Fewer health care options for illegal immigrants

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

___

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

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

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What Is a Right-to-Work Law?

This week Michigan became the 24th state in the country to adopt a right-to-work law. The passage of the bill by the state legislature, and eventual signing by Rick Snyder, the state's Republican governor, brought a huge wave of protests in a state with deep union roots.

Right-to-work laws have garnered a lot of national attention in recent years as more states have implemented this legislation that prohibits unions from requiring workers to pay dues as a condition of their employment. The laws are meant to regulate agreements between employers and labor unions that would prohibit the employer from hiring non-union workers.

The laws are particularly divisive--proponents argue that businesses will be more likely to set up shop in the state, while opponents argue that weakening union power will lead to lower wages. Because each state has a variety of factors that must be considered individually when assessing its overall economic standing, it's difficult to fully assess the validity of each side's argument, since you can't isolate the direct effect of these laws on the state's economy.

However, a study conducted in 2007 by Lonnie Stevans of Hofstra University suggested that both sides of the argument are, to some degree, accurate.

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"Findings are that the number of businesses and self-employed are greater on average in right-to-work states, but employment, wages, and per-capita personal income are all lower on average in right-to-work states," Stevans wrote.

But he noted that there was little "trickle down" from the business owners to the workers--the laws benefitted the business owners who did not have to contend with union contracts, but business employees didn't get those same positive effects--as evidenced by the lower salaries on average.

An analysis by ABC News of the most recent seasonally adjusted unemployment rates in states with right-to-work laws vs. those without such laws found that on average, the unemployment rate in states with right to work laws was slightly lower than those without. The average unemployment rate in the 24 states with right-to-work laws was 7 percent, while the average rate in the 26 states plus D.C. that do not have right-to-work laws was just under 7.6 percent--a difference of just under .6 percent.

The state with the lowest unemployment rate in the country--Nebraska at just 3.8 percent unemployment--has such a law in place, as does the state with the highest unemployment rate, Nevada at 11.5 percent.

Support for the laws has often tended to fall along party lines, with Democrats opposing and Republicans supporting. The vast majority of states with right-to-work laws are Republican led, the majority of states without are led by Democrats.

Below is the list of the 24 states with right-to-work laws.

Alabama

Arizona

Arkansas

Florida

Georgia

Idaho

Indiana

Iowa

Kansas

Louisiana

Michigan

Mississippi

Nebraska

Nevada

North Carolina

North Dakota

Oklahoma

South Carolina

South Dakota

Tennessee

Texas

Utah

Virginia

Wyoming

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For North Korea, next step is a nuclear test

SEOUL (Reuters) - North Korea's next step after rattling the world by putting a satellite into orbit for the first time will likely be a nuclear test, the third conducted by the reclusive and unpredictable state.

A nuclear test would be the logical follow-up to Wednesday's successful rocket launch, analysts said. The North's 2009 test came on May 25, a month after a rocket launch.

For the North and its absolute ruler Kim Jong-un, the costs of the rocket program and its allied nuclear weapons efforts - estimated by South Korea's government at $2.8-$3.2 billion since 1998 - and the risk of additional U.N. or unilateral sanctions are simply not part of the calculation.

"North Korea will insist any sanctions are unjust, and if sanctions get toughened, the likelihood of North Korea carrying out a nuclear test is high," said Baek Seung-joo of the Korea Institute of Defense Analyses.

The United Nations Security Council is to discuss how to respond to the launch, which it says is a breach of sanctions imposed in 2006 and 2009 that banned the isolated and impoverished state from missile and nuclear developments in the wake of its two nuclear weapons tests.

The only surprise is that the Security Council appears to believe it can dissuade Pyongyang, now on its third hereditary ruler since its foundation in 1948, from further nuclear or rocket tests.

Even China, the North's only major diplomatic backer, has limited clout on a state whose policy of self reliance is backed up by an ideology that states: "No matter how precious peace is, we will never beg for peace. Peace lies at the end of the barrel of our gun."

As recently as August, North Korea showed it was well aware of how a second rocket launch this year, after a failed attempt in April, would be received in Washington.

"It is true that both satellite carrier rocket and (a) missile with warhead use similar technology," its Foreign Ministry said in an eight-page statement carried by state news agency KCNA on August 31.

"The U.S. saw our satellite carrier rocket as a long-range missile that would one day reach the U.S. because it regards the DPRK (Democratic Peoples Republic of Korea) as an enemy."

