Advocate staff report
The LSU Health Care Services Division Office of
Communications and Media Relations received honors from the Press Club of New
Orleans in its 2009 annual journalism and public relations competition. The
awards and categories were first place in “Best TV PSA” for an agency or
staff of five or fewer; second place for “Best Electronic Newsletter;” and
third place in “Best Public Relations Campaign” for an agency or staff of
five or fewer.
The staff includes Marvin McGraw, director; Michael
Higgins, coordinator; Shawn Taylor, public information officer; and Stephanie
Aymond, administrative assistant. Marcia Kavanaugh of the Interim LSU
Public Hospital
media relations participated in the production of the PSA’s.
Korry Melton and Kevin Barraco
of KSM Advertising provided production services, and Jere
Hales served as on-camera spokesperson.
http://www.2theadvocate.com/news/business/52689447.html
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New Orleans CityBusiness |
08.10.09
by Richard A. Webster
The odds against Louisiana State
University’s gleaming
new downtown medical complex seem to be increasing.
First, the Federal Emergency Management Agency came up
more than $300 million short of LSU’s request for reconstruction funding.
Then state lawmakers tried to block the acquisition of property in lower
Mid-City where plans call for the hospital to be built.
Finally, LSU rejected a proposal for a shared governing
board with Tulane and Xavier universities that would limit LSU to four of the
11 seats.
On top of that, opponents of the Mid-City site have filed
lawsuits to block construction, and time is ticking on a deadline to turn
over city property for a Veterans Administration hospital planned next to the
LSU facility.
Now the fate of the $1.2 billion medical complex, hailed
as a surefire economic boon and the future of health care, appears to be
permanently trapped in limbo four years after Hurricane Katrina. And no one
can provide a definitive answer as to what will happen next.
Tulane University President Scott Cowen remains hopeful New Orleans will one day
see a new Mid-City hospital facility.
“I’m cautiously optimistic FEMA will provide the funding
we asked for and feel is warranted and that the new hospital will be built,”
Cowen said. “And that’s what we will continue to believe until we hear
differently from FEMA.”
The New Orleans Business Council remains a steadfast
supporter of the LSU plan but is concerned that its board of supervisors’
recent rejection of a joint governing board could be a crucial setback, NOBC
chairman Greg Rusovich said.
Securing the $492 million FEMA funding is key, but the best way to accomplish that is by presenting
a united front, he said.
“We have to get coordinated but unfortunately with the
recent breakdown in discussions we don’t have a coordinated approach,” Rusovich said. “I don’t think FEMA will be as cooperative
without that governance settled. The good of the community is at stake here
and certainly its medical health. It’s critical this is worked out.”
Sandra Stokes, executive vice chairwoman of the Foundation
for Historical Louisiana, said the trouble started from the very beginning
when state officials did not allow public input on the site selection
process. The foundation is opposed to LSU abandoning the old Charity Hospital campus.
“If the state had been open and transparent from the
start, if they went through the public process and engaged the people, I
don’t think they’d be in the position they are in now, pushing through a bad
plan that never had a chance of completion,” Stokes said.
Stokes has been a consistent critic of LSU’s proposal and
has pushed a plan to renovate and reopen the old Charity facility. But just
because the LSU plan seems to be stuck in neutral doesn’t necessarily mean
the movement to reopen Charity will gain new support. Stokes said her
attempts to contact Gov. Bobby Jindal have been
rebuffed at every turn.
“We’ve never gotten the chance to present the plan to
reopen Charity to him,” she said. “We’ve asked for meetings but have never
had opportunity to go in. It seems like he’s been isolated and hasn’t gotten
as many of the facts as he needs to have.”
Walter Gallas, director of the
National Trust for Historic Preservation’s field office, is convinced LSU is
going to proceed with plans to build the new hospital no matter how badly the
odds are stacked against them. The trust has filed a lawsuit challenging the
planning process for the LSU hospital.
“They have $300 million from the state that’s now being
used to do designs for the hospital,” Gallas said.
“My sense is they’re eager to show this project will be too far along to stop
it. They’re going to spend the money they have on design so if something
happens they can say, ‘Look how much money has been spent already. It’s too
late to change direction. We need to move this forward.’”
There is one person, however, who thinks the delay in
replacing the old Charity with either a new hospital or a renovated Charity
may benefit the city.
Health care will soon undergo massive changes with the
federal push for reform, and that could have a significant impact on what a
new hospital should look like and how care is delivered, said Dr. Ann Cary,
director of the Loyola University School of Nursing.
“The silver lining in this is that in next 18 months we’ll
know more clearly what the nature of health care reform will look like,” Cary said. “And
shouldn’t the function follow the form? The delay is frustrating. But suppose
we built this facility two years ago for acute care, and then the whole
organization of health care suddenly changed and it didn’t fit our model.
Sometimes things happen for a reason.”
http://www.neworleanscitybusiness.com/viewStory.cfm?recID=33846
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New Orleans,
LA – The School of Medicine at
LSU Health Sciences Center New Orleans has admitted the largest freshman
class in the history of the school – 201 students. They are participating
in orientation activities on the downtown LSUHSC campus today in preparation
for the start of classes on Wednesday, August 12, 2009. The incoming class
comprises 107 males and 94 females.
By comparison, 188 students were admitted in 2008. The
2009 incoming freshman class represents a 19% increase over the freshman
class of 2004, which was 169 students.
“As the primary source of Louisiana’s
physicians, we are addressing the projected physician shortage to ensure that
the citizens of this state will continue to have access to high quality
health care,” notes Dr. Steve Nelson, Dean of the School of Medicine
at LSU Health Sciences Center New Orleans.
