JOHN HANNA, AP Political Writer

TOPEKA, Kan. (AP) — The next insurance commissioner in Kansas says creating a more robust market is a top goal and argues that greater competition will address problems with the federal health care overhaul.

Commissioner-Elect Ken Selzer is confident that he can attract companies into the state and encourage others already in Kansas to do more business.

Selzer is a Republican and takes office Jan. 12. He’ll replacing retiring Commissioner Sandy Praeger.

Praeger also is a Republican but broke with the GOP by praising the federal health care overhaul for expanding insurance coverage. Selzer says he’ll look for ways to push back against federal regulation under the 2010 law championed by Democratic President Barack Obama.

Selzer came back repeatedly during an Associated Press interview to promoting competition as a crucial job for a commissioner.

WASHINGTON (AP) — A $1.1 trillion spending bill is on its way to President Barack Obama for his signature.

The Senate voted 56-40 on Saturday for the long-term funding bill, the main item left on Congress’ year-end agenda.

Senator Moran and McCaskill voted against the measure. Senators Roberts and Blunt voted in favor of the bill.

The measure provides money for nearly the entire government through the Sept. 30 end of the current budget year.

The sole exception is the Department of Homeland Security, which is funded only until Feb. 27. Republicans intend to try then to force the president to roll back a new immigration policy that removes the threat of deportation from millions of immigrants living in the country illegally.

The compromise bill had faced opposition from Democratic liberals upset about the repeal of a banking regulation and Republican conservatives unhappy that it failed to challenge Obama’s immigration moves.

BY REBECCA FRENCH SMITH

On my mantle, there sits an elf. He is not of the “Shelf” variety. He is old, and not because of the curly white beard he wears, which my 5-year-old niece says is “weird” because he doesn’t look like her clean-shaven Elf. No, the bendable wire in his legs and arms has been repositioned year after year ever since I can remember. He has been with me a long time — a Christmas tradition from my childhood.

My elf tradition and more have made their way into our family over time. New ornaments every year, an advent calendar and the hanging of handmade stockings have become part of our Christmas. I’m fairly certain I wouldn’t get away with dropping oranges in those stockings, like I had as a kid, but if the advent calendar isn’t stocked full of candy on December 1, I will hear about it. The kids overlook the occasional inclusion of ribbon candy, but that is more for me.

Apart from the oranges in the stockings and ribbon candy on the coffee table, our Christmas meal has some traditions of its own. Many memories and traditions revolve around food, and certain dishes must make the menu. If they do not, it risks becoming one of those stories told every year, “Do you remember that year we didn’t have Grandma’s noodles?” Whether it’s turkey or roast matters not, as long as those noodles and broccoli casserole are on the table.

The dishes that mean the most have a history, a story to tell and a connection beyond the food. To change the recipe in any fashion is not allowed, nor is skimping or taking shortcuts. Using store-bought noodles instead of scratch, for example, is not a good idea. (Don’t ask how I know; that’s another story.)

As a result, the cooking of the holiday meal involves more thought and planning. I am appreciative of those who provide the ingredients, wherever they farm, because as Santa knows, some of those items don’t grow in December in Missouri, or any other time of year for that matter. Come to think of it, he is the culprit responsible for those oranges in my stocking. Perhaps he understands that we need farmers from many places to enjoy certain foods year-round.

As for new recipes or rituals, we have those from time to time, too. Some stick. Some don’t. Every year, though, I try and sneak in a new dish or dessert. What did we ever do without Pinterest? It certainly makes discovering that next tradition easier — as long as it doesn’t replace my elf or Grandma’s noodles.

Rebecca French Smith, of Columbia, Mo., is a multimedia specialist for the Missouri Farm Bureau, the state’s largest farm organization.

By MIKE SHERRY

A business-led group based in Kansas City, Mo., is leading an effort to quadruple Missouri’s lowest-in-the-nation cigarette tax and direct the proceeds to early childhood health and education programs.

Organizers of the “Raise Your Hand for Kids” campaign on Friday outlined their plan for a statewide ballot initiative to an audience of about 100 business, education, health and early-childhood leaders at the Greater Kansas City Chamber of Commerce.

The campaign aims to increase Missouri’s cigarette tax from 17 cents to 67 cents a pack.

Campaign leaders estimated the increase would generate $250 million in state proceeds, which they said is about seven times more than Missouri currently spends on early childhood care and education programs.

About a fifth of the tax dollars would return to counties in the Kansas City area, including nearly $31 million to Jackson County.

“This is a huge win for kids,” said Erin Brower, vice president of the Alliance for Childhood Education (ACE), the group spearheading the campaign.

ACE is a coalition of business leaders looking to improve college and workforce readiness among Missouri students. Its board includes executives from a number of Kansas City-area companies, including U.S. Toy Co., Hallmark, and U.S. Engineering.

“Is it going to solve all of our problems? No,” Brower added. “Is it going to give us that seed money to really get these programs going? Yes. We think so.”

ACE hopes to get the cigarette tax increase on the ballot in November 2016. Convenience store owners, who opposed previous, unsuccessful campaigns to increase the tax, have indicated they’re willing to negotiate with campaign leaders.

