combat air crewmen, placing particular importance on carrier landings.He later flew from aircraft carriers as a tail gunner in the Avenger torpedo bomber. As a radioman/gunner, he served aboard the USS Bunker Hill during the battle for Okinawa in the spring of 1945. He was ordered to the ship with a draft of replacements shortly before the attack, but by a fluke of war was held back because his pilot had an ear infection. The rest of his detail died.

After the war, he completed his degree at Kenyon College, graduating in 1949.[14] Newman later studied acting at Yale University and under Lee Strasberg at the Actors’ Studio in New York City.
Oscar Levant wrote that Newman was initially hesitant to leave New York for Hollywood: “Too close to the cake,” he reported him saying, “Also, no place to study.”

Film career

Newman made his Broadway theater debut in the original production of William Inge’s Picnic, with Kim Stanley. He later appeared in the original Broadway productions of The Desperate Hours and Sweet Bird of Youth with Geraldine Page. He would later star in the film version of Sweet Bird of Youth, which also starred Page.

His first movie was The Silver Chalice (1954), followed by acclaimed roles in Somebody Up There Likes Me (1956), as boxer Rocky Graziano; Cat on a Hot Tin Roof (1958), opposite Elizabeth Taylor; and The Young Philadelphians (1959), with Barbara Rush and Robert Vaughn.

Newman appeared in a screen test with James Dean for East of Eden (1955). Newman was testing for the role of Aron Trask, Dean was testing for the role of Aron’s fraternal twin brother Cal Trask. Dean won the part of Cal, while the role Newman was up for went to Richard Davalos. The same year Newman would co-star with Eva Marie Saint and Frank Sinatra in a live — and color - television broadcast of the Thornton Wilder stage play Our Town. In 2003 Newman would act in a remake of Our Town, taking on Sinatra’s role as the stage manager.

Major films

Newman was one of the few actors who successfully made the transition from 1950s cinema to that of the 1960s and 1970s. His rebellious persona translated well to a subsequent generation. Newman starred in Exodus (1960), The Hustler (1961), Hud (1963), Harper (1966), Hombre (1967), Cool Hand Luke (1967), The Towering Inferno (1974), Slap Shot (1977) and The Verdict (1982). He teamed with fellow actor Robert Redford and director George Roy Hill for Butch Cassidy and the Sundance Kid (1969) and The Sting (1973).

He appeared with his wife, Joanne Woodward, in the feature films The Long, Hot Summer (1958), Rally ‘Round the Flag, Boys!, (1958), From the Terrace (1960), Paris Blues (1961), A New Kind of Love (1963), Winning (1969), WUSA (1970), The Drowning Pool (1975), Harry & Son (1984) and Mr. and Mrs. Bridge (1990). They also both starred in the HBO miniseries Empire Falls, but did not have any scenes together.

In addition to starring in and directing Harry & Son, Newman also directed four feature films (in which he did not act) starring Woodward. They were Rachel, Rachel (1968), based on Margaret Laurence’s A Jest of God, the screen version of the Pulitzer Prize-winning play The Effect of Gamma Rays on Man-in-the-Moon Marigolds (1972), the television screen version of the Pulitzer Prize-winning play The Shadow Box (1980) and a screen version of Tennessee Williams’ The Glass Menagerie (1987).

Twenty-five years after The Hustler, Newman reprised his role of “Fast” Eddie Felson in the Martin Scorsese-directed The Color of Money (1986), for which he won the Academy Award for Best Actor.

Last works

In 2003, he appeared in a Broadway theatre revival of Thornton Wilder’s Our Town, receiving his first Tony Award nomination for his performance. PBS and the cable network Showtime aired a taping of the production, and Newman was nominated for an Emmy Award, for Outstanding Lead Actor in a Miniseries or TV Movie.

His last screen appearance was as a conflicted mob boss in the 2002 film Road to Perdition opposite Tom Hanks, although he continued to provide voice work for films. In keeping with his strong interest in car racing, he provided the voice of Doc Hudson, a retired race car in Disney/Pixar’s Cars. Similarly, he served as narrator for the 2007 film Dale, about the life of the legendary NASCAR driver Dale Earnhardt, which turned out to be Newman’s final film performance in any form.

Retirement from acting

Newman announced that he would entirely retire from acting on May 25, 2007. He told US broadcaster ABC that he didn’t feel he could continue acting on the level that he would want to. “You start to lose your memory, you start to lose your confidence, you start to lose your invention. So I think that’s pretty much a closed book for me.”