The larger class sizes also accommodates
the medical school’s expanding Rural Scholars Track Program which prepares
medical students to practice in Louisiana’s
rural communities where they are most needed. Tuition is waived for students
enrolled in the LSUHSC School of Medicine’s Rural Scholars Track Program,
which is one of the most successful in the country.
The class of 2013 also includes students admitted to the
MD/PhD Program, which is one of the rare exceptions to the school’s Louisiana residency
admissions requirement.
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SHREVEPORT,
LA (KSLA) - While some students
prepare to return to the classroom, it was graduation day for some Ark-La-Tex
medical students Saturday.
60 students walked across the stage Saturday and were
awarded degrees from LSU Health Sciences
Center in Shreveport.
The keynote speaker for this year's commencement exercise
was Shreveport Chancellor, Dr. Robert Barish.
Barish says it's a great time to
bring more doctors into the state of Louisiana.
"We just have outstanding graduates who are now going
to help the citizens of Louisiana, we at
LSUHSC in Shreveport
are really proud to be a part of their training," said Barish.
Chancellor Barish added that
nearly 90 percent of the new doctors will stay in Louisiana to practice.
Other majors ranged from Occupational Therapy to
Cardio-Pulmonary Science.
http://www.ksla.com/Global/story.asp?S=10872561&nav=menu50_2
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New Orleans CityBusiness |
08.10.09
by Richard A. Webster
Starting this month, the New Orleans Musicians Clinic is
no longer providing mental health services. Next up on the chopping block
could be its gig fund, which bankrolls work for struggling musicians when
jobs are sparse.
And if the financial picture gets any worse, vital medical
procedures could be endangered as well as the future of the clinic itself.
“Everyone is talking about health care reform, but what
happens to those of us who are running out of money who treat the uninsured
now?” NOMC director Bethany Bultman said.
The Musicians Clinic received a three-year $3 million
grant from the U.S. Department of Health and Hospitals in 2007. The money
allowed the clinic to provide mental health services in addition to paying
for costly surgeries and chemotherapy treatments, and it freed up other funds
for the paid gig program.
But with the sunset of the federal funds on the horizon
and no other sources of money emerging, musicians may once again be left
without critical health care services.
In September the clinic will receive its last federal
payment of $500,000, which covers the remaining 14 months of the grant. And
that is nowhere near enough to cover its current level of services, Bultman said.
During the grant’s first two years, the number of patients
receiving care at the clinic skyrocketed from 987 to 1,683 as of March. The
clinic was forced to put its budget under the knife in July when the decision
was made to eliminate mental health services.
The money provided to St. Anna’s Episcopal Church medical
van was reduced from $141,000 over 12 months to $40,000 for 14 months. And
the gig fund shrunk from $14,000 a month to just $10,000 a month through the
end of the year at which point the program’s future will be reassessed.
The decision will not be easy, Bultman
said.
“Do we provide gig funding so an elderly performer can use
his performance fee to pay his car note? Or do we pay for his ongoing
glaucoma care so he can read his music? Or do we help pay for his dental care
so he can continue to play his trumpet?”
The clinic’s budget decreased from $872,291 over 12 months
to $635,000 over 14 months.
The only thing that can save NOMC is the New Orleans
community, Bultman said, but so far it has not
stepped up to the plate. Besides the medical services provided by Louisiana State and Tulane universities,
donations from the private sector and local organizations are almost
nonexistent.
“The dirty little secret is that a small Rotary Club in
northern Germany
gives us $9,000 once or twice a year and does everything they can to make
sure we survive. And that’s more than all the private donations from New Orleans combined,” Bultman said.
Many people talk a good game when it comes to supporting
musicians but few back it up financially.
“These are the same people who say, ‘Can you get me on the
list for the Dr. John show? Can you get me on list so I don’t have to pay the
cover charge because I’m special?’” Bultman said.
“And then they sit at the table but won’t put money in the tip jar. It seems
that when it comes down to it, no one really views musicians as being the
most vital natural resource we have.”
Musicians struggle more than most groups. Their average
income is $12,000 a year, according to Sweet Home New Orleans. More than 83
percent of those enrolled at the clinic receive medication for a chronic
condition.
“If we don’t get funding, we’ll become a very small clinic
that only has pro bono resources,” Bultman said.
“There won’t be a gig fund or community outreach like nutrition and wellness
programs. And our ability to pay for chemotherapy and hand surgery are going
to be completely diminished within a year.”
Before the clinic offered mental health services, it was
rare if not unheard of for a musician to seek psychiatric care, said Dr.
Janet Johnson with Tulane
Medical Center’s
Department of Psychiatry. Mental health care is often stigmatized among
musicians, as many fear treatment will rob them of their creativity and
ability to perform. But they trust the clinic and took advantage of its
services, she said. At one point more than 200 musicians were in some form of
therapy or treatment.
Johnson saw 100 musicians through the clinic but will be
forced to reduce that number to 20 because of the budget cuts. And if the
musicians can’t rely on the clinic to receive psychiatric care, it is
unlikely they will seek care at another facility, she said.
Musicians are a unique class of patients with special
needs who work odd hours and often can’t fit into the average doctor’s
schedules. But the clinic was flexible and able to work with them. Musicians
will begin to neglect their physical health if they do not receive ongoing
mental health care, Johnson said, which could lead to severe problems if they
neglect conditions such as arthritis, diabetes or high blood pressure.
