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The co-pilot who deliberately downed an airliner over the French Alps this week, killing all 150 aboard, had told a girlfriend sometime last year that he would "do something" that would make people remember his name, a German newspaper reports.

Andreas Lubitz, 27, who reportedly had hidden a note declaring him medically unfit to fly on the day he crashed the Germanwings A320, told a former girlfriend and flight attendant, identified by Bild only as "Mary W." that: "One day I will do something that will change the whole system, and then all will know my name and remember it."

She was quoted by the newspaper as saying she didn't understand what he meant by the remark until she heard of the crash on Tuesday.

She also told Bild that Lubitz had nightmares and had woken up at night and screamed "We're going down!"

Meanwhile, prosecutors in Dusseldorf confirmed that they had found a torn-up doctor's note in Lubitz' apartment that pronounced him unfit to fly.

"Medical documents were found that indicate an ongoing illness and appropriate medical treatment," the prosecutors said in a statement. "The circumstance that torn-up current medical certificates – also pertaining to the day of the act – were found, supports, after preliminary examination, the assumption that the deceased hid his illness from his employer and his professional circles."

According to Euronews:

"Germanwings said Lubitz had not given them a sick note that would have grounded him on the day of the crash.

"German law requires workers to immediately tell their employers if they are unable to work."

But The New York Times reports that there remains "considerable confusion about the precise nature and severity of his psychiatric condition. A German hospital said it had evaluated Mr. Lubitz twice in the past two months but added that he had not been there for assessment or treatment of depression."

And, The Guardian writes:

"No suicide note or claim of responsibility had been found, the prosecutors said.

"Legal experts said that on the evidence that has emerged so far – which suggests the co-pilot may have had a history of depression and psychiatric problems – the airline would find it difficult to prove that the crash was not its fault."

germanwings Flight 4U 9525

Germany

The global aviation industry is moving swiftly to change policies to reassure the traveling public in the wake of the apparently deliberate crash of airliner into the French Alps, killing all 150 aboard.

Airlines from around the world have announced that they will begin requiring two crew members in the cockpit at all times after investigators on Thursday announced that the crash of Germanwings Flight 4U 9525 occurred when the co-pilot locked the pilot out of the cockpit and placed the Airbus A320 into a deliberate descent.

The changes include requiring two people in the cockpit at all times. In the U.S., the Federal Aviation Administration already requires this.

Germanwings crash prompts two-person cockpit rule: Several European airlines are planning a two-person cockpit... http://t.co/XzAmCrJkah

— DW | Germany (@dw_germany) March 27, 2015

Lufthansa, the parent of Germanwings, issued a statement today saying it was moving to the "rule of two" policy as a "precautionary measure."

"Under the new procedure, two authorized persons must be present in the cockpit at all times during a flight," the airline said.

The BBC says: "Air Canada, Westjet and charter airline Air Transat, Norwegian Air Shuttle, major German airlines including Lufthansa and Air Berlin, EasyJet, Monarch Airlines, Virgin and Thomas Cook have all confirmed they are changing their safety policies."

New Zealand's 3 News says: "National carrier Air New Zealand and Emirates – which flies to and from New Zealand – have both issued statements today, saying they would be making the change."

Canada's Federal Transport Minister Lisa Raitt announced that all airlines there will be required to abide by the two crew-member rule.

germanwings Flight 4U 9525

FAA

Airlines

Europe

Got a high-deductible health plan? The kind that doesn't pay most medical bills until they exceed several thousand dollars? You're a foot soldier who's been drafted in the war against high health costs.

Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more. Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they're making medically wise choices.

Shots - Health News

Many Big Employers Plan To Offer Skimpy Health Options Despite Law

Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care.

What nobody knows is whether such plans, also sold to individuals and families through the health law's online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off.

A new study delivers cautiously optimistic results for employers and policymakers, if not for consumers paying a higher share of their own health care costs.

More U.S. Companies Switch To High Deductible Health Plans

Researchers led by Amelia Haviland at Carnegie Mellon University found that overall savings at companies introducing high-deductible plans lasted for up to three years afterwards. If there were any cost-related time bombs caused by forgone care, at least they didn't blow up by then.

"Three years out there consistently seems to be a reduction in total health care spending" at employers offering high-deductible plans, Haviland said in an interview. Although the study says nothing about what might happen after that, "this was interesting to us that it persists for this amount of time."

The savings were substantial: 5 percent on average for employers offering high-deductible plans compared with results at companies that didn't offer them. And that was for the whole company, whether or not all workers took the high-deductible option.

Shots - Health News

As Big Employers Pinch Pennies, Health Savings Accounts Take Off

The size of the study was impressive; it covered 13 million employees and dependents at 54 big companies. All savings were from reduced spending on pharmaceuticals and doctor visits and other outpatient care. There was no sign of what often happens when high-risk patients miss preventive care: spikes in emergency-room visits and hospital admissions.

The suits in human resources call this kind of coverage a "consumer-directed" health plan. It sounds less scary than the old name for coverage with huge deductibles: catastrophic health insurance.

But having consumers direct their own care also requires making sure they know enough to make smart choices. That means getting vaccines and skipping dubious procedures like an expensive MRI scan at the first sign of back pain.

"What happens five years or 10 years down the line when people develop more consequences of reducing high-value, necessary care?"

- Amelia Haviland

Not all employers are doing a terrific job. Most high-deductible plan members surveyed in a recent California study had no idea that preventive screenings, office visits and other important care required little or no out-of-pocket payment. One in five said they had avoided preventive care because of the cost.