CASH IN EXCHANGED FOR COLDER WAR

The end-game for the North is a formal peace treaty with Washington, diplomatic recognition and bundles of cash to help bolster its moribund economy.

"They might hope that the U.S. will finally face the unpleasant reality and will start negotiations aimed at slowing down or freezing, but not reversing, their nuclear and missile programs," said Andrei Lankov, a North Korea expert at Kookmin University in Seoul.

"If such a deal is possible, mere cognition is not enough. The U.S. will have to pay, will have to provide generous 'aid' as a reward for North Koreans' willingness to slow down or stop for a while."

Recent commercially available satellite imagery shows that North Korea has rebuilt an old road leading to its nuclear test site in the mountainous northeast of the country. It has also shoveled away snow and dirt from one of the entrances to the test tunnel as recently as November.

At the same time as developing its nuclear weapons test site, the North has pushed ahead with what it says is a civil nuclear program.

At the end of November, the International Atomic Energy Agency (IAEA) said the construction of a light water reactor was moving ahead and that North Korea had largely completed work on the exterior of the main buildings.

North Korea says it needs nuclear power to provide electricity, but has also boasted of its nuclear deterrence capability and has traded nuclear technology with Syria, Libya and probably Pakistan, according to U.S. intelligence reports.

It terms its nuclear weapons program a "treasured sword".

The missile and the nuclear tests both serve as a "shop window" for Pyongyang's technology and Kookmin's Lankov adds that the attractions for other states could rise if North Korea carries out a test using highly enriched uranium (HEU).

In its two nuclear tests so far, the North has used plutonium, of which it has limited stocks. However it sits on vast reserves of uranium minerals, which could give it a second path to a nuclear weapon.

"An HEU-based device will have a great political impact, since it will demonstrate that North Korean engineers know how to enrich uranium, and this knowledge is in high demand among aspiring nuclear states," Lankov said.

(Editing by Raju Gopalakrishnan)

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Nurse in royal hoax call case was found hanged: inquest

LONDON: A nurse duped by a prank call to the London hospital treating Prince William's pregnant wife Catherine was found hanging in her room, an inquest heard Thursday.

Jacintha Saldanha, 46, who was found in nurses' accommodation near King Edward VII's Hospital in central London on Friday, also left three notes before she died, a police officer told the hearing.

The mother-of-two also had injuries on one of her wrists.

Detective Chief Inspector James Harman told the inquest: "Jacintha Saldanha was found by a colleague and a member of security staff. Sadly she was found hanging. There was also injuries to her wrist.

"The London Ambulance Service was called to the scene.

"At this time there are no suspicious circumstances."

Two notes were found in her room and another was among her possessions, Harman told the inquest at Westminster Coroner's Court, without revealing their contents.

In England, inquests are held to examine sudden or unexplained deaths. They set out to determine the place and time of death as well as how the deceased came by their death. They do not apportion blame.

Australia's media watchdog on Thursday opened an investigation into the prank call.

The Australian Communications and Media Authority (ACMA) said its probe was into the broadcaster, 2Day FM, and not presenters Mel Greig and Michael Christian who have borne the brunt of worldwide anger.

Saldanha, a nurse originally from near Mangalore on the southwest Indian coast and a mother of two children, was found dead Friday.

Three days earlier she answered a prank call to the hospital made by two Australian radio presenters impersonating Queen Elizabeth II and her heir Prince Charles, William's father.

Saldanha put the call through to a nurse who divulged details of Kate's condition as she recovered from acute morning sickness.

- AFP/lp

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Venkaiah Naidu for privilege motion against Moily

NEW DELHI: Senior BJP leader M Venkaiah Naidu demanded bringing privilege motion against petroleum minister M Veerappa Moily for "misusing" his office by announcing government's intent to increase cap on subsidised LPG outside Parliament when the session was on.

Raising the issue in Rajya Sabha during Zero Hour on Thursday, Naidu said the policy decision was announced by Moily outside the House when Parliament was in session.

This is also violation of "code of conduct" as elections were going on in some parts of the country and the announcement could "influence" the voters, he said.

"This is misuse of the office," he said terming it as a matter of breach of privilege.

Naidu had raised the issue on Wednesday also. Moily had on Tuesday stated that the decision to raise the cap will be taken by the Cabinet "very shortly" and that he had two rounds of discussion with finance minister P Chidambaram on the impact of the decision.

