Employers Must Offer Family Health Care, Affordable or Not, Administration Says

WASHINGTON — In a long-awaited interpretation of the new health care law, the Obama administration said Monday that employers must offer health insurance to employees and their children, but will not be subject to any penalties if family coverage is unaffordable to workers.

The requirement for employers to provide health benefits to employees is a cornerstone of the new law, but the new rules proposed by the Internal Revenue Service said that employers’ obligation was to provide affordable insurance to cover their full-time employees. The rules offer no guarantee of affordable insurance for a worker’s children or spouse. To avoid a possible tax penalty, the government said, employers with 50 or more full-time employees must offer affordable coverage to those employees. But, it said, the meaning of “affordable” depends entirely on the cost of individual coverage for the employee, what the worker would pay for “self-only coverage.”

The new rules, to be published in the Federal Register, create a strong incentive for employers to put money into insurance for their employees rather than dependents. It is unclear whether the spouse and children of an employee will be able to obtain federal subsidies to help them buy coverage — separate from the employee — through insurance exchanges being established in every state. The administration explicitly reserved judgment on that question, which could affect millions of people in families with low and moderate incomes.

Many employers provide family coverage to full-time employees, but many do not. Family coverage is much more expensive, and the employee’s share of the premium is typically much larger.

In 2012, according to an annual survey by the Kaiser Family Foundation, premiums for employer-sponsored health insurance averaged $5,615 a year for single coverage and $15,745 for family coverage. The employee’s share of the premium averaged $951 for individual coverage and more than four times as much, $4,316, for family coverage.

Starting in 2014, most Americans will be required to have health insurance. Low- and middle-income people can get tax credits to help pay their premiums, unless they have access to affordable coverage from an employer.

In its proposal, the Internal Revenue Service said, “Coverage for an employee under an employer-sponsored plan is affordable if the employee’s required contribution for self-only coverage does not exceed 9.5 percent of the employee’s household income.”

The rules, though labeled a proposal, are more significant than most proposed regulations. The Internal Revenue Service said employers could rely on them in making plans for 2014.

In writing the law, members of Congress often conjured up a picture of employees working year-round at full-time jobs. But in drafting the rules, the I.R.S. wrestled with the complex reality of part-time, seasonal and temporary workers.

In addition, the administration expressed concern that some employers might try to evade the new requirements by firing and rehiring employees, manipulating their work hours or using temporary staffing agencies. The rules include several provisions to prevent such abuse.

The law says an employer with 50 or more full-time employees may be subject to a tax penalty if it fails to offer coverage to “its full-time employees (and their dependents).”

Employers asked for guidance, and the Obama administration provided it, saying that a dependent is an employee’s child under the age of 26.

“Dependent does not include the spouse of an employee,” the proposed rules say.

Thus, employers must offer coverage to children of an employee, but do not have to make it affordable. And they do not have to offer coverage at all to the spouse of an employee.

The administration said that the rules — which apply to private businesses, nonprofit organizations and state and local government agencies — would require changes at many work sites.

“A number of employers currently offer coverage only to their employees, and not to dependents,” the I.R.S. said. “For these employers, expanding their health plans to add dependent coverage will require substantial revisions to their plans.”

In view of this challenge, the agency said it would grant a one-time reprieve to employers who fail to offer coverage to dependents of full-time employees, provided they take steps in 2014 to come into compliance. Under the rules, employers must offer coverage to employees in 2014 and must offer coverage to dependents as well, starting in 2015.

The new rules apply to employers that have at least 50 full-time employees or an equivalent combination of full-time and part-time employees. A full-time employee is a person employed on average at least 30 hours a week. And 100 half-time employees are considered equivalent to 50 full-time employees.

Thus, the government said, an employer will be subject to the new requirement if it has 40 full-time employees working 30 hours a week and 20 half-time employees working 15 hours a week.

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California regulators seek to police out-of-state pharmacies

SACRAMENTO — State regulators are responding to a deadly nationwide meningitis outbreak linked to contaminated drugs by seeking new power to inspect out-of-state pharmacies that sell special-order prescription drugs in California.

