By Bill Barrow
Capital bureau
BATON ROUGE -- Marking the latest wrinkle in the ongoing
saga over a proposed New Orleans
teaching hospital, a House panel approved a bill Wednesday that could slow
the state's acquisition of lower Mid-City land where the complex is to be
constructed.
But state authorities say they are within weeks of
securing much of the necessary land, with no intentions of altering course as
House Bill 780 by Rep. Rick Nowlin, R-Natchitoches,
moves through the Legislature.
"I have no plans to stop what I'm doing," said
Pam Perkins, general counsel for the Division of Administration.
Perkins is leading the team conducting title searches,
appraisals, negotiations with property owners and, where needed,
expropriation of 70 acres for the state teaching hospital and adjacent U.S.
Department of Veterans Affairs hospital.
Nowlin's bill would bar the
state from buying or taking land for the state hospital until the
Legislature's Joint Budget Committee approves a "financing plan"
for what is projected as a $1.2 billion, 424-bed complex bound by South
Claiborne Avenue, Tulane Avenue, Galvez Street and Canal Street.
Perkins and state facilities chief Jerry Jones did not
explicitly oppose Nowlin's bill but said it further
complicates a project already beset by delays, including the state's dispute
with the federal government over how much Louisiana
is owed for Hurricane Katrina damage to Charity Hospital.
The Legislature has dedicated $300 million to a Charity
replacement, with $75 million for land and relocation assistance; the Joint
Budget Committee has previously approved two business plans, the most recent
a revised version released last summer at Gov. Bobby Jindal's
behest.
But the construction budget assumes a $492 million Charity
reimbursement and subsequent $400 million bond sale to be repaid by the
hospital's future operating revenue. Neither the state nor the Louisiana
State University System, which runs the public hospital system, has detailed
when they might go to the bond market or what their backup plan is if the
federal government doesn't come through.
Nowlin and his supporters cast
the bill as a protection against the state amassing land only to leave it
vacant.
"My biggest fear is that our neighborhood will be
leveled, with the land cleared, and the funding will run out and, all that
will be left is 70 acres of nothing with a fence around it," lower
Mid-City resident Kevin Krauss said.
Perkins told lawmakers that 80 percent of the parcels in
the state footprint are vacant, suggesting that residents and
preservationists are overselling the cultural value of the land.
The city of New
Orleans issued a moratorium on construction and
rebuilding permits in the footprint in late 2007.
State Treasurer John Kennedy questioned the construction
budget and said the latest business plan is obsolete given the impending
federal health-care changes.
LSU health-care Vice President Fred Cerise did not testify
but said afterward that Kennedy's concern is unfounded. Cerise said that even
if Congress changes the way health-care money is distributed, it is almost
certain to expand coverage. That confirms LSU's and the state's assumptions
about a paying-patient base larger than that which Charity historically
enjoyed, he said.
That difference of opinion spilled over into a heated
hallway exchange.
Cerise confronted Kennedy and chided him for telling
lawmakers LSU has no business plan.
"I can give it to you, but I can't make you read it,"
Cerise said, later telling the treasurer to "shut up."
Kennedy shot back, "That business plan is not worth
the paper it's written on. You take that business plan to (the bond market
in) New York
and they will laugh you out of the room. This entire process has been bull --
-- from the beginning, Fred, and you know it. . . . Every time I start asking
questions, you guys tell me to shut up. Well, I'm not shutting up."
http://www.nola.com/news/t-p/capital/index.ssf?/base/news-7/1243488720243390.xml&coll=1&thispage=2
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By Bruce Eggler
Staff writer
After months of calling for such a meeting, critics of
plans for new Veterans Affairs and Louisiana
State University
hospitals in New Orleans
will get a chance to voice their opinions to a city agency tonight.
Many of the critics, however, are likely to be
disappointed with the results and even the format of the session.
The City Planning Commission will hold the meeting in the
City Council chamber at City Hall. It is scheduled to begin at 4 p.m. and to
run as long as five hours.
Under special rules approved Tuesday by the commission, members
of the public wishing to speak must sign up by 7 p.m. They will be limited to
three minutes each and may not ask to allocate their time to another speaker.
The commission has emphasized that it has no jurisdiction
over the $2 billion hospital projects in lower Mid-City and intends to take
no action as a result of today's session, which is being termed a
"special forum" rather than a public hearing because the commission
has nothing on its agenda requiring a vote.
Planning Director Yolanda Rodriguez said information
gathered at the meeting will be reviewed by those writing the city's master
plan, now under preparation by a team of consultants led by the Boston planning firm
Goody Clancy.
Under the format approved by the commission, the forum is
scheduled to begin with presentations of as long as 15 minutes each by the
city's Office of Recovery and Development Administration, the LSU system, the
Foundation for Historical Louisiana and, perhaps, FEMA. The U.S. Department
of Veterans Affairs also was invited but is not expected to participate.
The historical foundation hired the well-known
architectural and planning firm RMJM Hillier to conduct an independent
assessment of the Charity
Hospital building that
has been closed since Hurricane Katrina. That study found the building to be
structurally sound and suitable for renovation into a modern hospital.
Critics of the LSU plan say renovating Charity would be
cheaper and quicker than building a new state hospital, would put one of the
city's landmark buildings back into commerce and would avoid the need to
demolish several blocks of a historic neighborhood.
LSU officials have said the idea of renovating the
70-year-old, storm-damaged Charity is unrealistic.
Even though the foundation will be allowed to present its
conclusions, some opponents of the LSU plan have complained that their side
will be given less time to present its case than the combined time offered to
those favoring the LSU and VA plans.
Mayor Ray Nagin last year signed
an agreement to amass the land for the VA hospital, which would occupy the
upper portion of a footprint bounded by South Rocheblave Street,
Tulane Avenue, South
Claiborne Avenue and Canal
Street. Galvez Street would divide the VA
campus from a new state academic medical center anchored by LSU.
The VA hopes to open its hospital in 2012. The state is
aiming for a 2013 opening, though financing questions remain for the
estimated $1.2 billion venture.
Several dozen community and national groups, including
preservationists, neighborhood associations and the American Planning
Association, have criticized the current planning process for the hospitals
as insufficient.
