F.D.A. Requires Cuts to Dosages of Ambien and Other Sleep Drugs

The Food and Drug Administration announced on Thursday that it was requiring manufacturers of popular sleeping pills like Ambien and Zolpimist to cut their recommended dosage in half for women, after laboratory studies showed that they can leave people still sleepy in the morning and at risk for accidents.

The agency issued the requirement for drugs containing the active ingredient zolpidem, by far the most widely used sleep aid. Using lower doses means less of the drug will remain in the blood in the morning hours, and leave people who take it less exposed to the risk of impairment while driving to work.

Women eliminate zolpidem from their bodies more slowly than men and the agency told manufacturers that the recommended dosage for women should be lowered to 5 milligrams from 10 milligrams for immediate-release products like Ambien, Edluar and Zolpimist. Dosages for extended-release products should be lowered to 6.25 milligrams from 12.5, the agency said. The agency also recommended lowering dosages for men.

An estimated 10 to 15 percent of women will have a level of zolpidem in their blood that impairs driving eight hours after taking the pill, while only about 3 percent of men do, said Dr. Robert Temple, deputy director for clinical science in the F.D.A.'s Center for Drug Evaluation and Research.

Doctors will still be told that they can prescribe the higher dosage if the lower one does not work, Dr. Temple said.

“Most people thought that by the morning it is gone,” he said. “What we’re reminding people is that is sort of true, but that in some women who take a full 10 milligram dose, and in a lot of people who take the control release dose, it is not entirely true. Some people will be impaired in the morning.”

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Nokia Sees Results From New Smartphone Line

BERLIN — Nokia said Thursday that its struggling mobile phone business was showing signs of a rebound, turning a profit in the fourth quarter fueled by sales of its Lumia smartphones that use Microsoft software.

Stephen Elop, the Nokia chief executive, said sales of smartphones and more basic cellphones, as well as profitability at the Nokia Siemens network-equipment venture, all came in better than expected during the three months through December.

“While we definitely experienced some tough challenges in the first half of 2012, we are managing through these issues,” Mr. Elop said in a conference call with journalists.

Nokia has amassed nearly €5 billion, or $6.5 billion, in losses since Mr. Elop, a former Microsoft executive, announced plans to phase out Nokia phones that used its own Symbian operating system for the Lumia line, which uses the Windows Phone 8 software, in February 2011.

Sales of Lumia phones increased only modestly during the early part of 2012, raising concern that the company’s turnaround strategy, marked by cost cutting and the sale of subsidiary businesses, would not be enough to save the former market leader.

But in the fourth quarter, amid heavy television and print ad spending in Europe and North America, Nokia said it sold 4.4 million Lumia phones, up from 2.9 million in the third quarter.

The company said revenue from the sale of 86.3 million mobile phones of all kinds amounted to €3.9 billion in the quarter, without providing comparative figures.

The company’s shares surged as much as 16 percent in Helsinki on the news.

In a statement, Nokia said that it expected operating profit at its devices and services business, which makes up about half of its total sales, to break even or generate a profit of as much as 2 percent of sales in the fourth quarter. In October, Nokia had told investors that it expected the business to make an operating loss of as much as 10 percent of sales.

But sales of its Lumia smartphone and Asha feature phones rose more than expected. Also, Nokia Siemens, its network gear venture, will report an operating profit of 13 percent to 15 percent of sales in the fourth quarter, compared with an expected range of 4 percent to 12 percent.

Looking ahead, Nokia said it expected to return to an operating loss of 2 percent of sales in the first quarter amid the post-holiday buying lull and harsh competition. But the results for the coming three months could vary widely, Nokia warned, from an even bigger 6 percent operating loss to a 2 percent operating profit.

Pete Cunningham, an analyst at Canalys, a research firm in Reading, England, said Nokia’s improving financial position was a positive step. But the company, which ceded its market leadership to Samsung and Apple, is not out of the woods yet.

