by Bill Barrow,
The Times-Picayune
David Grunfeld/T-P
file photo
This neighborhood in lower Mid-City is slated for
razing so the U.S.
Department of Veterans Affairs and the state of Louisiana can build adjacent medical
complexes to replace those damaged by Hurricane Katrina. A federal lawsuit
challenges the planning process various levels of government have used.
A federal judge in
Washington, D.C.,
has ordered that a lawsuit challenging the planning process for state and
federal hospitals in lower Mid-City be moved to the New Orleans-based U.S.
district court.
Seeking to block
land acquisition and construction, the National Trust for Historic
Preservation in May filed the lawsuit in Washington, D.C.,
against the U.S. Department of Veterans Affairs and FEMA.
The change of
venue means the matter, including pending requests by the state and city of
New Orleans to intervene in the case, will be heard by a yet-to-be assigned
judge in a city where government officials at all levels have lined up in
support of the new hospitals.
If successful, the
lawsuit would not necessarily kill the projects, but it could vacate much of
the work done to comply with the federal planning guidelines and force the
participating agencies to retrace some of their steps on the hospitals, which
would cover the 70-plus acres bound by South Claiborne Avenue, Tulane Avenue, South
Rocheblave Street and Canal Street.
The lawsuit hinges
on the interpretation of the National Environmental Policy Act, a
wide-ranging 1969 law that governs federal construction projects.
The suit alleges
that the VA and FEMA erred when they, along with the city of New Orleans, declared as
part of the federal review that the planned teaching and VA hospitals would
yield "no significant impact" on the neighborhood.
FEMA is involved
because the state plans to help pay for its portion of the project using its
pending federal reimbursement for Hurricane Katrina damage to Charity
Hospital, which has been shuttered since the storm and would be replaced by a
new academic medical center.
The city's role
comes through a memorandum of understanding with the VA to give the agency a
construction-ready tract of land by Nov. 24, though that agreement is the
subject of a separate, ongoing lawsuit in state court. The state, with the
aid of contractors, is handling land acquisition for both hospital sites.
The National Trust
argues that the agencies' initial work should have yielded a finding of
significant impact to the affected area. That would have forced a more
intensive review of the project and a greater focus both on alternatives and
programs to mitigate potential damage.
Instead, the
defendants have opted for a "tiered process, "
with the first phase, site selection, already concluded and preliminary
building design -- phase two -- under way.
The VA's 200-bed,
$600 million-plus medical complex is slated to open in 2012 on the upper
portion of the footprint, which would be divided by Galvez Street. The 424-bed state
hospital, which officials maintain can open in 2013 for a price of $1.2
billion, would be built on the lower tracts, between Galvez and Claiborne.
http://www.nola.com/news/index.ssf/2009/07/lawsuit_challenging_planning_o_1.html
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Chabert:
Change from a familiar name
Jeremy Alford
Capitol
Correspondent
BATON ROUGE — When
you’re running to fill a state Senate seat that your father previously, and
famously, held, you can expect to hear stories about him everywhere you go.
Just ask Norby Chabert, son of the late
Leonard J. Chabert and a candidate for Senate
District 20.
One such story
came during a Tuesday campaign stop, he said, when a family friend reminisced
with the younger Chabert, 33, about how his father
once called a hospital in the middle of the night to find the friend a bed
after doctors told him none were available.
“The funny thing
is, I’ve heard that same exact story from about a dozen people over the
years,” Chabert said. “My father always said if you
were sick and poor, you’re still sick and you deserve to be treated. It’s a
true testament to what people can do when they go to Baton Rouge.”
Chabert, D-Houma, who was 15 when his father died,
doesn’t shy away from the long shadow his last name casts over Terrebonne and
Lafourche parishes, which comprise Senate District 20.
“He was a
dirt-poor son of an alcoholic oyster fishermen and an Italian immigrant, went
to Korea
and was educated on the GI Bill and knew what his life’s mission was — to
serve the people,” Chabert said. “I want the same
opportunity.
In fact, securing
the money needed to run his father’s namesake, Leonard
J. Chabert Medical
Center in Houma, the region’s only charity hospital,
is a top campaign issue.
“I will fight to
protect Chabert more than anyone,” he said. “I’m on
the board of directors and have been working hard already. We raised $100,000
this year, and all of that money will go to patient care. The rising cost of
health care is a serious problem in the state and I naturally want to play a
larger role in that.”
Chabert will have his chance on Saturday, when
voters head to the polls to cast a ballot in the three-man race. Other
candidates are state Rep. Damon Baldone, D-Houma,
and Brent Callais, R-Cut Off.
The candidates
have had several public debates, and Chabert said
the responses given during those exchanges have done more to blur the lines
between the contenders than anything else. “We all agree on a lot of things.
We all agree that coastal restoration and hurricane protection is the top
issue in this campaign,” Chabert said. “It’s just
going to have to come down to who do you trust and believe in more.”
Chabert has made flood protection a personal issue
in his campaign, noting that his family home was inundated with water from
levees that failed to work.
He’s also promised
his support of coastal protections.
“As a state
senator, I’ll focus right away on getting more money for the beneficial use
of dredge material,” Chabert said. “That’s the way
you do it. We’re all for coastal restoration, but it’s important to remember
that we all have different views on how to get it done.”
After graduating
from Nicholls State University
in 2001, Chabert started his career in government
as a consultant and became a trusted aide to U.S. Sen. Mary Landrieu, D-New
Orleans.
He considers the
time spent working on her re-election campaign a top achievement.
“Doing everything
I could to see Sen. Landrieu get elected was a major accomplishment for me,”
he said. “And then to see her secure billions of dollars for the coast from
oil revenues validates every moment I spent working for her. And I’ve learned
a lot from Sen. Landrieu as well.”
Chabert went on to manage campaigns and work for
many Republicans, like Billy Tauzin III and former House Speaker Hunt Downer,
even though he is a Democrat.
He said he’ll
approach being a state senator in the same bipartisan fashion.
“We can all be
friends at the end of the day and compromise and work toward the same goals,”
Chabert said.
He also spent a
year lobbying at the State Capitol to generate support for a film festival in
the New Orleans
area.
According to his
lobbyist report on file with the state Board of Ethics, Chabert
spent about $500 on one lawmaker, Sen. John Alario,
D-Westwego, the dean of the Legislature and the rumored frontrunner for
Senate president following this current term.
“Sen. Alario is like a father to me and another person I’ve
learned a great deal from,” he said.
Following the
vicious storms of 2005 that saw the family home flooded with more than 3 feet
of water, Chabert left behind political consulting
to be closer to friends and family and aid in their recovery.
In 2006, he formed
Chabert Development, a Chauvin-based land company
which is now dormant.
He also
established Fieldhouse Merchandising, a collegiate
marketing firm that eventually led to working for his alma mater, Nicholls State University,
as associate director of marketing and development.
Chabert said it was a “dream job” until this
year’s devastating budget cuts came from the Legislature, and his department
was eliminated.
He resigned from
the job before the position was eliminated to focus on his ongoing campaign.
“Luckily, this was
only a short race and I’m basically living off of my savings right now,” Chabert said. “I’m that serious about it. And I’m
definitely not running to get a job, because being a lawmaker really doesn’t
pay that much.”
In his free time, Chabert prefers to be in a duck blind.