Philanthropy

With writer A.E. Hotchner, Newman founded Newman’s Own, a line of food products, in 1982. The brand started with salad dressing, and has expanded to include pasta sauce, lemonade, popcorn, and salsa, and wine among other things. Newman established a policy that all proceeds from the sale of Newman’s Own products, after taxes, would be donated to charity. As of early 2006, the franchise has resulted in excess of $200 million in donations.[4] He co-wrote a memoir about the subject with Hotchner, Shameless Exploitation in Pursuit of the Common Good. Among other awards, Newman’s Own co-sponsors the PEN/Newman’s Own First Amendment Award, a $25,000 reward designed to recognize those who protect the First Amendment as it applies to the written word.

One beneficiary of his philanthropy is the Hole in the Wall Gang Camp, a residential summer camp for seriously ill children, which is located in Ashford, Connecticut. Newman cofounded the camp in 1988; it was named after the gang in his film Butch Cassidy and the Sundance Kid (1969). Newman’s college fraternity, Phi Kappa Tau, adopted “Hole in the Wall” as their “national philanthropy” in 1995. One camp has expanded to become several Hole in the Wall Camps in the U.S., Ireland, France and Israel. The camp serves 13,000 children every year, free of charge.

In June 1999 Newman donated $250,000 to Catholic Relief Services in aid refugees in Kosovo.

On June 1, 2007, Kenyon College announced that Newman had donated $10 million to the school to establish a scholarship fund as part of the college’s current $230 million fund-raising campaign. Newman and Woodward were honorary co-chairs of a previous campaign.[dead link]

Marriages and family

Newman was married twice. His first marriage was to Jackie Witte[14] and lasted from 1949 to 1958. Together they had a son, Scott (1950), and two daughters, Susan Kendall (1953) and Stephanie.[14] Scott Newman, who died in November 1978 from an accidental drug overdose,[22] appeared in the films Breakheart Pass, The Towering Inferno and the 1977 film Fraternity Row. Newman started the Scott Newman Center for drug abuse prevention in memory of his son.[23] Susan is a documentary filmmaker and philanthropist and has Broadway and screen credits, including a starring role as one of four Beatles fans in 1978’s I Wanna Hold Your Hand. She also received an Emmy nomination as co-producer of his telefilm, The Shadow Box. Newman had eight grandchildren, all by his daughters.

Newman married actress Joanne Woodward on January 29, 1958. They had three daughters: Elinor “Nell” Teresa (1959), Melissa “Lissy” Stewart (1961), and Claire “Clea” Olivia (1965). Newman directed Elinor (stage name Nell Potts) in the central role alongside her mother in the film The Effect of Gamma Rays on Man-in-the-Moon Marigolds.

Newman lived away from the Hollywood environment. He made his home quietly in Westport, Connecticut, and was devoted to his wife and family. When asked about infidelity, he quipped, “Why go out for hamburger when you have steak at home?”

Political activism

For his strong support of Eugene McCarthy in 1968 (and effective use of television commercials in California), Newman was 19th on Richard Nixon’s enemies list.

Consistent with his work for liberal causes, Newman publicly supported Ned Lamont’s candidacy in the 2006 Connecticut Democratic Primary against Senator Joe Lieberman, and was even rumored as a candidate himself until Lamont emerged as a credible alternative. He had donated to Chris Dodd’s presidential campaign.

Newman was also a vocal supporter of gay rights and in particular, same-sex marriage.

Newman was an avid auto racing enthusiast, and first became interested in motorsports (”the first thing that I ever found I had any grace in”) while training for and filming Winning, a 1969 film. Newman’s first professional event was in 1972, in Thompson, Connecticut, and he was a common competitor in Sports Car Club of America events for the rest of the decade, eventually winning several championships. He later drove in the 1979 24 Hours of Le Mans in Dick Barbour’s Porsche 935 and finished the race in second.Newman rejoined Dick Barbour in 2000 to compete in the Petit Le Mans.
From the mid-’70s to the early ’90s, he drove for the Bob Sharp Racing team, racing mainly Datsuns (later rebranded as Nissans) in the Trans-Am Series. He became heavily associated with the brand during the ’80s, even appearing in commercials for them. At the age of 70 he became the oldest driver to be part of a winning team in a major sanctioned race,[citation needed] winning in his class at the 1995 24 Hours of Daytona.Among his final experiences in racing was competing in the Baja 1000 in 2004 and the 24 Hours of Daytona once again in 2005.