“On face value, this is a positive for Nokia,” Mr. Cunningham said. “But 2013 could still turn out to be another very difficult year for Nokia. It is way too premature to say that the company has made a turnaround.”

Mr. Cunningham said he used the Lumia 920, Nokia’s newest smartphone, during the Christmas holidays and liked the experience.

“But the more I used the phone, the more apparent it became to me that there are big gaps between Lumia and its competitors in terms of the functionality and usability of its apps,” Mr. Cunningham said. “I still think there is a lot of work to be done on Lumia.”

Mr. Elop said Nokia would continue to innovate to close the gap with competitors. The big issues that Nokia faces, he said, are “managing efficiently, building great products and changing the way we operate. We’re beginning to see that happen.”

Nokia’s shares closed up nearly 13 percent at €3.39 in Helsinki trading.

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Iranian Captives Freed in Major Prisoner Exchange in Syria

ISTANBUL — More than 2,000 prisoners incarcerated by the Syrian authorities were being released on Wednesday in return for 48 Iranians freed by rebels after five months in captivity in what appeared to be the biggest prisoner swap since the uprising against President Bashar al-Assad began almost two years ago.

The exchange, brokered by Turkey and Qatar, came days after Mr. Assad warned on Sunday that he would not abandon the fight against armed adversaries pressing on the approaches to the Syrian capital, Damascus, and brushed aside calls for him to quit.

Word of the exchange dominated news in Iran, the Syrian government’s only Middle East ally, leading the Web site of the official Islamic Republic News Agency. Iran state television showed a brief clip of the released hostages at the Sheraton Hotel in Damascus, grinning, flashing victory signs and holding flowers. In an interview on Iran state TV, the Foreign Ministry spokesman, Ramin Mehmanparast, thanked those involved in the swap for the hostages and expressed happiness that “we managed to get them released.”

Precise details of the exchange, including when the 48 Iranians would be repatriated, remained unclear. Mr. Mehmanparast also said two Iranian engineers who had been abducted earlier in Syria remained captive. But Prime Minister Recep Tayyip Erdogan of Turkey, a regional power broker allied to the Western and Arab nations seeking Mr. Assad’s departure, said he hoped the exchange on Wednesday would lead to freedom for more prisoners in Syria.

“We wish many other innocent people, and people in need, to be released from Syrian jails without delay,” Mr. Erdogan said in a televised news conference in Niamey, Nigeria, where he arrived on an official visit.

“This process needs to be appreciated. We are not in a position to say anything more than, ‘May this produce some good.’ ”

The exchange emerged from months of behind-the-scenes negotiations involving a Turkish charitable foundation, the Humanitarian Relief Foundation, an Islamist-leaning aid organization based in Istanbul and widely known as I.H.H.

The aid group had set up an operation center in Damascus to unite 2,130 prisoners, including 73 women, at one base while another aid team remained in Douma, near the Syrian capital, to oversee the return of the 48 Iranians.

“Captivity is a hard thing,” said Bulent Yildirim, the foundation’s director, who coordinated the exchange in Damascus.

“I saw young women crying, many people lost a lot of weight, and there were also many sick people.”

The Syrian opposition has claimed that the Iranians are members of Iran’s Islamic Revolutionary Guards Corps, but Tehran has denied the assertion, saying the captives are Shiite civilian pilgrims. The Iranians were seized in August while traveling on a bus from Damascus International Airport to a Shiite shrine on the outskirts of the capital, Iran’s Press TV said.

Opposition fighters had threatened to kill the Iranians unless Mr. Assad’s forces halted military operations. But since then the fighting around Damascus has intensified.

Iran is Mr. Assad’s main ally in a region where most Arab states and neighboring Turkey have turned against him. The Iranian captives offered the rebels holding them a source of powerful pressure on the Syrian leader to release opposition prisoners in return.

“We expect the swap to be completed in the next hour,” Huseyin Oruc, a member of the aid group’s executive board said in a telephone interview around midday. He said the captives released by the Syrian authorities included four Turks and a Palestinian.

