Staff Report
The LSU Bogalusa Medical
Center received the Silver Level
2008 Louisiana Hospital Quality Award from the Louisiana Health Care Review,
the Medicare quality improvement organization for Louisiana.
LSU BMC is one of only 18 hospitals in Louisiana to receive the silver level
award, which the local hospital also won the previous year.
The award recognizes the LSU Bogalusa
Medical Center
for improving the quality of health care given to its patients.
“The LSU Bogalusa
Medical Center
is an important part of the equation for health care on the North Shore,”
said Dr. Michael K. Butler, CEO of the LSU Health Care Services Division. “It
has long provided the quality health care that LSU is known for.”
LHCR established the awards to recognize Louisiana hospitals that successfully
implement quality initiatives to improve patient care in the hospital
setting, specifically in the areas of acute myocardial infarction (heart
attack), heart failure, pneumonia, and surgical care. The Centers for
Medicare and Medicaid Services have designated these clinical topics as
national health care priorities.
“Our staff deserves credit for the success the award
represents,” said Kurt Scott, LSU BMC hospital administrator. “Throughout the
hospital, staff daily put into practice the high standard of care that is
necessary for quality improvement.”
LSU BMC staff have been working
with quality improvement specialists from LHCR to use proven, evidence-based
practices to improve patient care.
“Louisiana Health Care Review is pleased to recognize the LSU Bogalusa
Medical Center
for achieving measured improvement in patient care,” said Gary Curtis, LHCR
CEO. “More importantly, we know that using evidence-based interventions can
save lives, and we applaud the work of the LSU Bogalusa
Medical Center
in its dedication to quality patient care for the people of its community.”
The awards were announced at the second annual Louisiana
Health Care Quality Summit hosted by the LHCR. 2008 is the fourth year the
awards were given.
http://www.gobogalusa.com/articles/2009/06/10/news/doc4a2fcb8f25c3d298273031.txt
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OPINION: Jindal making cuts, seeking more
I write to express the Jindal
administration's agreement with, and continued support for, the position
advanced in a recent News-Star editorial: "Don't tax; cut back."
But I also wish to provide News-Star readers with the actual data behind our
efforts.
As an answer to "what ails Louisiana's state
budget," the editorial says that, rather than raise taxes or cut
education spending, it makes better sense to "thin out the state work
force." I agree, and that's precisely the approach the Jindal administration has been taking.
The editorial cites a claim that state employment has
grown by 3,000 jobs since the beginning of the Jindal
administration. That is not the case.
Between Dec. 31, 2007,
and May 2, 2009,
the number of full-time employees in Higher Education and LSU's Health Care
Services Division increased by 916. But during the same time period, the
number of full-time employees at all other state agencies decreased by 470.
The editorial acknowledges: "Nor can Jindal control every hire, although the executive branch
controls most. Higher education and health-care hires can elude his
control." As these figures demonstrate, employment has decreased in
those areas under direct administration control. Ironically, the growth in employment
has come in those areas outside direct administration control.
What's more, the fiscal year 2010 budget that we proposed
called for the reduction of 1,421 full-time authorized positions across state
government. Combined with 971 position eliminations associated with the FY 09
mid-year budget reductions, and 1,019 eliminations previously implemented
through budgetary action, these new recommended position eliminations would
bring the total to 3,411 eliminations of full-time authorized positions since
the beginning of the Jindal administration — and,
all told, generating $222 million in total savings. This kind of job
elimination through "attrition" is essential for long-term
reductions to the size and cost of government.
It's also indicative of the kind of cost-savings we are
seeking across state government to help restore higher education funding
without delaying planned tax relief for the citizens of Louisiana. We will continue to work with
the Legislature on solutions that tighten the belt of state government
instead of raising taxes.
Angele Davis is commissioner of administration for Bobby Jindal.
http://www.thenewsstar.com/article/20090611/OPINION02/906110303
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An announcement has just been made on the house floor that
former Senate Secretary Mike Baer has passed away.
Baer, who served as Secretary of the Louisiana Senate, until 2004 had been
ill for nearly a decade.
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by Gwen Filosa, The
Times-Picayune
An Ivy League graduate who fudged transcripts and invented
her standardized test score to get into the LSU School of Dentistry pleaded
guilty Wednesday to federal financial aid fraud.