Newman initially owned his own racing team which competed in the Can-Am series, but later co-founded Newman/Haas Racing with Carl Haas, a Champ Car team, in 1983. The 1996 racing season was chronicled in the IMAX film Super Speedway, which Newman narrated. He was also a partner in the Atlantic Championship team Newman Wachs Racing. Newman also owned a car NASCAR Winston Cup before selling it to Penske Racing, where it now serves as the #12 car.

Illness and death

Newman was scheduled to make his professional stage directing debut with the Westport Country Playhouse’s 2008 production of John Steinbeck’s Of Mice and Men, but he stepped down on May 23, 2008, citing health issues.

In June 2008 it was widely reported that Newman, a former chain smoker, had been diagnosed with lung cancer and was receiving treatment at Sloan-Kettering hospital in New York City.Photographs taken of Newman in May and June showed him looking gaunt.[35] Writer A.E. Hotchner, who partnered Newman to start Newman’s Own salad dressing company in the 1980s, was quoted as saying that Newman told him about the disease about 18 months ago. Newman’s spokesman told the press that the star is “doing nicely,” but neither confirmed nor denied that he had cancer. In August, Newman reportedly had finished chemotherapy and told his family he wished to die at home. He did so on September 26, 2008 aged 83, surrounded by his family and close friends.[38] His daughter Nell Newman is poised to take over Newman’s Own.

LONDON (Reuters) - Images of actor Paul Newman, who died late on Friday, adorned newspaper front pages around the world on Sunday, his piercing blue eyes vying for attention alongside headlines of the global financial crisis.

Underlining Newman’s international appeal, Britain’s Independent on Sunday featured his photograph across the whole of page one, relegating the latest news of the country’s banking woes to the inside pages.

“Paul Newman: Death of King Cool” ran the caption headline in the Sunday Times above a portrait of the heartthrob and philanthropist, who died of cancer aged 83.

The Observer weekly devoted a two-page spread under the words: “An Actor of True Genius and a Man of Great Decency,” focusing on Newman’s philanthropy and devotion to his family, as well as on his big screen roles.

In France, politicians lined up to praise Newman, with President Nicolas Sarkozy hailing him as a “Hollywood legend.”

“Actor, author, screenwriter, director, producer and philanthropist, he was also a great friend of France and fans of motor racing will remember his successive appearances at the Le Mans 24-hour race,” Sarkozy said in a statement.

“The death of a good guy,” France’s main Sunday newspaper, Le Journal du Dimanche, said in a headline, giving over most of its front page to a photo of the U.S. actor.

Even conservative Muslim Iran, which would not usually concern itself with reporting on a Western film star, marked his death. Two pro-reform newspapers displayed the actor on their front pages while Iran’s state media also reported his death.

The Etemad newspaper, published Newman’s picture, saying “Fading away the last classic star” and the Kargozaran daily said “End of the blue-eyed boy.”

In Germany as elsewhere, news television channels have been showing clips from his films.

“Paul Newman - the Last Hero is Dead” ran a headline on the back page of the mass-selling Bild am Sonntag. A strapline in the same newspaper read: “This damn cancer. Now it has killed the bluest eyes in the world!”

Several obituaries repeated comments he made about his famous good looks.

“I picture my epitaph,” he was quoted as saying. “Here lies Paul Newman, who died a failure because his eyes turned brown.”

“WHAT PAIN!” SAYS LOREN

The New York Times called him a “magnetic Hollywood titan,” and in Italy actress Sophia Loren, who appeared in the film “Lady L” with Newman, called the news “a blow.”

“When such important personalities die, one despairs and thinks that, little by little, all the greats are disappearing,” she told the Il Messaggero daily.

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Rachel Anne McAdams (born October 7, 1976) is a Teen Choice Award-nominated Canadian actress. She is known for her roles in the Hollywood films Mean Girls, The Notebook, Wedding Crashers and Red Eye.

Biography

Early life

McAdams was born in London, Ontario and grew up in nearby St. Thomas. Her father, Lance, is a truck driver, and her mother, Sandra, is a nurse.She has a younger brother, Daniel, and a younger sister, Kayleen. She took up competitive figure skating at the age of four and acting at age twelve.at a summer theatre camp in St. Thomas, Ontario named Original Kids. When the company extended to a year-round company (and eventually relocated to London, Ontario), she was invited to continue with them. She attended the Myrtle Street Public School and the publicly-funded secondary school Central Elgin Collegiate Institute in St. Thomas from grade nine to OAC and starred in the Award-winning student production I Live in a Little Town. Later she graduated f