National group picks LSU official for post

The Advocate | 07.12.09

NEW ORLEANS — The head of infant, child and adolescent psychiatry at LSU’s medical school is president-elect of the American Academy of Child and Adolescent Psychiatry.

The LSU Health Sciences Center New Orleans School of Medicine said Dr. Martin J. Drell will be installed in October, during the academy’s national meeting in Hawaii.

After two years as president-elect, he will serve a two-year term as president.

He also has been treasurer and assembly chairman for the academy, and has been president of two other national professional organizations.

The academy is made up of more than 7,500 child and adolescent psychiatrists and other interested physicians.

Drell joined the LSU medical school in 1987.

http://www.2theadvocate.com/news/50548592.html#

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New law eases way for crisis workers to provide care after disasters

The Times-Picayune | 07.13.09

by Amber Sandoval-Griffin,

With Gov. Bobby Jindal's signature, Louisiana has become the 10th state to enact a law that makes it easier for medical workers to cross state lines to provide help after a disaster.

The Uniform Emergency Volunteer Health Practitioners Act provides interstate recognition of licenses held by medical professionals who volunteer during emergencies, helping to ensure more organized and available medical support, advocates say.

Approved recently by the Legislature, the act allows Louisiana to receive assistance from medical professionals from nine other states. Medical workers from Louisiana could, in turn, assist with care during emergencies in the other listed states.

Professionals covered by the act, including doctors, nurses and mental health counselors, would be legally certified to help during a disaster -- and their exposure to potential lawsuits would be sharply limited. They would be required to sign up with the interstate compact in advance.

Limitations on liability risks would expire 30 days after the end of a declared state of emergency in the affected state. The legal protection could be extended if the state's governor decides a public health emergency persists for a longer period.

"What you have is people from neighboring states that are pre-registered come there," said Eric Fish, legislative counsel for the Chicago-based Uniform Law Commission. "It will supplement their (states') capacity to respond to disaster with trained, licensed professionals and it will get rid of the problems that came up during Katrina and Rita."

Government regulations that bar or restrict the work of medical professionals beyond the borders of their home states played a major role in limiting medical support in New Orleans after the 2005 storm. There also were major concerns at the time about the training and credentials of volunteers who appeared and tried to provide medical help.

Jullette Saussy, director of New Orleans Emergency Medical Services, who experienced first-hand the dire shortage of medical resources during and after Katrina, said the new act will make it easier for legitimate medical professionals to provide care.

"We don't need to go through a laborious paperwork process that requires multiple stages of making sure it's OK," Saussy said. "There's no time for that. People lose their lives when we are stuck doing paperwork."

After witnessing the mayhem among medical professionals in the storm zone, the Uniform Law Commission introduced multistate compact legislation. Under the act, health professionals in participating states can register to volunteer in advance -- or after an emergency has begun -- with a simple public or private registration process. They can then travel to the state suffering from the disaster and offer medical assistance, unless barred from doing so by that state's emergency managers.

Each state would establish its own pool of health volunteers by notifying medical professionals of the opportunity to register in advance and determining what types of services they can provide.

"The state remains the manager, so the governor and his emergency management offices are always going to be in control of who comes in and who doesn't come in," said Fish. "What the bill does is allow a fully stocked bullpen in times of an emergency to help out."

In addition to Louisiana, Arkansas, Colorado, Kentucky, Tennessee, Indiana, North Dakota, Oklahoma, Utah and New Mexico have passed the act and nine additional states have introduced the legislation. Local health professionals like Saussy believe the cooperative program could be critical during another major disaster.

"One of the things that still haunts me today was the lack of help we had post-storm, just trying to help the masses of people with the very few staff that were here -- and adding to that the fact that the majority of the staff were victims of the storm as well," she said. "It was mass chaos."

http://www.nola.com/news/index.ssf/2009/07/new_law_eases_way_for_crisis_w.html

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Honore: Charity could have reopened

WWL TV | 07.11.09

NEW ORLEANS - The retired army general who commanded military relief efforts after Hurricane Katrina hit the Gulf Coast in 2005 questions why Louisiana still hasn't reopened Charity Hospital or built a hospital to replace it.

Shame on us, Lt. General Russel Honore says, that a trauma center once rated one of the best in the nation no longer exists.

Honore has a hard time comprehending Louisiana's failure to move forward on Charity Hospital -- either rebuilding it or replacing it almost four years after Katrina.

“Give me a damn break,” he said. “Four years to make a decision? I mean we built the pentagon in 17 months. It's got 26 miles of hallway.”

In the early days after Katrina, Army Staff Sgt. John Johnson was among members of the military and emergency room doctors working to clean the first few floors of Charity and restore electricity.

“We were given three days to get the water out and the system powered back up,” Johnson said. “We did that.”

Johnson, who won commendation medals for his work in Iraq and Afghanistan as well as Katrina, says the first few floors of Charity were cleaned, inspected for chemicals and ready to be reopened.

“If this would have been Iraq or Afghanistan, we would have used that building. That building would have been used immediately.