He recently moved
near Maple Street Park,
near enough to downtown to be able to hear the bells of St. Francis deSales Cathedral.
That area is also
in Baldone’s House district, which, in theory,
would perfectly position Chabert for another run at
office if Baldone emerges the winner and a special
election is held to fill his seat.
Chabert, however, said a House seat is the
furthest thing from his mind right now.
If elected to the
Senate, Chabert said he’ll do his best to help all
those he represents.
“Does government
have to accomplish every single thing for every single person all the time?” Chabert asked. “Not no, but hell no. Big government isn’t
the answer to everything, but what’s wrong with government making sure, if
nothing else, that people are properly taken care of? Nothing at all.”
http://www.dailycomet.com/article/20090729/ARTICLES/907299904/1212?Title=Chabert-Change-from-a-familiar-name
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By Matthew Pleasant
Staff Writer
HOUMA
— An autopsy performed on a woman who died at the Terrebonne Parish jail
found she overdosed on prescription drugs, a report received by officials
says.
Gwendolyn Bourdier, 51, of 155 St. Michel St., Houma, was arrested July 2 on charges of
driving impaired and improper lane usage, said trooper Gilbert Dardar, a State Police spokesman.
She died in a holding cell about two days afterward,
deputies said.
After arresting Bourdier, a
trooper found she appeared to be talking to herself, and took her to Leonard J. Chabert
Medical Center.
Hospital staff, police said, found no health issues beyond
her impairment.
At the hospital the trooper who arrested Bourdier, Corey Brunet, found eight syringes, a makeshift
tourniquet and several spoons with suspected drugs on them, Dardar said.
Bourdier was booked into the
jail at 2 a.m. July 2.
She was found dead in her cell about 8 p.m. July 4, said
Sheriff’s Maj. Malcolm Wolfe.
A toxicology report performed on Bourdier
as part of her autopsy found she died of a prescription drug overdose, Wolfe
said Tuesday.
He refused to release information on the type of medicine
she took.
It is undetermined whether she took the drugs by using the
syringes found in her purse, he said.
It is unclear how Bourdier got
the drugs that killed her.
Rhonda Green, the
administrator of Chabert, refused to comment
specifically on Bourdier’s treatment at the
hospital.
She said patients
brought to the hospital by officers are checked into the emergency room and
the tests performed depend on the symptoms patients describe.
“They’re all
treated the very same way,” she said.
And what of a
patient too impaired to complain of symptoms?
“That would be up
to the doctor who is seeing the patient and the complaints the patient has,”
she said. “I’m not going to put that into a cookie-cutter mold for you.”
Bourdier’s husband, Kim Bourdier of Houma,
refused to comment when notified that the toxicology results had returned.
http://www.dailycomet.com/article/20090729/ARTICLES/907299890/1212?Title=Autopsy-reveals-inmate-died-of-drug-overdose
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Serving Rural Patients: Louisiana HIE earns ADVANCE's
2009 IT Project of the Year Award.
Frank Irving
ADVANCE's 2009 IT Project of the Year goes to the
Louisiana Rural Health Information Exchange (LARHIX), the Louisiana Rural
Hospital Coalition (LRHC) and the Louisiana
State University
Health Sciences
Center in Shreveport (LSUHSC-S). The three
organizations collaborated on development of a regional health information
exchange (HIE) that facilitates electronic sharing of clinical information
among community providers.
As judged by ADVANCE's editorial staff, the LARHIX project outpointed
other entries in this year's contest, particularly in the areas of project
scope, clinical excellence and overall performance.
The innovative
project utilizes telemedicine, distance learning, information-sharing via Web
portal, mobile mammography and rotations by LSUHSC-S students to bring
world-class care to rural Louisiana
residents.
The challenge
Louisiana's rural population is poor and often
isolated from quality health care: Close to 24 percent live below the federal
poverty line. Twenty-three percent are uninsured, while 32 percent live in federally
designated medically underserved communities. There are 1,925 patients for
each physician in rural Louisiana
(more than twice the 870:1 ratio in the state's urban areas).
In the wake of
Hurricane Katrina in 2005, with New Orleans'
health care facilities shut down, all specialty care was re-routed to Shreveport. LSUHSC-S
became the only Level One trauma center serving the region's uninsured
population. The facility ran at 100 to 110 percent occupancy.
"With the
hallways lined with patients waiting for rooms, LSUHSC-S was
overwhelmed," explained Donald Hines, MD, CEO of LARHIX, who was Louisiana state senate
president at the time.
The chancellor of
LSUHSC-S wanted to find a way to partner with rural hospitals to avoid
unnecessary transfers and duplicate tests, and to shorten stays at the
medical center in Shreveport.
Dr. Hines referred the chancellor to LRHC.
Together, LRHC and
LSUHSC-S came up with the idea for LARHIX, through which hospitals would be
electronically linked and share patient information. During the fiscal 2007
legislative session, Louisiana's
Department of Health and Hospitals (DHH) approved $13 million in funding for
LARHIX with the following multifaceted mission:
• maintain an
organization that will support Louisiana's
health information technology initiatives in rural areas;
• develop and
maintain the LARHIX portal - a health information system (HIS) that operates
over the Internet and enables health care professionals to access medical
records from any provider database connected to the network;
• promote the
adoption and utilization of electronic health records in order to make the
records accessible to providers, patients and other authorized persons via
the LARHIX portal;
• provide an HIE
for the 23 LRHC member rural hospitals north of (and including) Bunkie, La.,
within 5 years; and
• minimize the
time patients requiring specialty care must spend away from their family and
home by providing interconnectivity between rural physicians and LSUHSC-S
specialists.
LSUHSC-S hosts and
technically supports the network of LARHIX. LSUHSC-S also serves as the
tertiary care site for all of the rural hospitals in LARHIX.
Project
progress
As a first step
toward enabling LARHIX, LRHC provided seven initial hospitals with a complete
HIS to enable them to electronically connect and exchange patient data. HIS
installation is underway at an additional seven hospitals.
"The second
phase was the telemedicine/distance learning component, which is installed at
all 23 hospitals," said Dr. Hines. "Fifteen of the hospitals are
doing telemedicine consults.and we're looking to
expand that. And distance learning will allow us to offer continuing medical
education, and let health care providers get their credits at home without
having to take off work or leave the area. We've applied for grants to expand
the telemedicine/CME offering."
The third phase
aligns LSUHSC's internal medicine residency program
with an emphasis on rural medicine. Six third-year residents a year for three
years (18 total residents) will rotate through the rural hospitals, supported
by an internal medicine specialist on staff at LSUHSC-S.
In addition, Carefx, CA,
IBM and Initiate Systems worked together to deploy and maintain a secure and
reliable infrastructure for the timely and accurate electronic sharing of
clinical information between the community providers in North
Louisiana and LSUHSC-S. LARHIX's
clinical portal allows clinicians to access reports and patient information
from radiology, laboratory, microbiology, pathology, medication lists,
allergies, vital signs, and intake and output.
The LARHIX teleconsultation network now serves more than 1.5 million
Louisiana
residents. LARHIX plans to grow to 44 rural hospitals and 10 teaching
hospitals.
By the third
quarter of 2010, LARHIX hopes to implement comprehensive disease management,
emergency department psychiatric evaluations, and expanded patient
information available through the portal and public health reporting.