"This evidence of persistent reductions in spending places even greater importance on developing evidence on how they are achieved," Kate Bundorf, a Stanford health economist not involved in the study, said of consumer-directed plans.

"Are consumers foregoing preventive care?" Bundorf asks. "Are they less adherent to [effective] medicine? Or are they reducing their use of low-value office visits and corresponding drugs or substituting to cheaper yet similarly effective prescribed drugs?"

Employers and consultants are trying to educate people about avoiding needless procedures and finding quality caregivers at better prices.

That might explain why the companies offering high-deductible plans saw such significant savings even though not all workers signed up, Haviland said. Even employees with traditional, lower-deductible plans may be using the shopping tools.

The study doesn't close the book on consumer-directed plans.

"What happens five years or 10 years down the line when people develop more consequences of reducing high-value, necessary care?" Haviland asked. Nobody knows.

And the study doesn't address a side effect of high-deductibles that doctors can't treat: pocketbook trauma. Consumer-directed plans, often paired with tax-favored health savings accounts, can require families to pay $5,000 or more per year in out-of-pocket costs.

Three people out of 5 with low incomes and half of those with moderate incomes told the Commonwealth Fund last year their deductibles are hard to afford.

As in all battles, the front-line infantry often makes the biggest sacrifice.

health care costs

Affordable Care Act

Health Insurance

Some of the seafood that winds up in American grocery stores, in restaurants, even in cat food may have been caught by Burmese slaves. That's the conclusion of a yearlong investigation by The Associated Press.

The AP discovered and interviewed dozens of men being held against their will on Benjina, a remote Indonesian island, which serves as the base for a trawler fleet that fishes in the area.

AP correspondent Martha Mendoza was one of the lead reporters for the investigation. The men AP found unloading seafood in Benjina were mostly from Myanmar, also known as Burma. When they realized one of the AP reporters spoke Burmese, "they began calling out, asking for help, and explaining that they were trapped and that they were being beaten and that they were enslaved," Mendoza tells NPR's Renee Montagne.

i

Thai and Burmese fishing boat workers sit behind bars inside a cell at the compound of a fishing company in Benjina, Indonesia. The imprisoned men were considered slaves who might run away. They said they lived on a few bites of rice and curry a day in a space barely big enough to lie down, stuck until the next trawler forces them back to sea. Dita Alangkara/AP hide caption

itoggle caption Dita Alangkara/AP

Thai and Burmese fishing boat workers sit behind bars inside a cell at the compound of a fishing company in Benjina, Indonesia. The imprisoned men were considered slaves who might run away. They said they lived on a few bites of rice and curry a day in a space barely big enough to lie down, stuck until the next trawler forces them back to sea.

Dita Alangkara/AP

When the reporter went to the island, she found men held in a cage so that they wouldn't run away. "They were trapped. They had no way to go home; they had not heard from their family in five, 10 years. They were in a desperate situation," Mendoza says.

The Salt

Why Slave Labor Still Plagues The Global Food System

How did the men wind up in this modern-day form of slavery? In some cases, they were lured by promises of a job by brokers in Burma, Mendoza says. The men had pledged to pay the brokers a fee for finding them the job, but when they arrived, they found out the work was in fishing, which they hadn't signed up for, she says. "And they were obliged to not only pay back the broker fee but now they're being told they must pay for food and shelter as they work 22-hour days. The debt becomes bottomless."

Others were kidnapped and forced to work. Still others signed up for the fishing work but decided it was not for them "because they weren't getting paid and it was a terrible situation," she says.

After the AP reporters made this discovery, they began tracking where the seafood went. They watched the seafood get loaded into a cargo ship called the Silver Sea Lion, then used GPS to track it to a port in Thailand.

"We followed as many as we could to the processing plants," Mendoza says. Literally. The seafood was offloaded into some 150 trucks. The reporters — in cars — followed as many of those trucks as they could, taking notes, shooting video and jotting down the names of the plants where the seafood was delivered.

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A 3,000-ton cargo ship at Thajeen Port in Samut Sakhon, Thailand, 15 days after it set sail from Benjina, Indonesia. The company that owns the ship said it is not involved with the fishermen. "We only carry the shipment and we are hired, in general, by clients," said owner Panya Luangsomboon. "We're separated from the fishing boats." Wong Maye-E/AP hide caption

itoggle caption Wong Maye-E/AP

A 3,000-ton cargo ship at Thajeen Port in Samut Sakhon, Thailand, 15 days after it set sail from Benjina, Indonesia. The company that owns the ship said it is not involved with the fishermen. "We only carry the shipment and we are hired, in general, by clients," said owner Panya Luangsomboon. "We're separated from the fishing boats."

Wong Maye-E/AP

Then AP dug into customs records "to see which of those companies was shipping seafood into the United States, on what date, under what label," Mendoza says.

Those labels included Iams, Meow Mix, Fancy Feast, and other types of cat food shipped to the U.S. "And the distributors in the United States who are receiving some of the seafood from these factories also sell to Wal-Mart, Kroger, Albertson's, Safeway and others," Mendoza says.

The response from cat-food makers, grocers, fish sellers and others in the U.S. has "really been remarkable," she says, from "the National Fisheries Institute on down."

They've "all said that they appreciate the information that we brought to them and that they want to do something about this," Mendoza says. "Nobody denied what we found. Everybody wanted more information."

human trafficking

Seafood