Obialunamma Agubuzu,
25, of River Ridge admitted to sending off fraudulent claims of a 4.0
undergraduate grade point average and a high score on the Dental Admission
Test -- which she never took -- to land $35,572 in loans under the Federal
Family Education Loan Program, along with $8,000 in private scholarships.
Agubuzu is due in U.S. District
Court for sentencing Oct. 14, where she will face up to five years in prison
and a $20,000 fine.
Her roommate, Anthony Juan Walker, 27, still faces a
charge of financial aid fraud for allegedly teaming up with Agubuzu in the scam. Both were indicted May 21 on several
counts of fraud.
Walker drew the attention
of LSU officials this spring after a computer consultant reported that he had
received an e-mail from Walker
asking him to break into an LSU faculty member's computer account to get test
answers, federal investigators said.
A month later, LSU police found Walker at 3:30 a.m. in a school building,
kneeling by the door of a professor's office with a backpack full of tools
that might be used in a burglary. LSU
Health Sciences
Center's Katherine Muslow examined the two students' files and found that
their Cornell University transcripts didn't reflect
the high marks on their applications to the dental school.
Instead of a 4.0 GPA, Agubuzu
graduated in 2007 from Cornell with a 2.452, authorities said. She also had
taken none of the science courses listed as prerequisites for admission to
LSU's dental program.
Agubuzu's father is a retired
Nigerian ambassador, and her parents live in Nigeria, federal agents said.
http://www.nola.com/news/index.ssf/2009/06/ivy_league_graduate_admits_fak.html
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La. health care industry prepares for deep
cuts along with higher education
Kyle Bove
Senior Writer
B ENJAMIN
OLIVER HICKS / The Daily Reveille
Baton Rouge General potentially faces $6.1 million in
cuts.
Health care and higher education are both looking at steep
budget reductions next fiscal year.
And just as Chancellor Michael Martin and LSU System
President John Lombardi have spoken up about the effects a $219 million
funding reduction would have on public colleges, universities and the state
in general, health care officials are spreading the word about the cuts House
Bill 1 dealt them.
“[The effects] would stretch throughout the entire state,
very similar to what is being thought about in higher education,” said John Matessino, president of the Louisiana Hospital
Association. “There would be layoffs all over.”
HB 1, the state’s $28 billion state spending proposal, has
hospitals taking a $200 million cut in reimbursements they receive for
providing care to the state’s poor through the Medicaid health insurance
program. The funding reduction is to help make up for an expected $1.3
billion state revenue shortfall for the fiscal year that starts July 1.
The cuts to Medicaid would result in about 4,000 layoffs
statewide, according to data collected by the Louisiana Hospital Association.
The Baton Rouge
area would suffer 564 layoffs if the $200 million cut goes through, and Baton
Rouge General alone would have to endure a $6.1 million reduction in their
Medicaid reimbursement.
But last week, the State Senate Finance Committee restored
75 percent of the Medicaid cuts, which leaves health care with $90 million in
major reductions to deal with, said Michelle Clement, spokeswoman for the
Louisiana Hospital Association.
The 75 percent restored would still leave Louisiana facing about
2,000 layoffs, though.
“HB 1 will now go to the full House for concurrence, and
the bill will most likely end up in Conference Committee,” Clement said in an
e-mail to The Daily Reveille. “The House could strip away everything the
Senate put back in or they can restore the cuts 100 percent ... We will have
to wait and see.”
Matessino said Senate Bills 1
and 2 could help health care and higher education the most.
Backed by Gov. Bobby Jindal, the
bills would make it easier for the state to balance the budget using certain
dedicated funds without having to dip so deeply into health care and higher
education’s budgets.
The state constitution currently leaves health care and
higher education the most vulnerable during financial downturns because most
other funds are not susceptible to cuts. The bills would allow the state to
dip into those dedicated funds up to 10 percent, instead of the current 5.
“That’s something that’s got to happen,” Matessino said. “We have to take the pressure off higher
education and health care.”
Matessino said Medicaid is
already under-reimbursed, with Louisiana
hospitals only receiving 83 cents for every dollar they use for Medicaid. He
said a funding cut as large as $200 million would drop hospitals down to
their 1988 level of reimbursement.
Many health care leaders have expressed the importance of Louisiana hospitals to
the state’s economic development.