Under the plan, the state would redistribute the new cigarette tax dollars to counties based on the number of children up to the age of five living in each county. County leaders would then designate the worthiest programs in their area.

Brower said local control was important because of voter mistrust of Jefferson City. But working out how counties will make funding decisions has proven to be one of the thorniest aspects of the plan.

“The more we learn, the harder we know it is going to be,” she said.

Friday’s meeting, designed to get input from local experts, was one of several the campaign has held around the state in recent months.

Leaders hope to wrap up the meetings by February and submit a proposal to state election authorities by May.

Brower said Raise Your Hand for Kids is trying to avoid mistakes that killed proposed tobacco tax increases in 2002, 2006 and 2012.

In general, she said, those efforts failed because voters perceived them as being dominated by urban interests in St. Louis or Kansas City, the laundry list of proposed funding priorities was too hard to digest or the tax increase was seen as too high.

Brower said efforts to keep this campaign simple extended even to discussions about the amount of the proposed tax increase.

“People understand 50 cents – two quarters,” she said. “That is pretty easy to explain.”

Previous efforts to raise the tax ran into opposition from the Missouri Petroleum Marketers and Convenience Store Association.

The association’s executive director, Ron Leone, said in a phone interview that his organization had never rejected a cigarette-tax increase out of hand. He said the association had always said it could support a reasonable increase.

Leone said, however, that he considered a 50-cent increase unreasonable because it erases Missouri’s advantage of having a lower cigarette tax than neighboring states.

He said the two sides might be able to craft a compromise if, for example, the tax-hike campaign lowered the increase as part of a deal that included an excise tax on so-called e-cigarettes, which are growing in popularity.

“We are always open to taking control of our own fates in supporting a tax increase we can all live with,” Leone said.

He said the association would also like assurances that there won’t be additional petition initiatives after the November 2016 election to raise the tax even more.

Some of the comments from the speakers and audience stressed that the tax increase was an investment in a future workforce and a pro-economic-development measure.

Stephen Green, superintendent of Kansas City Public Schools, urged campaigners to focus on the moral and ethical aspects of providing services to children. He also said they should ensure that only high-quality programs receive the tax dollars.

Missouri and Kansas typically rate in the bottom half of surveys of states’ tobacco prevention and cessation programs.

In the 2014 America’s Health Rankings, an annual survey by the United Health Foundation, Missouri ranked 41st in the nation with an adult smoking rate of 22.1 percent. Kansas ranked 31st at 20 percent. The national average is 19 percent.

Brower said research shows that a 250 percent increase in the cigarette tax is a key price point in deterring children from taking up smoking.

Anti-smoking advocates in Kansas have launched their own anti-smoking campaign through a coalition called Kansans for a Healthy Future. Partners include the Kansas Health Foundation and the American Heart Association.

The coalition is not actively seeking an increase in the Kansas cigarette tax. Rather, it’s stressing to lawmakers that pricing strategies are an effective deterrent to smoking, along with clean-indoor-air ordinances and tobacco-prevention programs, said Tracy Russell, tobacco prevention manager with the Kansas chapter of the American Heart Association.

Russell said that polling done last year by the American Cancer Society found that 70 percent of Kansans supported a $1.50 increase to the state cigarette tax.

According to a coalition fact sheet, such an increase would generate an additional $87.5 million in annual cigarette tax receipts.

Russell also noted that the state last raised its cigarette tax in two stages in 2002 and 2003.

“It certainly begs the question of whether it is time to revisit that,” she said.

According to the coalition, youth smoking rates in Kansas dropped from 26 percent to 21 percent after the last increase.

Mike Sherry  is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

By Eric Whitney for Kaiser Health News

For centuries, the central challenge in health care was ignorance. There simply wasn’t enough information to know what was making a person sick, or what to do to cure the patient.

Now, health care is being flooded with information. Advances in computing technology mean that gathering, storing and analyzing health information is relatively cheap, and it’s getting cheaper by the day. As computers continue to fall in price, the cost of sequencing a single person’s genome is tumbling, too.

Entrepreneur Dr. Patrick Soon-Shiong is working on wearable, real-time monitors to give doctors the ability to “interrogate” a person’s individual blood cells “all the way down to the atom level” to see how a given drug works or why it fails.

Information from patients around the globe could then be compared, in theory. Computers could ultimately help doctors match specific treatments at the molecular level to the people for whom they would work best. Software might also detect patterns in data that would suggest new uses for existing drugs.

Collecting biochemical and genomic data on billions of people around the world is just the tip of the data iceberg that a few dozen health information technology experts described recently in New York at a gathering sponsored by Forbes magazine.

“You now have all of health care digitized, which is pretty cool,” said Paul Black, president of the electronic health records company Allscripts.

But it’s still unclear how to make sense of all the digital information on a big-picture scale. “There’s different approaches in the marketplace to how you would make this all be actually valuable to people,” Black said.

Some doctors are finding it valuable to “see the community information, versus just the campus information,” he said. Meaning: If they know where their patients are going for health care beyond their hospital or office, and whether they’re actually filling all the prescriptions they’ve been given, doctors make different treatment decisions nearly 70 percent of the time, Black said.