By midafternoon it was not clear whether the 2,130 prisoners had been freed.

“It is the first time that the ‘humanitarian diplomacy’ we initiated succeeded in releasing such a large group of people at once,” Mr. Oruc said. “There are many more held captive and our efforts to free them will continue without delay.”

The Turkish aid group gained international attention in 2010 for organizing a flotilla of boats heading to Gaza, ostensibly with relief supplies, that prompted a deadly Israeli commando raid in which eight Turks and an American of Turkish descent died. At the time of the raid, the group was reported to have extensive connections with Turkey’s political elite. The episode began an unraveling of Turkey’s once close ties with Israel.

In recent months, the organization has also been part of negotiations to free smaller numbers of prisoners, including two Turkish journalists held in Syria, Reuters reported. It has been active since the early 1990s in charitable works in the Middle East and Africa, focusing most recently on Gaza.

Since the start of the uprising against Mr. Assad, the organization has also cast itself as a leading private charitable organization in Syria, delivering food and other basic supplies and pursuing what it calls “humanitarian diplomacy” to help free captive civilians.

While the numbers involved in Wednesday’s exchange seemed dramatic, some rebel commanders said more modest prisoner exchanges had become a feature of the conflict.

The leader of a rebel fighting group in the central city of Hama, reached via Skype, said pro-government militia members had captured his uncle and two other relatives in a village in the northern Idlib province more than a month ago.

 “The  only  way to release them is capturing  hostages,” the commander said, adding that negotiations were under way to win the release of his relatives in return for 12 captives held by the rebels. Two months ago, the commander said, nine members of the pro-government militia, known as shabiha, were  exchanged for five captured rebels. Syria’s uprising began in March 2011 with peaceful demonstrations, but a harsh suppression broadened into civil war with an estimated 60,000 people killed, according to United Nations estimates.

Sebnem Arsu reported from Istanbul and Alan Cowell from London. Hwaida Saad contributed reporting from Beirut, Lebanon, and Thomas Erdbrink from Tehran.

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Google drops key patent claims against Microsoft

WASHINGTON (Reuters) - Google unit Motorola Mobility has asked a trade panel to drop two key patents from an infringement complaint that it filed against Microsoft, according to a filing at the International Trade Commission.

The ITC has been considering accusations by Motorola Mobility, which has since been purchased by Google, that Microsoft infringed on its patented technology to make its popular Xbox.

Google filed a motion with the ITC on Tuesday, asking that two patents be withdrawn from the case. One patent remains, according to the filing.

The withdrawal was required under an agreement that Google made with the Federal Trade Commission last week settling a pair of long-running antitrust investigations.

The FTC, U.S. Department of Justice and U.S. Patent and Trademark Office assert that companies should not request sales bans when filing patent infringement lawsuits based on patents that are essential to a standard in most cases. Standard essential patents ensure that devices are interoperable.

Microsoft identified the two patents withdrawn from the ITC case as standard essential patents.

"We're pleased that Google has finally withdrawn these claims for exclusion orders (sales bans) against Microsoft, and hope that it will now withdraw similar claims pending in other jurisdictions," David Howard, Microsoft's deputy general counsel, said in an emailed statement.

Google did not immediately respond to requests for a comment.

Microsoft said that standard essential patents had been asserted in cases in Wisconsin and Washington district courts, both of which have been stayed. Sales bans, or injunctions, were requested in both cases, Microsoft said.

The ITC is a popular venue for patent lawsuits because it can bar the importation of infringing products and because it issues decisions relatively quickly.

The International Trade Commission case is No. 337-752.

(Reporting By Diane Bartz; Editing by Maureen Bavdek)

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Oprah to interview Armstrong for Jan. 17 show

LOS ANGELES (AP) — Lance Armstrong has agreed to an interview with Oprah Winfrey in which he is to address allegations he used performance-enhancing drugs during a career in which he won seven Tour de France titles.

