University Medical
Center Nurses Receive Awards
Baton Rouge (June 23, 2009) –– The Louisiana State Nurses
Association (LSNA), District IV, presented professional achievement awards to
five members of the University Medical Center nursing staff during the
district’s annual Acadiana Celebrates Nursing
program.
Cameron Foreman, RN, nurse educator, was recognized for
his leadership skills, role as a mentor, and unyielding support of
students.
Lou Ann Gerard, RN, UMC director of patient relations, was
recognized for her nursing expertise and patient advocacy.
Dawn Huggins, RN, BSN, was recognized for her improvement
of UMC employee assistance, health, and safety programs.
Lisa Judice, RN, BSN, head of
nursing for the Intensive Care Unit, was recognized for training UMC staff in
post-Katrina kidney transplant services, her service on hospital committees,
and development of the ICU Ventilator Care Bundle.
Peggy McCabe, RN, MSN, nurse educator, was recognized for
her comprehensive knowledge and teaching of pediatric care.
The Louisiana State Nurses Association has 13
districts. District IV includes the
parishes of Lafayette, St. Landry, St. Martin,
Vermilion, Acadia, Evangeline, and Iberia.
The LSU Health System - Health Care Services Division is
one of the largest public health care delivery systems in the country. It has over 35,000 inpatient admissions,
nearly 196,000 inpatient days, 515,500 outpatient clinic visits, 894,000
outpatient encounters, and nearly 244,000 emergency department visits. Each year nearly 500 residents and fellows
from the LSU and Tulane Schools of Medicine and Ochsner
Health System and 2,200 nurses and allied health students from many colleges
and universities are trained in LSU facilities.
LSU is the largest single provider of uncompensated inpatient care in Louisiana. LSU HCSD hospitals have an economic impact
of over $1.4 billion in asset business activity, $568 million in personal
earnings, and generate over 12,000 jobs.
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All seven LSUHCSD hospitals received 2008 Louisiana
Hospital Quality Awards from the Louisiana Health Care Review (LHCR). Lallie Kemp Regional
Medical Center,
Leonard J.
Chabert Medical Center,
and University Medical Center
received Gold Level awards. Only 26 hospitals in Louisiana received the gold level award. Earl K. Long Medical
Center, LSU
Bogalusa Medical
Center, and W. O. Moss Regional
Medical Center
received Silver Level awards.
Only 18 hospitals in the state received the silver level
award. The Interim
LSU Public
Hospital received the
Bronze Level Award. Only 19 hospitals in the state received the bronze level
award. "These awards recognize the ongoing efforts we are making in all
of our hospitals to provide quality health care to our patients," said
Dr. Michael K. Butler, CEO of the LSU Health Care Services Division.
"Our well integrated system of hospitals fosters the provision of the
right health care, at the right time, and at the right cost."
LHCR established the awards to recognize Louisiana hospitals that successfully
implement quality initiatives to improve patient care in the hospital
setting, specifically in the areas of acute myocardial infarction (heart
attack), heart failure, pneumonia, and surgical care.
The Centers for Medicare and Medicaid Services have
designated these clinical topics as national health care priorities. HCSD
hospital staff have been working with quality
improvement specialists from LHCR to use proven, evidence-based practices to
improve patient care.
The awards were announced at the second annual Louisiana
Health Care Quality Summit hosted by the LHCR. 2008 is the fourth year the
awards were given.
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Chad
Bower / Eyewitness News
Video: Watch the
Story:
http://www.wwltv.com/topstories/stories/wwl062309cblandacquisition.1c620afe.html
NEW ORLEANS – A proposed
teaching hospital for New Orleans is on hold,
after the state suspended land purchases because of a disagreement between
LSU and Tulane University over governance of the
hospital.
The state waits on a compromise, while Mid-City residents
wonder about their future in the neighborhood.
Wallace Thurman has lived in lower Mid-City since birth.
"75 years. Good ones up until now. Because all I've
been doing, for two years I've been walking around, (asking) what's going to
happen, because I don't know," he said.
LSU approves medical center plan with strings attached
State unveils medical center proposal; universities
approval pending
Thurman's been waiting to find out if his home and his
rental property will be torn down for a new LSU Medical
Center and VA Hospital.
Word Tuesday that land purchases are on hold for part of
the project gives Thurman hope.
"I was born in my house and I hope to die in my
house," said Thurman, whose property is on the proposed VA Hospital
portion of the project.
Tuesday the state released a statement, saying that it
will delay buying property for the new medical center because "there's
no agreement on the proposed governing structure."
Monday, LSU's Board of Supervisors rejected an agreement
favored by the Jindal administration, and one
approved by Tulane
University, to run the
hospital by a non-profit corporation controlled by an independent, 12-member
board of directors, but LSU said it would have too few appointees.
While the state has suspended acquiring land for the Charity Hospital replacement, it says the VA
Hospital project is still on track.
Mayor Ray Nagin is concerned
about the state's decision.
"I am hoping they can resolve this shortly. I just
hope it doesn't unnerve the VA people, and so far so good," he said.
Mid-City residents simply want an answer, whatever it may
be.
"We have been in limbo for the last three years. As
you can see nobody's doing anything with the neighborhood," said Barry
Green.
"If they don't want it just say they don't want it
and move on so we can move on," he said.
Tulane
University and LSU
released written statements on Tuesday, both expressing their support to
build the teaching hospital.
Tulane said the agreement they approved had the
appropriate safeguards and independent oversight to protect the public
interest.
LSU said its board of supervisors has approved its own
version – with a "workable governance structure" that it is ready
to implement.
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By Bill Barrow
Capital bureau
BATON ROUGE -- Seeking leverage to force a truce between Louisiana State
University and Tulane University,
the Jindal administration announced Tuesday that it
is suspending land-acquisition activities for the teaching hospital proposed
for lower Mid-City.
The move comes a day after LSU rejected a state-brokered
compromise. Both schools remain entrenched in pushing different governing
models for the not-for-profit corporation that would run the 424-bed medical
complex slated for a footprint bound by Canal Street, South Claiborne Avenue, Tulane Avenue and
Galvez Street.
Commissioner of Administration Angele Davis, Gov. Bobby Jindal's top budget officer, said, "There remains no
agreement on the proposed governing structure, and it is critical that we
make an intensified effort to reach an agreement before the state acts to
purchase the property. . . . Without this corporation, or an agreement by the
stakeholders to form the corporation, financing the project becomes a bigger
challenge."
The proposed corporation, which would be affiliated with
LSU, is expected to have to borrow at least $400 million via bonds backed by
future hospital revenue. The bond sale would be more should the state fail to
get a full $492 million federal reimbursement for hurricane damage to Charity Hospital. That long-running dispute
appears headed to arbitration in Washington.
Davis
said her office would not resume the land-acquisition process for the state
hospital until LSU and Tulane agree on how to govern the corporation. The
state will continue cobbling together the adjacent footprint for the proposed
U.S. Department of Veterans Affairs Hospital, to be built across Galvez Street
extending to South Rocheblave Street.
--- Tulane approves plan ---
Tulane last week approved a draft memorandum of
understanding that emerged from private negotiating sessions that state
Health Secretary Alan Levine mediated between Tulane President Scott Cowen
and LSU System President John Lombardi, among others. But LSU's board rejected
that deal Monday, substituting its own proposal to give the Baton Rouge-based
system greater control over the hospital corporation board.
"It's just a complex problem that will take some more
time," said Blake Chatelain, chairman- elect
of the LSU System board. "We'd like to see (Tulane's board) look at (the
LSU plan) and ask can they live with it as amended on one point?"
The two schools agree about distribution of medical
residency slots.
Statements from each campus Tuesday reaffirmed a
"commitment" to building the hospital.
http://www.nola.com/news/?/base/news-2/124582082539190.xml&coll=1
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By MARSHA SHULER
Advocate Capitol News Bureau
The Jindal administration
brought the land purchase for a proposed $1.2 billion academic medical center
in New Orleans
to a screeching halt Tuesday as it sought to put pressure on LSU to sign-off
on governance control.
Commissioner of Administration Angèle
Davis issued the stop order, saying it would not be lifted until an agreement
on the center’s governance structure could be worked out.