In September, the New England Compounding Center in Framingham, Mass., sent three shipments of contaminated injectable steroid solutions to 76 healthcare facilities and pain-control clinics in 23 states, including four in California.

These customized drugs, which were injected into patients' spines and joints, caused 39 deaths among 620 reported cases of fungal meningitis and other infections, according to a Dec. 17 report from the federal Centers for Disease Control and Prevention in Atlanta.

The steroids were recalled by the now-bankrupt firm before they caused any deaths or illnesses in California. But that fortunate outcome hasn't kept the California Board of Pharmacy from being more aggressive about policing sometimes poorly regulated pharmacies that produce and ship large volumes of these medications, known as compounded drugs.

At issue is whether these outfits ought to be regulated by the U.S. Food and Drug Administration. The FDA regulates large drug manufacturers, but its legal authority to oversee the compounding pharmacies has been disputed in the courts. As a result, states are moving to play a bigger role in ensuring the safety of their products.

In one such case in 2012, the now-defunct Franck's Compounding Pharmacy in Ocala, Fla., shipped supposedly sterile products for injecting into the eye that caused infections in 17 California surgery patients.

The state pharmacy board, which oversees and licenses nearly 7,000 drugstores in California, plans to sponsor a bill in the Legislature this year that would give state agents the authority to make unannounced on-site inspections of out-of-state pharmacies that the board licenses to ship sterile medicines, such as injectable steroids, eyedrops and inhaled aerosol drugs, to healthcare providers here.

The California initiative is getting preliminary support from two industry trade groups, the Pharmacy Compounding Accreditation Board and the International Academy of Compounding Pharmacies. The FDA also is supportive of the thrust of the proposed legislation, said Virginia Herold, the state pharmacy board's executive director.

"We're being proactive for the public health because we don't want another incident," she said. "We want to make sure that if the product is coming into California, it meets the requirements of California law."

Increasing amounts of these compounded drugs are flowing into the state. The Board of Pharmacy told a congressional committee in December that it licensed 86 out-of-state compounding pharmacies to make sterile medications for use in California in fiscal year 2011-12, compared with just 17 in 2003-04 and none in 2002-03.

But keeping track of out-of-state, large-volume pharmacies isn't easy, Herold conceded, because both state and federal laws are ambiguous about who is responsible for regulating different types of compounded drugs.

The advantage of traditional compounding, federal and state health officials agree, is that it enables pharmacies to offer prescriptions in individualized formats. That includes producing such drugs as creams, powders or solutions to direct relief to specific parts of the body or supplying drugs as a liquid to make it easier for people who can't swallow pills, for example.

Any state-licensed pharmacist can make these drugs with a doctor's prescription, if the pharmacy also has a state license. In most cases, regulation and inspections are the legal province of state pharmacy boards, not the FDA.

But over the last decade, the definition of what is a compounding pharmacy has been blurred. Some pharmacies have begun manufacturing large volumes of drugs — such as sterile, injectable steroids used to temporarily ease back pain — that are shipped in bulk to hospitals and outpatient surgical centers.

"FDA's ability to take action against compounding … that exceeds the bounds of traditional pharmacy compounding and poses risks to patients has been hampered by gaps and ambiguities in the law, which have led to legal challenges to FDA's authority to inspect pharmacies and take appropriate enforcement actions," FDA Commissioner Margaret Hamburg said in congressional testimony Nov. 14.

The House Energy and Commerce subcommittee on oversight and investigations was probing the New England Compounding Center-related deaths.

As part of Hamburg's effort to boost enforcement and protect patients, she met in December with representatives from the boards of pharmacies in all 50 states.

California supports federal and state efforts to figure out a way to avoid more contamination-related illnesses from these drugs, said Amy Gutierrez, a California Board of Pharmacy member and chief pharmacy officer for the Los Angeles County Department of Health Services.

"The problem is really the other states" that might have different or weaker standards or less enforcement resources than California, she said.

"What we're looking for is holding the out-of-state pharmacies that compound sterile products to the same standards as our own state-licensed pharmacies."

marc.lifsher@latimes.com

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Congress edges closer to 'fiscal cliff' deal but can't close it

WASHINGTON — Democrats and Republicans on Capitol Hill inched toward a compromise to avert part of the so-called fiscal cliff but remained unable to close a deal as each side struggled with internal tensions as well as the remaining gap between them.