According to Winfrey's website on Tuesday, this will be a "no holds-barred interview." It will be the first with Armstrong since his cycling career crumbled under the weight of a massive report by the U.S. Anti-Doping Agency. The report detailed accusations of drug use by Armstrong and teammates on his U.S. Postal Service teams.

It's unclear if the interview at Armstrong's home in Austin, Texas, has already been taped. Nicole Nichols, a spokeswoman for Oprah Winfrey Network & Harpo Studios, declined comment.

The show will be broadcast Jan. 17 at 9 p.m. EST on OWN and Oprah.com.

Armstrong has strongly denied the doping charges that led to him being stripped of his Tour de France titles, but The New York Times reported Friday he has told associates he is considering acknowledging the use of performance enhancers.

The newspaper report cited anonymous sources, and Armstrong lawyer Tim Herman told The Associated Press that night he had no knowledge of Armstrong considering a confession.

Earlier Tuesday, "60 Minutes Sports" reported the head of USADA told the show a representative for Armstrong offered the agency a "donation" in excess of $150,000 several years before an investigation by the organization led to the loss of Armstrong's Tour de France titles.

In an interview for the premiere on Showtime on Wednesday night, USADA chief executive Travis Tygart said he was "stunned" when he received the offer in 2004.

"It was a clear conflict of interest for USADA," Tygart said. "We had no hesitation in rejecting that offer."

Herman denied such an offer was made.

"No truth to that story," Herman wrote Tuesday in an email to the AP. "First Lance heard of it was today. He never made any such contribution or suggestion."

Tygart was traveling and did not respond to requests from the AP for comment. USADA spokeswoman Annie Skinner said Tygart's comments from the interview were accurate. In it, he reiterates what he told the AP last fall: He was surprised when federal investigators abruptly closed their two-year investigation into Armstrong and his business dealings, then refused to share any evidence they gathered.

"You'll have to ask the feds why they shut down," Tygart told the AP. "They enforce federal criminal laws. We enforce sports anti-doping violations. They're totally separate. We've done our job."

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Economic Scene: Health Care and Pursuit of Profit Make a Poor Mix

Thirty years ago, Bonnie Svarstad and Chester Bond of the School of Pharmacy at the University of Wisconsin-Madison discovered an interesting pattern in the use of sedatives at nursing homes in the south of the state.

Patients entering church-affiliated nonprofit homes were prescribed drugs roughly as often as those entering profit-making “proprietary” institutions. But patients in proprietary homes received, on average, more than four times the dose of patients at nonprofits.

Writing about his colleagues’ research in his 1988 book “The Nonprofit Economy,” the economist Burton Weisbrod provided a straightforward explanation: “differences in the pursuit of profit.” Sedatives are cheap, Mr. Weisbrod noted. “Less expensive than, say, giving special attention to more active patients who need to be kept busy.”

This behavior was hardly surprising. Hospitals run for profit are also less likely than nonprofit and government-run institutions to offer services like home health care and psychiatric emergency care, which are not as profitable as open-heart surgery.

A shareholder might even applaud the creativity with which profit-seeking institutions go about seeking profit. But the consequences of this pursuit might not be so great for other stakeholders in the system — patients, for instance. One study found that patients’ mortality rates spiked when nonprofit hospitals switched to become profit-making, and their staff levels declined.

These profit-maximizing tactics point to a troubling conflict of interest that goes beyond the private delivery of health care. They raise a broader, more important question: How much should we rely on the private sector to satisfy broad social needs?

From health to pensions to education, the United States relies on private enterprise more than pretty much every other advanced, industrial nation to provide essential social services. The government pays Medicare Advantage plans to deliver health care to aging Americans. It provides a tax break to encourage employers to cover workers under 65.

Businesses devote almost 6 percent of the nation’s economic output to pay for health insurance for their employees. This amounts to nine times similar private spending on health benefits across the Organization for Economic Cooperation and Development, on average. Private plans cover more than a third of pension benefits. The average for 30 countries in the O.E.C.D. is just over one-fifth.

