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Showing posts with label second. Show all posts
Showing posts with label second. Show all posts

Sunday, September 22, 2013

Wealthy Chinese seek U.S. surrogates for second child, green card

By Alexandra Harney

(Reuters) - Wealthy Chinese are hiring American women to serve as surrogates for their children, creating a small but growing business in $120,000 "designer" American babies for China's elite.

Surrogacy agencies in China and the United States are catering to wealthy Chinese who want a baby outside the country's restrictive family planning policies, who are unable to conceive themselves, or who are seeking U.S. citizenship for their children.

Emigration as a family is another draw - U.S. citizens may apply for Green Cards for their parents when they turn 21.

While there is no data on the total number of Chinese who have sought or used U.S. surrogates, agencies in both countries say demand has risen rapidly in the last two years.

U.S. fertility clinics and surrogacy agencies are creating Chinese-language websites and hiring Mandarin speakers.

Boston-based Circle Surrogacy has handled half a dozen Chinese surrogacy cases over the last five years, said president John Weltman.

"I would be surprised if you called me back in four months and that number hadn't doubled," he said. "That's the level of interest we've seen this year from China and the very serious conversations we've had with people who I think will be joining us in the next three or four months."

The agency, which handles about 140 surrogacy cases a year, 65 percent of them for clients outside the United States, is opening an office in California to better serve clients from Asia which has easier flight connections with the West Coast. Weltman said he hopes to hire a representative in Shanghai next year.

The increased interest from Chinese parents has created some cultural tensions.

U.S. agency staff who ask that surrogates and intended parents develop a personal relationship have been surprised by potential Chinese clients who treat surrogacy as a strictly commercial transaction.

In China, where surrogacy is illegal, some clients keep the fact that their baby was born to a surrogate a secret, going so far as to fake a pregnancy, agents say.

CITIZENSHIP DRAW

Chinese interest in obtaining U.S. citizenship is not new. The 14th Amendment to the U.S. constitution gives anyone born in the United States the right to citizenship.

A growing number of pregnant Chinese women travel to America to obtain U.S. citizenship for their children by delivering there, often staying in special homes designed to cater to their needs.

While the numbers are unclear, giving birth in America is now so commonplace that it was the subject of a hit romantic comedy movie, "Finding Mr Right", released in China in March.

Overall, the number of Chinese visitors to the United States nearly doubled in recent years, from 1 million in 2010 to 1.8 million in 2012, U.S. immigration statistics show.

Weltman said that prospective Chinese clients almost always want to chose U.S. citizenship for their babies, while other agencies pointed to a desire to have children educated in the United States.

Some wealthy Chinese say they want a bolt-hole overseas because they fear they will the targets of public or government anger if there were more social unrest in China. There is also a perception that their wealth will be better protected in countries with a stronger rule of law.

At least one Chinese agent promotes surrogacy as a cheaper alternative to America's EB-5 visa, which requires a minimum investment in a job creating business of $500,000.

While the basic surrogacy package Chinese agencies offer costs between $120,000 and $200,000, "if you add in plane tickets and other expenses, for only $300,000, you get two children and the entire family can emigrate to the U.S.," said a Shanghai-based agent.

That cost still means the surrogacy alternative is available only to the wealthiest Chinese.

Intended parents typically pay the surrogate between $22,000 and $30,000, an agency fee of about $17,000 to $20,000 and legal fees of up to $13,000. If egg donation is required, that can cost an additional $15,000 and pre-natal care and delivery fees can run between $9,000 and $16,000.

Indeed, surrogacy in the United States is so expensive that in recent years hundreds of American parents have reportedly turned to surrogates in India.

CHINESE BABIES, AMERICAN WOMBS

Often it is infertility that sends Chinese couples to U.S. surrogacy agencies. More than 40 million Chinese are now considered infertile, according to the Chinese Population Association. The incidence of infertility has quadrupled in the last two decades to 12.5 percent of people of childbearing age.