The health care industry employs the largest amount of
people in the state, said Paul Salles, chief
executive officer of the Metropolitan Hospital Council of New Orleans at a
State Capitol news conference in late May. He said the health care industry
is important to economic development and has a $7.8 billion payroll and more
than 250,000 employees.
http://www.lsureveille.com/news/la-health-care-industry-prepares-for-deep-cuts-along-with-higher-education-1.1761831
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Thank goodness for the Senate Committee on Health and
Welfare.
After compelling testimony Wednesday from emergency room
doctors opposed to weakening the state's motorcycle helmet law, committee
members did the sensible thing. They refused to vote on House Bill 639, which
likely killed the legislation for the session.
The issue shouldn't even have been in question. The
emergency room physicians testified that the helmet mandate saves lives and
reduces injuries in crashes. Louisiana's
fatality statistics bear that out.
When former Gov. Mike Foster talked lawmakers into
scrapping the helmet law during his first term, motorcycle deaths increased.
After former Gov. Kathleen Blanco pushed lawmakers to reinstate the helmet
requirement in 2004, fatalities dropped.
That should have been sufficient evidence of the value of
the law.
But some lawmakers and Gov. Bobby Jindal
persist in trying to get rid of the helmet requirement. The governor's
executive counsel Jimmy Faircloth argued in favor of HB 639 at the committee
meeting, saying the legislation was a matter of "freedom of
choice."
Fortunately, the committee members listened to the ER
doctors instead.
To claim that the issue is about freedom ignores the fact
that highways are shared by all of us, and the state has an obligation to
make them as safe as possible. The consequences of risky behavior aren't
confined to the rider who chooses not to wear a helmet. High fatality rates
drive up the cost of auto insurance, and riders who suffer serious injuries
can be a financial drain on taxpayers.
It's a simple concept: Requiring motorcyclists to wear a
helmet is an issue of public safety, as are seat belt laws and prohibitions
against drinking and driving.
HB 639 was a bad bill based on a bad premise, and the
committee was right to let it die. Let's just hope it stays dead.
http://www.nola.com/news/t-p/editorials/index.ssf?/base/news-5/1244698286168270.xml&coll=1
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By JORDAN BLUM
Advocate Capitol News Bureau
TRAVIS SPRADLING/THE ADVOCATE
Marjorie Esman, left, of
the American Civil Liberties Union of Louisiana, speaks Wednesday against
House Bill 517, by state Rep. Harvey LeBas, D-Ville
Platte, which would allow medical workers to opt out of performing services
for ethical or religious reasons. At right, Julie Mickelberry
of Planned Parenthood of Louisiana and Mississippi Delta, waits to also speak against HB517 at the hearing.
Marjorie Esman, left, of the
American Civil Liberties Union of Louisiana, speaks Wednesday against House
Bill 517, by state Rep. Harvey LeBas, D-Ville
Platte, which would allow medical workers to opt out of performing services
for ethical or religious reasons. At right, Julie Mickelberry
of Planned Parenthood of Louisiana and Mississippi Delta,
waits to also speak against HB517 at the hearing.
Legislation to allow medical workers to opt out of
performing services for moral or religious reasons narrowly passed out of a
state Senate committee Wednesday.
The Senate Health and Welfare Committee approved House
Bill 517 on a 3-2 vote after tinkering with some of the language.
HB517 would permit health-care workers to refuse to
participate in any medical service “that violates his conscience.” Conscience
is defined as religious belief or moral conviction.
That includes procedures such as abortions, euthanasia, cloning and human embryonic stem cell research.
The legislation is backed by Gov. Bobby Jindal and groups such as the Louisiana Family Forum and
the Louisiana Right to Life Federation. The bill is sponsored by state Rep.
Harvey LeBas, D-Ville Platte.
Opponents include Planned Parenthood, Louisiana Agenda for
Children, the Forum for Equality and the American
Civil Liberties Union.
Marjorie Esman of the ACLU of
Louisiana said the bill could lead to all kinds of discrimination and racism
under the guise of moral objections.
“At best, this bill would lead to all kinds of unintended
consequences,” Esman said.
For instance, she said, some religions oppose immunization
shots for children. In a rural area, a doctor refusing to do immunizations
could lead to a school being temporarily shut down, she said.