They have called for an independent review of the plans
and for making the plans subject to the city's master plan process. They also
want the City Council to express its opinion on the LSU and VA proposals --
something the council has shown no inclination to do.
The National Trust for Historic Preservation filed a
lawsuit May 1 trying to block land acquisition and construction work for the
two hospitals.
The suit, filed in the U.S. District Court for the District of Columbia,
named the U.S. Department of Veterans Affairs and FEMA as defendants. FEMA is
involved because the state plans to help pay for its portion of the project
using its yet-to-be-determined federal reimbursement for Katrina damage to
Charity.
The suit alleges that the VA and FEMA erred when they and
the city declared as part of a required federal review that building the
hospitals would have "no significant impact" on the Mid-City
neighborhood. If the court agrees, hospital construction would be delayed
significantly, though not necessarily derailed or steered away from the
current site.
http://www.nola.com/news/t-p/neworleans/index.ssf?/base/news-10/1243488705243390.xml&coll=1
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Susan Edwards / Eyewitness News
Watch video:
http://www.wwltv.com/topstories/stories/wwl052709cblsuhospital.226dbe6d.html
NEW ORLEANS – Supporters of
a new LSU Medical
Center have remained tight-lipped
about their plans for the project and why it is needed for New Orleans, until now.
Video: Watch the Story
Some worry the prolonged silence, coupled with strong,
vocal opposition could harm their efforts to build brand new.
"Yes, we have been silent, but I'm tired of it. I've
decided I'm going to speak out," said Dr. Randolph Green, chairman of the
LSU Health Sciences Center Foundation.
Green is also a staunch supporter of an all new, LSU Academic
Medical Center,
and worries if supporters of the project continue their silence, a potential
$1.2 billion dollar economic engine for New
Orleans and the state could be lost for good.
"There are reasons we have held back, but I feel we
have been bombarded from every direction and all we want to do is do
something positive for city," said Green.
He blames political agendas, preservationists and other
detractors who he says have spread false information about a project he says
would only bring more jobs, more money – and greater improvements to a city
still reeling from Katrina.
"The fact is that these are blighted areas of our
community that will remain blighted unless we seize the opportunity to change
it and the neighborhood into something very special," Green said.
As part of LSU's now open approach, Dr. John Lombardi, LSU
system president, came to New
Orleans Wednesday night to explain why a new medical
center is essential, and how they can make it happen where all universities
here would be supported, and so the state isn't forced to fit the entire
bill.
"We figured out through LSU a mechanism to have a
private not-for-profit corporation affiliated with LSU capable of getting
bonds, building a medical center. We are in the process of accomplishing
that. It is the same mechanism we used to build Tiger Stadium so we know it
works," said Lombardi.
The key is getting the backing of all, but some residents
who support restoring Charity Hospital are still hesitant, and point to the
latest action in Baton Rouge,
as a small success in their direction.
"House Bill 780 has the opportunity to say look, show
us the financing, the reality, and don't do anything until it is in
place," said Brad Ott, who heads a committee
to restore Charity
Hospital.
"There have been residents who say we support a hospital, and we are glad to move if given a fair price
and it is not going to be a wasted move," he said.
Green worries such action in the midst of a fight with
FEMA over federal dollars – and in looking toward Washington for support – puts the project
in further limbo.
"Every time we have detractors, people throwing shots
at us left and right about this project, about LSU trying to create a medical
complex empire, they (in Washington) are watching and realize if we can't get
our act together, that money is out the window," said Green.
As for the ongoing feud with FEMA on the $492 million, Dr.
Lombardi said they are suing FEMA and pursuing all administrative and legal
avenues to get those funds, critical to a new LSU Medical
Center.
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Paul Murphy / Eyewitness News
Watch video: http://www.wwltv.com/topstories/stories/wwl052709cbhospital.2216f756.html
NEW ORLEANS – A north Louisiana state representative is now getting in the
middle of the fight over a new LSU teaching hospital in New Orleans.
Video: Watch the Story
“This is not a local issue," state Rep. Ricky Nowlin, R-Natchitoches told the House Health and Welfare
Committee. "This is not a New
Orleans issue."
Nowlin's bill would block the
state from buying land for the new hospital until lawmakers approve a plan to
pay for the new facility.
New Orleans
state Rep. Neil Abramson chided Nowlin for taking
up an issue in his district.
"As the committee may know, this new hospital as
planned will be in my district and Representative Nowlin
has shown an unusual interest in my district this term," said Abramson,
D-New Orleans.
Heated argument over hospital plans
Nowlin responded,
"Representative Abramson, I'm interested in anything that affects a
billion dollars in the state of Louisiana."
Debate over the bill gave opponents to the new hospital a
rallying point.
Some Mid-City property owners testified that that they
should not be displaced by the project, if there is any possibility at all
the state won't be able to afford to build it.
"My biggest fear is that our neighborhood will be
leveled, with the land cleared and the funding will run out and all that will
be left is 70 acres of nothing with a fence around it," said Kevin
Krauss, who said he moved to Mid-City after Hurricane Katrina.
"LSU and the powers that be have decided to
expropriate my building, and I ask myself why did I come
back here?" said Michael Weiser of Weiser Security. "The state
clearly thinks that I'm disposable."
State Treasurer John Kennedy told the committee there is
no business plan for the new hospital.
"It's probably an understatement to say that there's
a great deal of uncertainty that surrounds this project," Kennedy said.
After the panel approved the legislation, LSU Vice
President for Health Services Fred Cerise followed Kennedy out into the
hallway and the two state officials started arguing.
"I can't go for a billion dollars without a sound
business plan," Kennedy argued. "There is not a business
plan."
A clearly agitated Cerise shot back, "I understand
your concern, but you can't change the facts with your concern and testify
there is no business plan when there is a business plan."
Kennedy responded, "When you get one, I'll be glad to
review, but there is not a business plan."
Cerise ended the argument saying, "There is a plan,
but I can't read it for you John."
The LSU VP said two governors and the legislature has already signed off on a funding plan.