Shanghai businessman Tony Jiang and his wife Cherry were among them. They turned twice to domestic surrogates after struggling and failing to conceive on their own. Both attempts were unsuccessful, and left them unimpressed with the impersonal nature of in-vitro fertilization (IVF) treatment in China.

Jiang researched surrogacy in Thailand, India and the Ukraine before settling on the United States, in part because of its superior healthcare system.

In December 2010, he and his wife welcomed a daughter, born in California to an American surrogate he calls "my Amanda". The same surrogate later carried twins for the couple.

Friends began to ask him to help them do the same thing and in 2012, he set up his own agency, DiYi Consulting. He has handled 75 surrogacy cases for Chinese parents so far.

Agents said that while many of their clients struggle with infertility, a substantial portion already have one child - some in their teens - and are looking to have a second outside China's 1979 family planning policy that restricts couples, in most cases, to one child.

They count among their clients government officials and employees of state-owned enterprises, for whom a second child would be a fireable offence. Members of the Chinese Communist Party would also face disciplinary action if a second child were reported.

Families who violate the one-child policy face the prospect of forced abortions, sterilizations and fines, policies that have been most brutally enforced in poor, rural areas.

Technically, Chinese who deliver their second child overseas still violate family planning policies, but in practice the government has little way to enforce this, says Zhong Tao, a Shanghai-based lawyer who has handled similar cases.

Obtaining a Chinese household registration, which is necessary to enjoy subsidized health care and enroll for lower tuition as a local student in state schools, is more complicated, if not impossible for second children.

For children who are foreign citizens, parents must apply for visas and residence permits.

BESPOKE BABIES

Seeking surrogacy overseas is not in itself illegal, and Chinese surrogacy agency websites, often adorned with pictures of chubby infants, highlight the possibility of bespoke babies.

Chinese surrogacy clients typically want to use their own eggs and sperm, which allows them to have a child who is fully biologically theirs, agents said.

A growing number, though, are open to egg donation. Often Chinese donors will seek ethnically Chinese or Asian egg donors, commonly with Ivy League degrees.

But others want tall, Eurasian children, agents said. "Lots of clients that are Chinese do use tall blond donors," said Jennifer Garcia, case coordinator at Extraordinary Conceptions, a Carlsbad, California-based agency where 40 percent of clients are Chinese.

Agents said that clients believe these taller, bi-racial children will be smarter and better looking.

Chinese clients also often request boys, a consequence of a cultural preference for boy children. While sex-selective abortion is illegal - though still common - in China, gender selection is technically straightforward through IVF in the United States, where it is used in surrogacy cases.

Genetic screening also allows intended parents to rule out inherited conditions. "You can basically make a designer baby nowadays," said Garcia.

(Additional reporting by Christine Chan in Singapore; Editing by Alex Richardson)


View the original article here

Wednesday, September 18, 2013

Young women with breast cancer overestimate the benefit of having second breast removed

Sep. 16, 2013 — Young women with breast cancer often overestimate the odds that cancer will occur in their other, healthy breast, and decide to have the healthy breast surgically removed, a survey conducted by Dana-Farber Cancer Institute investigators indicates. The survey also shows that many patients opt for the procedure -- known as a contralateral prophylactic mastectomy, or CPM -- despite knowing it will be unlikely to improve their chance of survival.

The study, published in the Sept. 17 issue of the Annals of Internal Medicine, shows a certain disconnect between what many patients know on an abstract, intellectual level -- that CPM has little impact on survival rates for most women -- and the choices they make after receiving the anxiety-inducing diagnosis of breast cancer, the authors say.

"An increasing percentage of women treated for early-stage breast cancer are choosing to have CPM," says the study's lead author, Shoshana Rosenberg, ScD, MPH, of the Susan F. Smith Center for Women's Cancers at Dana-Farber. "The trend is particularly notable among younger women."

The survey results, explains Rosenberg, suggest that many patients are going into this decision with an unrealistic sense of the benefits of CPM, and of the risks. "Improving the communication of those risks and benefits -- together with better management of anxiety surrounding diagnosis -- and providing patients with the support they need to make decisions based on solid evidence -- are worthwhile steps," says Rosenberg.