Davis’
decision came a day after LSU rejected a proposed “memorandum of
understanding,” or MOU, on the project and as the state prepared this week to
send out “buyout offers to property owners.”
The governance structure for the proposed medical center
has been a major sticking point in negotiations which have included the
state, LSU and Tulane
University.
LSU and Tulane each would operate physician-training
programs at the facility which would also provide care for the poor and
uninsured.
Tulane accepted the draft agreement on Friday. LSU
rejected it Monday.
LSU suggested that it should have a larger role on the
board that would run the private nonprofit organization that would finance
and operate the medical center. The corporation would be affiliated with LSU.
It would have an independent board of directors.
It is on that board that LSU wants more say because it
claims it is taking the financial risks involved and assuming all the
responsibility.
State Department of Health and Hospitals Secretary Alan
Levine said the formation of the nonprofit corporation and agreement on its
governance structure is key to project financing.
“I think there’s a significant concern you are buying
people’s property yet we are not in a point yet where we even have the
governance resolved,” said Levine, who represents the state in negotiations.
Levine said he does not understand LSU’s objections. The
MOU establishes an independent enterprise “albeit that leans heavily toward
LSU.”
LSU spokesman Charles Zewe said
LSU officials would not be available for comment.
Zewe issued a statement which
said that LSU “remains committed to building an academic medical center in New Orleans.”
LSU Board of Supervisors member Hank Gowan
said the administration’s decision “makes me more convinced my vote was
correct.”
“I don’t really think that’s going to be as effective as
they think it’s going to be,” said Gowan, who added
that LSU is trying to live up to its legal responsibility.
LSU called its revision to the MOU “a workable governance
structure for the new hospital that LSU is ready to implement with its
partners so that this medical facility … can be built.”
Under the draft agreement, LSU would own the academic
medical center and lease it to the corporation.
The agreement proposed a 12-person, independent operating
board with four LSU representatives.
But the LSU Board on Monday instead approved a plan for an
11-member board with five LSU representatives. Tulane would have one
representative on the board in both versions.
Establishing the governance structure is critical to
developing a financial model for the new medical center development, Davis said in a news
release.
“The proposed agreement called for a nonprofit corporation
to operate the hospital, with the corporation being responsible for obtaining
debt financing,” Davis
said. “Without this corporation, or an agreement by the stakeholders to form
the corporation, financing the project becomes a bigger challenge.”
Davis said the cessation of
land purchase will have no impact on the Veterans Administration hospital
which is being constructed on the same campus as the state’s new University Medical
Center — that will replace Charity Hospital
and University Hospital.
Land purchase for the VA project will continue, Davis said.
http://www.2theadvocate.com/news/politics/48953711.html
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By Jim Watts
DALLAS - Louisiana State
University System's governing board on Monday rejected a proposed management
agreement for a new academic and charity hospital in New
Orleans to avoid sharing power with Tulane University.
Board of Supervisors members and LSU officials said they
were concerned that revenue from the proposed University Medical
Center would not be
sufficient to support some $400 million of revenue bonds for the facility
without financial support from Tulane.
Because LSU is putting up most of the money, the board
said, the school should control the nonprofit corporation that will run the
new medical center. The $1.2 billion complex is to be built adjacent to a new
federal Veterans Affairs hospital.
The financing plan, developed by Gov. Bobby Jindal's administration last year, includes $300 million
of state grants, $498 million in federal reimbursements for Old Charity
Hospital, and
approximately $400 million of revenue bonds.
The business plan calls for LSU to own the facility but
lease it to the nonprofit corporation that would issue the revenue bonds, and
govern the 424-bed hospital.
LSU attorney Ray Lamonica said
the system would not have a legal obligation to support the bonds, but would
have moral and practical reasons to do so.
"If the bonds fail, technically it is the
responsibility of the nonprofit entity, but I am virtually certain that the
bond industry would take position that it is LSU's moral obligation to repay
the bonds," he said. "It needs to be regarded as a practical obligation
as well, if LSU ever intends to issue bonds again."
LSU president John Lombardi said the business plan can
succeed only if a significant portion of the patients treated at the hospital
are privately insured rather than charity cases. Without the private insurance
payments, he said, revenues likely would not be sufficient to support the
planned debt.
Tulane refused to guarantee that a minimum of 20% of its
insured patients would be treated at the medical center, Lombardi said,
because the private school is affiliated with a for-profit hospital near its
campus.
The university owns 17.5% of the for-profit Tulane Medical Center,
with the rest controlled by a publicly traded hospital corporation. Tulane
would receive 200 medical residency slots at the new hospital, and LSU would
receive 373.
"We have no other financial commitment from anybody
but the state and LSU," Lombardi told the board. "When we borrow
this money - if we are able to borrow this money - the bondholders will also
have a commitment to contribute financing."
He said the Jindal
administration suggested the financing plan to avoid having the bonds count
against the state constitutional cap. Annual state debt service is limited to
6% of annual general fund revenue.
The board approved an amended agreement that reduces the
size of the governing board to 11 from 12 and increases LSU's representation
to five members from four. In both versions, an LSU appointee must chair the
board.
Tulane's board approved the original management proposal
earlier in the day, and said the disapproval of it by LSU revealed
"fundamental and philosophical differences" between the two
schools.
http://www.bondbuyer.com/additionalregionalnews.html?regiondate=20090624
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Louisiana Gov. Jindal Admin. Stops Acquisition Of Property In Charity
Hospital Dispute
BayouBuzz
| 06.23.09
Written by: BayouBuzz Staff
Due to the conflict
between LSU and Tulane, the Jindal Administration
through the Division of Administration has sent out this release. Tulane signed the proposed MOU on Friday
and LSU refused to sign it citing that it was taking the risk without
sufficient benefit. Meanwhile, some
are complaining that the New Orleans
indigent and non-insured population continues to suffer due to the lack of
medical care. Others complain that the
lack of an institution is stifling economic growth in New Orleans:
BATON ROUGE – Commissioner of Administration Angele Davis
today announced the suspension of land acquisition activities for the
proposed new University Medical Center
in New Orleans,
pending a resolution of the MOU concerning the governance structure for the
proposed medical center. The
governance structure is a critical step toward developing a financing model
for the new facility.
Commissioner Davis said, “There remains no agreement on
the proposed governing structure and it is critical that we make an
intensified effort to reach an agreement before the state acts to purchase the
property. The proposed agreement called for a non-profit corporation to
operate the hospital, with the corporation being responsible for obtaining
debt financing. Without this
corporation, or an agreement by the stakeholders to form the corporation, financing
the project becomes a bigger challenge.
“This will have no impact on the VA Hospital and the
on-going land acquisition activities for the new VA Hospital in New Orleans. Today, we are suspending land acquisition
activities and efforts for the MCLNO / Charity replacement hospital pending a
resolution of the governance issue.”
Commissioner Davis reached this conclusion after
consulting with DHH Secretary Alan Levine.
Both are in agreement on the urgency of reaching a conclusion on the
governance structure so land acquisition activities can continue and this
important project can move forward.
http://www.bayoubuzz.com/News/Louisiana/Government/Louisiana_Gov._Jindal_Admin._Stops_Acquisition_Of_Property_In_Charity_Hospital_Dispute__9074.asp
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New Orleans CityBusiness |
06.23.09
by CityBusiness staff reports
BATON ROUGE — The state has stopped the process for
acquiring land for a proposed teaching hospital in Mid-City while an
agreement over who will run the facility is at a stalemate.
Commissioner of Administration Angele Davis said there
will be no more land purchases for the new University
Medical Center
in New Orleans until Louisiana State
University can reach a
compromise on the governance of the hospital with the other schools involved.
The LSU Board of Supervisors recently approved a structure
that provides the school with more seats on the nonprofit board that will run
the facility, altering a proposal the Jindal administration brokered involving LSU, Tulane and
Xavier universities.
LSU backs an 11-member board with five representatives for
the school, while the original proposal called for 12 members and four LSU
seats.
"The governance structure is a critical step toward
developing a financing model for the new facility," Davis said in a statement. "There
remains no agreement on the proposed governing structure and it is critical
that we make an intensified effort to reach an agreement before the state
acts to purchase the property. ... Without this corporation, or an agreement
by the stakeholders to form the corporation, financing the project becomes a
bigger challenge."