“Bethany
made mental health services available and encouraged it, and to lose these
services now is particularly heartbreaking,” she said. “This was the first
time musicians have actually been accepting this kind of help.”
http://www.neworleanscitybusiness.com/viewStory.cfm?recID=33836
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New Orleans CityBusiness |
08.10.09
by From CityBusiness Staff
Reports
The state health department last Tuesday started paying
many private health care providers less money for taking care of Medicaid
patients.
The payment rate cuts are part of the Department of Health
and Hospitals’ budget reductions for the current fiscal year. Jerry Phillips,
state Medicaid director, said the cuts will save an estimated $86 million
this year.
State health officials say it will take about a month to
fully implement the rate changes.
Among the cuts, private hospitals throughout the state will
be paid 5 percent to 6 percent less for services, depending on the type.
Doctors who care for patients older than 16 will be paid 10 percent less.
Health and Hospitals Secretary Alan Levine said he also is
considering requiring adults in the Medicaid program to submit a co-pay if
they use emergency rooms for nonemergency care.
North Oaks keeps expansion on hold because of economy
A nearly $200 million expansion at North Oaks Health
System in Hammond remains on hold because of unfavorable conditions in the
municipal bond market, hospital officials said.
The expansion is in its third and final phase, but a new
completion date has not been determined. Projects on hold include a $90
million five-story hospital addition and a medical office plaza.
Two projects remain unaffected and are on track, including
a $6.5 million parking garage scheduled to open one month early in September.
The $32 million North Oaks-Livingston Parish Medical
Complex in Satsuma also broke ground in April and is expected to open by the
fall of 2010.
The overall expansion was expected to be completed in
2011. After Hurricane Katrina, the hospital was tasked with completing what
was once was a 10-year expansion in five years.
http://www.neworleanscitybusiness.com/viewStory.cfm?recID=33838
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Shreveport Times | 08.10.09
By Melody Brumble
Private hospitals in Shreveport,
Bossier City and Minden are analyzing how they'll absorb an
estimated $9 million in Medicaid cuts.
The estimates are from an analysis by the Louisiana
Hospital Association. The cuts could mean $98 million in lost revenue for
private hospitals throughout the state. The association estimates the lost
income could mean a loss of about 179 jobs in northwest Louisiana and 1,000 statewide.
The decrease in Medicaid reimbursements to private
hospitals and doctors is part of state budget-cutting efforts. The cuts don't
affect public hospitals like LSU Hospital in Shreveport
or rural hospitals like North
Caddo Medical
Center in Vivian.
The projections don't include income losses to individual
doctors or practices that accept Medicaid.
Christus Schumpert
Health System would take the biggest hit locally, with a projected income
loss of slightly more than $5 million. The projections include cuts the state
made in February and cuts that started Aug. 1.
Nearly half of Christus Schumpert's cuts would come for services provided to
premature babies and adults with complicated medical conditions.
"There is obviously concern about how this may impact
our facilities and the services we provide," said Sally Croom, spokeswoman for Christus
Schumpert. "We are disappointed in the
decision to cut state Medicaid dollars, but providing quality care to all
those we are privileged to serve remains our focus."
The hospital system is "committed to working with our
state's legislators to ensure that access to care continues in our
community," Croom said.
Willis-Knighton Health System
stands to lose about $3.2 million, according to the association's analysis.
Willis-Knighton administrators
declined to offer details about how the system will handle the projected
income loss.
"Willis-Knighton will make
the appropriate adjustments while continuing our focus on providing
high-quality health care to the community," said Charlie Cavell, a
spokesman for Willis-Knighton.
Some Louisiana
hospitals are starting hiring freezes and reducing employee benefits in an
effort to handle the cuts, said John Matessino, the
association's president and CEO.
Health care providers continue to negotiate with state
health officials to lessen the impact of the cuts, state Sen. Sherri Smith
Cheek said.
Most of those discussions focus on what services doctors
and other providers think is most important, the Keithville Republican said.
"It really comes down to a lot of billing issues.
"Everybody's at the table trying to do the least
amount of damage. That's good," Cheek said.
"But then you realize there is that limited pool of dollars, and you realize quite quickly that you're
probably not covering the actual cost of them delivering that care."
http://www.shreveporttimes.com/article/20090810/NEWS01/908100308
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Associated Press
(AP)
Louisiana
health officials urge families to add flu prevention to their back-to-school
plans.
State Health Secretary Alan Levine said both seasonal and
H1N1 flu are expected, so it makes sense to plan.
That includes standard hygiene tips such as covering the
mouth and nose with a tissue when sneezing, and washing hands often with soap
and water, especially after coughing or sneezing.
Health officer Jimmy Guidry suggests getting both the
seasonal and H1N1 flu vaccines when available, and staying home when ill.
http://www.2theadvocate.com/news/52802657.html
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New Orleans CityBusiness |
08.09.09
by The Associated Press
WASHINGTON — It's one issue in the health care debate that
nearly everyone — even the insurance lobby — seems to agree on: Better consumer
protections are needed to end the nightmare of not being able to get covered
for a treatable, if costly, illness.
Yet such practical considerations are being overlooked in
a debate that's become a passionate argument about the government's reach and
role in medical matters.
Experts say the bills before Congress include significant
consumer protections that would end denial or cancellation of coverage for
medical reasons, from high cholesterol to cancer.
Insurers no longer could base premiums on a person's
medical history, although they still could charge more to 50-year-olds than
to people in their 20s.
People buying their own policies, and those working for
small businesses, would gain many of the advantages employees of Fortune 500
companies now have. That would eliminate "job lock," the fear of
leaving employment that provides medical benefits.