While narrowing language in the bill through amendments,
state Sen. Cheryl Gray Evans, D-New Orleans, said, “I’m trying to make a bad
bill a good bill. It’s problematic in committee.”
Committee members said more amendments could come on the
Senate floor.
Committee Chairwoman Willie Mount, D-Lake Charles; Dale Erdey, R-Livingston; and David Heitmeier,
D-New Orleans, voted in favor of the bill.
Gray Evans and Sen. Yvonne Dorsey, D-Baton Rouge, opposed
it.
http://www.2theadvocate.com/news/47736037.html
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Advocate Capitol News Bureau
TRAVIS SPRADLING/THE ADVOCATE
State Sen. Rob Marionneaux,
D-Grosse Tete, seated left, with state Reps. Kevin
Pearson, R-Slidell, and Walker Hines, D-New Orleans, talk with Rep. Jim
Morris, R-Oil City, standing, in the Senate Health and Welfare Committee
between testimony on bills Wednesday.
Controversial legislation concerning dentistry will have
to wait another week for a chance to progress in the Senate.
State Rep. Kevin Pearson, R-Slidell, spent close to three
hours Wednesday in and around the Senate Health and Welfare Committee waiting
for his dentistry legislation to come up.
Pearson’s House Bill 687 was the last to be taken up by
the committee, and Chairwoman Sen. Willie Mount, D-Lake Charles, asked an
exasperated Pearson if the bill could be taken up first thing next week
instead because of time constraints.
That could put HB687 at greater risk because only two
weeks remain in the legislative session and the bill must still be approved
by the Senate committee and the full Senate.
HB687 was first designed to outlaw performing dentistry in
schools. But a compromise was approved on the House floor to force the
Louisiana State Board of Dentistry to enact rules for dentistry in schools or
mobile dental units by Jan. 1.
The amended legislation also requires any dentist
providing such school care to have at least $1 million in medical malpractice
liability insurance. Opponents said the insurance measure would price out
many dentists from practicing.
HB687 centers on the new trend in Louisiana of dentists going to schools in
primarily low-income and rural areas and performing dental work on children
who are covered by Medicaid, the government insurance program.
Pearson contended removing “partial” dentistry care in
school libraries and gyms is needed to encourage parental involvement and to
get students the quality care they really need.
Several in opposition have argued that dentistry in
schools is the only way many students from low-income families will get any
dental care at all.
http://www.2theadvocate.com/news/47735932.html
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Paul Murphy / Eyewitness News
Watch video:
http://www.wwltv.com/video/featured-index.html?nvid=370167
BATON ROUGE, La.
-- This week a group of health care providers, led by the Louisiana Hospital
Association, started running a commercial on local radio stations that warn
about service reductions and job losses in the wake of expected major cuts in
state Medicaid funding.
"The Louisiana Legislature is about to make major
cuts to hospitals and health care providers this week," the
advertisement said. "That means higher bills for you and your
family."
Last week, the state senate restored about 75 percent of
the Medicaid cuts included in the proposed state budget.
But, that still leaves providers with about $90 million in
Medicaid reductions across the state.
Providers say that could cost the state more than 1,700
jobs.
There would be more than $35 million in cuts in the New Orleans area with
694 jobs lost.
Ochsner Hospital CEO Dr. Patrick
Quinlan says for every $20 the state spends on Medicaid, the federal
government kicks in an $80 match.
"This leverage of the 80 percent federal contribution
to these dollars makes this a particularly beneficial cut to remove because we're
losing far more federal dollars than state dollars," said Quinlan.
The cuts would also affect the ambulance industry.
The budget now reflects a more than 7 percent Medicaid cut
to ambulance providers.
"It's a very sad reality, but that is the reality,"
said Acadian Ambulance VP Steve Kuiper. There would
be a substantial decrease in the number of personnel, not just Acadian
Ambulance, but all the ambulance providers would be face that statewide.
Kuiper says lawmakers need to
think long and hard about what the cuts will do to response time.
"If it's their family member, their loved one, their
friend that has to wait an additional, one, two, three minutes for an
ambulance, those one, two, three minutes can make the difference between life
and death, think about that message," said Kuiper.
Providers say with the amount of cuts coming down the
pike, on top of mid-year cuts last year, patient care is expected suffer.
"It's a very difficult task to do, particularly at a
time when the baby-boomers come on and the city is getting its population
back, to have less to do more with is a very difficult challenge," said
Quinlan.