Davis
said delays in the teaching hospital will not impact the adjoining Veterans
Affairs facility planned for the same Mid-City campus.
LSU System spokesman Charles Zewe
said in a statement that the university is still committed to building a
facility in New Orleans.
"The LSU Board of Supervisors has approved an MOU
with a workable governance structure for the new hospital that LSU is ready
to implement with its partners so that this medical facility, which is critical
for the future of graduate medical education and health care in Louisiana, can be
built," he said.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=25418
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New Orleans CityBusiness |
06.23.09
By Deon Roberts
The makeup of the board for a new teaching hospital in New Orleans has become an area of dispute between LSU
and Tulane University.
According to The Associated Press, LSU’s Board of
Supervisors wants to boost LSU’s representation on the board.
But Tulane has rejected an LSU board plan that gives LSU
five appointees on an 11-member hospital board, according to AP.
Here are some excerpts from the story:
Tulane’s Board of Trustees last week approved a plan
giving LSU four seats on a 12-member board. LSU board members amended the
plan after voicing frustration that LSU would not have significant control
over a project in which the school would be responsible for backing $400
million in bond debt for the 424-bed hospital, estimated to cost $1.2
billion.
“We’re the ones taking all of the financial risk,” board
member Rod West of New Orleans
said. “LSU … is the only one on the hook.”
What happens now? According to AP:
LSU’s move essentially sent the plan back to Tulane,
though Tulane spokesman Mike Strecker said the
board of the private New Orleans
university is finished negotiating it.
Tulane issued a statement saying the LSU board’s move
“indicates that Tulane and LSU have fundamental and philosophical differences
with respect to the board composition and the appropriate safeguards and
independent oversight of the proposed academic medical center.”
“Given the importance of the unresolved issues to the community
and the state, Tulane believes the matter should now return to the
Legislature and the administration for further action.”
Meanwhile, John Lombardi, LSU system president, tried to
downplay the dispute, according to the story.
He said his board’s action was a positive sign: Only one
significant point of disagreement remains, over how to manage the proposed
hospital in downtown New Orleans.
Many people say the teaching hospital, which will replace Hurricane Katrina-damaged
Charity Hospital,
will be a major economic driver for New
Orleans. For now, it’s driving a wedge between LSU
and Tulane, it seems.
It’s also causing a delay in the project. Today, the state
stopped the process for acquiring land for the hospital because of the
disagreements over the board.
http://neworleanscitybusiness.wordpress.com/2009/06/23/lsu-tulane-disagree-over-hospital-board/
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BATON ROUGE, LA (AP) - Gov. Bobby Jindal's
administration on Tuesday suspended acquisition of land for a proposed
teaching hospital in New Orleans,
amid a deepening feud between LSU and Tulane over how the hospital should be
governed.
The two schools' long dispute came to a head this week
when LSU rejected a Tulane-approved proposal for the makeup of the hospital's
governing board. LSU wanted five seats on an 11-member board, while Tulane
wanted LSU to have four seats on a 12-member board.
Angele Davis, Jindal's top
fiscal adviser, released a statement saying the two schools need to intensify
efforts to agree on the issue before the state can continue the process of
buying downtown real estate.
"The proposed agreement called for a nonprofit
corporation to operate the hospital, with the corporation being responsible
for obtaining debt financing," Davis
said in the statement. "Without this corporation, or an agreement by the
stakeholders to form the corporation, financing the project becomes a bigger
challenge."
Both LSU and Tulane also issued statements on the matter,
but neither side displayed any compromise: LSU stuck with its 11-member board
and Tulane with its 12-member board.
The LSU-run
Charity Hospital
was flooded and shuttered by Hurricane Katrina in 2005. The university opened
a temporary replacement, called the Interim LSU
Public Hospital,
while pushing plans to build a new 424-bed teaching hospital, estimated to
cost $1.2 billion.
http://www.ksla.com/Global/story.asp?S=10584468&nav=menu50_2
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Associated Press
NEW ORLEANS
(AP) — Faculty and students from the professional health schools at LSU
Health Sciences Center New Orleans will offer free health education and
screenings as part of a community outreach.
Schools of Medicine, Nursing, and Allied Health
Professions faculty will screen participants for high blood pressure,
diabetes, depression, lung function, colorectal cancer and oral cancer.
Staff from the Breast and Cervical Health Program at the School of Public Health will educate women about
breast cancer and walk them through the process of getting mammograms. They
will also provide information about skin cancer and sunscreen.
There will also be testing for prostate cancer,
vaccinations for children, and information provided about dental health and
nutrition.
The programs will be held on July 1 from 1 to 6 p.m. at
Grace Episcopal Church in New
Orleans.
http://www.theadvertiser.com/article/20090624/NEWS01/90624002/LSU+offers+free+health+programs
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LSUHSC - Shreveport Receives Elite Clinical Trial
Accreditation
The high ethical standards that LSU
Health Sciences
Center at Shreveport employs to protect human
research participants were confirmed today when
it became the first academic
medical center in Louisiana
to earn accreditation from the Association for the Accreditation of Human
Research Protection Programs, Inc. (AAHRPP).
Until accreditations announced today, no Louisiana institution had achieved the
elite AAHRPP accreditation.
An AAHRPP news release issued today announced
accreditation of 13 organizations nationwide including LSUHSC-S. Also receiving accreditation was the
Overton Brooks VA Medical Center in Shreveport,
an affiliated institution which utilizes the LSUHSC-S Institutional Review
Board to review and approve many of its research protocols involving humans.
News of full AAHRPP accreditation was welcomed by LSUHSC-S
officials, who noted that it culminated a process that began in 2008 and
represented an institutional team effort.
“Participants in any the 593 active clinical trials
offered by LSUHSC-S and their families now have external confirmation that
our research staff doesn’t settle with just meeting federal standards for
human research. LSUHSC-S voluntarily
exceeds those standards so that the safety of every person who participates
in clinical trials here is protected to the fullest extent possible,” said
Chancellor Robert A. Barish, M.D.
“Public trust in research is crucial if we are to recruit
volunteers for these important studies that help pioneer new medical
treatments that are proven safe for the American public. AAHRPP accreditation
helps foster public trust in our programs,” Dr. Barish
added.
One of the hallmarks of LSUSHC-S clinical research is
following-up with volunteers to inform them of the outcome of the study in
which they participated.
AAHRPP was established in 2001 by seven founding
organizations, the Association of American Medical Colleges, Association of
American Universities, Consortium of Social Science Associations, Federation
of American Societies of Experimental Biology, National Association of State
Universities and Land-Grant
Colleges, National
Health Council, and Public Responsibility in Medicine and Research.
AAHRPP employs a voluntary, peer-driven, educational model
of accreditation for organizations engaged in research involving human participants.
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By Karina Donica
Tia Owens-Powers
AHEC program participants Alexis Caletka
(center), 17, and Elizabeth Doggett (right), 16, listen as special procedures
tech Anthony Lambing explains heart catheterization surgery Tuesday at Christus St. Frances Cabrini Hospital. The AHEC program
allows high schoolers to learn about opportunities
in health care.
If there was any doubt about a post-high school career
choice for Keana Howell and William "Beni" Murdock, it's
quickly disappearing.
That's thanks to a five-week immersion program that is
allowing the students to take a closer look at what the medical industry
could have in store for them.
Keana, 14, and Beni, 17, are two of about 14 high school students
learning about the medical profession this summer at Christus
St. Frances Cabrini Hospital in Alexandria
through the Central
Louisiana Area
Health Education
Center, known as AHEC.
The summer program is also offered at other hospitals,
including Huey P. Long Medical Center in Pineville.
"I knew I wanted to go into the medical field,"
but was split between "pharmacy and cardiology," said Beni, a student at Holy Savior
Menard Central
High School.
"After being here, I want to say I want to go to cardiology."
While the program is an opportunity for young people to
get some real-life experience and determine if this is the best option for
them, it also attempting to lure them into an industry in need of more
professionals, said Susan Babineaux, Cabrini's
community education coordinator.