We let the private sector handle tasks other countries would never dream of moving outside the government’s purview. Consider bail bondsmen and their rugged sidekicks, the bounty hunters.

American TV audiences may reminisce fondly about Lee Majors in “The Fall Guy” chasing bad guys in a souped-up GMC truck — a cheap way to get felons to court. People in most other nations see them as an undue commercial intrusion into the criminal justice system that discriminates against the poor.

Our reliance on private enterprise to provide the most essential services stems, in part, from a more narrow understanding of our collective responsibility to provide social goods. Private American health care has stood out for decades among industrial nations, where public universal coverage has long been considered a right of citizenship. But our faith in private solutions also draws on an ingrained belief that big government serves too many disparate objectives and must cater to too many conflicting interests to deliver services fairly and effectively.

Our trust appears undeserved, however. Our track record suggests that handing over responsibility for social goals to private enterprise is providing us with social goods of lower quality, distributed more inequitably and at a higher cost than if government delivered or paid for them directly.

The government’s most expensive housing support program — it will cost about $140 billion this year — is a tax break for individuals to buy homes on the private market.

According to the Tax Policy Center, this break will benefit only 20 percent of mostly well-to-do taxpayers, and most economists agree that it does nothing to further its purported goal of increasing homeownership. Tax breaks for private pensions also mostly benefit the wealthy. And 401(k) plans are riskier and costlier to administer than Social Security.

From the high administrative costs incurred by health insurers to screen out sick patients to the array of expensive treatments prescribed by doctors who earn more money for every treatment they provide, our private health care industry provides perhaps the clearest illustration of how the profit motive can send incentives astray.

By many objective measures, the mostly private American system delivers worse value for money than every other in the developed world. We spend nearly 18 percent of the nation’s economic output on health care and still manage to leave tens of millions of Americans without adequate access to care.

Britain gets universal coverage for 10 percent of gross domestic product. Germany and France for 12 percent. What’s more, our free market for health services produces no better health than the public health care systems in other advanced nations. On some measures — infant mortality, for instance — it does much worse.

In a way, private delivery of health care misleads Americans about the financial burdens they must bear to lead an adequate existence. If they were to consider the additional private spending on health care as a form of tax — an indispensable cost to live a healthy life — the nation’s tax bill would rise to about 31 percent from 25 percent of the nation’s G.D.P. — much closer to the 34 percent average across the O.E.C.D.

A quarter of a century ago, a belief swept across America that we could reduce the ballooning costs of the government’s health care entitlements just by handing over their management to the private sector. Private companies would have a strong incentive to identify and wipe out wasteful treatment. They could encourage healthy lifestyles among beneficiaries, lowering use of costly care. Competition for government contracts would keep the overall price down.

We now know this didn’t work as advertised. Competition wasn’t as robust as hoped. Health maintenance organizations didn’t keep costs in check, and they spent heavily on administration and screening to enroll only the healthiest, most profitable beneficiaries.

One study of Medicare spending found that the program saved no money by relying on H.M.O.’s. Another found that moving Medicaid recipients into H.M.O.’s increased the average cost per beneficiary by 12 percent with no improvement in the quality of care for the poor. Two years ago, President Obama’s health care law cut almost $150 billion from Medicare simply by reducing payments to private plans that provide similar care to plain vanilla Medicare at a higher cost.

Today, again, entitlements are at the center of the national debate. Our elected officials are consumed by slashing a budget deficit that is expected to balloon over coming decades. With both Democrats and Republicans unwilling to raise taxes on the middle class, the discussion is quickly boiling down to how deeply entitlements must be cut.

We may want to broaden the debate. The relevant question is how best we can serve our social needs at the lowest possible cost. One answer is that we have a lot of room to do better. Improving the delivery of social services like health care and pensions may be possible without increasing the burden on American families, simply by removing the profit motive from the equation.

E-mail: eporter@nytimes.com;

Twitter: @portereduardo

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Richard Ben Cramer Dies at 62; Chronicled Presidential Politics

Richard Ben Cramer, a Pulitzer Prize-winning reporter and the author of “What It Takes,” a prodigious account of the 1988 presidential election that has been widely hailed as among the finest books about American politics ever written, died on Monday night in Baltimore. He was 62.