"We could probably work with a small reduction, maybe
1 percent, but to look at a 7 percent across the board cut for all of us is
devastating to the point where patient care would positively be, negatively
impacted," said Kuiper.
Lawmakers admit they are left with a series of tough
choices this year.
They have to find some way to trim about $2 billion out of
the state's nearly $30 billion budget.
Health care and Higher Education are easier targets
because funding for those services are not
constitutionally obligated.
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Los Angeles Times | 06.11.09
By Noam N. Levey and Janet Hook
Reporting from Washington — Behind the open brawling over
how to rebuild the nation's healthcare system, another struggle is beginning
that may be the toughest test for the drive to cover millions of people
without insurance and improve medical care for all: who should pay the
eye-popping bill.
President Obama and his congressional allies -- who are
also struggling to hold down the national debt after years of deficit
spending and new outlays to combat the recession -- have pledged to raise
more than $1 trillion over the next decade to offset the costs of what would
be the biggest health overhaul in generations.
But the prospect of new taxes, new fees for businesses and
cutbacks in other government spending has set off a furious behind-the-scenes
struggle that is reviving the old maxim attributed to the late Sen. Russell
Long of Louisiana:
"Don't tax you, don't tax me, tax that fellow
behind the tree."
Faced with a proposal to increase the tax on liquor and
soft drinks, for instance, the liquor lobby sent Anchor Brewing Co. of San
Francisco to see House Speaker Nancy Pelosi (D-San Francisco). The milk
industry objected too, saying it would have to raise the price of chocolate
milk.
And when congressional Democrats started warming up to the
idea of curbing the tax break for employer-provided health benefits, the
labor movement attacked one of the idea's leading champions, liberal Sen. Ron
Wyden (D-Ore.).
"I suspect what will emerge as the toughest issue for
lawmakers is not the ideological debate about the
role of government, because there is some consensus there about the need for
a centrist approach. Rather, it will be how to pay for the plan," said
Drew Altman, president of the nonprofit Henry J. Kaiser Family Foundation.
"The bottom line is there is no slam-dunk, easy way to do this."
To date, interest groups remain reluctant to appear
intransigent and risk getting shut out of negotiations.
But the jockeying is expected to become public soon.
And it's already worrying Democrats on Capitol Hill, where
there is little consensus about how to come up with hundreds of billions of
dollars.
It also provides an indication of how hard it may be to
maintain broad support once it gets down to specifics.
Obama, who at a White House meeting Wednesday urged a
bipartisan group of senior lawmakers to press ahead with healthcare
legislation, is stepping up his efforts. He travels to Wisconsin today for a town hall meeting
focusing on healthcare.
So far, neither the president nor senior Democrats such as
Senate Finance Committee Chairman Max Baucus of Montana have provided more than scant
details about how they plan to raise the money.
A recent poll by the Kaiser Family Foundation found solid
majorities of Americans favor some ideas for funding the overhaul, such as
raising taxes on cigarettes, alcohol and families making more than $250,000.
But taxing sodas and unhealthy snacks is less popular, as
is an across-the-board income tax hike.
Obama sparked an immediate backlash when he laid out plans
to raise nearly $300 billion over the next decade by cutting payments to
private insurers that contract to provide healthcare to seniors under the
Medicare Advantage program.
The insurance industry, which helped derail the Clinton administration's
healthcare push in the early 1990s, mobilized thousands of senior citizens by
organizing Medicare Advantage community meetings across the country.
AARP, with more than 40 million members, blanketed Capitol
Hill with letters warning lawmakers not to cut benefits to seniors.
Others rebelled at a second Obama proposal to come up with
an additional $300 billion by reducing deductions for high-income taxpayers
on charitable contributions, home mortgage interest, and state and local
taxes.
Charitable organizations, who claimed the change would
reduce the incentive for people to give to nonprofits during a recession,
were so successful getting their message across on Capitol Hill that home
builders and Realtors did not bother mounting a high-octane lobbying campaign
of their own.
Congressional ideas have fared little better, with
lobbyists challenging proposals to levy fees on businesses that don't provide
health insurance and to raise taxes on liquor and sugary drinks.
Many interest groups are competing to convince lawmakers
that they can't afford to get saddled with a healthcare tab.