He said state lawmakers have already committed $300
million, FEMA would kick in $492 million to cover the cost of shuttering the
old Charity Hospital and LSU would borrow the rest
of the $1.2 million by leveraging future revenue at the new hospital.
But, Cerise admits so far FEMA is only offering to pay
$150 million.
"The biggest uncertainty is are
we going to get the full amount of money that FEMA owes the state for this
project," Cerise said. "Without that, I think we're all in
agreement that you can't move forward on this project."
"You take the business plan that he talks about
that's a year or two old, and you take that to the rating agencies and
investment bankers in New York
and say I want to borrow a half a billion to a billion dollars, and they're
going to laugh you out of the building," said Kennedy.
The Nowlin bill now heads to the
full house for more debate.
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Associated Press
BATON ROUGE, La. (AP) - The expropriation and purchase of
land for a new LSU hospital in New
Orleans would be stalled until lawmakers review and
approve financial plans for the hospital, under a bill approved yesterday by
the House Health and Welfare Committee.
Representative Rickey Nowlin, of
Natchitoches,
said he wasn't trying to slow plans for the new medical teaching hospital run
by LSU, to replace the one flooded by Hurricane Katrina four years ago.
But he said lawmakers should have more clarity from LSU
about the plans before land is expropriated, including the costs to the state
and the impact on local landowners and historic property slated to be
expropriated.
Nowlin's bill would block the
state from buying or expropriating land for the hospital until a
"financing proposal" is approved by the Joint Legislative Committee
on the Budget. The Health and Welfare Committee agreed without objection to
send the measure to the full House for debate.
http://www.wxvt.com/Global/story.asp?S=10435907&nav=menu1344_2
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New Orleans CityBusiness |
05.27.09
by The Associated Press
BATON ROUGE — The expropriation and purchase of land for a
new LSU hospital in New Orleans would be stalled until lawmakers review and
approve financial plans for the hospital, under a bill approved today by the
House Health and Welfare Committee.
Rep. Rickey Nowlin,
R-Natchitoches, said he wasn't trying to slow plans for the new, LSU-run
medical teaching hospital, which would replace the one flooded by Hurricane
Katrina four years ago.
But he said lawmakers should have more clarity from LSU
about the plans before land is expropriated, including the costs to the state
and the impact on local landowners and historic property slated to be
expropriated.
"I'd like to know on the front end what we're doing
and why," Nowlin said.
Nowlin's House Bill 780 would
block the state from buying or expropriating land for the hospital until a
"financing proposal" is approved by the Joint Legislative Committee
on the Budget. The Health and Welfare Committee agreed without objection to
send the measure to the full House for debate.
The budget committee has twice approved plans submitted by
LSU and the current and former governors' administrations on the hospitals.
What must be contained in the proposal required under Nowlin's
bill that would be different from those plans isn't defined.
The proposed hospital has run into complaints from
historic preservationists and some New Orleans
residents who say it would be cheaper and cause less damage to historic
buildings to rebuild the now-shuttered Charity Hospital.
LSU is operating a temporary hospital while the state
haggles with the Federal Emergency Management Agency over how much federal
rebuilding money the state will receive to replace the damaged hospital. Some
lawmakers question whether the state can afford the $1.2 billion proposed
replacement facility.
Jerry Jones, the chief manager of state construction
projects for the Jindal administration, questioned
whether Nowlin's bill could slow land acquisition
for the hospital and could damage a planned collaboration with the U.S.
Department of Veterans Affairs to share some costs and services.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=24952
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Frank de Caro
If the development of the LSU and VA hospitals in New Orleans is derailed,
it will not be because of "misguided preservationists." It will not
be because of anyone's desire to preserve an architectural landmark which,
after all, no one has said would be destroyed (presumably, the old Charity
Hospital building would be reused in some way). It will be because LSU and
the state have pursued their plans so stupidly.
For their most basic funding they have relied on money
from FEMA, which will never materialize. They seek to destroy a neighborhood
in a city where so many neighborhoods were already destroyed by Katrina.
They ignored environmental regulations, opening their
project to an inevitable lawsuit. They tried to leave out key local players
like Xavier and Tulane universities.
The plans for the new hospital complex, in which the
sharing of LSU and VA facilities was such an important selling point, turned
out to be unclear, at best, on facilities-sharing.
And then we discover that the costs that have been set out
as paying for the expensive new complex cover only partial completion:
"Phase 1" of the project. Plans for "Phase 2" are vague
and have no time line, and much of the land to be appropriated will remain
vacant indefinitely. So of course opposition to the new hospital project has
developed, not only from preservationists.
One group of preservationists has come up with a plan they
say is better, and perhaps it is. But LSU and the
state seem unwilling to consider anything but their own very compromised
design, though surely it is time for them to look at alternatives.
Frank de Caro
New Orleans
http://blog.nola.com/letterstotheeditor/2009/05/if_hospital_falls_through_blam.html
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Donna Stelly Jorden, RRT and Lana Credeur-Gammage,
RRT, AE-C
LAKE CHARLES - LSU Health Care Services Division - W. O.
Moss Regional
Medical Center
–
Donna Stelly Jorden,
RRT recently passed the National Asthma Educator Certification
Examination.
She joins Lana Credeur-Gammage,
RRT, AE-C as W.O. Moss
Regional Medical
Center’s second board
certified asthma educator. An AE-C is
an expert in teaching, educating, and counseling individuals with asthma and
their families in the knowledge and skills necessary to minimize the impact
on their quality of life.
Donna is a registered respiratory therapist and holds a
Bachelor of Science degree from Louisiana
State University. Lana is also a registered respiratory
therapist and has an Associate of Arts degree from Allegany College of
Maryland and a Bachelor of Arts degree from West Virginia University.
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LSU Health
Sciences Center | 05.28.09
Leslie Capo
New Orleans, LA – Xiaoming, Xu, PhD, Associate Professor and Director of Biomaterials
Research at LSU Health Sciences Center New Orleans School of Dentistry, has
been awarded a grant in the amount of $1.77 million over four years by the
National Institutes of Health to develop new antibacterial,
fluoride-releasing, and bioactive dental materials including dental
composites, bonding agents, and sealants. Currently most dental fillings and
cosmetic restorations, including bonding and veneers, are done with
resin-based dental composites – tooth-colored, plastic, and glass materials.