His daughter, Ruby Cramer, said he died of complications of lung cancer at Johns Hopkins University Medical Center.

Mr. Cramer was awarded a Pulitzer Prize in 1979 for his coverage of the Middle East as a correspondent for The Philadelphia Inquirer, and he wrote a best-selling biography of Joe DiMaggio (“Joe DiMaggio: The Hero’s Life,” 2000), but he was most known for “What It Takes: The Way to the White House,” published in 1992.

At 1,047 pages, the book uses exhaustive research and vigorous, detailed reporting to delve into the passions, idiosyncrasies and flaws of George Bush, Bob Dole, Michael Dukakis, Joseph Biden and other candidates as they fought for the presidency in 1988.

As he reported for the book, Mr. Cramer spent time with the candidates’ relatives, college roommates and sometimes even their elementary-school teachers. He grew close to the candidates themselves and in some cases formed friendships that endured after the election. Mr. Biden later gave him tips on fixing up an old farmhouse that he purchased in Maryland, Mr. Cramer said.

“He made no bones about the fact that he became friendly with the people he reported on,” said Mr. Cramer’s longtime friend Stuart Seidel, an editor at NPR. “He liked Joe Biden and Bob Dole and both Bushes. He did not feel compromised by allowing himself to get close to them. He did not see himself in a confrontational reportorial role — he was telling a story.”

The book is a product of a bygone era, before campaigns tried to micromanage the press corps as they do now — granting interviews, for example, only on the condition that quotations for publication be subject to the campaigns’ approval. It was a time when minute-by-minute coverage of a presidential campaign was a technological impossibility.

“What It Takes” begins with Mr. Bush, then the vice president, throwing out the first pitch at a Houston Astros game in 1986.

“He’ll be cheered by 44,131 fans — and it’s not even a risky crowd, the kind that might get testy because oil isn’t worth a damn, Houston’s economy is down the crapper, and no one’s buying aluminum siding,” Mr. Cramer wrote. “This is a playoff crowd, a corporate-perks crowd, the kind of fellows who were transferred in a few years ago from Stamford, Conn. You know, for that new marketing thing (and were, frankly, delighted by the price of housing), a solid G.O.P. crowd, tax-conscious, white and polite.”

Mr. Cramer was born on June 12, 1950, in Rochester. He received a bachelor’s degree from Johns Hopkins University and later studied at Columbia University’s Graduate School of Journalism. He worked at The Baltimore Sun before joining The Inquirer in the 1970s.

After “What It Is” was published, Mr. Cramer went on to write for Sports Illustrated, Rolling Stone and Esquire, where in 1986 he wrote an article about Ted Williams that became a hallmark of sports journalism. The article, titled “What Do You Think of Ted Williams Now?,” demythologized one of the greatest hitters in baseball.

“It was often said Ted would rather play ball in a lab, where fans couldn’t see,” Mr. Cramer wrote. “But he never blamed fans for watching him. His hate was for those who couldn’t or wouldn’t feel with him, his effort, his exultation, pride, rage or sorrow.”

Mr. Cramer’s first marriage, to Carolyn White, ended in divorce. Besides his daughter, Ruby, from that marriage, Mr. Cramer is survived by his second wife, Joan Cramer. He lived in Chestertown, Md.

Disappointed with the sales of “What It Takes,” Mr. Cramer never again wrote as expansively about politics. He turned his Esquire article about Ted Williams into a book in 2002 and returned to write about the Middle East in “How Israel Lost: The Four Questions,” published in 2005. At his death he was working on a book about Alex Rodriguez of the Yankees.

But campaigns and the news media’s role in them remained an abiding interest. In a 2011 interview with The New York Times, he described political journalists in his day as wielding real power, in contrast to their heirs today, who often appear to be at the mercy of the campaigns they cover.