"Our primary mission is to allow students to have
health-care exploration in a realistic environment and encourage them to go
into health-care careers," said Babineaux, who
has been a nurse for 20 years.
Programs like AHEC are designed to help reduce the
shortage of professionals in the health-care industry, she said.
Babineaux helps coordinate the
local program each summer and welcomes new students each year.
"They are great students with great potential, and
hopefully they'll stay here" in Central Louisiana,
she said.
Tia Owens-Powers
Terry Womack (right), pharmacy assistant director at Christus St. Frances Cabrini Hospital, explains how a
pill-sorting machine works as AHEC program participants Keana
Howell (left), 14, and William “Beni” Murdock, 17,
listen on Tuesday.
During the course of the summer, the students are assigned
mentors and get the chance to work next to medical professionals in different
areas of the hospital, where they learn about CPR, measuring blood pressure,
CAT scans, dentistry and pediatrics.
Learning about baby delivery has been the most exciting
part of the training for Keana, who loves children
and is fascinated by the miracle of life, she said.
"I want to go back to baby delivery. I want to see a
natural delivery," said Keana, who along with Beni was assigned to the
pharmacy on Tuesday.
Two of the mentors, Terry Womack, the pharmacy assistant
director, and Darren Roberts, a surgical technician, said it's rewarding to
see the young students' eagerness to learn.
They also said they recognize the value of the program for
future generations of medical professionals.
"They didn't have programs like this when I was
little. I definitely would have done something like this "» in high
school for sure," said Roberts, who has been a surgical technician for
nine years.
The mentors also said they like participating because it
gives them a chance to help students get direction in an industry that offers
a world of opportunities.
-- As the largest industry in 2006, health care provided
14 million jobs --13.6 million jobs for wage and salary workers and about
438,000 jobs for the self-employed.
-- Of the 20 fastest-growing occupations, seven are health
care-related.
-- Health care will generate 3 million new wage and salary
jobs between 2006 and 2016, more than any other industry.
-- Most workers have jobs that require less than four
years of college education, but health diagnosing and treating practitioners
are among the most-educated workers.
http://www.thetowntalk.com/article/20090624/NEWS01/906240324/1002/Students-get-look-at-health-care-careers
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Our Views: The two faces of the Sun Belt
For years, Louisiana
was among the laggard stepchildren of the South. When other states boomed, we
either were suffering from low energy prices — one of the reasons states with
more balanced economies boom — or grew only modestly in terms of population
and wealth.
Now, though, there’s an upside to the bad news of the
past, and more spring in the stepchild’s stride because Louisiana’s economy in general is
weathering the national recession better than many other states.
Having not risen so high, in
terms of both house price inflation and in terms of real economic growth, our
state has not had so far to fall.
The Brookings Institution think tank called it a case of
two Sun Belts.
“Large swaths of the South and West, particularly
metropolitan areas in Florida, Arizona, Nevada, and
inland California,
have suffered severe employment, output, and home value declines over the
past year due to the broader housing fallout,” a Brookings analysis reported.
“Wages in those metro areas have
risen rapidly, most likely due to a slowdown in less-skilled migration to
those areas, and to disproportionate losses of lower-paying jobs. Yet parts
of the Southwest and Deep South — including metro areas in New Mexico, Texas,
Oklahoma, Arkansas, and Louisiana — have performed relatively well,
experiencing less severe job losses, relatively large wage gains, and modest
home price increases.”
The reasons for the difference: “Specializations in energy
and government, large amounts of federal hurricane recovery funding for the Gulf Coast,
and smaller increases in housing prices during the early and mid-2000s may
all help to account for their better performance.”
Those are key factors in Baton Rouge’s
economy and the reason that indexes compiled by Brookings and others have
been kind lately to Louisiana’s
capital city. There is still hurricane recovery-related spending helping New Orleans and energy-development continues along the
coast, making the Houma metropolitan area
among the best for job growth in the United States.
We welcome the good news, but we also caution against a
belief that today’s good news will automatically translate into a quick
recovery from today’s recession. Job losses are all too common in the state
and in Baton Rouge’s
metro area; national business trends have a local impact.
With college
budgets and state health-care
spending on the chopping block, the foundations of current success might be
eroded very quickly.
The cities — not
only Baton Rouge but Lafayette
and others — might have been helped by the concentration of “eds and meds,” what Brookings called the jobs driven by
higher education and health-care institutions. Cities as diverse as Honolulu, El Paso and Washington, D.C.,
are among the eds and meds capitals.
Some perspective is in order. We can recall years and
years of analysts noting that Baton Rouge and Lafayette were brighter spots in a Louisiana economy that lagged its peers in
the South.
If that story is not to be repeated, Louisiana must orient
itself toward a competitive future with the leading states of the South —
even if those states struggle now with housing collapses and slowdowns in
their traditional manufacturing bases.
A new economy awaits after this recession.
Louisiana, and particularly Baton
Rouge and Lafayette,
must make decisions today to use relatively good times to position ourselves
for that new economy.
http://www.2theadvocate.com/opinion/48945726.html
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DAVID ESPO
The Associated Press
(AP) — WASHINGTON
- Health and Human Services Secretary Kathleen Sebelius
told lawmakers Wednesday that President Barack Obama is willing
to listen to suggestions on how
to pay for a health care overhaul, as long as they don't increase the
deficit.
"The president is open to good ideas about how we
finance health reform," she said in testimony prepared for delivery to a
House committee. "But we are not open to deficit spending."
Sebelius' appearance before the
House Energy and Commerce Committee comes as congressional Democrats struggle
with the $1 trillion-plus price tag for extending health coverage to 50
million uninsured Americans over 10 years.
Although lawmakers are considering an option Obama has
opposed-taxing employer-provided benefits-Sebelius'
testimony indicates that the administration is ready to be flexible if
Congress can deliver a bill.
That has seemed uncertain, as cost concerns and partisan
disputes have stalled progress. Sebelius used her
testimony to encourage Democratic efforts-and to make clear that Obama
expects lawmakers to deliver.
"Health reform constitutes our most important
domestic priority," she said.
In an interview with ABC News that aired Wednesday, Obama
declined to say whether he was open to taxing health benefits. But he
indicated there was a breaking point in the balance sheets where he would say
that the cost of reforming the system is too great for the federal government
to handle.
"I'm going to wait and see what ideas ultimately they
(Congress) come up with," he said.
"I think that if any reform that we get is not
driving down costs in a serious way," Obama added. "If people say,
'We're just going to add more people onto a hugely inefficient system,' then
I will say no. Because ... we can't afford it."
Obama also said in the broadcast interview that his
position on many elements of health care overhaul has "evolved"
over time.
And he said he could support a law mandating that
individuals buy health care coverage, with fines for those who do not. But he
stressed in the ABC interview that there has to be some kind of waiver for
people who simply don't have enough money to pay for it.
A new Washington Post-ABC poll found that most Americans
are "very concerned" that a health care overhaul would lead to
higher costs, lower quality, fewer choices, a bigger deficit, diminished
insurance coverage and more government bureaucracy. About six in 10 are at
least somewhat worried about all of these factors, the poll found.
More than eight in 10 said they were satisfied with the
quality of care they now receive and were relatively content with their own
current expenses.
Addressing that issue, Obama on Tuesday dismissed as
"not logical" the insurance lobby's assertion that a new government
health plan he backs would dismantle the employer-sponsored coverage most
Americans now have. Yet, despite the harsh words from the president, senators
attending a Tuesday evening meeting in the Capitol with White House Chief of
Staff Rahm Emanuel said the administration was not
ready to abandon the search for compromise.
That puts the spotlight on a small group of senators who
are trying to find common ground on the issue of giving the middle class the
option of joining a government health plan. Republicans are almost
unanimously opposed, while Democrats insist it must be part of any final
deal.
Dubbed "the coalition of the willing," the
Senate group is focusing on nonprofit co-ops as an alternative both to
private insurance and full-blown government intervention.
"The co-op proposal is alive and well, and
negotiations are ongoing," said Sen. Kent Conrad, D-N.D., who proposed
the idea, adding that it's the only version of a public plan that stands a
chance of getting Republican support.