Dr. Xu is working to develop the next generation of
dental materials designed to reduce the secondary cavities that often develop
around dental resin-based composite fillings as they shrink, causing them to
fail. The new materials are expected to reduce secondary cavities and to
prolong the life of restorations.
According to the National Institute of Dental and
Craniofacial Research, tooth decay remains the most prevalent chronic disease
in both children and adults, even though it is largely preventable. For the
latest reporting period (1999-2004), the percentage of people who have had
cavities in their permanent teeth are 92% of adults 20 to 64, 59% of
adolescents 12 to 19, and 92% of seniors 65 and older. Forty-two percent of
children 2 to 11 have had cavities in their primary teeth.
"The development of these materials has the potential
to make a huge impact on oral health care and oral health quality of life, in
particular for the vast number of people at high risk for cavities –
children, the elderly, those medically compromised who suffer from xerostomia or dry mouth, and those with mental or
physical challenges," notes Dr. Xu.
LSU Health Sciences Center New Orleans School of Dentistry
is the only dental school in the State of Louisiana. Through its doctor of dental
surgery, dental hygiene, and dental laboratory technology degree programs, LSUHSC''s dental school educates about 70% of the dental
professionals practicing in Louisiana.
Dental school faculty and students provide oral health care through clinics
in metropolitan New Orleans, Baton
Rouge, Lafayette, Alexandria,
Hammond, Houma,
and Independence.
With the only oral health center of excellence in Louisiana, faculty at the LSUHSC School of
Dentistry are working to improve oral health and quality of life.
http://www.eurekalert.org/pub_releases/2009-05/lsuh-ldr052809.php
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by Jan Moller, The
Times-Picayune
BATON ROUGE -- So far this session the loudest noise about
the looming budget cuts has come from colleges and universities, whose
financial plight has garnered widespread attention and sympathy from
editorial writers, captains of industry and good-government groups.
Meanwhile, health-care--the other major driver of state
government spending--has been mostly ignored, even though the budget bill
includes a $375 million haircut to the programs that serve Louisiana's poorest citizens (and the
bottom lines of numerous health-care providers that are considerably less
poor).
Maybe that's because Health and Hospitals Secretary Alan
Levine has been warning that this year's cuts are child's play compared to
what's in store next year. Or maybe it's because the cuts are being partially
buffeted by a one-time windfall of hurricane-relief dollars, much of which
will flow to the five hospitals in the New
Orleans area that took the biggest financial hits
after Hurricane Katrina.
In either case, the Louisiana Hospital Association is
hoping to change the conversation today with an 11 a.m. press conference,
where hospital officials will be joined by folks from Acadian Ambulance and
the Metropolitan Hospital Council in describing how the cuts will affect
various services.
Later in the day, Levine is scheduled to make his third
appearance before the Senate Finance Committee to discuss his agency's
budget. The committee's vice-chair, Sen. Lydia Jackson, D-Shreveport, has
been unhappy with Levine's explanations of how the budget cuts will affect
service delivery, and Levine promises to be ready with new statistics to make
his case.
Elsewhere in the Capitol:
* Rep. Ernest Wooton's
much-discussed bill to allow concealed weapons on college campuses, delayed
last week because of a school shooting in Larose, gets its hearing on the
House floor
* The House is scheduled to chew on the dentists
bill for a second time, and will take up Rep. Hunter Greene's bill to give
doctors an oversight role in the Medicaid program, an idea Gov. Bobby Jindal's administration doesn't like.
* Sen. Butch Gautreaux, D-Morgan City, will try convincing the Senate
Education Committee to cap TOPS scholarships at $3,200 a year.
* The health-care "conscience" bill, partially
rewritten on the House floor, is due for its first hearing on the Senate
side.
*The House
Ways and Means Committee met well past 10 p.m.
Wednesday and is back at it this morning conducting
hearings for tax bills, most related to tax credits. Very few have gotten up
or down votes from the panel. The pool of bills awaiting final action has
grown into an ocean of legislation, and only a select few will emerge when
the committee is finished with its broad assessment of bills.
It was a busy Wednesday at the Capitol, which is reflected
in the morning papers:
- The Senate's push to raise $118 million by delaying a
scheduled tax cut got a bit more difficult after 47 members of the House
announced their unwavering opposition. According to the news release,
released Wednesday night at 10:16 p.m., the Republican-dominated list of
members "will do everything we can to block this legislation and prevent
Louisiana
families from being burdened with more taxes."
If "everything" includes a refusal to override Jindal's promised veto, Sen. Lydia Jackson can forget
about her bill becoming law.
- Hundreds of people rallied outside the Capitol in
support of accepting those federal unemployment dollars. Inside the House
chamber, Republicans were thwarted in an attempt to undo last week's
humiliation.
- The Saints deal goes marching on.
- Attorney General Buddy Caldwell gives up on his
contingency-fee plan, but vows to fight another day.
- The most interesting part of the debate over Rep. Rick Nowlin's bill on the New Orleans teaching hospital was
the hallway dust-up between LSU health care czar Fred Cerise and Treasurer
John Kennedy.
- A bill making it easier to prosecute the owners of
violent dogs passed its first committee test.
- Rep. John LaBruzzo managed to
revive his plan for drug testing welfare mothers, but it still faces long
odds because of its $1 million price tag.
- If the 2010 U.S. Senate race comes down to Dardenne vs. Vitter, give the first round to Louisiana's
junior senator.
- Jim Beam of the Lake Charles American Press doesn't like
the dentist bill, but predicts it will clear the House.
- The House watered down, then
approved, the bill banning the use of hand-held cell phones while driving.
- A House panel thinks the Legislature can do a better job
than the Department of Wildlife and Fisheries in deciding when people should
have the right to hunt.
- A bill to create a state-level witness protection
program cleared its first hurdle. But there's very little money attached to
the plan.
-
Home-schoolers
should have the right to play interscholastic sports. And they shouldn't have
to get very good grades to be eligible.
http://www.nola.com/politics/index.ssf/2009/05/healthcare_cuts_gunsoncampus_t.html
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By RT Morgan
Solutions do exist to cure the nation's ailing health-care
system, according to Dr. David Holcombe, Louisiana Office of Public Health
regional medical director in Alexandria.