When senior Democrats this week put forward their proposal
for requiring employers to provide health insurance or pay into a fund to
cover the uninsured, business groups led the charge.
"All we have been talking about for months is cost,
cost, cost," said R. Bruce Josten, lobbyist
for the U.S. Chamber of Commerce. "It seems like employers are the one
group getting stuck paying the bill."
Gerry Shea, a top official at the AFL-CIO, which has been
leading the fight against taxing health benefits, suggested charities, not
people with health benefits, should pay.
"Nothing could turn my stomach more than seeing the
charitable foundations going into panic mode," Shea said. "This is
about healthcare. These foundations think their budget is more important than
health."
http://www.latimes.com/features/health/la-na-health-funding11-2009jun11,0,170284.story
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Gov. Bobby Jindal is critical of
the Senate's attempts to ease severe budget cuts on higher education and
health care, saying they would only delay the inevitable.
The Senate's budget proposal, which includes delaying an
income tax break and dipping into the state's rainy day fund, doesn't
"so much relieve the budget pressure as much as it moves it forward,
maybe a year," the governor said.
That may be true, but cushioning the blow isn't
necessarily a bad thing.
The depth of cuts proposed by the administration could be
damaging, particularly in higher education. What the state ought to do is
weed out duplicate and under-performing or unnecessary programs, including a
hard look at whether Louisiana
has too many four-year colleges.
That isn't what will happen if 15 percent -- $219 million
-- in cuts have to be made to colleges and universities for the next budget
year. Higher education already absorbed a $55 million cut in the middle of
this budget year.
If some cuts were delayed for a year, there would be more
time to make trims strategically and plan for the long-term. A strong higher
education system is crucial to Louisiana's
ability to compete for jobs and attract investment.
The Senate's revisions would make that possible. Its $28.7
billion version of the budget restores $284 million to higher education and
health care but still cuts spending in most state programs. The infusion of
money is contingent upon the approval of other measures, including a partial
delay of an income tax reduction approved last year.
The House declared that proposal unconstitutional Monday
because it didn't originate in that chamber, which is where revenue and tax
measures are supposed to begin.
The idea is sound, though, and would give the state $118
million more to spend on colleges and universities in the upcoming budget.
Gov. Jindal is right to be
concerned about future budgets, especially as federal stimulus money
evaporates.
But the Senate budget doesn't ignore financial realities.
Its budget still includes $166 million in cuts to the Department of Health
and Hospitals and $105 million to colleges and universities.
But it would allow the state to slow down a bit and be
smart about where it makes cuts.
http://www.nola.com/news/t-p/editorials/index.ssf?/base/news-5/1244611202184190.xml&coll=1
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By Matthew Perrone
Associated Press
ADELPHI, Md. - Advisers to the Food and Drug
Administration said yesterday that three blockbuster psychiatric drugs appear
safe and effective for children and adolescents, despite side effects that
can increase the risk of diabetes.
The FDA's panel of psychiatric experts voted to approve
the use of drugs from AstraZeneca, Eli Lilly, and Pfizer for treating
schizophrenia and bipolar disorder in patients ages 10 to 17.
The FDA is not required to accept the group's advice,
though it usually does.
"We'll take all of this into consideration, but I
can't make any promises about when we'll take action," said Dr. Thomas Laughren, FDA's director of psychiatric drugs.
All three drugs already are approved for adults with
schizophrenia and bipolar disorder.
Their side effects include weight gain, high blood sugar,
and sleepiness.
A positive FDA decision will expand the use of drugs that
already make up the top-selling class of prescriptions in the United States,
with 2008 sales of $14.6 billion, according to healthcare analysis firm IMS
Health.
The panel - mainly comprised of psychiatrists - largely
brushed aside concerns from patient and consumer advocates that the companies
should have been required to conduct longer studies of the drugs' side
effects.
The panel voted 11-4, with four abstentions, that Lilly's
drug Zyprexa is safe for treating bipolar, despite evidence the drug causes significantly
more weight gain than other treatments.
The Indianapolis-based company is only seeking approval
for the drug as a second-choice, after other drugs have been tried.
"I had concerns about the metabolic side effects but
if this is going to be used as the last treatment option then I think having
other treatments available to physicians is worthwhile," said Dr. Frank
Greenway, of Pennington Biomedical Research
Center in Baton Rouge, La.