Lawmakers have been trying to beat a deadline of midnight Monday, when tax rates are scheduled to go up for the vast majority of Americans. But they could continue chasing a deal for days — even until the new Congress is sworn in at noon Thursday. After that, the political dynamics could shift with the entrance of new members.

If Congress fails to act, the combination of new taxes and sharp cuts in defense spending and domestic programs, which also would take effect with the new year, could tip the economy back into recession, economists have warned.

On Sunday, talks hit a standstill early in the day after Senate Republican leader Mitch McConnell of Kentucky proposed slowing Social Security cost-of-living increases as part of the spending package. Democrats rejected the idea, and many Republicans quickly disavowed it.

In response to a request from McConnell, the Obama administration assigned Vice President Joe Biden to broker further negotiations.

"I'm willing to get this done, but I need a dance partner," McConnell said on the Senate floor. "The sticking point appears to be a willingness, an interest, or courage to close the deal."

Biden and McConnell talked by phone throughout the afternoon as the two sides appeared to close in on a potential compromise.

Republicans have said they are willing to raise taxes on wealthier households while stopping the tax increases for most Americans. The two sides have not agreed on an income threshold for the tax increases. Republicans suggested starting about $550,000 in taxable income for couples and $450,000 for single households. The most recent offer from Democrats had set the tax level slightly lower, about $450,000 for couples and $360,000 for singles.

But Republicans were also seeking to preserve inheritance taxes at the current rate of 35%, while Democrats have sought to raise them. Republicans want to keep the automatic spending cuts in place for now, while Democrats suggest easing them. Democrats also want to continue long-term unemployment benefits as part of the year-end package.

Other sticking points remain over adjustments to the rates Medicare pays doctors and fixing the tax code to protect middle-income Americans from the alternative minimum tax, which was designed to prevent tax avoidance by the wealthy. Both provisions involve laws that are not indexed for inflation and have required annual adjustments by Congress.

The closer the two sides edged toward compromise Sunday, the more divisions within their ranks became apparent.

Republican senators, worried they would be blamed for harming seniors, openly revolted once the McConnell proposal to trim Social Security benefits became public.

After a closed-door meeting, Sen. John McCain (R-Ariz.) articulated the public relations challenge the proposal posed his party: "What [Democrats] are saying now is, 'Republicans want to preserve tax breaks for rich people and give up seniors' Social Security.' It should be off the table. And I think most Republicans believe it should be off the table."

"I'm not a fan," said retiring Sen. Olympia J. Snowe (R-Maine). "I don't think it should be part of it, and I think there are others who shared that view."

Democrats rejected the proposal. An aide, speaking on the condition of anonymity to discuss the talks, said Senate Majority Leader Harry Reid (D-Nev.) "was taken aback and disappointed" by the idea. "We feel we are further apart than we were 24 hours ago."

Adjusting the cost of living for recipients of government benefits, including Social Security, had been offered by President Obama in talks with House Speaker John A. Boehner (R-Ohio) when they were negotiating a broader deficit reduction deal. But Democrats have rejected including the idea in the more limited package now under discussion.

At the same time, some Democrats worried that Biden, who has closed several deals before with McConnell, might be too eager to compromise compared with Reid. White House officials have been more worried than many congressional Democrats about the potential economic damage that the tax cuts and spending reductions could cause.

Obama made clear the line of attack that the White House would use against Republican leaders if Congress could not find a resolution.

"They have had trouble saying yes to a number of repeated offers," Obama said in an interview on NBC's "Meet the Press," which was recorded Saturday.

"If they can't do a comprehensive package of smart deficit reductions, let's at minimum make sure that people's taxes don't go up and that 2 million people don't lose their unemployment insurance."

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14 Solutions to Your New Year’s Midnight Kiss

Find a Baby

There’s got to be one crawling around somewhere. What’s cuter than kissing a baby’s fat cheek? Photo by Win McNamee/Getty Images

Click here to view this gallery.

[More from Mashable: Here’s a Depressing Look at Man’s Impact on Earth]

Do you find yourself in a panic every New Year’s Eve because everyone’s counting down and Billy Crystal has yet to explain all of the reasons why he’s madly in love with you?