Democratic liberals in Congress are leery of the co-op
idea, even if the White House is open to it. Part of the debate centers on
whether the co-ops would be part of a national organization, or isolated
outposts.
The health care industry went on the attack, meanwhile,
warning in a letter to senators released Tuesday that a government plan would
take over the U.S.
health care system.
America's
Health Insurance Plans and the Blue Cross Blue Shield Association also said
they didn't believe it was possible to design a government plan that could
compete fairly with private companies in a revamped health care market.
"We do not believe that it is possible to create a
government plan that could operate on a level playing field," said the
insurers' letter, signed by AHIP head Karen Ignagni
and Scott Serota, the Blue Cross CEO. " Regardless of how it is initially structured, a
government plan would use its built-in advantages to take over the health
insurance market."
The public plan that most Democrats envision would be
offered alongside private plans through a new kind of insurance purchasing
pool called an exchange. Individuals and small businesses would be able to
buy coverage through exchanges, but eventually businesses of any size might
be able to join.
Officials disclosed Tuesday that key Senate Democrats had
whittled more than $400 billion off the cost of a health care plan that
carried a $1.6 trillion price tag last week. The new cost is below $1.2
trillion, but still above the informal target lawmakers have set. The
officials spoke on condition of anonymity, saying they were not authorized to
disclose details of the closed-door talks.
Conrad told reporters the reductions were achieved by
lowering subsidies designed to make insurance affordable for those who lack
it, as well as other changes.
http://www.nola.com/newsflash/index.ssf?/base/national-4/1245832864202490.xml&storylist=health
[BACK TO TOP]
SEAN STEHURA
These are the questions that we, and our politicians,
should be asking about healthcare. Should our system be based on the
for-profit business model or a not-for-profit public financing system of
social insurance? Is the healthcare system for patients and their families or
corporate market stakeholders and their investors? As a basic human need, is
healthcare a right or not?
According to Sen. Bernie Sanders, the only way you're
going to provide comprehensive, universal and cost-effective healthcare to
every man, woman and child in this country is through a single-payer system.
That's just a simple reality. And the reason for that is that to pay for
universal comprehensive healthcare you have to deal with the enormous amount
of waste that is currently within the private health insurance industry. The
estimate is about $400 billion to $500 billion a year in administrative
costs, in billing, in profits, in CEO compensation (one CEO made $250,000 a
day), in advertising - these things which have nothing to do with providing
healthcare.
A single-payer healthcare system wrings out all of the
waste that the private dysfunctional healthcare system creates. According to
the Harris Poll, only 7 percent of people judge private health insurance
companies to be "honest and trustworthy." The health insurance
industry appears about as popular with Americans as the tobacco industry,
with both considered highly hazardous to your health. A report from the
American Cancer Society and Kaiser Family Foundation showed that despite
having private health insurance, cancer patients are running up large debts,
filing for personal bankruptcy, and even delaying or
forgoing treatment because they can't afford care. The study shows medical bills
underlie 60 percent of all U.S.
bankruptcies. A Lake Research Study found that a whopping 73 percent of
voters want everyone to have a choice of a public health insurance plan,
while only 15 percent want everyone to have private insurance.
Because we are again about to be sold out by our
congressional representatives, you must participate in this decision about
your healthcare. The time is now. This week the healthcare corporate
lobbyists are swarming Capitol Hill to defeat true healthcare reform. Call
Sen. Patty Murray, 202-224-2621. Call Sen. Maria Cantwell, 202-224-3441. Call
Rep. Norm Dicks, 202-225-5916. This is what democracy is all about. Our
economy and healthcare system depend on our massive involvement.
SEAN STEHURA
Port Townsend
http://www.ptleader.com/main.asp?SectionID=5&SubSectionID=5&ArticleID=24532&TM=32683.07
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(HealthNewsDigest.com) - Irvine, Calif. – A new survey
by Prescription Solutions, a leading pharmacy benefit management organization
and a UnitedHealth Group (NYSE: UNH) company, found that many Americans still
have limited understanding when it comes to the cost, ingredients and
effectiveness of generic drugs. The study also confirmed that the current
economic crisis is affecting consumer prescription drug use.
The use of generic drugs has saved the health care system
$734 billion over the past decade (IMS Health, 2009).
Jacqueline Kosecoff, Ph.D.,
chief executive officer of Prescription Solutions, said, “Using generics
helps make health care more affordable without compromising results. Many
Americans erroneously believe that the most expensive drug is always the most
effective drug, so by helping to change perceptions, we can help people save
money and still get the best treatment available.”
Knowledge of generics still limited; Economy causing
consumers to alter prescription drug use
Among the key findings of the Prescription Solutions
survey:
· Nearly one-third of Americans do not know or believe
that generics have the same active ingredients and effectiveness as brand
name drugs.
· Two-thirds of those surveyed do not understand the true
cost differences between brand name drugs and generics. Only 31 percent of
survey respondents indicated they knew that a brand name drug cost 50-70
percent more on average than its generic counterpart.
· 71 percent of consumers remain concerned about drug
costs – with more than one in four (27 percent) having either delayed
filling, not filled, or not taken as directed a prescription drug in order to
save money. Further, 21 percent of all respondents say they have talked to
their doctor recently about switching to a less expensive drug.
· 57 percent of those polled said they take prescription
drugs on a weekly basis. Of those who do so, 83 percent (or 47 percent of the
total sample) take generics. Further, among those
who take generics, 82 percent say they do so because of the lower cost.
· Of those who do not take generic drugs on a weekly
basis, 58 percent say it is because there is no generic available for the
drug they need.
· Doctors and pharmacists are key influencers in
encouraging the use of generics. Of those surveyed who take generic drugs on
a weekly basis, 64 percent say their doctor recommended generics and 43
percent say their pharmacist recommended them.
· Of those who do not take generic drugs on a weekly
basis, 58 percent say they would if their pharmacist brought a generic to
their attention as a less expensive, identical substitute; and 52 percent say
their doctor would have to recommend it.
Taken together, these survey findings demonstrate the need
to further educate consumers about the differences between brand name and
generic drugs and the potential value of generic drug use; and, doctors and
pharmacists have a major role to play in this effort.
A Look Forward The Next Cost Wave
As the nation looks at how to rein in health care costs
without sacrificing quality, generic drugs are a proven resource. However,
biologic drugs, also known as specialty drugs, are becoming the most costly
and fastest-growing area of pharmaceuticals, expected to grow from a $40
billion market in 2005 to more than $90 billion estimated by the end of this
year.
However, there currently are no generic alternatives for specialty
drugs.
Biologic drugs can cost tens of thousands of dollars a
year for a single person’s treatment needs. A regulatory approval pathway for
follow-on versions of these biologic drugs or biosimilars
must be created by Congress in order for patients, the government and U.S.
businesses to afford them,
Kosecoff said.
Prescription Solutions offers money-saving programs,
rewards, advice for consumer generics use
Prescription Solutions has found that when consumers use
generics regularly, it lowers the cost of insurance and helps keep premiums
lower in the long run. In fact, according to company data, a one percent
increase in generics utilization by consumers translates into 1.7 percent in
total cost savings for payers like employers. Equally important, Prescription
Solutions has found that, while results vary depending on the plan design,
members enrolled in its prescription drug plans typically save $20 upward to
over $60 per prescription when switching from a brand to a generic drug.
At a time when rising costs are taking an increasing toll
on many American families, especially during the economic crisis,
Prescription Solutions is working to ensure consumers have access to
lower-priced generic drugs, said Kosecoff.
The company offers innovative, money-saving programs to
influence and reward the use of generic drugs among customers. For example,
it partnered with clients and customers to help pioneer zero-dollar co-pays
for generics ordered through its mail service for seniors in Medicare Part D
plans. Among other programs, the company provides clinical education,
including cost-saving tips and information on lower cost alternative
medications for patients to discuss with their doctors and pharmacists.
Kosecoff offers these
five tips to consumers when it comes to navigating prescription drugs:
1) Use Generics When Available, and Shop for the Best
Price. Generic drugs on average are 50-70 percent less expensive than branded
drugs, but prices can differ from pharmacy to pharmacy or from drug plan to
drug plan.