"It would bring insurance and insurabilty
standards into line with medical practice and with the way people live their
lives," said Dallas Salisbury, president of the nonprofit Employee
Benefit Research Institute. "When people are in the doctor's office,
they're worried about that day's issue. You're not thinking, 'If I take this
pill for my cholesterol, will it cause me to be denied insurance coverage in
the future?'"
If President Barack Obama's effort to remake the health
care system implodes, chances are slim that such protections could be enacted
on their own. What consumer groups call discrimination by insurance
companies, the industry sees as self-defense against people who put off
getting coverage until they're seriously ill.
Major insurers will accept a rollback of the industry's
restrictive practices only if they're guaranteed that all Americans would be
covered — a central goal of Obama's approach and a potential financial boon
to the industry.
The consumer protections are part of what Republican Sen. Mike
Enzi of Wyoming
calls the 80 percent of health care fixes that there's consensus for. Enzi is
one of six members of the Senate Finance Committee who are trying work out a
bipartisan solution — with no guarantee of success.
Obama may have made a critical error by not stressing the
consumer aspects of the legislation, and his advisers seem to have realized
it as they belatedly retooled the White House pitch in recent days.
If a bill does pass, the biggest winners are likely to be
self-employed people and small-business owners and employees, who now have
the most trouble getting and keeping coverage. Those working for big
companies would only benefit indirectly; they'd find it easier to keep their
coverage if they get laid off or leave to launch a new career.
Insurance companies could come out ahead, too.
"They'll get a big new market with millions and
millions of new customers," said Gary Claxton, a health policy expert
with the Kaiser Family Foundation. "Their average profit per person may
not be as high, but they still should be able to earn a profit by insuring
more people."
One major catch is that the consumer protections would not
be available immediately. They are timed to take effect alongside government
subsidies to help people buy coverage. In the House Democratic legislation,
the coverage expansion would come in 2013 — after the next presidential
elections. Part of the reason for the delay is to make the costs of the bill
appear more manageable.
"It's a long time to wait," said John Rother, policy and strategy chief for AARP. "This is
complicated stuff, but I would have personally liked to see it done in two
years."
The House legislation, the Senate health committee bill
and the evolving Senate Finance Committee package differ on some important
specifics, but follow the same general approach.
All would set up an insurance marketplace. This exchange
would be open to individuals and small businesses, and maybe big companies
later on. Government subsidies would be available for low-to-middle income
households. People buying health insurance through the exchange would be part
of a large pool that spreads risks, giving participants leverage similar to
what government employees — including lawmakers — now have.
Health plans offered through the exchange would have to
meet basic standards, so it would be easier for consumers to understand what
their insurance covers. To protect against catastrophic illness, there would
be annual limits on out-of-pocket costs for co-payments and deductibles.
Year-to-year increases in premiums would be more predictable for small
companies.
Insurers could not charge more to people in poor health or
to women, as they do now. But they still could charge higher premiums due to
family size, geographic location and age.
The House and the Senate health committee bills would
limit age-related premiums so that a 64-year-old pays no more than twice as
much an 18-year-old. But Senate Finance Committee negotiators are considering
allowing as much as a 5-to-1 difference, a big savings for the young but a
significantly higher cost for older people who are more likely to have health
problems.
The federal consumer protections would set a basic
standard for the whole country, changing a situation in which state-level
safeguards vary widely.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=26185
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Terry Verigan
The ignorance and misguided opinions that have run rampant
in this newspaper regarding H.R. 3200, "America's Affordable Health
Choices Act of 2009," just amaze me.
You would think that the public would have learned from a
decade of misdirection and obfuscation that the GOP is the party of big
profits and corporate America.
It lies and confuses in order to get people angry, to keep them from engaging
in a civil discussion of the challenges we face.
The undeniable truth is that Congress, the elderly and
veterans all have access to the best health care systems in America, rivaling the best
systems in the world. The GOP does not want us to understand that the systems
serving Congress, the elderly and veterans are the result of government
takeover. These systems are government-run.
I want some of that, too!
Among them, Sens. Mary Landrieu and David Vitter and the
rest of the Louisiana
congressional delegation have accepted millions of dollars in "campaign
contributions" from the very industries that have made billions in
profits from our misery. What a deal.
Instead of representing Wall Street, insurance companies,
and the health care industry, Louisiana's
congressional delegation needs to try representing American citizens for a
change. What a concept!
Terry Verigan
Metairie
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1249881636214610.xml&coll=1
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Tim Ortego
I do not want to subsidize more Americans’ health care
than I am doing already with inevitable increases of middle-class taxes.
The numbers keep fluctuating, but about 90 percent of
Americans have health insurance, and of that, 80 percent are satisfied with
their coverage. The 10 percent who do not have coverage is tricky because
some can afford coverage, but choose not to purchase coverage. Because this
is America,
that is their FREEDOM.
The Emergency Medical Treatment and Labor Act allows for
anyone with no insurance (the 10 percent) to walk into a hospital and be
stabilized, and charity hospitals treat those with little to no income, hence
the name.
So do we really have people who cannot be treated? Some
would argue, “But it’s not great treatment, and it is limited.” I would say
that you get what you pay for.
I pay for my family’s insurance, like the other 90 percent
of us out there, and I also pay for Medicare/Medicaid, so I expect good
treatment for my family, and do not want to water down my treatment and wait
longer to cater to the 10 percent. Call me selfish, but I am tired of footing
the bill for everyone else. The honeymoon is over, and it’s time to say no.
Tim Ortego
educator
Washington
http://www.2theadvocate.com/opinion/52722837.html
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Michael S. Ellis, M.D.