Real-world
results
Prior to the
creation of LARHIX, rural Louisiana
residents typically waited anywhere from 110 to 180 days for an appointment
at LSUHSC-S. Now they wait four to five days for a telemedicine consultation.
"The network
allows the patient to stay in his or her rural area and be seen by a specialist
hundreds of miles away at the medical center," observed Dr. Hines.
"A lot of these people have difficulty obtaining transportation. Some
are disabled and have to ask family members to take off work to go to Shreveport and spend all
day or two days while the patient is being seen in a clinic. This way, when
they have an appointment, within 30 minutes they've had a consult and they're
on their way back home. Patient satisfaction, which we're measuring through
surveys, has been almost 100 percent."
Jamie Welch, CIO
of LRHC and IT director for LARHIX, told ADVANCE she pulled statistics from a
random group of 50 teleconsultation patients.
"The results are pretty remarkable," she commented. "The
average number of days saved in getting a patient an appointment with a
specialist in Shreveport
is 84."
Welch noted that
93 percent of patients avoid duplicate testing. Because physicians now have
access to the results of prior tests, they realize that they don't have to
re-run them.
"We also
saved patients an average of 199 miles driving," Welch continued.
"And that figure is coming from just 50 patients; you can imagine if 199
is the average mileage, some patients are really traveling a long way."
Teleconsultation saves the public money, too. In the past,
Medicaid would have covered transportation costs for qualified patients'
travel to/from in-person visits.
Mobile
mammography
Welch highlighted
the project's mobile mammography services as another example of bringing
much-needed technology to rural patients. An RV outfitted with digital
mammography equipment currently makes monthly visits to two rural hospitals.
The mobile unit sees 20 patients per visit and transmits the digital
mammogram images to a radiologist at LSUHSC-S.
The pilot site, Union General
Hospital in Farmerville, La.,
previously had no capability to provide breast screenings. "The
administrator of the hospital told us that, unfortunately, many times in the
past women didn't find out that they had a problem until it was too late to
do anything about it," Welch said.
Louisiana's DHH Secretary Alan Levine added,
"If you take our Medicaid population, only 40 percent of our women are
getting access to breast cancer screenings right now. We have the highest
rate of death from breast cancer in the United States. So the screening
program that was created by virtue of having this network is literally going
to save lives. I can't think of anything else that will have the singular
impact of the screening program."
Dr. Hines told
ADVANCE that patients will soon be able to get their mammogram results before
they leave their screening appointment. "As the patient is getting
dressed, she'll be informed of whether everything is normal, she needs to
schedule another test in a year, or she needs to go to Shreveport for additional testing on a
suspicious finding. I believe this is one of the few places in the United States
where this is being done."
Levine commented,
"The reason it's so important to be able to do the real-time
transmission and evaluation of the test is that we're talking about a
population that is very poor and difficult to reach. Once patients leave, it
can be very difficult to get in touch with them to let them know their
results. Many of them don't have transportation, and they can't come back to get
the results. So the real-time nature of this is going to be a critical piece
of the project."
Success factors
Close observers of
LARHIX point to teamwork and focus as primary factors in the project's
success.
Andrew Hurd, CEO of Carefx, told
ADVANCE: "People all around the country are trying different programs,
and doing very admirable work. In the end, it is the absolute commitment and
discipline that this team has demonstrated that has led to their success -
delivering care at lower cost and providing a significant improvement in the
quality of care to an underserved constituency. People now have access to
improved care, and they're going to use it, which is good for all of Louisiana. The team
here has stayed focused on the end game of delivering quality care to the
rural population. This is a model that can be used all over the country, and
all over the world, wherever people live in rural populations."
Levine added his
personal perspective: "My career started as the CEO of a rural hospital
in 1998. I remember sitting there thinking, 'I've got this technology, now
what?' I didn't have a network of rural hospitals to which I was able to link
and combine resources. So it doesn't matter how enterprising you are at a
rural hospital or anywhere.if you don't have an
innovative network like what the Rural Hospital Coalition has put together,
you're spinning your wheels.
"The
networking capability and the way the rural hospitals have come together as a
coalition has been the driving force. The most important advice I would give
any other rural state is that you've got to form a coalition. And through
that coalition you'll find the efficiencies and the ability to come up with
one way forward. Once you've done that, you can break down so many different
barriers."
Welch concluded,
"I know we're discussing the IT Project of the Year, but I don't view
this as an IT project. This is a patient-care project. That's the whole
point. The entire focus is patient care and making sure that patients finally
have access to specialists, such as radiologists, cardiologists and
neurologists."
Mr. Irving is
editor of ADVANCE.
Honorable
Mention
The judging panel
for ADVANCE's 2009 IT Project of the Year cited two
projects for honorable-mention staus in this year's
contest. Their project summaries appear below:
BayCare Health System in Clearwater,
Fla., reported that this was the first
health care system in the state of Florida
to implement palm vein recognition for patient identification. BayCare's existing information system was enhanced to
support biometric patient identification linking the patient's unique palm
vein pattern to the electronic medical record. Success of the project was
demonstrated by a 99 percent acceptance rate by patients, according to BayCare.
Once a patient is
enrolled in the system, his or her associated medical record can be
identified by the unique vein pattern anytime he/she presents at any one of BayCare Health System's nine hospitals or numerous
outpatient facilities.
The first facility
went live with the palm vein technology within 60 days of the project
kickoff. BayCare completed the rollout of the
entire health system within approximately six months.
The AmeriHealth Mercy Family of Companies, a Medicaid managed
care plan, uses technology solutions to improve health care quality and
access for the underserved. Effectively sharing clinical as well as
administrative information with its provider network is of critical
importance in achieving this goal. To that end, AmeriHealth
Mercy overhauled its existing provider Web portal that served all providers
doing business with six different AmeriHealth Mercy
plans across five states. The company completed this massive project in
record time and with minimal disruption to its provider network.
At press time, AmeriHealth Mercy's new portal had been installed for
eight months. Based on preliminary information from one AmeriHealth
Mercy health plan, provider utilization of the Web had increased by 25
percent for administrative transactions.
Lessons Learned
from LARHIX
ADVANCE asked Ishak Mansi, MD, medical
director of LARHIX, what other states and national leaders could learn from
the Louisiana
project.
Dr. Mansi responded by highlighting the following points:
• Despite the
extreme heterogonous structure of the rural hospitals participating in a
network such as LARHIX, it is possible to tightly connect them. We have
worked through differences in administrative structure, treatment of patient
information and HIPAA compliance, among others.
• Although LSUHSC-S
reached a bed-occupancy rate of greater than 100 percent, the project's
approach helped prioritize and ease patient access to care.
• A tertiary
center, such as LSUHSC-S, can actually strengthen the principle of medical
homes and the role of rural hospitals in offering medical care to their
communities. How? The rural hospitals can access live LSUHSC-S electronic
medical records of their patients; this extends their reach to all imaging
techniques, advanced laboratory investigations and specialized consultations.
Rural physicians now review first-hand information and can be involved in
making decisions - rather than waiting for delayed discharge summaries to
advise them about what has been done with their patients.
• The running cost
of the telemedicine office in the department of medicine at LSUHSC-S is
relatively small. A locally created, maintenance-free, Web-based software
program connects the rural hospitals to the telemedicine office with minimal
manpower.