“It was capable of being reopened,” said Honore. “That’s my bottom line. I've said that once, I’ve said it twice.”

Soon after Katrina, when the city only had an emergency trauma center in the Convention Center, Honore says he thought state and local officials would want to reopen the first few floors of Charity Hospital to provide improved health care. But he says they told him no.

“What the state said was, we got it, but the plan is not to open it,” said Honore. “I didn’t think much about it at the time because I didn’t know they were not going to ever open it again.”

Honore says the state suggested it wasn't feasible to reopen Charity at the time.

“There was conversations about well if we turn the lights back on Charity, where are we going a staff from. I mean all the doctors are gone, the nurses are gone. And the people who would go there, the city's depopulated,” he said.

Then he says he started hearing that the state officials were coming up with a different plan for Charity. Within weeks, state officials argued FEMA should pay full replacement cost $492 million because the hospital was more than 50 percent damaged.

FEMA still disputes that, saying it won't pay more than $150 million.

“The state need to move on do their job and build a hospital or fix it and repair it or replace it and stop waiting for the federal government to do it.”

Honore says a medical complex is a great idea; it could be a driver for a lot of good jobs, but it can't happen until the state, once and for all, makes a decision.

http://www.wwltv.com/topstories/stories/wwl071009mlhonore.2a523c4c.html#

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For Doctors in Congress, Little Harmony on Health Care

New York Times | 07.12.09

By ANDREA FULLER

WASHINGTON — In the struggle to overhaul the nation’s health care system, 16 physicians have ended up in ringside seats — as members of the House and Senate.

But they have taken different lessons from their experiences in medicine, and they do not agree on what a bill should look like.

“Doctors are very individualistic,” said Representative Michael C. Burgess, Republican of Texas and an obstetrician. “We all think we’re right.”

Of the doctors elected to Congress, 11 are Republicans and 5 are Democrats. Two serve in the Senate and 14 in the House, 7 of whom are on the three committees preparing a health care bill.

Both Democratic and Republican doctors can recall patients who had inadequate insurance or none at all.

Representative Steve Kagen, a Wisconsin Democrat first elected in 2006, was an allergist whose patients included two asthmatic children of a single mother who were so ill that they could not go to school. He wrote prescriptions, but a few weeks later, the children returned to the office still suffering.

“She unzipped her bag, and she pulled out the same prescriptions,” Dr. Kagen said. “She said, ‘I went to the pharmacy, I could see the medicine my kids need and I can’t afford to buy it.’ ”

As a short-term solution, Dr. Kagen gave her samples of the drug. He did the same with another patient, of whom he said: “She’s old but not old enough for Medicare, and she’s poor but not poor enough for Medicaid. She and her husband were too proud to beg.”

As a long-term solution, he says, the nation needs a public health plan to compete with private insurers.

Another Democrat, Representative Vic Snyder of Arkansas, had dealt with patients who could not afford medicine at his family practice before he was first elected to Congress in 1996.

“I’ve certainly had experiences of writing out a prescription for someone and either having the pharmacist call me up or having the patient tell me they saw what the bill for the medicine was going to be and just handed it back,” he said.

But Dr. Snyder remains hesitant about a public plan and is emphatic that it must preserve patient choice and pay for itself. He said he had positive experiences with Medicaid, however, calling it his practice’s “most efficient payer.”

“It’s not a deal breaker for me either way,” he said of the public plan. “I don’t know why it’s resonating so much with Democrats.”

Republican members of Congress who practiced medicine, united under the banner of the G.O.P. Doctors Caucus, oppose a public plan.

Dr. Burgess, who was first elected to Congress in 2002, is a member of that caucus and sits on the Energy and Commerce Committee, which is working on health care legislation. He remembers treating a patient who had difficulty giving birth.

“She was very, very sick and very, very dehydrated,” Dr. Burgess said. “She lost some blood in delivery.”

Dr. Burgess wanted to keep her in the hospital, but the medical director of her managed care company wanted her discharged. Dr. Burgess was able to persuade the company that she should not go home only after a lengthy argument.

Dr. Burgess, who reported having similar experiences with Medicaid, said, “Interference from both insurance companies and the federal government have really worn down the practicing physician.”

Dr. Burgess is open to tax credits or deductions that would help patients manage their own health care. He strongly favors a health savings account that would allow individuals to put away money tax free for medical care.

Representative John Fleming, Republican of Louisiana, who was elected last year, agrees. As a family doctor, he was familiar with uninsured diabetic patients who sought medical care — in the emergency room — only when they developed gangrene and sepsis. They would stay in the hospital for several days, costing the government tens of thousands of dollars.

Getting those patients insured with a public plan, Dr. Fleming says, is not the solution. He has seen physicians refuse to take Medicare patients because it compensates poorly, and he fears that doctors would turn away patients on a public plan if it offered inadequate compensation.

Rather, Dr. Fleming favors a tax credit or a tax deduction, measures that would give patients an incentive to “watch the pocketbook.” He says he is even open to an individual mandate that would make health insurance compulsory, much like automobile insurance.