“Even if you had the wherewithal to embarrass a reporter, there was no mechanism to do it,” Mr. Cramer said. “And in most cases, you might as well save your breath because the reporter had no shame anyway.”

Jennifer M. Preston and Katharine Q. Seelye contributed reporting.

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Quarterback's girlfriend in spotlight after game

TUSCALOOSA, Ala. (AP) — Alabama's routing of Notre Dame for its second straight national championship has been overshadowed in part by a new breakout star — Katherine Webb, girlfriend of quarterback AJ McCarron and Miss Alabama USA 2012.

Webb gained tens of thousands of Twitter followers during and after Monday night's game, when ESPN cameras visited and revisited Webb in the stands and announcer Brent Musburger piled on the compliments. As of noon Tuesday, she had topped 143,000 followers, trumping McCarron's 101,000. Before the game, Webb had only a few hundred.

"Wow, I'm telling you quarterbacks: You get all the good-looking women," Musburger said as the camera focused on Webb, sitting with McCarron's mother. "What a beautiful woman. Wow!"

Arizona Cardinals defensive end Darnell Dockett was among those who noticed Webb during the broadcast. He tweeted her his telephone number and suggested they meet after the game. He later tweeted that he meant to message her privately.

McCarron responded after the game, telling Docket on Twitter, "(hash)betterkeepdreaming like the rest of these dudes."

Webb, a 23-year-old model, told the Columbus Ledger-Enquirer that she first encountered McCarron on Twitter, and they met in early December when he attended the Miss Alabama USA pageant in Montgomery. The two visited over the holidays and publicly confirmed their romance right before the New Year.

"(McCarron) has such an amazing heart. He realizes that family and friends and the people closest to you are most important," she told the paper.

Webb's pageant biography says she was born in Montgomery and grew up in Phenix City. Webb worked for Chick-fil-A as a training director in Columbus, Ga., before moving to Los Angeles to pursue modeling. She finished in the top 10 in the national pageant.

The biography also notes that Webb studied business at longtime Alabama rival Auburn University.

Before Monday's game, Webb tweeted a photo of herself wearing a jersey with McCarron's number, her arms wrapped around the quarterback.

Early Tuesday, Webb posted her first tweet to her new followers: "So extremely blessed... (at)10AJMcCarron. Congrats to Alabama and making history! (hash)BCSChamps."

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Health Spending Growth Stays Low for 3rd Straight Year

WASHINGTON — National health spending climbed to $2.7 trillion in 2011, or an average of $8,700 for every person in the country, but as a share of the economy, it remained stable for the third consecutive year, the Obama administration said Monday.

The rate of increase in health spending, 3.9 percent in 2011, was the same as in 2009 and 2010 — the lowest annual rates recorded in the 52 years the government has been collecting such data.

Federal officials could not say for sure whether the low growth in health spending represented the start of a trend or reflected the continuing effects of the recession, which crimped the economy from December 2007 to June 2009.

Kathleen Sebelius, the secretary of health and human services, said that “the statistics show how the Affordable Care Act is already making a difference,” saving money for consumers. But a report issued by the Centers for Medicare and Medicaid Services, in her department, said that the law had so far had “no discernible impact” on overall health spending.

Although some provisions of the law have taken effect, the report said, “their influence on overall health spending through 2011 was minimal.”

The recession increased unemployment, reduced the number of people with private health insurance, lowered household income and assets and therefore tended to slow health spending, said Micah B. Hartman, a statistician at the Centers for Medicare and Medicaid Services.

In the report, federal officials said that total national spending on prescription drugs and doctors’ services grew faster in 2011 than in the year before, but that spending on hospital care grew more slowly.

Medicaid spending likewise grew less quickly in 2011 than in the prior year, as states struggled with budget problems. But Medicare spending grew more rapidly, because of an increase in “the volume and intensity” of doctors’ services and a one-time increase in Medicare payments to skilled nursing homes, said the report, published in the journal Health Affairs.