• Once the portal
is fully functioning, it will save millions of dollars spent on duplication
of imaging and laboratory investigation. Overall, the project is an
investment in our future, and will help decrease health cost.
http://health-care-it.advanceweb.com/Article/Serving-Rural-Patients.aspx
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Joel Mosley
Health-care reform
is at the forefront of politics today.
As a local
physician, I welcome this debate and hopefully a viable alternative to the
current situation.
The options
presented at this time are not clear, except in the fact that they will be
costly. With estimates as high as $1 trillion — that’s right, I said TRILLION
— the cost is clearly going to be high. That is not to say that the cost will
not be worth it.
One cannot put a
price on health, so with that being said, I present
an option that is free —yes, totally free! It is called diet and exercise.
Nearly a third of U.S.
adults are classified as obese, and the epidemic of childhood obesity is well
documented.
Preventable
diseases linked to obesity, such as diabetes and high blood pressure, which
ultimately lead to stroke and heart attacks, are estimated to cost 9 percent
of the health-care budget. Tobacco and alcohol abuse contribute to an even
larger expenditure of health care.
As Washington bickers
over cost and results, Americans suffer.
Politicians will
always act like politicians, with their accusations and endless games to
obtain re-election.
I have no
allegiance to party lines when it comes to health care. I took an oath to
always put my patients first, and I always will, which is exactly why I wrote
this letter.
Health care is
definitely a right, but it is also a responsibility that starts with the
patient. So, I ask you, Baton Rouge and America,
to look at yourself in the mirror and ask yourself, am I being a responsible
patient?
Joel Mosley
physician
Baton Rouge
http://www.2theadvocate.com/opinion/52034447.html
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Ilze Choi
It is
disheartening to see the health care debate degenerate to such hysterical
reactions as depicted in Steve Kelley's July 23 cartoon, which showed a
taxpayer running away from President Obama and yelling "Aaaaah!"
Obama's carefully
thought-out analysis of problems in the current system and how to fix them
does not deserve the ridicule in the cartoon.
There are many
misrepresentations in the public debate. One is that the government cannot be
trusted to do anything right. However, the mess we have now is as much the
fault of the private sector, if not more. How moral is it to base health care
on profit so the very people who need it the most are shut out?
Another
misrepresentation is that we will have rationing of health care under a
government plan. As everyone must be aware, we already have rationing based
on income. The higher your income, the more choices and better care you get.
Yet another
misrepresentation is that a government plan will interfere between you and
your doctor. Many private sector plans already offer a set choice of
physicians, and if you want to get a second opinion, it has to be out of
pocket.
Last, the idea
that the option of a government plan will drive out private insurance is a
wild supposition, to put it politely. Judging by how private insurance places
profit over helping people in need, it would do us
all good if it had some competition to worry about.
Ilze Choi
New Orleans
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1248931988216230.xml&coll=1
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By Theresa Schmidt
LAKE CHARLES,
LA (KPLC) - Research shows
healthy children do better in school than those who are often sick. That's
why a back to school enrollment drive is underway to get uninsured children
signed up for LaCHIP-- the Louisiana Children's
Health Insurance Program.
Jessica Mouton is trying to start a new life after
circumstances caused her to become a single mom. She is working but admits
help from government programs like the Louisiana Children's Health Insurance
Program have given her hope for the future. Her
oldest daughter receives health care through LaCHIP.
"I have medical attention for my daughter that I would not have right
now in the situations that I've been going through. She gets dental
assistance, eye care, physical exams, check ups."
David Duplechian with Family and
Youth Counseling is working with the state to educate and inform those who
may qualify for LaChip. He says healthier children
do better in school. "What we have found is that people who don't have
health coverage for their child will typically let minor illnesses go
untreated because they can't afford the cost of care and they eventually will
wind up bringing their kids to the emergency room because the illness has
progressed. So, the children are missing more school. And parents are missing
time from work to be with those sick children."
LaCHIP provides coverage for
primary health care such as doctor visits and dental. Duplechian
says people may not know a mere disruption in income may allow them to
qualify. "If you just have a month or two disruption
in your income you may qualify for that year's coverage. People that maybe
lost income from the hurricane because they were unable to work because their
business was closed or they had evacuated, they may have qualified for LaCHIP at that point for a year's coverage."
Jessica hopes one day she will no longer need LaCHIP or other government assistance. "If it wasn't
for the help that's out there now I'd probably be in a homeless shelter and
having to worry about my children getting sick or getting taken away. It's
wonderful that there is assistance out there that can help people like
me."
She says she appreciates the help from taxpayers.
LaCHIP is paid for with a
variety of federal and state tax sources. State director Ruth Kennedy says
78% of the funding comes from the federal government while 22% comes from the
state. More children were added when LaCHIP was
reauthorized by Congress in February 2009. Those children are paid for with
the tobacco tax.
LaCHIP also offers insurance for
some families who earn too much to qualify for the no cost coverage but still
struggle. They pay fifty dollars a month plus co-payments.
http://www.kplctv.com/Global/story.asp?S=10813905
[BACK TO TOP]
by Jeff Crouere
Last November, U.S. Senator Mary Landrieu (D-LA) was
re-elected to her third term. Once again, Landrieu was able to edge an
under-funded Republican candidate, State Treasurer John Kennedy. She defeated John Kennedy with only 52% of
the vote, but for Landrieu it was a landslide. In her two previous U.S.
Senate elections, Landrieu won by even smaller margins.
In her career, she has been able to defeat Republicans by
championing her independent and moderate views. She has also benefited by
receiving the endorsement of prominent Republican elected officials. For
example, in the last election, Landrieu was endorsed by the Republican
Sheriff of the largest parish in Louisiana
and the President of a large suburban parish outside of New Orleans.
Some moderate Republicans have been attracted to Landrieu
because throughout her Senate career, she has strived to appear moderate,
even though her heart is clearly on the left. In the early part of her
political career, as a Louisiana State Representative and Louisiana State
Treasurer, Landrieu was not bashful about expressing her liberal beliefs, but
she is much more careful today as a United States Senator. In 2008, her
American Conservative Union rating was only 32%, certainly left of center,
but nowhere near the liberal rating of Ted Kennedy or Barack Obama.
Luckily for Landrieu, her next election is five years
away. Without question, her popularity has dipped in the past year. In a July
2009 survey by Public Policy Polling, Landrieu’s approval rating is only 43%,
one point below the much maligned U.S. Senator David Vitter and a full 12
points below Governor Bobby Jindal.
Clearly Senator Landrieu is out of step with the majority
of Louisiana
voters. In the first six months of the Obama administration, Senator Landrieu
has generally supported most of the President’s proposals. She was a proud
supporter of his controversial $787 billion stimulus bill, touting the money
that was sent to Louisiana
for infrastructure projects.
Whenever she supports the President on a particular issue,
she is opposing the majority of voters in Louisiana. In the Public Policy Polling
survey, President Obama only received a 44% approval rating statewide. In the
last election, John McCain handily defeated Barack Obama in Louisiana, so it is not surprising that
the President’s approval rating is rather low in the state.
This political scenario creates a difficult situation for
Landrieu, who tries to support Obama and the Democratic Party whenever
possible, but does not want to appear too liberal. On issue after issue,
Landrieu must walk a political tightrope. She supported the President on the
stimulus bill and will vote for the Sotomayor
nomination, but her position on the union card check bill and the healthcare
reform proposal are unknown. On occasion, Landrieu has been forced to oppose
President Obama. She has publicly expressed her opposition to the cap and
trade bill that passed the House, a move that was politically necessary in a
state dominated by the oil and gas industry.