As a physician, I have watched with great interest the
push to reform our health care system. My personal belief is that reform is
about more than paying bills. It's about delivering quality care and
treatment to patients. Patients must come first. The way to do this is by
thoughtfully fixing the current system, not trying to rush through plans to
build a new one.
What I am most concerned about is the public option, a
euphemism for another government insurance product designed to compete
against private insurance companies. With Medicare nearly bankrupt and
Medicaid bankrupting states, do we believe more government will be better?
Original cost estimates for each of them were a fraction of the actual cost.
I see this state's medical care up close every day. In Louisiana 17 percent of our population is uninsured (21
percent in New Orleans)
and 24 percent have Medicaid. These patients have major access problems,
particularly to specialty care. The huge administrative costs and
certification hassles of Medicare -- and private insurers -- need reform, but
if we aren't careful, we could make all of this worse.
Congress is facing a health care bill with 1,000 pages,
which leadership has placed on the fast track. Hidden in the fine print is
the fact that government bureaucrats will decide which treatments are
covered. Patients will lose freedom of choice at all levels of the
decision-making process.
There are ways to reach our nation's health care goals
that will leave us with choices in coverage instead of a one-size-fits-all
approach.
We should proceed with caution and make sure we are aware
of what is in this bill and what its impact will be on patients.
Lives are at risk.
Michael S. Ellis, M.D.
New Orleans
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1249708912261300.xml&coll=1
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Robert E. Thomas
Re: "Will 'right to die' become obligation?", Other Opinions, Aug. 4.
Many thanks to columnist Cal Thomas for providing advance
warning of the inevitable leap from "Obamacare"
to government-mandated assisted suicide.
The fact that the Obama health plan has no such provision
is but a minor detail; why let the facts get in the way of a good story line
which is part and parcel of an overall effort to derail much-needed
health-care reform?
The "slippery slope" we're on is being
lubricated by the distortions, half-truths, and outright misstatements by
such conservative commentators.
Robert E. Thomas
Metairie
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1249622446136390.xml&coll=1
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Shreveport Times | 08.07.09
By Melody Brumble
Groups representing hospitals and health care providers
are still talking with state health officials to lessen the effects of
Medicaid reimbursement cuts.
Private hospitals around Louisiana could lose slightly more than
$98 million between cuts made in Februray and those
that became effective Aug. 1, according to an analysis by the Louisiana
Hospital Association.
The discussions are about details of reimbursement rates,
for example how much an anesthesiologist would be paid for one type of
procedure versus another, said state Sen. Sherri Smith Cheek, R-Keithville.
"It really comes down to a lot of billing
issues," Cheek said. "It's good that there's collaboration, but you
realize there's a limited pool of dollars, and you realize quite quickly
you're probably not covering the actual cost of them delivering that
care."
Local private hospitals, including Christus
Schumpert and Willis-Knighton
health systems, stand to lose about $9 million, according to LHA estimates.
The cuts don't affect public hospitals like LSU Health
Sciences Center-Shreveport or rural hospitals like North Caddo
Medical Center.
The cuts are part of a state plan to trim $86 million from
the state budget.
The LHA estimates that the cuts could lead to a loss of
179 direct and indirect jobs in northwest Louisiana and about 1,000 jobs statewide.
Direct jobs are those in health care. Indirect jobs are
jobs in other kinds of businesses supported by the spending of people
employed in the health care industry.
Read more about this story in tomorrow's Times.
http://www.shreveporttimes.com/article/20090807/NEWS01/90806033
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The New York Times | 08.09.09
By ROBERT PEAR and DAVID M. HERSZENHORN
WASHINGTON
— With the debate over the future of health care now shifted from Capitol
Hill to town halls, supporters and critics of the Democrats’ legislative
proposals are polishing their sound bites and sharpening their attack lines.
Increasingly, the battle looks like a presidential
contest, with expensive advertising campaigns and Internet-driven efforts to
mobilize local support. It can be difficult to sort fact from fiction, as
angry protesters denounce the legislation at raucous public forums.
President Obama and his Democratic allies in Congress have
made the health care overhaul their top priority, putting their political
futures on the line. Democrats had hoped to spend the month whipping up
support for the legislation, but instead find themselves on the defensive,
responding to what Mr. Obama describes as “outlandish rumors” spread by
critics.
Many Republicans view fighting the president as a smart
political strategy, turning a potentially wonkish
debate over Medicare reimbursement rates and subsidies for the uninsured into
an ideological battle over the government’s role in health care.
Each side hopes to win ground by boiling down one of the
most complex policy discussions in history into digestible nuggets. For
beachside viewers who might be more interested in iced-tea service than
fee-for-service, here is a guide to the main fight points.
KEEP IT OR LOSE IT?
Mr. Obama has said repeatedly, as he told the American
Medical Association in June: “If you like your doctor, you will be able to
keep your doctor, period. If you like your health care plan, you’ll be able
to keep your health care plan, period. No one will take it away, no matter
what.”
These assurances reflect an aspiration, but may not be
literally true or enforceable.
The legislation does not require insurers or employers to
continue offering the health benefits they now provide. The House bill sets
detailed standards for “acceptable health care coverage,” which would define
“essential benefits” and permissible co-payments. Employers that already
offer insurance would have five years to bring their plans into compliance
with the new federal standards.
The Senate health committee bill goes somewhat further by
offering an “option to retain current insurance coverage.”
The legislation could have significant implications for
individuals who have bought coverage on their own. Their policies might be
exempted from the new standards, but the coverage might not be viable for
long because insurers could not add benefits or enroll additional people in
noncompliant policies.