2) Ask Your Doctor to Check Your Prescriptions. Have your
doctor regularly review the full set of medications you are taking to be sure
you still need them all and to determine if there are lower cost alternatives
that would work as well.
3) Consider Mail Service. Using mail service is often less
expensive and more convenient, and you have access to exactly the same
medications available at retail pharmacies as well as 24/7 access to
pharmacists.
4) Find Out if It Is to Your Advantage to Enroll in
Medicare Part D, if Eligible and You Don Already Have Coverage. Seniors and
other Medicare-qualified individuals should join a Medicare Prescription Drug
Plan, a.k.a. Part D plan, which can help qualified beneficiaries save money.
5) Explore Assistance Programs.
National and Community-based Charitable Programs (such as
the National Patient Advocate Foundation or the National Organization for
Rare Disorders) may have programs that can help you with drug costs.
Information is available on the Benefits Checkup website.
(www.benefitscheckup.org/)
Pharmaceutical Assistance Programs are offered by many of
the major drug manufacturers, especially for seniors enrolled in Medicare
Part D. Find out whether such a program is offered by the makers of the drugs
you take by visiting the Pharmaceutical Assistance Program site on
Medicare.gov.
State Pharmaceutical Assistance Programs are offered in 21
states and one territory to help pay drug plan premiums and/or other drug
costs. Find out if your State has a program by visiting the State
Pharmaceutical Assistance Program site at Medicare.gov.
Apply for Extra Help. If you have Medicare and have
limited income and resources, you may qualify for extra help paying your
prescription drugs. If you qualify, you could pay between
$1-$5 for each drug. Contact Social Security for more information by
visiting www.socialsecurity.gov.
Additional information can be found at www.prescriptionsolutions.com.
http://www.dentalplans.com/articles/43312/many-americans-still-have-limited-knowledge-of-generic-drugs.html
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By RICARDO ALONSO-ZALDIVAR and ERICA WERNER
WASHINGTON (AP) — The insurance industry Tuesday laid down
a marker on health care, warning in stark terms that a proposed government
insurance plan would dismantle the employer coverage Americans have relied on
for a half century and overtake the system.
In a joint letter to senators, the two largest industry
groups also said they don't believe it's possible to design a government plan
that can compete fairly with private companies in a revamped health care
market. That particular statement seemed to be aimed at lawmakers of both
parties who are seeking a compromise on the contentious issue.
Release of the letter from America's Health Insurance Plans
and the Blue Cross Blue Shield Association came as House Democrats pushed
forward with a partisan health care bill. Meanwhile, key Senate Democrats
were still laboring to achieve an elusive bipartisan compromise on President
Barack Obama's top legislative priority of controlling costs and providing
health coverage to 50 million uninsured Americans.
Recent media polls have found strong public support for
the idea of a government plan. It would compete with private companies to offer
coverage to individuals and small businesses, but eventually might be opened
to large employers as well. The positive public reaction to the idea has
emboldened liberals, who are arguing that Democrats shouldn't compromise.
The insurers suggested a government plan would run counter
to Obama's promise that Americans can keep the coverage they have.
"A government-run plan no matter how it is initially
structured would dismantle employer-based coverage, significantly increase
costs for those who remain in private coverage, and add additional
liabilities to the federal budget," said the letter from AHIP chief
Karen Ignagni and Scott Serota,
the head of Blue Cross.
Supporters of a public plan say just the opposite would
happen — that competition would force private insurers to cut administrative
overhead and profits, putting a brake on costs all around.
"We do not believe that it is possible to create a
government plan that could operate on a level playing field. Regardless of
how it is initially structured, a government plan would use its built-in
advantages to take over the health insurance market," added the industry
letter.
Instead, the industry says it is ready to accept close
government regulation to protect consumers. Dated June 19, the letter was addressed
to Sen. Edward M. Kennedy, D-Mass.
Kennedy's committee, the Health, Education, Labor and
Pensions panel, has not yet finished its design for a government plan. Bogged
down in delays and partisan strife, the panel jettisoned an end-of-week
deadline for passing its bill.
Deliberations on both sides of the Capitol are continuing
with lawmakers mindful of next week's July 4 congressional recess. Most will
return home to face constituents with plenty of questions about their plans
to overhaul the nation's costly health care system.
A sweeping bill unveiled in the Democratic-controlled
House last week is being weighed in hearings that got under way Tuesday. The
draft legislation, written without Republican help, would require all
Americans to purchase health insurance and would put new requirements on
employers, too.
Obama's goal for signing a bill in October appears in
doubt.
But Sen. Max Baucus, D-Mont., chairman of the Senate
Finance Committee, is doggedly pursuing a compromise. "We will get a
bipartisan agreement," he insisted Monday.
Of the five House and Senate committees working on health
care, Finance is the only one that appears to have a chance at a bipartisan
agreement. Baucus planned to huddle behind closed doors Tuesday with a group
of senators he's dubbed the "coalition of the willing." Others
involved are top committee Republican Charles Grassley of Iowa;
Republicans Mike Enzi of Wyoming, Orrin
Hatch of Utah and Olympia Snowe of Maine; and Democrats Kent Conrad of North Dakota and Jeff Bingaman of New Mexico.
Looming large is the question of cost. Initial estimates
had Senate plans topping $1.6 trillion over 10 years, and senators are
working to scale back. Curbs on Medicare and Medicaid spending are assured,
and a range of taxes are under consideration, along with the possibility of
fees on employers who don't cover their employees.
The Senate's health committee is waiting for revenue
estimates from the Congressional Budget Office on three scenarios for
employer requirements, according to Sen. Chris Dodd, D-Conn., who's leading
the committee during Sen. Edward M. Kennedy's treatment for brain cancer.
They are a requirement that employers provide health coverage for employees
or pay a fee; an approach requiring employers to chip in to the federal
treasury for employees who are covered under public plans; and a scenario
where employers who don't cover their employees would pay the government a
set amount per employee.
http://www.google.com/hostednews/ap/article/ALeqM5jlMpJGn28kqCcgU-aGcYE_ZHW-ywD990F2RG0
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ROCHESTER, N.Y., June 23 /PRNewswire-USNewswire/
-- A landmark study has successfully demonstrated a 29 percent reduction in
heart failure or death in patients with heart disease who received an
implanted cardiac resynchronization therapy device with defibrillator (CRT-D)
versus patients who received only an implanted cardiac defibrillator
(ICD-only).
MADIT-CRT (Multicenter Automatic Defibrillator
Implantation Trial with Cardiac Resynchronization Therapy) is a clinical
trial that enrolled more than 1,800 patients in the United States, Canada
and Europe and followed the patients for up
to 41/2 years. The results of the trial were released today by the University
of Rochester Medical Center and Boston Scientific, the study's sponsor. The
MADIT-CRT Executive Committee stopped the trial on June 22, 2009, when the
trial achieved its primary end point - significant reduction in heart failure
or death with CRT-D versus ICD-only. Cardiologist Arthur Moss, M.D.,
professor of Medicine at the University of Rochester Medical Center, led the
MADIT-CRT trial.
A prior study (MADIT-II) led by Moss and associates in
2002 showed the ICD was effective in reducing mortality. The current
MADIT-CRT study sought to determine if CRT-D could reduce the risk of
mortality and heart failure, which affects 5.7 million Americans, and the
results were very positive.
Patients with heart disease have a risk of arrhythmias and
heart failure. The new generation of cardiac resynchronization therapy
defibrillators (CRT-Ds) was designed to stop dangerous, life-threatening
heart rhythms and improve the heart's contraction, thereby enabling the device
to improve survival and prevent heart failure.
CRT-Ds are approved for use in patients with severe heart
failure (New York Heart Association class III/IV), where they have been shown
to reduce heart failure symptoms. The findings from the current study
indicate that CRT-D therapy improves cardiac function and prevents the
development of heart failure in patients who have not previously experienced
heart failure.
"Now we can prevent sudden cardiac death and inhibit
the development of heart failure, thus improving survival and outcome in
patients with heart disease," Moss said. "There is a very large
population of patients with heart disease who will benefit from this combined
therapy."