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Dozens sue pharmacy, but compensation uncertain

NASHVILLE, Tenn. (AP) — Dennis O'Brien rubs his head as he details ailments triggered by the fungal meningitis he developed after a series of steroid shots in his neck: nausea, vomiting, dizziness, drowsiness, blurred vision, exhaustion and trouble with his speech and attention.

He estimates the disease has cost him and his wife thousands of dollars in out-of-pocket expenses and her lost wages, including time spent on 6-hour round trip weekly visits to the hospital. They've filed a lawsuit seeking $4 million in damages from the Massachusetts pharmacy that supplied the steroid injections, but it could take years for them to get any money back and they may never get enough to cover their expenses. The same is true for dozens of others who have sued the New England Compounding Center.

"I don't have a life anymore. My life is a meningitis life," the 59-year-old former school teacher said, adding that he's grateful he survived.

His is one of at least 50 federal lawsuits in nine states that have been filed against NECC, and more are being filed in state courts every day. More than 500 people have gotten sick after receiving injections prepared by the pharmacy.

The lawsuits allege that NECC negligently produced a defective and dangerous product and seek millions to repay families for the death of spouses, physically painful recoveries, lost wages and mental and emotional suffering. Thirty-seven people have died in the outbreak.

"The truth is the chance of recovering damages from NECC is extremely low," said John Day, a Nashville attorney who represents several patients who have been sickened by fungal meningitis.

To streamline the process, attorneys on both sides are asking to have a single judge preside over the pretrial and discovery phases for all of the federal lawsuits.

This approach, called multidistrict litigation, would prevent inconsistent pretrial rulings and conserve resources of all parties. But unlike a class-action case, those lawsuits would eventually be returned to judges in their original district for trial, according to Brian Fitzpatrick, a law professor at Vanderbilt University Law School in Nashville.

Even with this approach, Fitzpatrick noted that federal litigation is very slow, and gathering all the evidence, records and depositions during the discovery phase could take months or years.

"Most of the time what happens is once they are consolidated for pretrial proceedings, there is a settlement, a global settlement between all the lawyers and the defendants before anything is shipped back for trial," he said.

A lawyer representing NECC, Frederick H. Fern, described the consolidation process as an important step.

"A Boston venue is probably the best scenario," Fern said in an email. "That's where the parties, witnesses and documents are located, and where the acts subject to these complaints occurred."

Complicating efforts to recover damages, attorneys for the patients said, NECC is a small private company that has now recalled all its products and laid off its workers. The company's pharmacy licenses have been surrendered, and it's unclear whether NECC had adequate liability insurance.

Fern said NECC has insurance, but they were still determining what the policy covers.

But Day says, "It's clear to me that at the end of the day, NECC is not going to have sufficient assets to compensate any of these people, not even 1 percent."

As a result, many attorneys are seeking compensation from other parties. Among the additional defendants named in lawsuits are NECC pharmacist and co-founder Barry Cadden; co-founder Greg Conigliaro; sister company Ameridose and its marketing and support arm, Medical Sales Management.

Founded in 2006 by Cadden and Conigliaro, Ameridose would eventually report annual revenue of $100 million. An NECC spokesman didn't respond to a request for the pharmacy's revenue.

While Federal Drug Administration regulators have also found contamination issues at Westborough, Mass.-based Ameridose, the FDA has said it has not connected Ameridose drugs to infection or illness.

Under tort law, a lawsuit has to prove a defendant has a potential liability, which in this case could be anyone involved in the medical procedure. However, any such suit could take years and ultimately may not be successful.

"I would not be surprised if doctors, hospitals, people that actually injected the drugs, the people that bought the drugs from the compounding company, many of those people will also be sued," said Fitzpatrick.

Plaintiffs' attorneys said they're considering that option but want more information on the relationships between the compounding pharmacy and the hundreds of hospitals and clinics that received its products.

Day, the attorney in Tennessee, said the clinics and doctors that purchase their drugs from compounding pharmacies or manufacturers could be held liable for negligence because they are in a better position to determine the safety of the medicine than the patients.

"Did they use due care in determining from whom to buy these drugs?" Day said.

Terry Dawes, a Michigan attorney who has filed at least 10 federal lawsuits in the case, said in traditional product liability cases, a pharmaceutical distributor could be liable.

"We are looking at any conceivable sources of recovery for our clients including pharmaceutical supply places that may have dealt with this company in the past," he said.