Dallas L. Salisbury, president of the Employee Benefit
Research Institute, a private nonpartisan group, said: “The president and
Democrats in Congress are saying what they would like. Their promises may not
be literally true because your health plan may change, and your doctor may no
longer accept your insurance.”
SOCIALIZED MEDICINE
Or Uniquely American?
Republicans harshly criticize Democratic proposals to
create a government-run insurance plan, or public option, to compete with
private insurers. Republicans say the public plan would drive insurers out of
business and lead to “socialized medicine” or a government takeover of health
care. Democrats say they want a “uniquely American” system with public and
private elements.
For now, the Republican criticism seems overblown. Major
versions of the legislation all rely heavily on a continuation of private
health plans, offered by employers and by insurance companies, subject to
sweeping new federal regulations.
Whether a public plan would crowd out private insurers
depends on details yet to be decided, including its premiums and its payment
rates for health care providers.
The public plan is not even a certainty. To win bipartisan
support for the overhaul, some Democrats have proposed private nonprofit
health care cooperatives, instead of a public plan, to compete with private
insurers.
The Congressional Budget Office has estimated that, under
the House bill, the number of people with employer-sponsored insurance would
climb to 162 million in 2016, which is 3 million more than expected under
current law. Further, it said, enrollment in the proposed public plan might
total 11 million, far lower than estimates cited by Republicans.
An additional 10 million people, most of them now
uninsured, would enroll in Medicaid, the budget office said.
At any rate, the federal government already holds sway
over the health care system through Medicare, Medicaid and various insurance
programs for children, veterans, military personnel and other federal
employees. The federal government will account for 35 percent of the expected
$2.5 trillion in health spending this year, and that does not include
subsidies built into the tax code.
BLAMING INSURERS
Or Ensuring Blame?
Democrats have unleashed a blistering attack on private
health insurers as they try to convince the vast majority of Americans who
already have coverage that the current system is tilted in favor of corporate
profits, not patients, and that insurers are a main obstacle to passing
legislation.
Insurers say they support some of the most important
Democratic proposals, including a ban on denying coverage or charging higher
premiums based on pre-existing medical conditions.
The insurance industry does oppose a government-run
insurance plan and could eventually mobilize against the overhaul. But
insurers appear to be less of an obstacle than public apprehension over such
sweeping change and skittishness among lawmakers, including centrist
Democrats from Republican-leaning districts.
Most Americans do not know the full cost of their
employer-sponsored insurance. And it is easier for Democrats to paint
insurers as greedy than to explain the complex math
that shows current health care spending is unsustainable.
DEFICIT-NEUTRAL
Or Budget-Buster?
Mr. Obama has avoided dictating specific provisions of
health care legislation. But he has insisted that the bill not add to the
federal debt, leading Democrats to say that the overhaul will be “deficit
neutral,” with the roughly $1 trillion, 10-year cost to be offset by reduced
spending or new taxes.
The Congressional Budget Office has yet to issue cost
estimates for the latest versions of the bill approved by three House
committees. But it has warned that the legislation “would probably generate
substantial increases in federal budget deficits” beyond 2019, in part
because health costs are rising faster than the rate of inflation and
proposed new taxes would not keep up.
Republicans use those warnings to cast doubt on the claim
by Mr. Obama that the legislation will “bend the cost curve” by slowing the
growth of health spending in the long term. Democrats say the overhaul will
lead to savings that cannot be calculated under budgeting rules. At this
point, it is difficult to know who is right.
Over the next 10 years, the budget office said, the House
bill would “result in a net increase in the federal budget deficit of $239
billion,” partly because of an increase in Medicare spending to avert sharp
cuts in payments to doctors scheduled to occur under existing law.
House Democrats say the higher doctor payments should not
count in the cost because they fix a problem that predates the Obama
administration and Democratic control of Congress.
EUTHANASIA
And Abortion
Conservative critics say the legislation could limit
end-of-life care and even encourage euthanasia. Moreover, some assert, it
would require people to draw up plans saying how they want to die.
These concerns appear to be unfounded. AARP, the lobby for
older Americans, says, “The rumors out there are flat-out lies.”
The House bill would provide Medicare coverage for
optional consultations with doctors who advise patients on life-sustaining
treatment and “end-of-life services,” including hospice care.
The legislation instructs Medicare officials to propose
ways to measure the quality of end-of-life care. Doctors would have financial
incentives to report data on such care to the government.
On abortion, the situation is more complex. Opponents of
abortion, like the National Right to Life Committee, say the legislation
would use tax dollars to subsidize insurance that could cover abortion.
Under a bill approved by the House Energy and Commerce
Committee, health plans, including the new government insurance plan, could
choose to cover abortion. But they generally could not use federal money to pay
for the procedure and instead would have to use money from the premiums paid
by beneficiaries.
Douglas D. Johnson, legislative director of the National
Right to Life Committee, said, “Under either the Senate bill or the House
bill, the federal government would run a huge system of subsidizing elective
abortion.”
Representative Diana DeGette, Democrat of Colorado, said
the bill would keep current restrictions on the use of federal money for
abortion, but “would not expand the prohibitions, as many Republicans want to
do.”
CUTTING MEDICARE
Or Preserving It?
To help finance coverage for the uninsured, Congress would
squeeze huge savings out of Medicare, the program for older Americans and the
disabled. These savings would pay nearly 40 percent of the bills’ cost.
The legislation would trim Medicare payments for most
services, as an incentive for hospitals and other health care providers to
become more efficient. The providers make a plausible case that the cutbacks
could inadvertently reduce beneficiaries’ access to some types of care.