In the survey, researchers canvassed 123 women age 40 or younger who had undergone a bilateral mastectomy -- the removal of both breasts -- despite having cancer in only one breast. Respondents answered questions about their reasons for having the procedure, their knowledge of its risks and benefits, and their satisfaction with the outcome.

Almost all the women said they opted for CPM out of a desire to improve their chances of survival and prevent the cancer from spreading to other parts of the body. At the same time, however, most understood that removing both breasts does not extend survival for women who are free of an inherited genetic predisposition to breast cancer.

To explain this apparent contradiction, the authors write, "Most women acknowledge that CPM does not improve survival, but anxiety and fear of recurrence probably influence them during the decision-making process."

The survey also indicated that women who don't inherit an increased genetic risk of breast cancer tend to overestimate the chance that cancer will develop in both breasts. They estimated that 10 out of 100 women with cancer in one breast would develop cancer in the other breast within five years. The actual risk of that happening is approximately 2 to 4 percent.

By contrast, respondents who did have an inherited predisposition to breast cancer -- as a result of a mutation in the genes BRCA1 or BRCA2, for example -- more accurately perceived their risk for cancer in both breasts.

Even as they overestimated the benefits of CPM, many of the participants underestimated the severity of some of its side effects. Many respondents said the effect of CPM on their appearance was worse than they had expected. A substantial proportion of the respondents -- 42 percent -- reported that their sense of sexuality after CPM was worse than expected, although other studies have not found sexual problems to be prevalent.

"Our findings underscore how important it is that doctors effectively communicate the risks and benefits of CPM to women," Rosenberg says. "We need to be sure that women are making informed decisions, supported decisions, based on an accurate understanding of the pros and cons of the procedure, and in a setting where anxiety and concerns can be addressed."


View the original article here

Wednesday, July 4, 2012

Centene sees second quarter loss, cuts 2012 view, shares plunge

AppId is over the quota
AppId is over the quota

(Reuters) - Health insurer Centene Corp said it will post a loss in the second quarter and slashed its earnings forecast for 2012, citing higher costs and claims in Texas and Kentucky, and its Celtic individual health business.

The company's shares plunged 21 percent to $28.00 in premarket trade on Monday.

The health insurer also said it was evaluating the goodwill and intangible assets of its Celtic business and the review may result in a non-cash charge of about $28.0 million. The charge has not been accounted for in the current outlook, it added.

Centene now expects 2012 earnings of $1.45 to $1.65 per share, down sharply from its previous outlook of $2.64 to $2.84 a share.

The company said it expects to return to profitability in the third quarter, even as rising costs at its Texas, Kentucky and Celtic businesses impact results for the rest of the year.

The news comes less than a week after rival Molina Healthcare Inc withdrew its 2012 earnings forecast, claiming it was facing margin pressure in a Texas Medicaid plan.

Molina's Medicaid plans servicing the El Paso and Hidalgo counties in Texas saw high medical costs that outstripped the company's premium revenue from the region.

The El Paso and Hildago service areas experienced significantly higher-than-expected utilization in a contract that became active in March, Jefferies & Co analyst David Windley said in a note on Molina last week.

Centene too said on Monday it saw a significant rise in certain non-inpatient claims in its Hidalgo service area.

Other health insurers, such as Amerigroup Corp and Cigna Corp, which have plans for the El Paso and Hidalgo counties, may also be affected.

Shares of Molina had crashed early last week after it withdrew its full-year outlook, dragging down Centene shares with them. However, both stocks recovered much of the lost value later in the week as Molina and Centene won back a Medicaid contract in Ohio.

Centene shares, which have lost 5 percent of their value since Molina announced its margin issues in Texas, closed at $35.47 on Friday on the New York Stock Exchange.

(Reporting by Esha Dey in Bangalore; Editing by Sreejiraj Eluvangal)