Ten years ago, seven fungal meningitis illnesses and deaths were linked to injectable steroid from a South Carolina compounding pharmacy. That resulted in fewer than a dozen lawsuits, a scale much smaller than the litigations mounting up against NECC.

Two companies that insured the South Carolina pharmacy and its operators tried unsuccessfully to deny payouts. An appellate court ruled against their argument that the pharmacy willfully violated state regulations by making multiple vials of the drug without specific prescriptions, but the opinion was unpublished and doesn't set a precedent for the current litigation.

The lawsuits represent a way for patients and their families recover expenses, but also to hold the pharmacy and others accountable for the incalculable emotional and physical toll of the disease.

A binder of snapshots shows what life is like in the O'Briens' rural Fentress County, Tenn., home: Dennis hooked up to an IV, Dennis in an antibiotics stupor, bruises on his body from injections and blood tests. He's had three spinal taps. His 11-day stay in the hospital cost over $100,000, which was covered by health insurance.

His wife said she sometimes quietly checks at night to see whether her husband of 35 years is still breathing.

"In my mind, I thought we were going to fight this and get over it. But we are not ever going to get over it," said Kaye O'Brien.

Marjorie Norwood, a 59-year-old grandmother of three who lives in Ethridge, Tenn., has spent just shy of two months total in the hospital in Nashville battling fungal meningitis after receiving a steroid injection in her back. She was allowed to come home for almost a week around Thanksgiving, but was readmitted after her symptoms worsened.

Family members are still dealing with much uncertainty about her recovery, but they have not filed a lawsuit, said their attorney Mark Chalos. He said Norwood will likely be sent to a rehabilitation facility after her second stay in the hospital rather than return home again.

Marjorie Norwood's husband, an autoworker, has taken time off work to care for her and they depend on his income and insurance.

"It doesn't just change her life, it changes everyone else's life around her because we care about her and want her to be happy and well and have everything that she needs," said her daughter, Melanie Norwood.

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N. Korean Missile Hits Target of Alarming the World

North Korea's successful launch of an intercontinental ballistic missile hit its target: it bolstered the standing of its young tyrant Kim Jong Un and raised the specter of being able to eventually strike the U.S. with a nuclear weapon.

The pride in the success of the launch -- after several failures -- is a huge boost for Kim Jong Un, 29, who took power one year ago. He has been trying to cement his authority and win the hearts of the people with soft social and economic reforms, like allowing women to wear pants or more small businesses to operate based on profit.

But the rocket launch was on a different scale. A North Korean female announcer in a pink and dark grey national costume excitedly read an announcement of the missile's success and national TV aired interviews with people jumping and cheering on the news.

There had been reservations within and outside of North Korea when Kim Jong Un took power after his father's death on Dec. 17 last year as to whether the young Kim could lead a nuclear state. Looking determined at his first official appearance earlier this year, he had pledged to fulfill the legacy of his father Kim Jong Il to become a "self-sufficient strong nation" with space rocket technology.

The missile is believed to have a range of 6,212 miles, enough distance to reach the west coast of the United States. Its existence, along with a small North Korean nuclear arsenal, is an alarming possibility for many.

PHOTOS: An Inside Look At North Korea

North Korea, however, says it was simply putting a satellite in orbit.

"Picking on our launch (and not others) accusing that ours is a long-range missile and a provocative act causing instability comes from seeing us from a hostile point of view," said North Korea's foreign ministry in an official statement. "We do not want this to be overblown into something that none of us intended to be and hope all related nations act with reason and calmness."

But North Korean denials carry little credibility.

This evidence that North Korea has mastered the long-range missile technology does not mean there will be an imminent nuclear threat.

"They haven't figured out how to weaponize a nuclear (bomb) that will fit in a missile, nor do they have accurate guidance at long ranges," said Stephen Ganyard, ABC News consultant and former deputy assistant secretary of state.

Another crucial technology North Korea is yet to achieve is a proper heat shielding required to protect the warhead while re-entering the earth's atmosphere.

"This is a big leap for Pyongyang. They have been a threat with potential capability. But now a new era begins as a threat with possible capability," said Hwee-Rhak Park, professor of political leadership at Kookmin University in Seoul.

There was obvious alarm, however, as the international community condemned the launch, as North Korea is banned from developing nuclear and missile-related technology under U.N. resolutions.