Schizophrenia affects about 2.4 million Americans and is
characterized by hallucinations, delusions, and social withdrawal, according
to the National Institute of Mental Health.
About 5.7 million Americans experience bipolar disorder,
which causes rapid mood swings and shifts in energy.
http://www.boston.com/news/nation/articles/2009/06/11/fda_panel_backs_3_psychiatric_drugs_for_children/
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The New York Times | 06.10.09
By ROBERT PEAR
WASHINGTON
— As the health care debate heats up, the American Medical Association is
letting Congress know that it will oppose creation of a government-sponsored
insurance plan, which President Obama and many other Democrats see as an
essential element of legislation to remake the health care system.
The opposition, which comes as Mr. Obama prepares to
address the powerful doctors’ group on Monday in Chicago, could be a major hurdle for
advocates of a public insurance plan. The A.M.A., with about 250,000 members,
is America’s
largest physician organization.
While committed to the goal of affordable health insurance
for all, the association had said in a general statement of principles that
health services should be “provided through private markets, as they are
currently.” It is now reacting, for the first time, to specific legislative
proposals being drafted by Congress.
In the presidential campaign last year and in a letter to
Congress last week, Mr. Obama called for a new “public health insurance
option,” which he said would compete with private insurers and keep them
honest.
Speaker Nancy Pelosi of California said Wednesday that she
supported that goal. “A bill will not come out of the House without a public
option,” she said Wednesday on MSNBC.
But in comments submitted to the Senate Finance Committee,
the American Medical Association said: “The A.M.A. does not believe that
creating a public health insurance option for non-disabled individuals under
age 65 is the best way to expand health insurance coverage and lower costs.
The introduction of a new public plan threatens to restrict patient choice by
driving out private insurers, which currently provide coverage for nearly 70
percent of Americans.”
If private insurers are pushed out of the market, the group
said, “the corresponding surge in public plan participation would likely lead
to an explosion of costs that would need to be absorbed by taxpayers.”
While not the political behemoth it once was, the
association probably has more influence than any other group in the health
care industry. Lawmakers seek its opinion and support whenever possible. It
has repeatedly persuaded Congress to cancel or postpone cuts in Medicare
payments to doctors, though it has not secured a “permanent fix.”
If the doctors are too aggressive in fighting the public
plan, they risk alienating Democrats whose support they need for legislation
to increase their Medicare fees.
The group has historically had a strong lobbying
operation, supplemented by generous campaign donations. Since the 2000
election cycle, its political action committee has contributed $9.8 million
to Congressional candidates, according to data from the Federal Election
Commission and the Center for Responsive Politics. Republicans got more than
Democrats in the four election cycles before 2008, when 56 percent went to
Democrats.
Robert Gibbs, the White House press secretary, said that
in his address to the group next week, Mr. Obama would “outline the case for
health care reform and make clear why we can’t afford to wait another year,
or another administration, to bring down costs that are crushing families,
businesses and government.”
Mr. Gibbs did not say whether Mr. Obama would discuss a
public insurance plan, the most contentious issue in the debate.
The A.M.A., an umbrella group for 180 medical societies,
does not speak for all doctors. One group, Physicians for a National Health
Program, supports a single-payer system of insurance, in which a single
public agency would pay for health services, but most care would still be
delivered by private doctors and hospitals. In recent years, some doctors
have become so fed up with the administrative hassles of private insurance
that they are looking for alternatives.
Until now, stakeholders in the health care industry have
generally muted their criticism of Democratic proposals. But as details of
the legislation have emerged, the criticism has become more pointed.
America’s
Health Insurance Plans, a lobby for insurers, said Tuesday that the
government plan proposed by some Senate Democrats could “dismantle
employer-based coverage and significantly increase costs for those who remain
in private coverage.”
Under a proposal favored by many Democrats, doctors who
take Medicare patients would also have to participate in the new public plan.
Democrats say that requirement is needed to make sure the public plan can go
into business right away with a large network of doctors.
The medical association said it “cannot support any plan
design that mandates physician participation.” For one thing, it said, “many
physicians and providers may not have the capability to accept the influx of
new patients that could result from such a mandate.”
“In addition,” the A.M.A. said, “federal programs
traditionally have never required physician or other provider participation,
but rather such participation has been on a voluntary basis.”