“We seem to agree on everything,” Dr. Fleming said about his fellow physicians. “We agree on the fact that we need portability; we need to do away with pre-existing illnesses.”

But when it comes to a public plan, he said, doctors cannot seem to agree any more than other members of Congress.

http://www.nytimes.com/2009/07/12/health/policy/12docs.html

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Help For the Uninsured

Wall Street Journal | 07.12.09

By JANE ZHANG

Federal stimulus funding is helping community health centers nationwide deal with an influx of newly uninsured patients.

The centers, which offer primary care and other coverage free or at reduced prices based on patient incomes, will be able to serve 2.8 million new patients this year, thanks to funding distributed in March from the stimulus package that Congress passed earlier this year, according to the Department of Health and Human Services.

That money includes $155 million for the construction of 126 new health centers and $338 million to help 1,100 centers expand services or keep longer hours, says Mary Wakefield, head of HHS's Health Resources and Services Administration.

In addition, the Obama administration said last month that it would give an additional $850 million to more than 1,500 health centers for building construction or renovations.

More grants will come out later this year as HHS continues to spend the total $2 billion for health centers authorized in the stimulus package. "It's meeting a resource need in a very direct way," says Dr. Wakefield.

Clinics Attract More Patients

As the recession deepened and more people lost jobs, these clinics have seen a rapid rise in patient visits. Clinics across the country have seen 7.2 million uninsured patients since January, compared with 6.8 million for all of 2008, according to the National Association of Community Health Centers.

While the federal government is plunking down money for the centers, state and local governments, which set up the centers, are cutting budgets for Medicaid, the state/federal insurance program for the poor. Medicaid makes up 27% of the centers' revenues.

"It's sort of all happening at the same time," says Dave Taylor, chief operating officer at the National Association of Community Health Centers. The stimulus funding, he says, "couldn't have come at a better time."

The health center in Ingham County, Mich., is getting hundreds of additional phone calls for services, says Jaeson Fournier, the county's deputy health officer. The clinic has received $1.3 million from HHS for this year and 2010, which is allowing it to expand services to 5,000 new patients.

Much of the money has been used to hire 20 new employees, including a family physician, a nurse practitioner, a pediatrician and two dentists, Mr. Fournier says. The center now has a staff of 170.

Other Help on the Way

In addition to direct grants, community health clinics will benefit from other parts of the stimulus package. For example, Dr. Wakefield says HHS is accepting applications to send 3,300 new doctors, nurse practitioners, dentists and others to areas in need of staff. In exchange, the government will pay up to $50,000 for any student loans these individuals have.

President Barack Obama and leading lawmakers also are pushing measures to boost Medicare payments to primary-care doctors, which would lead to higher revenues for health centers.

That proposal, however, has been fiercely opposed by cardiologists and other specialists, who fear the federal government might cut their payments to boost pay to primary-care doctors.

http://online.wsj.com/article/SB124736677418727379.html

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Vitter Prevails in Prescription-Drug Debate

Wall Street Journal | 07.10.09

By ALICIA MUNDY

WASHINGTON -- A junior Republican senator prevailed in a lengthy battle Thursday night on the Senate floor to pass legislation that could let Americans buy cheap prescription drugs from Canada via the Internet.

But Sen. David Vitter of Louisiana acknowledged in an interview that his amendment to a $43 billion funding bill for the Department of Homeland Security is likely to be stripped from the final bill.

Mr. Vitter's proposal passed 55-36 with nine absentees.

"There was a lot of opposition and the drug industry has been doing everything it can to stop this," said Mr. Vitter, a longtime proponent of drug reimportation, as it is called in Congress. He added, "There was a concerted effort to kill this around the Democratic table last night."

Several key Democrats, including Majority Leader Harry Reid (D., Nev.) and his lieutenant, Richard Durbin, (D., Ill.), initially opposed the measure before eventually voting with Mr. Vitter, Democratic and Republican staffers said.

A spokesman for Mr. Reid said the majority leader was concerned that the amendment was not germane to the funding bill and slowed down its passage. The spokesman also said the bill doesn't guarantee people can purchase Canadian drugs via the Internet. "Because Sen. Reid does support lower drug prices, in the end he decided to vote yes," he said.

Reimportation has been politically popular, but Republicans and Democrats both complained that Mr. Vitter held up the appropriations vote for hours. Mr. Vitter said he thought it was important to raise the matter in some venue.

"I don't understand why I am not hearing about drug reimportation in all the health-care reform proposals," Mr. Vitter said.

The prescription drug industry and its lobbying group, the Pharmaceutical Research and Manufacturers of America, have strongly opposed reimportation. This week, the administration and the group's president, Billy Tauzin, said that reimportation is basically off the table.

After a meeting at the White House Tuesday morning, Mr. Tauzin said his industry and the White House agree that if the larger health-care bill passes, the cost savings will be big enough to make reimportation unnecessary.

A White House official said, "As a political matter there may be less pressure" to pursue reimportation after a health bill passes.

Mr. Vitter noted that he and then-Sen. Barack Obama co-sponsored a bill for reimportation in 2006.

http://online.wsj.com/article/SB124724848777024423.html

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