No? Oh okay — me neither.

[More from Mashable: Watch the Scariest Skiing Lesson of All Time]

But the final holiday of the year can put a lot of unnecessary pressure on people. We want to end and begin each year with a bang — this often means the perfect outfit, an amazing soiree and the midnight kiss that will sweep you off your feet.

Instead of starting 2013 in a state of panic, then promising to be better later, enjoy New Year’s Eve and stop worrying about a silly superstition. We’ve come up with a couple solutions to the big smooch at the end of the night.

Photo by Ian Gavan/Getty Images

This story originally published on Mashable here.

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Kanye West, Kim Kardashian expecting 1st child

ATLANTIC CITY, N.J. (AP) — The Kardashian clan is getting bigger: Kanye West and Kim Kardashian are expecting their first child.

The rapper announced at a concert Sunday night that his girlfriend is pregnant. He told the crowd of more than 5,000 at the Ovation Hall at the Revel Resort in song form: "Now you having my baby."

The crowd roared.

Kourtney Kardahsian and Kris Jenner also tweeted about baby news.

West also told concertgoers to congratulate his "baby mom" and that this was the "most amazing thing."

Representatives for West and Kardashian didn't immediately respond to emails about the pregnancy.

The rapper and reality TV star went public in March. Kardashian married NBA player Kris Humphries in August 2011 and their divorce is not finalized.

___

AP Writer Bianca Roach contributed to this report.

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Dr. Rita Levi-Montalcini, a Revolutionary in the Study of the Brain, Dies at 103

Fabio Campana/European Pressphoto Agency

Dr. Rita Levi-Montalcini in 2007. She discovered chemical tools the body uses to direct cell growth and build nerve networks.

Dr. Rita Levi-Montalcini, a Nobel Prize-winning neurologist who discovered critical chemical tools that the body uses to direct cell growth and build nerve networks, opening the way for the study of how those processes can go wrong in diseases like dementia and cancer, died on Sunday at her home in Rome. She was 103.

Her death was announced by Mayor Gianni Alemanno of Rome.

“I don’t use these words easily, but her work revolutionized the study of neural development, from how we think about it to how we intervene,” said Dr. Gerald D. Fishbach, a neuroscientist and professor emeritus at Columbia.

Scientists had virtually no idea how embryo cells built a latticework of intricate connections to other cells when Dr. Levi-Montalcini began studying chicken embryos in the bedroom of her house in Turin, Italy, during World War II. After years of obsessive study, much of it at Washington University in St. Louis with Dr. Viktor Hamburger, she found a protein that, when released by cells, attracted nerve growth from nearby developing cells.

In the early 1950s, she and Dr. Stanley Cohen, a biochemist also at Washington University, isolated and described the chemical, known as nerve growth factor — and in the process altered the study of cell growth and development. Scientists soon realized that the protein gave them a new way to study and understand disorders of neural growth, like cancer, or of degeneration, like Alzheimer’s disease, and to potentially develop therapies.

In the years after the discovery, Dr. Levi-Montalcini, Dr. Cohen and others described a large family of such growth-promoting agents, each of which worked to regulate the growth of specific cells. One, called epidermal growth factor and discovered by Dr. Cohen, plays a central role in breast cancer; in part by studying its behavior, scientists developed drugs to combat the abnormal growth.

In 1986, Dr. Levi-Montalcini and Dr. Cohen shared the Nobel Prize in Physiology or Medicine for their work.

Dr. Cohen, now an emeritus professor at Vanderbilt University, said Dr. Levi-Montalcini possessed a rare combination of intuition and passion, as well as biological knowledge. “She had this feeling for what was happening biologically,” he said. “She was an intuitive observer, and she saw that something was making these nerve connections grow and was determined to find out what it was.”

One of four children, Rita Levi-Montalcini was born in Turin on April 22, 1909, to Adamo Levi, an engineer, and Adele Montalcini, a painter, both Italian Jews who traced their roots to the Roman Empire. In keeping with the Victorian customs of the time, Mr. Levi discouraged his three daughters from entering college, fearing that it would interfere with their lives as wives and mothers.