South Korean President Lee Myung-Bak convened an emergency national security meeting. Japan's envoy to the United Nations called for consultations on the launch within the U.N. Security Council. Russian Foreign Ministry said it "has caused us deep regret," and even China "expressed regret," a significant notch up in condemnation from previous statements on North Korea, its traditional ally.

That international attention, analysts in Seoul say, is exactly what North Korea wanted.

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North Korea's new leader burnishes credentials with rocket

SEOUL/TOKYO (Reuters) - North Korea successfully launched a rocket on Wednesday, boosting the credentials of its new leader and stepping up the threat the isolated and impoverished state poses to its opponents.

The rocket, which North Korea says put a weather satellite into orbit, has been labeled by the United States, South Korea and Japan as a test of technology that could one day deliver a nuclear warhead capable of hitting targets as far as the continental United States.

"The satellite has entered the planned orbit," a North Korean television news-reader clad in traditional Korean garb triumphantly announced, after which the station played patriotic songs with the lyrics "Chosun (Korea) does what it says".

The rocket was launched just before 10 a.m. Korea time (01000 GMT), according to defense officials in South Korea and Japan, and easily surpassed a failed April launch that flew for less than two minutes.

The North American Aerospace Defense Command (NORAD) said that it "deployed an object that appeared to achieve orbit", the first time an independent body has verified North Korean claims.

North Korea followed what it said was a similar successful launch in 2009 with a nuclear test that prompted the United Nations Security Council to stiffen sanctions that it originally imposed in 2006 after the North's first nuclear test.

The state is banned from developing nuclear and missile-related technology under U.N. resolutions, although Kim Jong-un, the youthful head of state who took power a year ago, is believed to have continued the state's "military first" programs put into place by his deceased father Kim Jong-il.

North Korea lauded Wednesday's launch as celebrating the prowess of all three Kims to rule since it was founded in 1948.

"At a time when great yearnings and reverence for Kim Jong-il pervade the whole country, its scientists and technicians brilliantly carried out his behests to launch a scientific and technological satellite in 2012, the year marking the 100th birth anniversary of President Kim Il Sung," its KCNA news agency said.

Washington condemned Wednesday's launch as a "provocative action" and breach of U.N. rules, while Japan's U.N. envoy called for a Security Council meeting. However, diplomats say further tough sanctions are unlikely to be agreed at the body as China, the North's only major ally, will oppose them.

"The international community must work in a concerted fashion to send North Korea a clear message that its violations of United Nations Security Council resolutions have consequences," the White House said in a statement.

U.S. intelligence has linked North Korea with missile shipments to Iran. Newspapers in Japan and South Korea have reported that Iranian observers were in the North for the launch, something Iran has denied.

Japan's likely next prime minister, Shinzo Abe, who is leading in opinion polls ahead of an election on December 16 and who is known as a North Korea hawk, called on the United Nations to adopt a resolution "strongly criticizing" Pyongyang.

BEIJING BLOCK

China had expressed "deep concern" prior to the launch which was announced a day after a top politburo member, representing new Chinese leader Xi Jinping, met Kim Jong-un in Pyongyang.

On Wednesday its tone was measured, regretting the launch but calling for restraint on possible counter-measures, in line with previous policy when it has effectively vetoed tougher sanctions.

"China believes the Security Council's response should be cautious and moderate, protect the overall peaceful and stable situation on the Korean peninsula, and avoid an escalation of the situation," Chinese Foreign Ministry spokesman Hong Lei told journalists.

Bruce Klingner, a Korea expert at the Heritage Foundation, told a conference call: "China has been the stumbling block to firmer U.N. action and we'll have to see if the new leadership is any different than its predecessors."

A senior adviser to South Korea's president said last week it was unlikely there would be action from the U.N. and that Seoul would expect its allies to tighten sanctions unilaterally.

Kim Jong-un, believed to be 29 years old, took power when his father died on December 17 last year and experts believe the launch was intended to commemorate the first anniversary of the death.

The April launch was timed for the centennial of the birth of Kim Il Sung, the grandfather of its current ruler.

Wednesday's success puts the North ahead of the South which has not managed to get a rocket off the ground.

"This is a considerable boost in establishing the rule of Kim Jong-un," said Cho Min, an expert at the Korea Institute of National Unification.

There have been few indications the secretive and impoverished state, where the United Nations estimates a third of the population is malnourished, has made any advances in opening up economically over the past year.