The Senate Republican leader, Mitch McConnell of Kentucky, said
Democrats would make “massive cuts to Medicare to pay for more government-run
health care.”
Mr. Obama told AARP last month, “Nobody is talking about
reducing Medicare benefits.” All the savings, he said, would come from
measures to “eliminate waste and inefficiency in Medicare.” As an example, he
cited duplicative tests ordered by different doctors for the same patient.
But some proposals could affect beneficiaries. The major
bills in Congress would cut more than $150 billion over 10 years from federal
payments to private health plans that care for more than 10 million Medicare
beneficiaries.
http://www.nytimes.com/2009/08/10/health/policy/10facts.html?_r=1&ref=health
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The New York Times | 08.08.09
By MILT FREUDENHEIM
MORE than 10 years after she tried without success to have
a baby, Marcy Campbell Krinsk is still receiving
painful reminders in her mail. The ads and promotions started after she
bought fertility drugs at a pharmacy in San
Diego.
Marketers got hold of her name, and she found coupons and
samples in her mail that shadowed the growth of an imaginary child — at
first, for Pampers and baby formula, then for discounts on family photos, and
all the way through the years to gifts suitable for an elementary school
graduate.
“I had three different in vitro procedures,” said Ms. Krinsk, now 55, a former telecommunications executive who
lives with her husband in San Diego.
“To just go to the mailbox and get that stuff, time after time after time, it
was just awful.”
Like many other people, Ms. Krinsk
thought that her prescription information was private. But in fact,
prescriptions, and all the information on them — including not only the name
and dosage of the drug and the name and address of the doctor, but also the
patient’s address and Social Security number — are a commodity bought and
sold in a murky marketplace, often without the patients’ knowledge or
permission.
That may change if some little-noted protections from the
Obama administration are strictly enforced. The federal stimulus law enacted
in February prohibits in most cases the sale of personal health information,
with a few exceptions for research and public health measures like tracking
flu epidemics. It also tightens rules for telling patients when hackers or
health care workers have stolen their Social Security numbers or medical
information, as happened to Britney Spears, Maria Shriver and Farrah Fawcett before she died in June.
“The new rules will plug some gaping holes in our federal
health privacy laws,” said Deven McGraw, a health
privacy expert at the nonprofit Center for Democracy and Technology in Washington. “For the
first time, pharmacy benefit managers that handle most prescriptions and
banks and contractors that process millions of medical claims will be held
accountable for complying with federal privacy and security rules.”
The law won’t shut down the medical data mining industry,
but there will be more restrictions on using private information without
patients’ consent and penalties for civil violations will be increased.
Government agencies are still writing new regulations called for in the law.
Ms. Krinsk was never able to
find out who sold her information, but companies that have been accused in
lawsuits of buying and selling personal medical data include drugstore chains
like Walgreens and data-mining companies like IMS Health and Verispan. CVS Caremark, which handles prescriptions for
corporate clients, has also been accused of violating patients’ privacy.
These companies all say that names of patients are removed
or encrypted before data is sold, typically to drug manufacturers.
But as Ms. Krinsk’s case shows,
there are leaks in the system.
Before the changes, privacy regulations mainly applied to
hospitals and doctors. Enforcement was weak, and there were lots of
loopholes.
Privacy experts cite research by Latanya
Sweeney, director of the Data Privacy Lab at Carnegie
Mellon University
in Pittsburgh,
which shows that a computer-savvy snooper can easily match names, addresses,
Social Security numbers and so on to “re-identify” information that had
supposedly been rendered anonymous.
“Our biggest concern is the complete lack of protection
against re-identifying data that was supposed to be anonymous and secure,”
Ms. McGraw said.
TRACKING prescriptions has been a big business for
decades. Data miners say their research is valuable because gathering and
analyzing information from thousands of people helps identify trends and
provides indications of potentially dangerous side effects of drugs.
“Data stripped of patient identity is an important
alternative in health research and managing quality of care,” said Randy
Frankel, an IMS vice president. As for the ability to put the names back on
anonymous data, he said IMS has “multiple encryptions and various ways of
separating information to prevent a patient from being re-identified.”
“De-identified health information is our core business,”
he said.
IMS Health reported operating revenue of $1.05 billion in
the first half of 2009, down 10.6 percent from the period a year earlier. Mr.
Frankel said he did not expect growing awareness of privacy issues to affect
the business.
CVS Caremark says it is careful about patient data. “In
very limited circumstances, we exchange aggregated, de-identified data with
third parties to assist the health care community in understanding patient
use of prescription medications with the goal of achieving better health
outcomes,” said Carolyn Castel, a company spokeswoman.
Selling data to drug manufacturers is still allowed, if
patients’ names are removed. But the stimulus law tightens one of the biggest
loopholes in the old privacy rules. Pharmacy companies like Walgreens have
been able to accept payments from drug makers to mail advice and reminders to
customers to take their medications, without obtaining permission. Under the
new law, the subsidized marketing is still permitted but it can no longer
promote drugs other than those the customer already buys.
The ban on marketing is even more strict
in California,
where Walgreens is fighting off a class-action lawsuit filed on behalf of
customers who received the subsidized mailings before the state outlawed them
in 2004. Michael Polzin, a Walgreens spokesman,
defended the mailings as a cost-cutting measure. “Patients who fail to
properly take their medication cost the U.S. health care system $177
billion a year,” when they fall sick and need treatment, he said.
The data mining industry, meanwhile, is challenging laws
in New Hampshire, Maine
and Vermont
that ban collecting and selling prescription information to drug makers,
which use it to decide which doctors to market to.