Prior to 2008, Moss received honoraria from Boston
Scientific for talks at scientific programs. He holds no stock in any device
company, and since Dec.
1, 2008, has received no honoraria from
Boston Scientific for any professional activity.
http://sev.prnewswire.com/health-care-hospitals/20090623/DC3717923062009-1.html
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The New York Times | 06.23.09
By JEFF ZELENY and ROBERT PEAR
WASHINGTON
— President Obama made a detailed case on Tuesday for a new
government-administered health insurance plan, but he did not rule out
signing a bill that lacks such an option if he cannot win enough support from
Democrats in Congress.
In a White House news conference, Mr. Obama dismissed as
“not logical” the suggestion that a public plan, which is intended to create
more competition and therefore act as a brake on the rise of health insurance
costs, would undermine the private insurance market. He argued that a government-run
plan competing with private insurers would be an “important tool to
discipline insurance companies” and scoffed at complaints that it could drive
some out of business.
“We have not drawn lines in the sand other than that
reform has to control costs and that it has to provide relief to people who
don’t have health insurance or are underinsured,” Mr. Obama said. “Those are
the broad parameters that we’ve discussed.”
With an uncertain fate for the public plan, the president
and insurance companies clashed sharply Tuesday. Two hours before Mr. Obama’s
news conference, the insurance industry fired off a new broadside against
proposals for a public insurance plan.
“We do not believe that it is possible to create a
government plan that could operate on a level playing field,” read a letter
to the Senate from Karen M. Ignagni, president of
America’s Health Insurance Plans, and Scott P. Serota,
president of the Blue Cross and Blue Shield Association. “Regardless of how
it is initially structured, a government plan would use its built-in
advantages to take over the health insurance market.”
Questions about a public plan are alive across Capitol
Hill. The White House chief of staff, Rahm Emanuel,
attended a closed-door meeting of senators on Tuesday evening in an effort to
assuage concerns.
Some leading Democrats, like Senator Kent Conrad of North Dakota, are
refining the idea of a nonprofit consumer-owned cooperative as an alternative
to a new government health insurance plan. Other Democrats, including Senator
Charles E. Schumer of New York,
prefer a full-fledged government plan.
Mr. Obama sought to build support for his health care plan
through the news conference, only his fourth since taking office. He also
will hold town-hall-style meetings with voters, including an hourlong program to be broadcast Wednesday on ABC News
from the White House.
Asked whether a public plan had to be in the bill if he
were to sign it, he said: “It’s too early to say that. Right now, I will say
that our position is that a public plan makes sense.”
He brushed aside concerns that a government plan would
drive private insurers out of business.
“If private insurers say that the marketplace provides the
best quality health care, if they tell us that they’re offering a good deal,
then why is it that the government — which they say can’t run anything —
suddenly is going to drive them out of business?” Mr. Obama said. “That’s not
logical.”
As the White House urged lawmakers to keep an open mind on
a public plan, a liberal advocacy group joined Republican senators on Tuesday
in criticizing one of the leading Democratic proposals to finance coverage of
the uninsured. Under the proposal, employers who do not offer “affordable”
coverage to employees would have to help pay the cost of such benefits for
their low-income workers.
Under the proposal, which was put forward by Senator Max
Baucus, Democrat of Montana and chairman of the Finance Committee, employers
would have to pay half the cost of providing Medicaid for any of their
low-income employees in that program. Employers would also have to pay the
full cost of subsidies for workers who buy coverage through a health
insurance exchange and qualify for assistance because they have low incomes.
The Center on Budget and Policy Priorities, a liberal
research and advocacy group, said this proposal “could unintentionally
discourage the hiring of lower-income people,” by adding a new “health
surcharge” to the cost of employing them. Under the proposal, it noted,
“employers would not have to contribute to the health insurance costs of any
other employees.”
The center’s concerns mirror those of Senator Orrin G.
Hatch, Republican of Utah. Mr. Hatch said Tuesday that the Democratic
proposal “would be a disaster, because it would create a disincentive for
employers to hire lower-income people on Medicaid.”
Mr. Baucus and Mr. Conrad said the Finance Committee had
made substantial progress in whittling down the cost of the bill. Senators
were shocked when the Congressional Budget Office said an earlier version of
the legislation would cost $1.6 trillion over 10 years.
“Costs have come down quite markedly,” Mr. Conrad said
Tuesday. He said senators had cut the costs, in part, by reducing subsidies
to help low-income people buy insurance.
Mr. Conrad said senators were “very actively negotiating”
on whether to create a new government insurance plan or a consumer-owned
nonprofit cooperative to compete with private insurers.
The co-op, as now envisioned, would get federal money to
start up, but after that it would have to survive on premiums and investment
income, as commercial insurers do.
Mr. Conrad has proposed an initial infusion of $3 billion
to $4 billion for the co-op. Mr. Schumer said the new entity needed at least
$10 billion. Mr. Schumer said a strong public plan was needed because “in
many areas of the country, one or two private insurers have a stranglehold on
the entire market.”
Mr. Obama concurred and suggested that a government-run
plan could create savings throughout the health care system. “If it turns out
that the public plan, for example, is able to reduce administrative costs
significantly,” he said, “then I’d like the insurance companies to take
note.”
http://www.nytimes.com/2009/06/24/health/policy/24health.html?_r=1&ref=health
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The New York Times | 06.23.09
By RONI CARYN RABIN
Over the course of human evolution, people with excess
stores of fat have been more likely to survive famines, many scientists
believe, living on to pass their genes to the next generation.
But these days, obesity is thought to be harmful, leading
to chronic inflammation and metabolic disorders that set the stage for heart
disease. So what went awry? When did excess fat stop being a protective
mechanism that assured survival and instead become a liability?
A provocative new hypothesis suggests that in some people,
fat not only stores energy but also revs up the body’s immune system. This
subgroup may have enjoyed a survival advantage in the 1800s, when people were
plagued by a disease that decimated Europe:
tuberculosis.
By some estimates, tuberculosis has killed more than one
billion people, eclipsing both the bubonic plague and the Spanish flu.
But the heightened immune response that helped some
overweight adults survive tuberculosis is now an “evolutionary anachronism”
that has outlived its usefulness, said Dr. Jesse Roth, who outlined the idea
this week in The Journal of the American Medical Association.
“Fat is not simply a collection of calories, it is acting
like a part of the innate immune system,” said Dr. Roth, an investigator at
the Feinstein Institute for Medical Research in Manhasset, N.Y. “But this
immune system has a downside.”
“We are paying a price for a highly activated defense
system that’s now pretty obsolete,” he added.
The idea has been greeted with some skepticism. It fails
to explain why obesity is rampantly increasing, several experts said, and it
does not provide a framework for resolving the epidemic.
Yet the question Dr. Roth tries to answer has baffled
scientists. The “thrifty gene” hypothesis suggests that evolution favored
those who could store fat reserves that helped them withstand lean times,
like periodic famines and food shortages.
But that does not explain why body fat carries so many
drawbacks, setting off inflammation and metabolic disorders like insulin
resistance, high cholesterol and atherosclerosis.
Visceral fat, which is stored in the abdomen, tends to
cause more inflammation than subcutaneous fat, which is stored closer to the
skin, on the arms and legs. It is possible that survival during the
tuberculosis era favored those who stored excess visceral fat, Dr. Roth said.
Dr. Anthony S. Fauci, director
of the National Institute of Allergy and Infectious Diseases, called Dr.
Roth’s explanation “very, very hypothetical.”
“His hypothesis,” Dr. Fauci
said, “is that if so many people have this propensity — not just for obesity,
but for the inflammatory response and atherosclerosis that generally goes
along with the tendency to be obese — they must have been selected
evolutionarily.”
But people rarely lived long enough to develop heart
disease in earlier centuries, he said, adding, “The long-range negative
effects of this genetic propensity would rarely be seen.”
http://www.nytimes.com/2009/06/24/health/research/24fat.html?ref=health
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The New York Times | 06.23.09
By RONI CARYN RABIN
Obesity is known to increase the risk of developing
pancreatic cancer, a particularly aggressive type of cancer. But a new study
suggests the risk is greatest among people who were already overweight during
their teenage years or obese during their 20s and 30s.