But the problem with all of them is the expense, said
Holcombe, who was one of four participants of a health-care reform roundtable
held Wednesday morning at Christus St. Frances
Cabrini Hospital.
"There are a lot of solutions, but people don't want
them. "» They're painful," Holcombe said after the roundtable
discussion.
The discussion on reform also included U.S. Rep. Rodney
Alexander, R-Quitman; Ray Peters, vice president of human resources for Roy
O. Martin; and Sara van Geertruyden, an attorney
with the Patton Boggs law firm.
Part of Holcombe's "painful"
choices include hospitals reducing their expectations of profitability
and the public reducing its high expectations of health care. It's a problem
that needs to be resolved, partly because of the huge and growing disparity
between those with insurance and those who are uninsured or on Medicaid.
As far as employees are concerned, health-care reform
could involve improving the efficiency of medical care and increasing
preventative care, said Peters. He believes these two steps combined with
insurance reform would equal savings with large benefits.
Alexander said reform is an issue with serious challenges.
He's expecting a health-care bill to come before Congress soon. It's a piece
of legislation that he described as "very confusing."
About government assuming a larger role in the health-care
industry, Alexander questioned the efficiency of that option: "Would you
want the (Federal Emergency Management Agency) overlooking your health
care?"
Alexander also wondered, if government stepped in the
fray, "just how far do we go?" This is a
question that ranges from laws mandating businesses provide health care to
requiring all U.S.
citizens to have health insurance.
Members of the roundtable were peppered with questions on
pharmaceutical reform from Father Chris Nayak. One
of Nayak's questions concerned: If the government
was able to subsidize pharmaceutical companies, why couldn't the government
negotiate for fairer drug prices?
Alexander responded that the federal money was used to
subsidize experimentation aimed at finding breakthroughs, not research and
development for consumer products. It's tough to ask for a cure for cancer
without helping fund the process, Alexander added.
Nayak said he was not satisfied
with the answer.
A lack of answers was the norm for the discussion. Several
times the phrase "What do we do?" was uttered by members of the
panel. Holcombe described the health-care reform issue as an interconnected
problem for all involved.
For him, the first question to answer is: "Where do
we begin?"
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It's hard to figure what some of our elected leaders have
against dental health for children.
First, fluoridation. This flap came up after the
Legislature last year decided to require proper fluoride levels in municipal
water systems of any size.
The object is the same as with the fluoride in toothpaste:
protect teeth, especially kids' teeth, from decay.
It's true that the American Dental Association has warned
against using fluoridated water to mix baby food concentrates that already
contain supplemental fluroide.
There is also a question about the potential ill effects
of fluoridate water on pregnant women and very young children.
That risk might seem unreasonable after European studies
showed more or less equal declines in tooth decay among children in countries
with and without fluoridated water.
It's important to note that the state mandate is about
maintaining the fluoride concentration at effective yet safe levels, in the
neighborhood of 1 part per million.
As for Europe, nations
there tend to have health care systems that deliver dental care more
frequently and effectively to children than we've managed.
As you'd expect, Louisiana
doesn't do as well without fluoridation.
Health and Hospitals Secretary Alan Levine recently cited
a Medicaid study that said eligible children from parishes without
fluoridation were more likely to be hospitalized for conditions related to
tooth decay.
And Medicaid expenditures on those children were more than
double those in parishes with fluoridation.
Yet the Lafayette City-Parish Council was snippy when it
passed a resolution opposing fluoridation here.
Members mocked fluoridation as an unfunded,
half-million-dollar mandate and an unwarranted surrender of our God-given
right to a throbbing abscess.
Our next story involves the Louisiana Dental Association.
Parts of Louisiana
are served by mobile dental vans that visit schools and care for the teeth of
kids who are enrolled in Medicaid.
The association - made up of dentists - would like to see
this stopped, for no apparent reason other than to eliminate competition.
The amazing thing is that the association actually found
someone, state Rep. Kevin Pearson, R-Slidell, to flop this bill in front of
the Legislature. It's hardly improved by a compromise amendment in which the
association agreed to allow mobile dental vans that meet standards
established by the State Dental Board - made up of dentists.
We find it hard to tell which is more offensive: the
disregard for the public health or the lack of political deftness in a state
where fluoride might be lacking, but gall gushes forth in an endless stream.
http://www.dailyworld.com/article/20090528/OPINION01/905280312
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La. targeted with health-care ad campaign
Advocate business staff
Louisiana
is one of eight states in which a conservative group will launch a television
ad campaign today criticizing the Democrats’ proposed overhaul of the
health-care system, according to a story in today’s Wall Street Journal.
Americans for Prosperity Foundation’s $1.7 million
campaign will compare the proposed U.S.
system to Canada’s
publicly run system. The conservative group is targeting states with
Congressional members considered influential in matters of health care.
The president and some Democrats favor a public health
plan that will help cover the uninsured and compete with private insurers.
The idea has been strongly opposed by Republicans and health insurance
companies.
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Massachusetts, Model for Universal Health Care, Sees
Ups and Downs in Policy
The New York Times | 05.28.09
By KEVIN SACK
Despite a weakening economy, Massachusetts continued to measure gains in
the share of residents who reported having a steady source of health care in
2008, its second year of near-universal coverage, a new study has found.
But the annual survey, taken each fall since 2006, also
raised red flags regarding the ability of residents to actually use that
care, with growing numbers saying they could not afford needed treatments and
many reporting shortages of primary care physicians.
The study’s authors wrote that there were lessons for Washington, where Congressional committees are
incorporating much of the Massachusetts
model into federal health care legislation.
“Although major expansions in coverage can be achieved
without addressing health care costs, cost pressures have the potential to
undermine the gains,” wrote the researchers, Sharon K. Long and Paul B. Masi of the Urban Institute.
The difficulties in receiving care were severest among
low-income residents, who have gained the most from expanded access under the
state’s law, passed in 2006. It requires most residents to have health
insurance and provides state-subsidized plans for the poor. Massachusetts now has the country’s lowest
percentage of the uninsured — 2.6 percent, compared with a national average
of 15 percent.