The companies in the case, IMS Health and Verispan, now part of the private company SDI Health,
said the identities of patients were removed. “At no time does SDI ever
receive any identifiable patient information nor any means to identify any
patient from the data we handle. All data is de-identified prior to
transmission to SDI,” said Andrew Kress, chief executive of SDI.
Privacy advocates and a judge in the case argued that
de-identified information could easily spin out of control. “This information
quickly finds its way into other databases, including those of insurance
carriers and pharmacy benefits managers,” Judge Bruce M. Selya
wrote in a federal appeals court decision upholding the New Hampshire law.
IN another big change, the stimulus law provides $19
billion to push doctors toward installing electronic records systems. It is a
milestone on the road toward President Obama’s goal of digitizing all medical
records within five years. But digitization creates the potential for more
abuses by hackers, as well as blackmail and insurance fraud.
“Privacy is under greater duress than ever before as
medical records are switched from paper to electronic,” said Pam Dixon, a
consumer advocate and executive director of the World Privacy Forum near San Diego.
Administration officials say privacy guarantees are
essential. “We can’t afford to go forward with our plans unless we have
assured the American public that the privacy of their information is
assured,” said Dr. David Blumenthal, the Health and Human Services
Department’s national coordinator for health information technology.
Companies like Google, Microsoft and WebMD see a lucrative
business opportunity in assembling and holding personal health records.
Patients and their doctors would be able to consult the records wherever and
whenever needed. But the companies themselves recognize that they have work
to do to persuade consumers and physicians that records will be safe and
protected.
Although as many as one in four adult Americans are
currently offered an online personal health record, by a health plan or
physician’s office, most have not taken up the offer.
Google, Microsoft and WebMD all say they will not show
advertising alongside a person’s health records. But visitors to WebMD,
Google Health and Microsoft’s site, HealthVault,
see ads for drugs for diseases like osteoporosis or acid reflux as they seek
information on an array of ailments.
Technology experts say identities of viewers and their
health interests are often captured at the moment they click on online ads
for a drug. That provides the advertiser with a prospective customer to
pursue online or by mail.
“Personal health records linked to advertising, even
indirectly, put them in the hands of marketers and profilers,” said Robert
Gellman, an independent privacy consultant in Washington.
Microsoft and WebMD acknowledge that the privacy rules in
the stimulus law apply to them. Google says the law’s prohibitions do not
apply to it, except for its duty to report any breaches of medical privacy. “Google
is bound by the privacy policy that people agree to when they sign up,” said
Christine Chen, a Google spokeswoman.
The new law also requires the Federal Trade Commission and
the Department of Health and Human Services to clarify the rules for privacy
violations and gives all 50 states’ attorneys general new authority to
enforce the federal rules.
Some recent high-profile incidents reveal the extent of
the problem. In Virginia,
a state health agency notified 530,000 residents in June that their Social
Security numbers were at risk after a hacker claimed to have invaded a state
monitoring database in April and demanded $10 million ransom to return the
stolen data. State officials said they were still investigating the breach.
Ms. Fawcett was plagued by lurid tabloid reports fueled
with information from her cancer treatment records at the University of California,
Los Angeles Medical Center.
And in May, Kaiser Permanente paid a $250,000 fine to California after it reported that 21
unauthorized employees and two physicians had invaded the records of Nadya Suleman, the woman who
gave birth to eight infants in a Kaiser hospital in January.
Since 2003, more than 45,000 complaints have been filed at
the civil rights office in the Department of Health and Human Services by
people who said their medical privacy was violated. The office says it has
taken enforcement actions on more than 8,900 cases in that period, covering
millions of people.
A single case can involve thousands of patients. For
example, CVS paid a $2.25 million settlement early this year after an
Indianapolis television station found paper records with CVS customers’
personal drug information had been tossed into Dumpsters. In the settlement
agreement, CVS promised to protect patient information at all 6,300 CVS
stores.
A survey sponsored by the Federal Trade Commission
suggested that tens of thousands of patients each year had their records
broken into by hackers and unauthorized employees of hospitals and other
health industry companies. Keith B. Anderson, an economist at the F.T.C.,
estimated that the personal information of about 890,000 adults was misused
between 2001 and 2006. Stolen identities and data were used to trick Medicare,
Medicaid and other insurers into paying for bogus medical treatment and
supplies, he said.
Deborah Peel, a psychiatrist in Austin, Tex.,
who lobbies for privacy rights, said she predicts “a looming battle between
the data thieves and those that believe in constructing a digital universe
with even stronger protections for the privacy of personal information than
we have in the world of medical records on paper.”
SOME people think that the stimulus law doesn’t go far
enough to protect patients’ privacy. While it bans paying a pharmacist for
marketing to patients, it does not bar the sale of personal drug information
by one pharmacy to another, as happened to Randee Lonergan, 35, a school administrator who now lives in Florida.
She says that when a pharmacy closed in a Stop & Shop
supermarket on Long Island, it sold her
information to a nearby Target store. She was upset when her new pharmacist
asked if she was still taking injections for a skin problem. “They knew all
about me and my family,” she said. Adding to her chagrin, she saw a person
she happened to know working at the pharmacy. A Target spokeswoman says the
company complied with all privacy laws.
Ms. Krinsk in San Diego, whose privacy was repeatedly
violated for more than a decade, says she is willing to speak out if it draws
attention to the problem. “I’m a pretty tough person,” she said.
http://www.nytimes.com/2009/08/09/business/09privacy.html?ref=health
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