Adults who were overweight as teens were twice as likely
as similar adults who had never been overweight to develop pancreatic cancer
later in life, and people who were obese as young adults were at more than
twice the risk of adults who had never been obese, the study found.
“That’s an important finding, because it tells us that
weight control at a younger age is really important if we want to reduce the
risk of this disease,” said Donghui Li, a professor
of cancer medicine at the University
of Texas and an author
of the new study.
The paper, to be published on Wednesday in The Journal of
the American Medical Association, compared 841 pancreatic cancer patients
with 754 healthy people matched by age, race and sex. Personal interviews
were done to obtain detailed histories of the participants’ height and weight
at each age period, as well as information about alcohol use, smoking and
family and personal medical backgrounds.
Smoking and diabetes also increased the risk of pancreatic
cancer, with obesity accounting for 27 percent of cases and smoking for
one-quarter of all cases. “Diabetes is a risk factor, but even without
diabetes, obesity increases the risk,” Dr. Li said.
http://www.nytimes.com/2009/06/24/health/24cancer.html?ref=health
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The New York Times | 06.23.09
By Tara Parker-Pope
Most people assume their doctor will call them if they get
a bad test result. But new research shows that doctors frequently fail to
inform patients about abnormal test results.
In a study led by doctors at Weill Cornell
Medical College,
researchers analyzed 5,434 patient records from 23 doctors’ offices around
the country. The research, published in The Archives of Internal Medicine,
found that the rate at which doctors fail to inform their patients varies. In
some practices surveyed, doctors had a near perfect track record for
informing patients about test results. In others, as many as one in four
patients failed to get the
bad news. Overall, the research
found that about 7 percent of patients aren’t getting essential information
about their health.
The researchers found that most doctor’s
offices didn’t have clear rules for managing test results. And researchers
said that many medical practices advise patients to make the “dangerous
assumption” that no news is good news. Notably, whether an office had
electronic medical records didn’t influence the likelihood of getting called
with your test results. The determining factor was whether an office took a
few simple steps to insure that patients got the information they needed,
including making sure that each patient’s own doctor always signed off on
test results.
Last year, another study published in the journal Quality
& Safety in Health Care reported that about one in every 30 office visits
results in a testing mistake. The biggest problems involved getting the
results back from the lab, which accounted for 25 percent of the mistakes
studied. Other mistakes included delays in returning results, errors on the
results report or failure by the lab to provide any results to the doctor’s
office. The problems were compounded by lack of follow-up by the physician’s
office. About 7 percent of the mistakes involved failing to notify patients
of the results.
To learn more, read Nicholas Bakalar’s
full story and interview with the researchers, “Abnormal Test Results May Not
Get to Patients.” And then, please join the discussion below. Have you
experienced a testing mistake? Did your doctor fail to inform you of abnormal
test results?
http://well.blogs.nytimes.com/2009/06/23/when-no-news-is-bad-news/
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The New York Times | 06.23.09
By DONALD G. McNEIL Jr.
Contrary to the popular assumption that the new swine flu
pandemic arose on factory farms in Mexico,
federal agriculture officials now believe that it most likely emerged in pigs
in Asia, but then traveled to North America
in a human.
But they emphasized that there was no way to prove their
theory and only sketchy data underpinning it.
There is no evidence that this new virus, which combines
Eurasian and North American genes, has ever circulated in North American
pigs, while there is tantalizing evidence that a closely related “sister
virus” has circulated in Asia.
American breeding pigs, possibly carrying North American
swine flu, are frequently exported to Asia,
where the flu could have combined with Asian strains. But because of disease
quarantines that make it hard to import Asian pigs, experts said, it is
unlikely that a pig brought the new strain back West.
“The most likely scenario is that it came over in the
mammalian species that moves most freely around the world,” said Dr. Amy L.
Vincent, a swine flu specialist at the Agriculture Department’s laboratory in
Ames, Iowa,
referring, of course, to people.
The first person to carry the flu to North America from Asia, assuming that is what happened, has never been
found and never will be, because people stop carrying the virus when they get
better.
Moreover, the officials said, the chances of proving their
theory are diminishing as the virus infects more people globally. It has now
reached more than 90 countries, according to the World Health Organization.
Since some of those people will inevitably spread it to pigs, its history
will become impossible to trace.
“To tell whether a pig is newly infected by a human or had
the virus before the human epidemic began really can’t be done,” said Dr.
Kelly M. Lager, another Agriculture Department swine disease expert.
The highly unusual virus — which includes genetic bits of
North American human, avian and swine flus and
Eurasian swine flu — has not been detected in any pigs except those in a
single herd in Canada that was found infected in late April.
A carpenter who worked on the farm after visiting Mexico had
been thought to have infected the herd. But in mid-June, Canadian health
agencies said he was not to blame. The whole herd was culled, and the virus
has not been found elsewhere in Canada, as it would have been if
it were endemic, since American and Canadian laboratories test thousands of
flu samples to help the pork industry develop vaccines.
But a sample taken from a pig in Hong
Kong in 2004 was recently found to have a virus nearly matching
the new flu. That flu, which had seven of the new flu’s eight genome
sequences, was noted in an article in Nature magazine on June 11, which
called it a “sister virus.”
Scientists tracking the virus’s lineage have complained
that there is far too little global surveillance of flu in swine. Public
databases have 10 times as many human and avian flu sequences as they do
porcine ones, said Dr. Michael W. Shaw, a scientist in the flu division of
the Centers for Disease Control and Prevention, and there are far fewer pig
flu sequences from Asia than from North America and Europe, and virtually
none from South America or Africa.
“Something could have been going on there for a long time and we wouldn’t
know,” Dr. Shaw said.
But national veterinary officials said they knew of no
close relatives of the new virus in the large private North American
databases, either. That makes it most likely, they said, that it has been
circulating in Asia.
The new virus was first isolated in late April by American
and Canadian laboratories from samples taken from people with flu in Mexico, Southern California and Texas. Soon the
earliest known human case was traced to a 5-year-old boy in La Gloria, Mexico, a rural town
in Veracruz.
Because that area is home to hog-fattening operations with
thousands of pigs in crowded barns near lagoons of manure, opponents of
factory farming were quick to blame the industry.
In May, the Mexican government said it had tested pigs on
the Veracruz
farms and found them free of the virus. Smithfield Foods, an owner of the
farms, and the National Pork Producers Council, the industry’s lobbying arm,
were quick to publicize that announcement.
But outside veterinary experts still disagree on whether
those tests proved anything.
According to Smithfield,
Mexican government veterinarians tested snout swabs taken on April 30 and
blood samples stored since January.
But since the human outbreak in Veracruz is believed to have started in
February, many veterinary experts said testing pig snouts for live virus in
April proved nothing. Any pig sick in February would have long since
recovered and, since hogs are usually slaughtered at 6 months old, many of those alive in early February would be bacon
by April.
But Dr. Greg Stevenson, an expert in swine diagnostics at Iowa State
University, said that
since flu could persist in a large herd for months, “if it had been there in
February, it would probably still be there at the end of April.”
The blood tests — in which scientists look for antibodies
formed in response to a previous infection — present a different set of
problems. Antibodies
are much harder to tell apart
from one another than viruses are.
A pig that had the new H1N1 flu would come up positive on
an antibody test. But so would a pig that had the regular H1N1 swine flu that
has circulated since 1930, or even a pig that had been vaccinated against the
earlier H1N1 flu — and all the Smithfield pigs routinely get flu shots.
The company said vaccinated pigs could be distinguished from
previously ill pigs because illness produced more antibodies.
But outside experts were skeptical. An antibody test
specific enough to identify only the new flu strain “would take months to
develop, at a minimum, and would require considerable R & D expertise and
technology,” said Dr. Christopher W. Olsen, a swine flu expert at the University of Wisconsin’s veterinary medical school.
The governor of Veracruz
has asked the National Autonomous University of Mexico to do its own
investigation of industrial hog farming in his state; the work is expected to
take months. Carlos Arias, the biochemist leading the team, said he hoped to
test all the swab and tissue samples stored by the farms and the national
veterinary laboratory.
http://www.nytimes.com/2009/06/24/health/24flu.html?_r=1&ref=health
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