North Korea remains reliant on minerals exports to China and remittances from tens of thousands of its people working on labor projects overseas.

The 22 million population often needs handouts from defectors who have escaped to South Korea in order to afford basic medicines.

Given the puny size of its economy - per capita income is less than $2,000 a year - one of the few ways the North can attract world attention is by emphasizing its military threat.

Pyongyang wants the United States to resume aid and to recognize it diplomatically, although the April launch scuppered a planned food deal.

It is believed to be some years away from developing a functioning nuclear warhead although it may have enough plutonium for around half a dozen nuclear bombs, according to nuclear experts.

The North has also been enriching uranium, which would give it a second path to nuclear weapons as it sits on vast natural uranium reserves.

"A successful launch puts North Korea closer to the capability to deploy a weaponized missile," said Denny Roy, a senior fellow at the East-West Center in Hawaii.

"But this would still require fitting a weapon to the missile and ensuring a reasonable degree of accuracy. The North Koreans probably do not yet have a nuclear weapon small enough for a missile to carry."

Pyongyang says that its development is part of a civil nuclear program, but has also boasted of it being a "nuclear weapons power".

(This story has been refiled to fix spelling, paragraph 14)

(Additional reporting by Jumin Park and Yoo Choonsik in SEOUL; David Alexander, Matt Spetalnick and Paul Eckert in WASHINGTON; Linda Sieg in TOKYO; Sui-Lee Wee in BEIJING; Rosmarie Francisco in MANILA; Writing by David Chance; Editing by Raju Gopalakrishnan)

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Indian sitar legend Ravi Shankar dies

NEW DELHI: Legendary Indian sitar player Ravi Shankar, a major influence on musicians ranging from The Beatles to violinist Yehudi Menuhin, has died at the age of 92 after surgery in the United States, his family said Wednesday.

Shankar, the father of American singer-songwriter Norah Jones, died Tuesday in a hospital in San Diego, California, where he had recently undergone heart-valve replacement surgery.

Indian Prime Minister Manmohan Singh hailed Shankar as "a national treasure and global ambassador of India's cultural heritage".

"An era has passed away... The nation joins me to pay tributes to his unsurpassable genius, his art and his humility," he said.

Shankar, who had houses in both California and India, was born into a high-caste Bengali Brahmin family in the Hindu holy city of Varanasi in northern India on April 7, 1920.

He taught his close friend the late Beatle George Harrison to play the sitar, and collaborated with him on several projects, including the groundbreaking Concert for Bangladesh in 1971.

The Beatles called him "The Godfather of World Music".

Shankar, a three-time Grammy winner, also played in front of nearly 500,000 people at the Woodstock Festival in New York state in 1969 -- one of the most iconic cultural events of the century, which also featured Janis Joplin and Jimi Hendrix.

In a statement released from New York via his official Twitter feed, Shankar's wife Sukanya and his daughter Anoushka described him as a "husband, father, and musical soul".

"His health has been fragile for the past several years and (last) Thursday he underwent a surgery that could have potentially given him a new lease of life," they said.

"Unfortunately, despite the best efforts of the surgeons and doctors taking care of him, his body was not able to withstand the strain of the surgery. We were at his side when he passed away.

"Although it is a time for sorrow and sadness, it is also a time for all of us to give thanks and to be grateful that we were able to have him as a part of our lives."

His family and the Ravi Shankar Foundation said he had been suffering respiratory and heart problems.

The statement said that Shankar performed his last concert on November 4 in Long Beach, California, with his daughter and fellow sitar player Anoushka.

Memorial plans would be announced shortly, it said.

- AFP/ha

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NCP rejects Sena's 'PM offer' to Sharad Pawar, says not power hungry

MUMBAI: NCP scoffed at senior Shiv Sena leader Manohar Joshi's invitation to party chief Sharad Pawar to join NDA, saying there was no question of doing so as they are not "power hungry".

On Tuesday in Pune, Joshi invited Pawar to join NDA, saying "he would be able to end quarrels within the BJP-led alliance and could also become the Prime Minister".

Joshi attended a function organised on the eve of Pawar's 72nd birthday on Wednesday. He showered praise on the Union agriculture minister and said the NCP leader has the capability to be the PM.

"There is no question of NCP joining the NDA led by communal forces," said NCP spokesman Nawab Malik responding to Sena leader's offer.

"We are not power hungry and will always stick to our secular credentials," he said rejecting Joshi's proposal.

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