But the study, which was scheduled for publication
Thursday in the journal Health Affairs, found that increased demand for care
from the newly insured was confronting an insufficient supply of willing
physicians. One in five adults said they had been told in the last 12 months
that a doctor or clinic was not accepting new patients or would not see
patients with their type of insurance. The rejection rates for low-income
adults and those with public insurance were double the rates for
higher-income residents and those with private coverage.
The authors concluded that the high rejection rates helped
explain another important finding: that there has been little change in the
use of emergency rooms for non-emergency treatment. Among low-income
residents — defined as those with incomes of less than three times the
federal poverty level, or $66,150 for a family of four — 23 percent said
their last trip to an emergency room had been for a non-emergency, the same
as in 2006.
The report sets the stage for legislative recommendations
expected next month from a state commission that hopes to slow the growth in
health spending. The commission has already drafted principles calling for a
system of global payments to networks of doctors, hospitals and other
providers. The networks would be paid for an individual’s ongoing care,
rather than for each procedure or office visit, providing an incentive to
keep patients healthy rather than merely treating their ailments.
The researchers found consistent yearly increases in the
percentage of residents who said they had a usual source of care and who had
seen a doctor or dentist in the past year. But they concluded that initial
gains in procuring needed care had begun to erode by the fall of 2008.
For instance, the share of people from low-income families
who did not get needed care in the previous year because of cost dropped to
17 percent in fall 2007 from 27 percent in fall 2006. But it then jumped to
18 percent last year.
http://www.nytimes.com/2009/05/28/health/policy/28massachusetts.html?ref=health
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The New York Times | 05.28.09
By ERIK ECKHOLM
Government spending related to smoking and the abuse of
alcohol and illegal drugs reached $468 billion in 2005, accounting for more
than one-tenth of combined federal, state and local expenditures for all
purposes, according to a new study.
Most abuse-related spending went toward direct health care
costs for lung disease, cirrhosis and overdoses, for example, or for law
enforcement expenses including incarceration, according to the report
released Thursday by the National Center on Addiction and Substance Abuse, a private
group at Columbia
University. Just over 2
percent of the total went to prevention, treatment and addiction research.
The study is the first to calculate abuse-related spending by all three
levels of government.
“This is such a stunning misallocation of resources,” said
Joseph A. Califano Jr., chairman of the center,
referring to the lack of preventive measures. “It’s a commentary on the
stigma attached to addictions and the failure of governments to make
investments in the short run that would pay enormous dividends to taxpayers
over time.”
Beyond resulting in poor health and crime, addictions and
substance abuse — especially alcohol — are major underlying factors in other
costly social problems like homelessness, domestic violence and child abuse.
Shifting money from hospitals and prisons to addiction
treatment and research has never been politically easy, and it is all the
harder now because the federal government and most states face large budget
deficits and are cutting many key services. But Mr. Califano
said that many preventive measures had rapid payoffs in medical and other
expenses.
The work of the center and of Mr. Califano,
who was a secretary of Health, Education and Welfare in the 1970s, have
sometimes drawn fire from conservatives who put more emphasis on law
enforcement than drug treatment and, on the other side, from groups who
advocate loosening some drug laws and using needle exchanges and supervised
addiction maintenance, as some European countries do, to reduce the personal
and societal costs.
Ethan Nadelmann, director of the
Drug Policy Alliance, a national group advocating legal reforms, said it was
misleading for the report to lump together direct costs of tobacco, alcohol
and drug abuse, like ill health, with expenses relating to enforcement of
marijuana laws and prison. Many of the criminal justice costs, Mr. Nadelmann said, are not an inherent result of drug use
but rather of policy choices to criminalize it.
“Still, the punch line of their report,
that society should invest far more in prevention and treatment, makes
total sense,” Mr. Nadelmann said.
The new report cites the antismoking campaigns of the last
several decades as a promising model: education, higher taxes and
restrictions on smoking zones have cut the incidence of smoking by close to
half, saving billions in costs. It called for similar efforts to curb
under-age drinking and excess alcohol consumption by adults, using higher
taxes on beer, for example.
Even with tobacco, far more could be done, according to
the report, which noted that only a small fraction of the more than $200
billion the states have received since 1998 under the Multi-State Tobacco
Settlement had gone to prevention of smoking.
Federal studies show that the best drug treatment programs
pay for themselves 12 times over, the report said, because patients who
succeed have quick improvements in health and behavior.
The Columbia
center called for legislation to require broader coverage of substance abuse
treatment by health insurers. Mr. Califano said
that as the new Obama administration tried to rein in spiraling health costs,
deepening such coverage would be vital.
Some insurance companies have opposed such a sweeping
requirement, arguing that the record of drug treatment is too spotty.
http://www.nytimes.com/2009/05/28/us/28addiction.html
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The New York Times | 05.27.09
By ANEMONA HARTOCOLLIS
Evan Abramson for The New York Times
Dr. Lawrence Haines checked Zarin
Hossain, 10, and her brother, Abir,
12, at Maimonides Medical Center
in Brooklyn.
In announcing this week that swine flu had been implicated
in the deaths of two more New Yorkers, the city’s health commissioner, Dr.
Thomas R. Frieden, added a by-now familiar caveat:
Both of them, he said, had “underlying conditions.”
He went on to enumerate a list of conditions that could
aggravate the effects of swine flu and that characterize a large portion of New York’s population:
diabetes, asthma, heart disease, lung disease, a weakened immune system and,
possibly, obesity.
He did not even mention three other risk factors that
alone apply to more than 1.2 million New Yorkers and 50 million Americans:
pregnancy, being younger than 2, or being older than 65.
Since the beginning of the swine flu outbreak, the phrase
“underlying medical condition” has been transformed from a snippet of medical
jargon into a household phrase. Mayor Michael R. Bloomberg had fully absorbed
the new vocabulary lesson by the city’s second swine flu death on Sunday,
that of a woman in her 50s. In an expression of empathy, he said his father
had also died in his 50s, “because of an underlying health condition.” (In
his autobiography, the mayor wrote, his father had heart damage from
childhood rheumatic fever.)