It was not a future that Rita wanted. She had decided to become a doctor and told her father so. “He listened, looking at me with that serious and penetrating gaze of his that caused me such trepidation,” she wrote in her autobiography, “In Praise of Imperfection” (1988). He also agreed to support her.

She graduated summa cum laude from the University of Turin medical school in 1936. Two years later, Mussolini issued a manifesto barring non-Aryan Italians from having professional careers. She began her research anyway, setting up a small laboratory in her home to study chick embryos, inspired by the work of Dr. Hamburger, a prominent researcher in St. Louis who also worked with the embryos.

During World War II, the family fled Turin for the countryside, and in 1943 the invasion by Germany forced them to Florence. The family returned at the close of the war, in 1945, and Dr. Hamburger soon invited Dr. Levi-Montalcini to work for a year in his lab at Washington University.

She stayed on, becoming an associate professor in 1956 and a full professor in 1958. In 1962, she helped establish the Institute of Cell Biology in Rome and became its first director. She retired from Washington University in 1977, becoming a guest professor and splitting her time between Rome and St. Louis.

Italy honored her in 2001 by making her a senator for life.

An elegant presence, confident and passionate, she was a sought-after speaker until late in life. “At 100, I have a mind that is superior — thanks to experience — than when I was 20,” she said in 2009.

She never married and had no children. In addition to her autobiography, she was the author or co-author of dozens of research studies and received numerous professional awards, including the National Medal of Science.

“It is imperfection — not perfection — that is the end result of the program written into that formidably complex engine that is the human brain,” Dr. Levi-Montalcini wrote in her autobiography, “and of the influences exerted upon us by the environment and whoever takes care of us during the long years of our physical, psychological and intellectual development.”

This article has been revised to reflect the following correction:

Correction: December 30, 2012

An earlier version of this obituary misstated the year Mussolini issued a manifesto barring non-Aryan Italians from having professional careers. It was 1938, not 1936.

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Tribune Co. set to exit bankruptcy protection

Tribune Co. is expected to emerge from bankruptcy protection Monday with a new board of directors composed largely of entertainment-industry veterans.

Exiting bankruptcy would mark a milestone for Tribune, the parent of the Los Angeles Times and other newspaper and television properties.

Tribune sought Bankruptcy Court protection in December 2008 after a leveraged buyout by real estate magnate Sam Zell saddled the company with $12.9 billion in debt just as advertising revenue was collapsing. It is one of the longest bankruptcy cases in U.S. corporate history.

Tribune will emerge as a slimmed-down entity with a more stable financial base. But the media conglomerate will still be buffeted by the larger forces pounding the newspaper industry, specifically uncertainty over whether papers can generate sufficient revenue from digital operations.

"Tribune is far stronger than it was when we began the Chapter 11 process four years ago and, given the budget planning we've done, the company is well-positioned for success in 2013," Eddy Hartenstein, Tribune's chief executive, wrote in a note to employees Sunday night.

Tribune's new board of directors is expected to be made up of a who's who of Hollywood players. Most have no hands-on experience running newspapers and television stations, which are Tribune's biggest assets.

Five of the seven members have ties to the entertainment and media industries, including Hartenstein and Peter Liguori, a former News Corp. executive who is expected to succeed Hartenstein as Tribune CEO in the next few weeks.

Also expected to be named to the board are Peter Murphy, previously a longtime executive at Walt Disney Co.; Ross Levinsohn, former head of global media at Yahoo Inc.; and Craig A. Jacobson, a veteran entertainment attorney.

The board will be rounded out by Bruce Karsh, president of Oaktree Capital Management, the Los Angeles investment firm that owns about 23% of the new Tribune; and Kenneth Liang, an Oaktree managing director.

Tribune owns 23 local television stations, eight daily newspapers and Internet and other media properties.

Those holdings include KTLA-TV Channel 5, the Chicago Tribune, and national cable station WGN-TV. Tribune also holds slightly less than one-third of the Food Network cable channel and about a 25% stake in the CareerBuilder website.

Liguori is also a former Discovery Communications senior executive whose resume is in programming and marketing. He headed both the FX cable network and Fox Broadcasting at News Corp. At Discovery he served as chief operating officer of the cable programming giant.