As the Senator tries to placate her party and the
President as much as possible, she faces the possibility of angering her
constituents. With the high stakes healthcare bill being debated across the
country, her tightrope act is getting more difficult. At a recent forum in
Reserve, Louisiana,
Landrieu introduced four members of the Obama cabinet who were in the state
to discuss the healthcare proposal being debated in Congress. To the surprise
of the panel and Senator Landrieu, the vast majority of the audience was
staunchly opposed to the bill. Most of the audience members loudly denounced
the bill and one activist shouted to the panel to give the President the
message that “It will be a cold day in hell before he socializes my country.”
In the last six months, a vibrant tea party movement has
spread throughout Louisiana.
Conservatives dominated the last session of the Louisiana Legislature and all
of the proposals to raise taxes were defeated. Since Hurricane Katrina, Louisiana has become a
more Republican and conservative state. In the last four years, the
population of New Orleans
has decreased by over 150,000 residents and many of the voters who left the
state were liberal Democrats, primarily African Americans, and the base of
support for Senator Landrieu.
Despite her difficulties in Louisiana, Senator Landrieu is a skilled
politician. She has been able to get re-elected even though she supported
liberal Democratic presidential candidates such as Al Gore, John Kerry and
Barack Obama. She has been helped along the way by weak Republican opposition
and political support from moderate Republicans.
However, in the upcoming healthcare debate, she faces her
biggest challenge. As the debate intensifies and dominates Capitol Hill will
Landrieu succumb to pressure from her party and her President? Or, will she
vote with her constituents who are largely opposed to the expensive
nationalized health care plan?
According to LSU-Shreveport Political Science Professor
Jeff Sadow, Landrieu faces an important political
test. “Five years is almost an eternity in politics, but how she votes on this
matter, given the magnitude of its importance, is something that will be
remembered for a long time. Which probably explains why, she has not given
any commitment to supporting what… (President) Obama is pushing, despite some
heavy-handed Democrat tactics against her. Seeing the way the wind is blowing
now may make her even more hesitant to support Obama on this, and thereby
save the state and nation a lot of agony.”
Landrieu is always caught between her true liberal
philosophy and the more conservative leanings of the voters of Louisiana. She is
trapped between the liberal platform of her party and the more traditional
views of her constituents. Senator Landrieu is never in a comfortable
political place, as she is constantly weaving around on each tough issue.
Landrieu rarely takes a hard stance on any issue, she
likes to be fluid so she can adapt to the shifting political winds.
Eventually, she has to make a decision and the time will soon come for her to
cast a vote on the healthcare bill. In the next few weeks, the eyes of Louisiana and the
nation will be on Senator Landrieu as she will cast a vote of major
significance to the economy of this country and to her political career.
http://www.humanevents.com/article.php?id=32882
[BACK TO TOP]
By SUSAN HAIGH (AP) – 17 hours ago
HARTFORD,
Conn. — Aurice
Barlow knows what happens when someone can't afford dental care.
"I see people walking the streets with toothaches,
teeth hanging out of their mouths," said the former nurse's aide. At
least 30 percent of the people in this city of 124,500 are impoverished.
"Nobody cares," she says.
Barlow is worried she'll now become one of them.
Washington
is pouring $87 billion in federal stimulus money into the states to help
maintain state-run Medicaid health care for the needy — and to handle the
expected surge in enrollment.
But Connecticut
and other cash-strapped states say they still must slash spending on health
care to cover massive budget deficits. At least 21 states have already
restricted low-income children's and families' eligibility for health
insurance or their access to services; at least 22 states and the District of Columbia
are cutting services for low-income elderly or disabled patients.
Those considering Medicaid cuts are targeting benefits
considered optional under federal rules — such as adults' dental coverage,
vision care and some therapy — as well as cuts or freezes in Medicaid
reimbursement. Some states are also looking to cut non-Medicaid or
state-funded programs.
In Connecticut,
where a budget agreement has not yet been reached, Gov. M. Jodi Rell wants to limit Medicaid dental benefits for adults
to emergencies only, saving nearly $51 million over two years.
Barlow is one of about 193,000 people eligible for Connecticut's dental
coverage. Out of work since 1998 and recently accepted for federal disability
assistance, she dutifully visits the Charter Oak Health Center in Hartford
for her twice-a-year cleanings and other dental needs, all paid by Medicaid.
If that coverage disappears, Barlow says she can't afford
to pay for dental care on her own.
"I would go without I guess, brush my teeth the best
I can," she said.
The Center on Budget and Policy Priorities in Washington, D.C.,
reports that at least 48 states have already addressed or still face budget
shortfalls for the new fiscal year, which began in most states on July 1.
Judith Solomon, a senior fellow at the nonpartisan center,
which focuses on budget issues regarding low- and moderate-income people,
said the situation would be much worse if there were no federal stimulus
money.
"But it certainly has allowed states to maintain
eligibility and not make some cuts they probably would have," she said.
Oklahoma used the federal
funds to increase its budget for Medicaid health care providers and Iowa expanded health
care to tens of thousands of children. Officials in South Carolina restored some proposed
cuts, such as daily meals for homebound people and support for autistic
children.
The programs that do face cuts are diverse. And the
reductions come at a time when the demand for government health care is
expected to rise as the unemployment rate climbs and people lose their
private health coverage.
_ Louisiana Gov. Bobby
Jindal plans to shut down a mental health hospital
in New Orleans by Sept. 1, consolidating its services with a suburban
facility 35 miles away. Residents have filed a lawsuit to stop the closure.
_ Illinois
plans to cut $40 million from a prescription drug program for about 200,000
low-income seniors and people with disabilities. About 150,000 of them will
have to pay more out-of-pocket.
_ The Ohio Legislature sharply cut drug and alcohol
addiction services and community-based mental health care.
_ Maryland's
Medicaid cuts include rates paid to nursing homes, spending on hospital stays
and an inflation adjustment for community health care providers.
_ Washington
state cut about $255 million, more than 40 percent, from a state program that
offers low-cost subsidized health insurance for the poor.
"While some things have been avoided, delayed, to
meet these significant budget shortfalls, states are considering some pretty
major cutbacks to the program," said Robin Rudowitz,
a principal policy analyst at the Kaiser Family Foundation in Washington, D.C.
Many of the programs facing cutbacks or elimination were
hard-won by advocates over the years.
Paul Gowins, an activist in Reno, Nev.
lobbied his state for about 20 years to pay for personal care attendants for
the disabled and elderly. He's relieved that Nevada lawmakers only cut attendants' pay
from $18.50 to $17 hour, crediting federal stimulus money for helping offset
the cost.
Gowins, a quadriplegic, gets
five hours of help a day for bathing and other needs. He worries what will
happen in December 2010, when the federal money ends.
"I anticipate as the economy keeps slowing down, as
it is in Nevada,
I expect in a year we'll be looking at cuts to those programs," he said.
"There's no option."
Connecticut
recently increased rates paid to dentists who serve needy adults under the
Medicaid program that's at risk of being cut. That encouraged Dr. Jonathan
Knapp of Bethel, Conn., and other dentists to begin
accepting more of the adult patients.