Dr. Frieden intended his
warning, which he has applied to all four New York deaths so far linked to the H1N1
virus, to be at once helpful to those who might be more at risk for the
disease and reassuring to those who are not.
But it may apply to so many households that efforts to
control public fears by using the term may be having something of an adverse
effect. Even accounting for people who have more than one condition,
statistics suggest that the city’s long list of red flags may encompass as
many as one in three people.
“Many, many people share the same underlying causes that
my husband had, and if he’s at risk, many people are at risk,” said Bonnie
Wiener, the widow of Mitchell Wiener, 55, the first New Yorker to die of
swine flu, on May 17.
She disputed the city’s assertion that underlying
conditions were a factor in his death. “He was overweight and he was taking
medicine for high blood pressure,” she said. “How many people 50 and above
don’t?”
About 50 percent of swine flu hospitalizations globally
and about 70 percent of those in the United States seem to involve
underlying conditions. Besides Dr. Frieden’s list,
they include anything that makes it difficult for patients to clear their
lungs, which can include some severe mental problems, seizure disorders or
neuromuscular disease.
They include chronic heart, liver and kidney disease;
suppressed immunity, whether caused by H.I.V. or drugs taken by cancer or
transplant patients; and blood diseases like sickle-cell anemia, which lowers
the blood’s ability to carry oxygen.
A similar list of conditions applies to any strain of flu.
About 400,000 New Yorkers have asthma, the city’s most
common chronic childhood illness; about 700,000, or 12.5 percent of adults,
have diabetes; about 100,000 have H.I.V.; about 17,000 women are pregnant at
any time, a conservative estimate, and about 900 people have tuberculosis,
another risk factor, according to 2008 city statistics.
There are about 1 million New Yorkers older than 65
(although there is some evidence that people born before 1957 may have
antibodies to H1N1) and 228,000 younger than 2. Obesity — which the federal
Centers for Disease Control and Prevention suspect may play a role because it
can impede lung functioning and immune responses — is practically epidemic.
One-third of adult Americans and more than 1 million adults and teenagers in New York City are
considered obese, but those with severe obesity are considered more at risk.
“We were surprised by the frequency of obesity among the
severe cases that we’ve been tracking,” Dr. Anne Shuchat,
the centers’ director of immunization and respiratory disease, said at a May
19 press conference.
The centers’ officials have said that pregnancy is a risk
factor because it suppresses the immune system to protect the fetus and can
decrease lung capacity.
Compounding the anxiety is that public health officials,
citing medical confidentiality, have refused to disclose not just the
identities of those who have died but even the most basic information about
their health conditions. (Mr. Wiener’s case was widely known because of his
long career in the school system.)
Judy Trunnell, 33, a teacher
from South Texas, was the first American
citizen to die of swine flu, in early May, after delivering a healthy baby
girl by Caesarean section. A Texas Health Department spokeswoman said she had
“chronic underlying health conditions,” which her husband, Steven, later
denied on CNN.
More details came to light a week later through a routine
scientific study, a weekly “Morbidity and Mortality” report by the federal
disease centers. Without using her name, it said she had a history of
psoriasis (not considered an underlying condition) and mild asthma, in
addition to her pregnancy.
Warnings about underlying conditions appeared to be
propelling people toward bursting emergency rooms. At Maimonides Medical
Center in Brooklyn, Sally Maugeri, an unemployed
kitchen worker who had a cough, had brought in her nephew, Salvatore Soria, 10, who had been sick with coughing, vomiting and
diarrhea, and his mother, Joanne Maugeri, 50, on
Tuesday.
They had a trifecta of underlying
conditions: Salvatore had a history of asthma, while Sally Maugeri was nine months pregnant and said that diabetes
ran in her family. “The fact that he’s sick and I’m pregnant, I wanted to
come in to see if he has the swine flu,” she said. “Because I have underlying
symptoms, it makes me more scared.”
Doctors diagnosed pneumonia in Salvatore and sent him home
with amoxicillin, an antibiotic.
On Wednesday, Shanaz Hossain brought in her son, Abir,
12, and daughter, Zarin, 10. Abir
had a fever of 103.6 at home, Mrs. Hossain said,
but her worries were aggravated by his asthma, the dreaded underlying
condition that she had heard about on the television news. Abir’s private doctor had diagnosed strep throat, but his
mother took him to the emergency room for a chest X-ray. “Of course I am
still worried,” she said.
Such anxiety has been a headache for doctors. They say
that people with underlying conditions who have flu
symptoms should consult their doctors, but that visiting an emergency room
full of sick people may actually put them in more danger.
“Like the asthmatics, we’d really prefer that pregnant
women would stay away from the emergency departments,” said Dr. Steven J.
Davidson, the chairman of the hospital’s emergency medicine department.
But City Councilman John C. Liu, who represents Flushing, Queens, where the outbreak is widespread, said the
Bloomberg administration had failed to disclose enough information to a
jittery public. “The cloak of secrecy is not alleviating anyone’s fears,
whether they’re real or perceived,” he said.
But Dr. Scott Harper, a city epidemiologist, said that
looking at the conditions behind just a handful of deaths could give people a
false sense of security.
“This isn’t an issue of secrecy, it’s an issue of
privacy,” Dr. Harper said. “If you’re talking about two deaths in this size
population, to be able to make decisions about your personal health knowing
about medical details on those two deaths doesn’t seem realistic. What does
seem realistic is to look at things that are published widely.”
Reporting was contributed by Jack Begg,
David W. Chen, Ann Farmer, Donald G. McNeil Jr. and Mathew R. Warren.
http://www.nytimes.com/2009/05/28/health/policy/28flu.html?_r=1&ref=health
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A Simple Smooch or a Toxic Smack?
The New York Times | 05.27.09
By ABBY ELLIN
THE debate seems to resurface every few years. Do some
lipsticks contain lead? If so, is the amount so negligible that consumers
have nothing to be concerned about? Or will all those years of applying
lipstick several times a day add up to a worrisome accumulation of a
dangerous substance?