Murphy spent almost two decades at Disney, rising to the position of chief strategist. He founded private investment firm Wentworth Capital Management. He has close ties to Angelo, Gordon & Co., an investment firm that will own roughly 9% of the new Tribune Co.

Levinsohn is a former head of global media at Yahoo. He also served briefly as its interim CEO before Google Inc.'s Marissa Mayer being tapped for that job. Levinsohn also is a former News Corp. executive who headed its interactive unit.

Jacobson, an attorney at Hansen, Jacobson, Teller, Hoberman, Newman, Warren, Richman, Rush & Kaller is one of Hollywood's more prominent deal-makers. His clients have included several high-profile executives and performers such as Ryan Seacrest.

Tribune remained profitable throughout the bankruptcy, building cash reserves of more than $2.5 billion as of Nov. 18, according to a U.S. Bankruptcy Court filing this month. Creditors are expected to immediately take nearly $3 billion in cash out of the new company, some of it coming from a new $1.1-billion loan that was approved as part of the bankruptcy.

The value of Tribune's newspaper properties has sunk to $623 million, a fraction of their value a few years earlier, according to an estimate filed in Bankruptcy Court in April.

A key question still to be answered is what Tribune will do with its newspapers. Some analysts believe the company will seek to sell the slower-growing newspapers to focus on TV holdings.

As for the Los Angeles Times, Rupert Murdoch's News Corp. has expressed interest, according to people familiar with the matter.

Aaron Kushner, owner of the Orange County Register, and Doug Manchester, the San Diego real estate developer who last year bought the local Union Tribune newspaper, also have shown interest.

Austin Beutner, the former venture capitalist and former deputy mayor of Los Angeles, told The Times in October that he has reached out to civic-minded investors who would consider acquiring the paper.

walter.hamilton@latimes.com

joe.flint@latimes.com

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Officials warn holiday revelers against firing weapons

By Richard Winton, Los Angeles Times

December 29, 2012, 8:59 p.m.

Los Angeles officials are warning that anyone discharging a firearm into the air to celebrate the new year not only risks killing someone but could also face a lengthy prison sentence.

"Firing into the air weapons in celebration puts innocent lives at risk," Mayor Antonio Villaraigosa said last week. "Nothing ruins the holiday season like an errant bullet coming down and killing an innocent."

Villaraigosa said the misuse of firearms is on everyone's mind in the wake of the Newtown, Conn., school shooting that left six adults and 20 children dead. The mayor vowed that authorities will pursue criminal charges for anyone caught in possession of a weapon in public.

For more than a decade, city and county leaders have tried to quell celebratory gunfire.

Los Angeles Police Chief Charlie Beck said a bullet discharged into the air falls at a rate of 300 to 700 mph, depending on the weapon — "easily enough to crack the human skull."

"Please celebrate New Year's with your family, not in [Sheriff] Lee Baca's jail or my jail," Beck said, pledging to capture anyone firing a weapon. "Firing a gun in the air isn't only dangerous and a crime but socially unacceptable."

L.A. County Dist. Atty. Jackie Lacey said that anyone caught firing a weapon — even if they don't hit someone — will face a felony charge and a fine of up to $10,000 and a possible three-year sentence. A conviction would be considered a strike offense and the suspect would lose the right to own a firearm.

Supervisor Mark Ridley-Thomas said that in some county areas, special equipment has been deployed to spot shots within seconds and track their locations.

"The madness of gun violence has to stop," he said. "This is a matter of physics. What goes up must come down."

richard.winton@latimes.com

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McCartney, 'God particle' scientist get honors

LONDON (AP) — Stella McCartney, who designed the uniforms worn by Britain's record-smashing Olympic team, and Scottish physicist Peter Higgs, who gave his name to the so-called "God particle," are among the hundreds being honored by Queen Elizabeth II this New Year.

The list is particularly heavy with Britain's Olympic heroes, but it also includes "Star Wars" actor Ewan McGregor, eccentric English singer Kate Bush, Roald Dahl illustrator Quentin Blake, and Jamie Lowther-Pinkerton, the royal aide who helped organize the watched-around-the-world wedding of Prince William to Kate Middleton.