The fees still don't cover his costs for those patients at
his practice, but Knapp — who participates in free Mission of Mercy dental
clinics in the state — said the Medicaid coverage for needy adults saves the
state money. An untreated infection can be deadly, he said.
"Most of these folks will end up in emergency rooms
if a tooth gets bad enough and it starts to abscess," said Knapp. Other
states that have cut coverage have seen similar results, he added. "It's
penny-wise and pound-foolish."
Mary Alford of Louisville,
Ky., whose 23-year-old son
Aaron is autistic and has a genetic disorder, receives Medicaid benefits for
adult day care and other services. He was initially denied coverage for his
occupational and speech therapy but she persuaded the state to cover some of
the services, which allow her to keep her son at home and not in an expensive
institution.
"It's a tough time for everyone, but there are many
ways we could actually be helping these disabled folks in the community and
help Kentucky's bottom line at the same time," she said.
http://www.google.com/hostednews/ap/article/ALeqM5isFa8Z14ZU7_1FdxV0gzofRplSOgD99OAHFO6
[BACK TO TOP]
By RICARDO ALONSO-ZALDIVAR and ERICA WERNER (AP)
WASHINGTON — Congressional Democrats are determined to
show progress on a health care overhaul by pushing President Barack Obama's
top domestic priority through two critically important committees before they
head home for their August break.
They're closer, but they're not there yet.
Democratic leaders in the House won agreement from
conservatives on the Energy and Commerce Committee that would allow that panel
to start voting on legislation as early as Thursday. In the Senate,
negotiators on the Finance Committee say they are nearer to a bipartisan
compromise that has eluded them for weeks.
The Finance panel and the Energy and Commerce panel are
seen as pivotal tests of prospects for the legislation because they reflect
the broader composition of the Senate and the House. Three other committees
that have already passed versions of the legislation are dominated by
Democratic liberals.
The earliest that floor votes could occur would be in
September.
The House bill and the plan under negotiation in the
Senate are designed to meet Obama's goals of spreading health coverage to
millions who now lack it, while trying to slow the skyrocketing growth in
medical costs. As recently as two weeks ago, Obama was pressing the House and
Senate to pass separate bills by the end of July or early August. After
Republicans and moderate Democrats objected to the rush, the president said
he'd settle for just progress.
Wednesday in the House, Democratic leaders gave in — at
least temporarily — to numerous demands from rank-and-file rebels from the
conservative wing of the party. The so-called Blue Dog Democrats had been
blocking the bill's passage in Energy and Commerce.
The House changes, which drew immediate opposition from
liberal lawmakers, would steer away from using Medicare as the blueprint for
a proposed government insurance option, reduce federal subsidies to help
lower-income families afford coverage, and exempt additional businesses from
a requirement to offer health insurance to their workers.
Bipartisan Senate negotiators reported progress on
legislation that aims to cover 95 percent of Americans without raising
federal deficits.
"We're on the edge, we're almost there," said
Sen. Charles Grassley of Iowa, the senior
Republican involved in the secretive talks, although a fellow GOP
participant, Sen. Mike Enzi of Wyoming,
dissented strongly.
Sen. Max Baucus, D-Mont., chairman of the Finance
Committee, said preliminary estimates from congressional budget experts
showed the cost of the emerging Senate plan was below $900 billion and would
result in an increase in employer-sponsored insurance — conclusions that may
reassure critics who fear a bloated bill that prompts businesses to abandon
the coverage they currently provide.
Congressional officials said Baucus was able to get the
cost under $1 trillion because his bill includes only the cost of the first
year of a 10-year, $245 billion program to increase doctor fees under
Medicare. House Democrats used a similar sleight of hand, excluding the
entire $245 billion when claiming their measure wouldn't add to the deficit.
The White House praised the developments in the House. At
appearances in North Carolina and Virginia, the
president sought to minimize the significance of the slippage in his
timetable.
"We did give them a deadline, and sort of we missed
that deadline. But that's OK," Obama said. "We don't want to just
do it quickly, we want to do it right."
Campaigning for the health care overhaul, Obama stressed
that any legislation he signs will include numerous consumer protections,
including a ban on insurance company denials of coverage based on
pre-existing medical conditions. A White House fact sheet left room for insurers
to continue charging higher premiums based on prior health problems.
Rep. Mike Ross of Arkansas,
a leader of the Blue Dogs, said the changes agreed to by the leadership in
the House bill would cut its cost by about $100 billion over 10 years.
The House deal was worked out over hours of talks that
involved not only Democratic leaders but also White House officials eager to
advance the bill. Senior congressional aides cast it as a temporary
accommodation, saying leaders had not committed to support it once the bill
advances to the floor of the House in the fall.
As word of the agreement spread, liberals fired back.
"We do not support this," said Rep. Lynn Woolsey, D-Calif., co-chair of the Progressive Caucus. "I think
they have no idea how many people are against this. They can't possibly be
taking us seriously if they're going to bring this forward."
Plans to convene the Energy and Commerce Committee for a
vote slipped until Thursday as leaders sought to allay concerns of liberals.
"We just need to get everybody on board," said
Rep. Frank Pallone, D-N.J., who chairs the panel's subcommittee on health.
In the Senate, the pace of negotiations appears to have
accelerated in recent days, with lawmakers all but settling on a tax on
high-cost insurance plans to help pay for the bill, as well as a new
mechanism designed to curtail the growth of Medicare over the next 10 years
and beyond.
More problematic from the point of view of most Democrats
is a tentative agreement to omit a provision in which the government would
sell insurance in competition with private industry. In its place, the group
is expected to recommend nonprofit cooperatives that could operate at the
state, regional or even national level.
Nor is any bipartisan recommendation likely to include a
requirement for large businesses to offer insurance to their workers.
Instead, they would have a choice between offering coverage or paying a portion of any government subsidy that
noninsured employees would receive.
Like the House bill, the bipartisan proposal under
discussion would expand eligibility for Medicaid to 133 percent of the
federal poverty level.
It provides for federal subsidies for individuals and
families up to 300 percent of poverty, less than the 400 percent in the House
measure.
Even if the negotiations succeed before the Senate's
vacation, which starts next week, it isn't clear when the Finance Committee
would vote.
http://www.google.com/hostednews/ap/article/ALeqM5jlMpJGn28kqCcgU-aGcYE_ZHW-ywD99OPJKG2
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New Orleans CityBusiness |
07.29.09
by The Associated Press
WASHINGTON
— After weeks of turmoil, House Democrats reached a shaky peace with the
party's rebellious rank-and-file conservatives today and cleared the way for
a vote in September on sweeping health care legislation.
Bipartisan Senate negotiators reported progress, too, on a
bill to extend coverage to 95 percent of all Americans without raising
federal deficits. "We're on the edge. We're almost there," said
Sen. Charles Grassley of Iowa,
the senior Republican involved in the secretive Senate talks.
Sen. Max Baucus, D-Mont., chairman of the Finance
Committee, said preliminary estimates from congressional budget experts
showed the cost of the emerging Senate plan was below $900 billion and would
result in an increase in employer-sponsored insurance — conclusions that may
reassure critics who fear a bloated bill that prompts businesses to abandon
the coverage they currently provide.
Across the Capitol, House Democratic leaders gave in to
numerous demands from rank-and-file rebels, so-called Blue Dogs from the
conservative wing of the party who had been blocking the bill's passage in
the last of three committees.