On one side are advocacy groups and doctors who insist
that, over time, those who wear lipstick containing lead are at risk of
absorbing high levels of a neurotoxin that may cause behavioral, learning and
other problems. On the other side are the Food and Drug Administration and
outside experts who say that any traces of lead that do exist are too minute
to cause harm.
In February, the debate reared its head again when the
Campaign for Safe Cosmetics, a coalition of health and environmental groups,
issued a plea to the F.D.A. to release information the agency had accumulated
on the amount of lead in lipstick. The study was conducted in response to an
independent analysis in 2007, paid for by the safe cosmetics group, which
found that one-third of 33 lipsticks had lead in excess of 0.1 parts per
million, the federal limit for candy.
Among the worst offenders were L’Oreal Colour
Riche “True Red” lipstick (with a lead content of 0.65 parts per million) and
Cover Girl’s Incredifull Lipcolor
“Maximum Red” (0.56 p.p.m.). Price had nothing to
do with lead levels: less expensive brands, like a $1.99 tube of Wet and Wild
Mega Colors “Cherry Blossom,” contained no lead, whereas a $24 tube of Dior
Addict “Positive Red” contained 0.21 p.p.m.
In response to the study, L’Oreal said: “Each and every
ingredient used in our products has been thoroughly reviewed and tested by
our internal safety team made up of toxicologists, clinicians, pharmacists
and physicians.” Parfums Christian Dior, which said
it no longer makes the Positive Red shade, said, “we are confident that our
products meet the highest standards and are entirely safe to be used by
consumers every day.”
Cover Girl said, “Our perspective is that our cosmetics
products meet the rigorous safety standards set by the U.S. F.D.A. and are
safe.”
Stacy Malkan, a founder of the
Campaign for Safe Cosmetics, said that lead is often present in the pigment
of the reddest lipsticks. The campaign urged manufacturers to reformulate
their products and called for the F.D.A. to set a safety standard for lead in
lipstick. Last November, Senators John Kerry, Barbara Boxer and Dianne
Feinstein asked the F.D.A. to do the same.
“The F.D.A. now says they are waiting for a peer-reviewed
journal to publish their study of lead in lipstick,” Ms. Malkan
said. “That could take years.”
Stephanie Kwisnek, a spokeswoman
for the F.D.A., said, “Since the report was released in 2007, we have been
telling the public that the levels of lead we are finding in lipstick are
consistent with what we would expect to find under good manufacturing
practices.”
Amid the debate, some are urging balance.
“These things sound terribly scary, but there’s a massive
disconnect between how toxicologists evaluate risks and how activist groups
evaluate risk, and even then there are debates,” said Trevor Butterworth, the
editor of stats.org, the Web site of Stats, a nonprofit research center
affiliated with George
Mason University’s
Center for Health and Risk Communication.
In March, Stats asked 937 members of the Society of
Toxicology if cosmetics were a “significant source of chemical health risk.”
Sixty-six percent disagreed, 26 percent agreed and 8 percent said they
“didn’t know.”
In October 2008, a federal judge for the Northern District
of Illinois dismissed a case against L’Oreal USA by a woman who is said to
have purchased lipstick allegedly tainted with high quantities of lead. The
judge, Robert W. Gettleman, said that the plaintiff
had not shown any actual harm resulting from her use of the lipstick.
In fact, there are no F.D.A. standards limiting lead and
other toxins in lipstick. The agency leaves it up to manufacturers to decide
which safety and efficacy tests to perform on products. Cosmetics companies
are required to list their “intended” ingredients on labels. But lead would
be considered an “unintended” byproduct of the manufacturing process. (To
combat this, the Environmental Working Group, a nonprofit research and
advocacy organization, has a consumer database at www.cosmeticdatabase.com
where it lists the ingredients in more than 42,000 products.)
When asked if consumers should be worried about lead in
lipstick, several doctors, including Dr. Sean Palfrey, a professor of
pediatrics and public health at Boston
University and the
medical director of the Boston Lead Poisoning Prevention Program, said there
may be reason for concern. “Yes, these are small amounts and if you licked
your lips once you probably would not cause damage — at least not to adults,”
he said, adding, “Lead is a substance that builds up in the body over time,
so small amounts applied daily can add up and stay in our bodies.”
Dr. David Bellinger, a
researcher at Harvard Medical School and the Harvard School of Public Health
who has conducted studies on the health risks of very low lead exposures,
agreed that “no level of lead exposure appears to be ‘safe.’ ”
But others are less concerned.
“Questions are raised whenever there are heavy metals, but
lead hasn’t been linked to breast cancer, colon cancer or other cancers,”
said Dr. Therese Bevers, the medical director of
the Cancer Prevention
Center at the MD Anderson Cancer
Center in Houston.
John Bailey, the chief scientist for the Personal Care
Products Council, a trade group representing the cosmetics and personal-care
products industry, said of the Campaign for Safe Cosmetics study, released in
2007, “The initial reports were presented in a very alarming way to make
people think there was something wrong, but after more deliberate assessments
by a number of different bodies, the facts remain that the levels of lead
found are not of concern.”
Ms. Kwisnek, of the F.D.A., said
that similar reports came out about lead in lipstick in the early 1990s, but
subsequent F.D.A. evaluation “did not detect levels of lead that would be
considered harmful.” She added: “The levels found did not exceed trace
amounts that would be unavoidable even under conditions of good manufacturing
practice, given background levels in the environment.”
STILL, some consumers are cautious.
“There’s lead in lipstick, and you put in on your lips, on
your mouth and you can eat it,” said Danielle Carro,
a director at an organic marketing company in New York.
Organic personal-care products sales reached about $443
million in 2008, a 19 percent jump over 2007, according to the Organic Trade
Association, an industry group. And in September, Teens Turning Green, a
national group promoting a healthier lifestyle, began a “Lips Against Lead”
campaign to ban lead in lipstick.
“I just picture a little room where the industry men are
saying ‘get the cheapest junk you can and put it in the box,’ ” said Judi Shils, the executive director of the group. “I think
consumers are in such a good place right now because everybody is paying
attention and consumers are demanding their right to health, as they should.”
http://www.nytimes.com/2009/05/28/fashion/28skin.html?ref=health
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