McCartney was honored with the title of Officer of the Order of the British Empire, or OBE, in part for her work creating the skintight, red-white-and-blue uniforms worn by British athletes as they grabbed 65 medals during the 2012 games hosted by London. McCartney is the designer daughter of ex-Beatle Paul McCartney and his first wife Linda, and she has moved to make the family name almost as synonymous with fashion as it is with music, setting up a successful business and a critically-acclaimed label.

Higgs' achievements, which made him a Companion of Honor, touch on the nature and the origins of the universe. The 83-year-old researcher's work in theoretical physics sought to explain what gives things weight. He said it was while walking through the Scottish mountains that he hit upon the concept of what would later become known as the Higgs boson, an elusive subatomic particle that gives objects mass and combines with gravity to give them weight.

For decades, the existence of such a particle remained just a theory, but earlier this year scientists working at the European Organization for Nuclear Research, or CERN, said they'd found compelling evidence that the Higgs boson was out there. Or in there. Or whatever.

All of Britain's gold medalists from this year's games were on the list, with cyclist Bradley Wiggins and sailor Ben Ainslie honored with knighthoods.

Sebastian Coe, who masterminded the games as chairman of the London organizing committee, was made a Companion of Honor — a prestigious title also awarded to Higgs. But Ken Livingstone, London's former mayor, said Saturday he turned down a Commander of the Order of the British Empire, or CBE, recognizing his services to the Olympics because he doesn't believe politicians should get the queen's honors.

Honors lists typically include a sprinkling of star power, and this year was no different. Ewan McGregor, who came to public attention through his role as the heroin-addled anti-hero of British drug drama "Trainspotting," was awarded an OBE. The 41-year-old actor is also known for his turn as a young Obi-Wan Kenobi in the "Star Wars" prequels.

"Babooshka" singer Kate Bush said she was delighted to be made a CBE for a musical career which has resulted in a string of quirky hits including "Wuthering Heights," ''Cloudbusting," and "Man With The Child In His Eyes."

Other art world honorees included artist Tracey Emin and Quentin Blake, whose spiky, exuberant illustrations are best known through the work of his collaborator Roald Dahl.

Politicians, policemen, and spies got honors too. Scotland Yard chief Bernard Hogan-Howe was awarded a knighthood; former British foreign minister Margaret Beckett was made a Dame Commander of the Order of the British Empire. Former Prime Minister Tony Blair's wife Cherie was made a CBE for her charity work. MI5 chief Jonathan Evans was made a Knight Commander of the Order of Bath.

Also honored was the man credited with helping pull off the wedding of the decade: Jamie Lowther-Pinkerton, principal private secretary to the Duke and Duchess of Cambridge (as Prince William and his wife are formally known) was made a Lieutenant of the Royal Victorian Order.

Britain's honors are bestowed twice a year by the monarch, at New Year's and on her official birthday in June. Although the queen does pick out some lesser honors herself, the vast majority of recipients are selected by government committees from nominations made by officials and members of the public.

In descending order, the honors are knighthoods, CBE, OBE, and MBE — Member of the Order of the British Empire. Knights are addressed as "sir" or "dame." Recipients of the other honors, such as the Order of the Companions of Honor given to Higgs and Coe or the Royal Victorian Order personally picked out by the queen, receive no title but can put the letters after their names.

The New Year's honors carried the usual batch of courtiers — even the royal household's switchboard operator got a medal — as well as senior civil servants, soldiers, charity executives, successful entrepreneurs, established academics, volunteers, and community workers. Some of the more eclectic honors included the OBE handed to card game columnist Andrew Michael Robson "for services to the game of bridge," and the OBE given to river conservationist Andrew Douglas-Home "for services to fishing."

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Individual mandate in healthcare was year's top consumer story

This was the year of the healthcare mandate. No other consumer story of 2012 comes close.

In a split decision, with Chief Justice John G. Roberts Jr. casting the deciding vote, the U.S. Supreme Court upheld the cornerstone of President Obama's healthcare reform law, the most sweeping overhaul of our dysfunctional medical system in decades.

The so-called individual mandate requires that most people have health insurance. It's the trade-off for the insurance industry's agreement to stop denying coverage to people with preexisting conditions and to stop charging higher rates if you get sick.