Companies like Castlight Health are betting that they can come up with ways to analyze seemingly unrelated data about how and why people use health care to improve health and save corporations money.

Castlight’s Dr. Dena Bravata said, “We can now actually marry information from [corporate human resources] systems — Are you a high performer in your company? What’s your absenteeism been? — with medical claims to really understand that, among our high performers, we’re having a lot of absenteeism because their kids’ asthma is not well controlled.”

There are concerns about privacy and data security. Blackberry CEO John Chen pitched his company’s mobile devices as secure enough to meet federal medical privacy laws. But the Forbes event was more focused on the potential benefits in the new Big Data world.

There’s a lot of optimism that having a more complete picture of people’s health and how they use the health care system will save insurance companies money and drive health care premiums down. Kevin Nazemi, co-CEO of Oscar Insurance, believes that a new generation of wearable wireless sensors will soon help doctors detect health problems early enough to prevent expensive treatments.

But, Nazemi said, it’s still hard for insurance companies to justify investing up front in data systems when “the value is reaped in year four or five in a market where [people switch insurance] on average every three years. You know, dollar in, 25 cents back. How do you think of that?”

David Goldhill, who runs a cable TV network and is the author of the book “Catastrophic Care,” is skeptical that technological breakthroughs, even if they make people healthier, will ever tame health care spending.

“We didn’t go from 4 percent to 17 percent of GDP on health care spending because Americans got a lot less healthy,” he said. “The increase in spending in health care isn’t because, ‘Oh my God, we’re sick and if we can just cure ourselves, it’s going to go away,’” he said. “It’s a business model issue, it’s the way we subsidize and manage demand.”

Some see a future when wirelessly enabled skin patches are cheap, common and accumulating personal health data on a massive scale, and all that information leads to better cures and detects health problems before they blossom into expensive diagnoses. Others predict an era where every minute abnormality, dangerous or not, is identified and money is spent needlessly treating it.

Yale School of Medicine cardiologist and Shots contributor Harlan Krumholz is optimistic about medicine’s ability to reel in meaningful insights in that vast sea of data. But, he says, it’s going to require a major shift in culture in clinics and hospitals. He says it’s still the norm for doctors to rely on their memories to determine whether a given drug is right for a particular patient, “as if nobody’s walking with a computer on their holster.”

Kansas Department of Wildlife, Parks and Tourism

PRATT – It’s a new year, you’ve got your tackle bag in order, your reels all have new line, and your buddy just called saying he found a school of fish and he’s catching them faster than he can reel them in. You hightail it to the lake and begin to unload your gear only to realize you forgot to buy your 2015 fishing license. So much for hitting that honey hole. Most annual licenses and permits expire Dec. 31, but you can avoid missing out on another fishing hot spot by buying early. Licenses and permits for the 2015 hunting, fishing seasons, as well as park permits, go on sale Dec. 15, 2014 and are valid through end of 2014 and all of 2015.

Licenses and permits can be purchased online at ksoutdoors.com, at any Kansas Department of Wildlife, Parks and Tourism state park or regional office, and at any license vendor.

Still have a few people on your Christmas list to buy for, but are stumped on what to get them? Consider giving the gift of a permit or license. It’s a gift that will last all year long, and make memories that will last even longer.

Licenses and permits that will go on sale Dec. 15 include:

-Hunting licenses and annual permits

-Fishing licenses and annual permits

-Furharvesting licenses

-State park vehicle, camping, and trail permits

For more gift ideas, including magazine subscriptions to Kansas Wildlife & Parks magazine, visit the KDWPT Outdoor Store online at ksoutdoors.com/outdoor-store. And, the state’s premier travel magazine, Kansas!, is available at www.travelks.com/ks-mag.

To purchase a license or permit online, visit ksoutdoors.com and click “Licenses/Permits.”

NEDRA PICKLER, Associated Press

WASHINGTON (AP) — President Barack Obama says the U.S. must remain vigilant in the Ebola fight even though there have been no recent domestic transmissions.

Obama says as long as the disease is spreading in West Africa, it’s likely to come back to the United States. He said, “This is not a problem that’s going to go away any time soon.”

Obama made the remarks at the White House as he met with his national security and public health teams to receive an update on the Ebola response.

Obama praised doctors and nurses fighting the spread in Africa. He says he was very pleased earlier this week to see Time Magazine make those health workers its Person of the Year. He says the courage, skill and professionalism they display makes him proud.

DAVID CRARY, AP National Writer

For years, backers of same-sex marriage have said more voters would support it if only they could hear directly from gay people with a personal stake in the issue. A new academic study bears out that hunch.

In an article released this month by Science magazine, researchers from Columbia University and the University of California-Los Angeles detail a study which found that openly gay canvassers were far more effective than straight canvassers in shifting voters’ views toward support for same-sex marriage.

According to the study, opinion changes produced by the straight canvassers tended to fade within a few weeks and those voters reverted to their previous views. Changes produced by the gay canvassers persisted nine months later, and the attitude changes often spread to other members of the voters’ households.