The House changes, which drew immediate opposition from
liberals in the chamber, would reduce the federal subsidies designed to help
lower-income families afford insurance, exempt additional businesses from a
requirement to offer insurance to their workers and change the terms of a
government insurance option.
At their core, both the House bill and the plan under
negotiation in the Senate are designed to meet President Barack Obama's goals
of spreading health coverage to millions who now lack it, while slowing the
skyrocketing growth in health care costs nationally.
Obama has placed the issue atop his domestic agenda, and
as recently as two weeks ago was pressing the House and Senate insistently to
pass separate bills by the end of July or early August.
The White House issued a statement praising the
development in the House, and with appearances in North Carolina and Virginia, the president
sought to minimize the significance of the slippage in his timetable.
"We did give them a deadline, and sort of we missed
that deadline. But that's OK," Obama said. "We don't want to just
do it quickly, we want to do it right."
In his appearances, Obama stressed that any legislation he
signs will include numerous consumer protections, including a ban on
insurance company denials of coverage based on pre-existing medical
conditions.
Rep. Mike Ross of Arkansas,
a leader of conservative and moderate "Blue Dog" Democrats, said
the changes agreed to by the leadership would cut the cost of the House bill
by about $100 billion over 10 years.
While Baucus reported the Senate Finance measure carried a
price tag of under $1 trillion, congressional officials said it included only
the cost of the first year of a 10-year, $245 billion program to increase
doctor fees under Medicare. House Democrats used a similar sleight of hand,
excluding the entire $245 billion when claiming their measure wouldn't add to
the deficit.
The House deal was worked out over hours of talks that
involved not only the chamber's leaders but also White House officials eager
to advance the bill. It was unclear, though, what commitments Speaker Nancy
Pelosi or the administration may have made to support the agreement once the
bill advances to the floor this fall.
As word of the agreement spread, liberals fired back.
"We do not support this," said Rep. Lynn Woolsey, D-Calif., head of the Progressive Caucus. "I think
they have no idea how many people are against this. They can't possibly be
taking us seriously if they're going to bring this forward."
Whatever the longer-term ramifications, Democrats said the
way was now clear for the Energy and Commerce Committee to approve its
portion of the legislation, the last step before it comes to the floor for a
vote.
"We're hoping to get a bill out before we leave ...
this week," said Rep. Henry Waxman, D-California, the panel's chairman.
In the Senate, Baucus, Grassley and two other senators
from each party have been negotiating for weeks in hopes of agreeing on
compromise legislation. Both men face considerable pressure from their
respective parties — Baucus not to stray too far from Democratic objectives,
Grassley not to hand the president a political victory.
Majority Leader Harry Reid, D-Nev.,
has given Baucus months to see compromise across party lines is possible, and
he told reporters during the day he expects a bipartisan plan to emerge.
The pace of decisions appears to have accelerated in
recent days, with negotiators all but settling on a tax on high-cost
insurance plans to help pay for the bill, as well as a new mechanism designed
to curtail the growth of Medicare over the next 10 years and beyond.
More problematic from the Democrats' point of view is a
tentative agreement to omit a provision in which the government would sell
insurance in competition with private industry. In its place, the group is
expected to recommend non-profit cooperatives that could operate at the
state, regional or even national level.
Nor is any bipartisan recommendation likely to include a requirement
for large businesses to offer insurance to their workers. Instead, they would
have a choice between offering coverage or paying a
portion of any government subsidy that noninsured employees would receive.
Like the House bill, the bipartisan proposal under
discussion would expand eligibility for Medicaid to 133 percent of the
federal poverty level.
It provides for federal subsidies for individuals and
families up to 300 percent of poverty, less than the 400 percent in the House
measure.
Even if the negotiations succeed before the Senate's
vacation, it is not clear when the Finance Committee would vote.
The proposal would have to be blended with a more liberal
measure that was approved last month by the Senate Health, Education Labor
and Pensions Committee. It would then go to the Senate floor, where Democrats
have 60-40 majority rather than the 3-3 lineup that Baucus and Grassley have
led for months.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=26001
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A lack of doctor trust, access and continuity are to blame
for black U.S.
men having a 55 percent higher rate of prostate cancer than white men, a
study found.
These factors -- plus possible doctor bias, erroneous stereotypes
or lack of understanding of minorities -- result in more advanced prostate
cancer among African-American men at the time of diagnosis than among white
men, the study published in Cancer said.
They also contribute to a death rate that's 2 1/2 times
higher than that of white men, the study said.
"Importantly, no differences in prostate cancer stage
at diagnosis were observed between men of either race when an established
relationship with a healthcare provider existed," noted investigator
Elizabeth Fontham, dean of the School of Public Health
at Louisiana State University Health Sciences Center New Orleans.
After interviewing more than 1,000 North
Carolina and Louisiana
men age 50 and older, researchers found white men generally exhibited higher
doctor trust levels than black men and were more likely to report a doctor's
office as their usual source of care.
White men also were more likely to see the same doctor at
regular medical visits and be screened for prostate cancer than their black
counterparts, the researchers found.
African-American men were less likely to report prostate
cancer screening before diagnosis and men with no history of screening were
more likely to be diagnosed with advanced-stage or high-grade prostate cancer
than men who reported a history of screening, the study, funded by the U.S.
Defense Department, indicated.
http://www.upi.com/Science_News/2009/07/29/Race-bias-tied-to-prostate-cancer-variance/UPI-11541248905378/
[BACK TO TOP]
The New York Times | 07.29.09
By ADAM NAGOURNEY and MEGAN THEE-BRENAN
Stephen Crowley/The New York Times
President Obama took his appeal for support of a
health care overhaul on the road Wednesday, speaking (and snacking) at a
Kroger grocery store in Bristol,
Va.
President Obama’s ability to shape the debate on health
care appears to be eroding as opponents aggressively portray his overhaul
plan as a government takeover that could limit Americans’ ability to choose
their doctors and course of treatment, according to the latest New York
Times/CBS News poll.
Americans are concerned that revamping the health care
system would reduce the quality of their care, increase their out-of-pocket
health costs and tax bills, and limit their options in choosing doctors,
treatments and tests, the poll found. The percentage who
describe health care costs as a serious threat to the American economy
— a central argument made by Mr. Obama — has dropped over the past month.
Mr. Obama continues to benefit from strong support for the
basic goal of revamping the health care system, and he is seen as far more
likely than Congressional Republicans to have the best ideas to accomplish
that. But reflecting a problem that has hindered efforts to bring major changes
to health care for decades, Americans expressed considerable unease about
what the end result would mean for them individually.
“We need to fix health care,” Mary Bevering,
a Democrat from Fort Madison,
Iowa, said in a follow-up
interview, “but if the government creates the system, I’m afraid the quality
of care will go down and costs will go up: We will pay more taxes.”
“It’s going to come down to regulation,” Ms. Bevering said. “What also worries me is whether we will
be told what physician we can have.”
The poll was taken at a moment of extreme fluidity, both
in terms of the complicated negotiations in the House and the Senate as
lawmakers and the administration sort out the substance and politics of
competing proposals, and in the efforts by both sides to define the stakes of
the health care debate for the public.
With Congress now almost certain to recess until after
Labor Day without floor votes on any specific plan, a vigorous advertising
and grass-roots effort to shift public opinion is likely in the next month or
two. The poll offers hope to both sides.