It's also the trade-off for insurers to remove limits on how much treatment they'll cover annually or over your lifetime.

"It's a huge deal," said Lee Goldberg, vice president of health policy for the National Academy of Social Insurance, a Washington think tank. "Without the mandate, you're much more likely to have spiraling healthcare costs and an unsustainable market for coverage."

Critics of the mandate, and there are plenty of them, say it represents a government takeover of healthcare, a socializing of medicine. The government, they say, can't make you buy something you don't want.

But that's not how the mandate works. No one's forcing you to buy insurance. No one's forcing you to be covered.

However, there will be a tax penalty if you decide that you want to take your chances. And there's a very good reason for this: Taking your chances is foolish.

Unless you're Superman, you're going to need healthcare at some point in your life. That's just a fact.

"No one's going to throw you in jail if you don't have insurance," said Richard Curtis, president of the Institute for Health Policy Solutions. "But if you ever have an accident and have to use the [emergency room], that tax penalty will help to defray the cost that will be covered by those who do have insurance."

Beginning in 2014, the penalty for going uninsured will be no more than $285 per family or 1% of income, whichever is greater. The cap rises to $975 or 2% of income a year later, and then up to $2,085 per family or 2.5% of income by 2016.

Quiz: How much do you know about business news in 2012?

Opponents of healthcare reform conveniently ignore the basic economics of the insurance business. Insurers aren't service providers. They're risk managers. They examine the risk they face by covering a group or individual and price their policies accordingly.

The larger the risk pool, obviously, the cheaper the coverage. That's because the risk to health insurers goes down if younger and healthier people are included in the mix. The result: more affordable coverage for everyone.

Taken to its logical extreme, the most effective and efficient health insurance system for the United States would be something like a Medicare-for-all approach in which the risk pool comprises everybody in the country — young and old, healthy and sick.

In fact, we're already well down that road. Federal and state programs such as Medicare, Medicaid and veterans' assistance accounted for about 45% of total U.S. healthcare spending in 2010, according to a recent study by the National Institute for Health Care Management Foundation.

The amount of public money spent on healthcare should serve as a wake-up call to all those who think the world would end if the U.S. followed Britain, France, Canada and other developed countries in enacting a national health insurance system.

For the U.S., it would simply be an expansion of a system that already exists but is hobbled by the inefficiency of denying Medicare and other programs access to healthier members of the population, thus saddling taxpayers with a disproportionately large number of higher-risk people.

The individual mandate won't radically change things. The healthcare insurance system will remain divided between a public sector that focuses primarily on aging and sick people and a private sector that, for purely financial reasons, provides increasingly less access to affordable coverage.

Average premiums for employer-sponsored family health insurance plans rose 62% from 2003 to 2011 to $15,022 a year, according to a recent report by the Commonwealth Fund.

Health insurance costs far outpaced people's incomes in all states during that time, the report found, with workers' average share of premiums for family plans soaring 74% and deductibles more than doubling, while the median household income rose only about 10%.

Still, the mandate is a big step toward remedying the system's economic irrationality. By extending coverage to about 30 million of the 50 million people who now lack insurance, the mandate will place medical care within reach of many who previously may have sought treatment only in emergencies.

As a result, national wellness will improve and, presumably, healthcare costs will go down, or at least will be better controlled as fewer people put off medical attention until an easily treated ailment becomes an expensive catastrophe.

"The mandate is the key to making this all work," said Devon Herrick, a healthcare economist at the National Center for Policy Analysis. "Otherwise people would just wait until they got sick before buying insurance and premiums would skyrocket."

There's still much to be done. The reform law's insurance exchanges are a work in progress, and it's unclear at this point how much coverage will be offered and how much it will cost.

But the Supreme Court has kept the ball rolling by maintaining the mandate as part of the equation. It was a decision that will change all our lives, probably for the better, and move us closer to a system under which all people can obtain affordable healthcare.

David Lazarus' column runs Tuesdays and Fridays. he also can be seen daily on KTLA-TV Channel 5 and followed on Twitter @Davidlaz. Send tips or feedback to david.lazarus@latimes.com.

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