National health spending grew at roughly the same pace as the overall economy, without adjusting for inflation, so its share of the economy stayed the same, at 17.9 percent in 2011, where it has been since 2009. By contrast, health spending accounted for just 13.8 percent of the economy in 2000.

Health spending grew more than 5 percent each year from 1961 to 2007. It rose at double-digit rates in some years, including every year from 1966 to 1984 and from 1988 to 1990.

The report did not forecast the effects of the new health care law on future spending. Some provisions of the law, including subsidized insurance for millions of Americans, could increase spending, officials said. But the law also trims Medicare payments to many health care providers and authorizes experiments to slow the growth of health spending.

“The jury is still out whether all the innovations we’re testing will have much impact,” said Richard S. Foster, who supervised the preparation of the report as chief actuary of the Medicare agency. “I am optimistic. There’s a lot of potential. More and more health care providers understand that the future cannot be like the past, in which health spending almost always grew faster than the gross domestic product.”

Evidence of the new emphasis can be seen in a series of articles published in The Archives of Internal Medicine, now known as JAMA Internal Medicine, under the title “Less Is More.” The series highlights cases in which “the overuse of medical care may result in harm and in which less care is likely to result in better health.”

Total spending for doctors’ services rose 3.6 percent in 2011, to $436 billion, while spending for hospital care increased 4.3 percent, to $850.6 billion.

Spending on prescription drugs at retail stores reached $263 billion in 2011, up 2.9 percent from 2010, when growth was just four-tenths of 1 percent. The latest increase was still well below the average increase of 7.8 percent a year from 2000 to 2010.

Federal officials said the increase in 2011 resulted partly from rapid growth in prices for brand-name drugs.

Prices for specialty drugs, typically prescribed by medical specialists for chronic conditions, have increased at double-digit rates in recent years, the government said. In addition, spending on new brand-name drugs — those brought to market in the previous two years — more than doubled from 2010 to 2011, driven by an increase in the number of new medicines.

“In 2011,” the report said, “spending for private health insurance premiums increased 3.8 percent, as did spending for benefits. Out-of-pocket spending by consumers increased 2.8 percent in 2011, accelerating from 2.1 percent in 2010 but still slower than the average annual growth rate of 4.7 percent” from 2002 to 2008.

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Monsanto Profit Balloons on Latin American Sales

WASHINGTON (AP) — Agricultural products giant Monsanto reported Tuesday that its profit nearly tripled in the first fiscal quarter as sales of its biotech corn seeds expanded in Latin America.

The company raised its earnings guidance for the year, briefly lifting its shares to its highest level in more than four years.

The company's sales grew 21 percent to $2.9 billion in the quarter, with most of increase coming from the company's corn seed business.

The St. Louis company earned $339 million, or 63 cents per share in the three months ended November 30. That compares to earnings of $126 million, or 23 cents per share, in last year's quarter.

Monsanto's results easily trumped analyst predictions of 36 cents per share on sales of $2.6 billion in revenue, according to FactSet.

The company's first fiscal period is usually not very profitable, as farming operations slow during the fall months in the U.S. and Europe. But increased sales in Argentina, Brazil, Mexico and other Latin American countries helped drive earnings from September through November.

Monsanto told investors last year that it expects to benefit more from the growing season in the Southern hemisphere. Monsanto predicts that international sales will account for half of its growth in seeds for fiscal 2013, which ends in August.

Sales of the company's largest unit, seeds and genomics, grew 27 percent to $1.1 billion, on demand from farmers in Brazil and Argentina.

Monsanto's corn and soybean seeds have genetically engineered traits meant to produce more crops and repel bugs. The company says these benefit farmers enough that they come out ahead, even though the seeds cost more than conventional seeds.

For all of fiscal 2013, the company expects profit of $4.30 to $4.40 per share.

Analysts predicted profit of $4.39 per share.

Shares added $2.39, or 2.5 percent, to $98.33 in midday trading Tuesday after rising as high as $99.99 earlier in the session. That was the highest price for Monsanto shares since October 2008.

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