The changes in the public’s attitude over the past month,
even if not huge, suggest one reason Mr. Obama sought so hard to get Congress
to vote on some version of an overhaul before heading home.
Opponents of the proposed health care overhaul have
already spent $9 million on television advertisements raising concerns about
it, said Evan Tracey, the chief operating officer of Campaign Media Analysis
Group, which tracks political advertising. The advertisements are financed by
the Republican National Committee and aimed at constituents of wavering
lawmakers. The committee is also running radio spots.
Officials said the advertising would accelerate as the
legislators returned home for the summer. The advertisements present the
overhaul as a risky experiment, or a government takeover of health care that
would prevent people from choosing their own doctors.
Mr. Obama is making an intense effort to rebut those
claims. On Wednesday, he flew to Raleigh,
N.C., for a town-hall-style
meeting to address the kinds of public concerns reflected in the poll
results.
“First of all,” Mr. Obama said, “nobody is talking about
some government takeover of health care. I’m tired of hearing that. I have
been as clear as I can be. Under the reform I’ve proposed, if you like your
doctor, you keep your doctor; if you like your health care plan, you keep
your health care plan. These folks need to stop scaring everybody, you know?”
Mr. Obama sought in particular to reassure people who
already have health insurance and whom the overhaul plans under consideration
in Congress would benefit by preventing insurers from dropping them or
diluting their coverage if they become ill, while also bringing rapidly
rising costs under control. And he sought to stoke a sense of urgency for
getting a bill signed this year.
“If we do nothing, I can almost guarantee you your
premiums will double over the next 10 years, because that’s what they did
over the last 10 years,” Mr. Obama said. “It will eat into the possibility of
you getting a raise on your job because your employer is going to be looking
and saying, ‘I can’t afford to give you a raise because my health care costs
just went up 10, 20, 30 percent.’ ”
The national poll was conducted by telephone starting on
Friday and ending on Tuesday. It involved 1,050 adults, and has a margin of
sampling error of plus or minus three percentage points.
Mr. Obama’s job approval rating has dropped 10 points, to
58 percent, from a high point
in April.
And despite his efforts — in speeches, news conferences,
town-hall-style meetings and other forums — to address public misgivings, 69
percent of respondents in the poll said they were concerned that the quality
of their own care would decline if the government created a program that
covers everyone.
Still, Mr. Obama remains the dominant figure in the
debate, both because he continues to enjoy relatively high levels of public
support even after seeing his approval ratings dip, and because there appears
to be a strong desire to get something done: 49 percent said they supported
fundamental changes, and 33 percent said the health care system needed to be
completely rebuilt.
The poll found 66 percent of respondents were concerned
that they might eventually lose their insurance if the government did not
create a new health care system, and 80 percent said they were concerned that
the percentage of Americans without health care would continue to rise if
Congress did not act.
By 55 percent to 26 percent, respondents said Mr. Obama
had better ideas about how to change health care than Republicans in Congress
did.
There is overwhelming support for a bipartisan agreement
on health care, and here again, Mr. Obama appears in
the stronger position: 59 percent said that he was making an effort to work
with Congressional Republicans, while just 33 percent said Republicans were
trying to work with him on the issue.
Over all, the poll portrays a nation torn by conflicting
impulses and confusion.
In one finding, 75 percent of respondents said they were
concerned that the cost of their own health care would eventually go up if
the government did not create a system of providing health care for all
Americans. But in another finding, 77 percent said they were concerned that
the cost of health care would go up if the government did create such a
system.
http://www.nytimes.com/2009/07/30/us/politics/30poll.html?_r=1&ref=health
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The New York Times | 07.29.09
By NICHOLAS WADE
A new approach to treating obesity has been opened up by a
discovery about how the body creates brown fat, the cells
that burn white fat and turn it into body heat.
Researchers led by Bruce M. Spiegelman
of Harvard Medical School
report their discovery in Thursday’s issue of the journal Nature. Their paper
describes the natural system by which brown fat cells are generated from
their precursors.
Dr. Spiegelman has used this
system — a pair of proteins that switch on the brown fat cell’s distinctive
genes — to convert both mouse and human skin cells into brown fat cells.
Brown fat cells have a very different role from the
better-known white fat cells. The white cells store fat; the brown cells burn
it off as heat.
Babies have lots of brown fat to help keep warm. Until
April 2009, biologists believed that the brown fat quickly disappeared and
was not found in adults. Dr. Sven Enerback of the University of Goteborg
in Sweden
and others then reported that some brown fat tissue persisted in adults,
raising the possibility that if the cells could be made more active, a person
might burn off more fat.
In a parallel line of research that has now converged with
the brown fat discovery, Dr. Spiegelman has long
been studying the body’s white fat cells and how they are controlled. In 1994
he found the body’s master regulator of white fat cells. Turning to brown fat
cells, he followed the general assumption that they were derived from white
fat cells.
A key element in making brown fat cells seemed to be a
kind of protein called a zinc finger (because it reaches into the spiral of a
DNA molecule to switch on particular genes). Dr. Spiegelman
figured that if he inactivated all the relevant zinc finger proteins in brown
fat cells, they should turn back into their precursors, the white fat cells.
The experiment worked. The brown fat cells did revert, but
not into white fat cells. They turned into muscle cells.
“It was the most bizarre experiment my lab ever did,” Dr. Spiegelman said Wednesday.
His discovery that muscle cells are the natural precursors
of brown fat cells was made last year. Dr. Spiegelman
has now found that the zinc finger protein, in combination with a second
protein produced in muscle cells, is the master switch for brown fat cells
and will also convert skin cells into brown fat, even though this is not the
process nature intended.
He has used this master switch to convert mouse skin cells
to brown fat cells, which seem to work as expected when transplanted into
normal mice. Now he is working on a second experiment, a crucial test for the
possibility of therapy, to see what happens when brown fat cells are
implanted into obese mice.
Asked if the mice were any thinner, Dr. Spiegelman said the results so far were encouraging. He
declined to go further, saying journal editors would be unhappy if he gave
away the findings before publication.
A similar procedure might be tried in people, he said, if the mouse experiments are promising. Further
discoveries might produce the natural protein for turning on the zinc finger
switch, and this protein might make a useful drug for converting skin cells
into brown fat cells.
Dr. Enerback said Dr. Spiegelman had taken a “really important step” in elucidating
the basic biology of brown fat cells. According to his calculations, Dr. Enerback said, inserting 50 to 100 grams of brown fat
cells into a person would enable them to burn off more than 10 pounds of
white fat tissue a year.
He said a cell therapy approach of this kind would allow a
brown fat deposit of cells made from the patient’s skin cells to be made
larger or smaller according to need. Such a therapy would be used not by
itself but along with lifestyle changes and other interventions.
Brown fat cells induce the body’s white fat cells to break
down their fat into fatty acids. These are released into the bloodstream and
taken up by the brown fat cells. Brown fat cells contain large numbers of
mitochondria, the chemical batteries of living cells.
The mitochondria (which originated long ago as bacteria
enslaved in cells) usually generate a chemical form of energy. But in brown
fat cells, this process is disrupted and the mitochondria produce heat
instead.
Because the mitochondria contain iron, the cells adopt the
brownish tinge that gives them their name.
http://www.nytimes.com/2009/07/30/science/30fat.html?ref=health
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