In an interview, Dr. Nancy H. Nielsen, president of the
American Medical Association, said she was delighted by Mr. Obama’s plan to
address the doctors.
“Health care reform is as important to us as it is to
him,” Dr. Nielsen said. “We will be engaged in discussions in a constructive
way. But we absolutely oppose government control of health care decisions or
mandatory physician participation in any insurance plan.”
Mr. Obama’s trip recalls a speech to the A.M.A. in Chicago on June 13, 1993,
by Hillary Rodham Clinton. She proposed “a new bargain” in which the White
House would limit malpractice lawsuits and free doctors from onerous rules if
doctors supported her effort to overhaul the health care system.
The association agrees with Mr. Obama on some points. It
says that individuals and families who can afford coverage should be required
to obtain it.
Like Mr. Obama, the association wants Congress to cut payments
to private Medicare Advantage plans. The White House says Medicare pays the
private plans 14 percent more than it would cost the government to care for
the same people in traditional Medicare.
http://www.nytimes.com/2009/06/11/us/politics/11health.html?_r=1&ref=health
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The New York Times | 06.10.09
By REED ABELSON
As Washington
debates an overhaul of health care, many small businesses are vehemently
opposed to the idea of requiring employers to help pay for their workers’
medical coverage.
But at least one small-business group says the proposals
now being considered by the Obama administration and Senate leaders could
save small companies tens of billions of dollars a year in health care costs
— even if there is a mandate for employer coverage.
An analysis by the group, the nonprofit Small Business
Majority, to be released Thursday, concludes that the changes would be better
for small employers than continuing the current system, which leaves many of
those businesses struggling to afford health benefits for their workers. Half
of companies with nine or fewer workers do not currently provide employee
coverage.
“Small businesses want to be part of the system,” said
John Arensmeyer, the group’s chief executive. “They
don’t want to shirk their responsibilities.” But “we need comprehensive
reform,” he added. “The entire system needs to be fixed.”
Founded in 2005 by executives of small companies who
wanted to broaden the small-business discussion about health reform, the
group was among those recently invited to the White House to discuss the
issues. Mr. Arensmeyer said any mandatory coverage
requirements would have to address the inability of some businesses to pay
for the contributions. “This doesn’t work in the short term without some
assistance to the smallest and least profitable businesses,” he said.
The analysis, conducted by Jonathan Gruber, an M.I.T.
economist who helped advise Massachusetts on its overhaul of health
insurance, examines proposals being discussed by the Senate Finance Committee
and others in which small companies would have to pay some portion of their
payroll toward health benefits but would also receive some form of tax
credits to defray the expense.
Small businesses would save in two major ways, Mr. Gruber
said. Because small companies traditionally pay much more than large
corporations for the same coverage for an employee, they would benefit from
proposals streamlining the purchase of insurance and lowering the
administrative expenses associated with the policies. The companies, he said,
would also benefit from the success of any legislative efforts to contain the
rapidly escalating cost of health care.
Over all, the study estimates that the proposals under
debate could save small businesses anywhere from $546 billion to $855 billion
over the next decade.
If nothing is done, on the other hand, the study says the
health care bill for small businesses — estimated at $156 billion this year —
would more than double, to $339 billion in 2018.
But some small-business groups still worry that the
proposals now being floated could do more harm than good.
The National Federation of Independent Business, an
association of small companies, says many of its members do not favor forcing
companies to pay a significant share of the cost of employee health coverage.
Susan Eckerly, senior vice
president of federal public policy for the federation, said her group was
concerned that the proposed measures could fail to contain the high costs of
medical care, which she said was a main concern for small businesses.
“Adding new, additional burdens to small-business owners —
especially in the form of an expensive mandate — is not an effective approach
to reform,” Ms. Eckerly said. “In fact, it burdens
the very people we are supposed to be trying to help.”
Reducing overall costs is a critical piece of any
proposal, Mr. Arensmeyer agreed. “Nobody wants
anyone to pay into a broken system.”
http://www.nytimes.com/2009/06/11/business/smallbusiness/11insure.html?ref=health
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The New York Times | 06.10.09
By MALIA WOLLAN
BY her eighth month of pregnancy, Rebecca Sloan, a
35-year-old biologist living in Mountain View, Calif., had read the
what-to-expect books, taken the childbirth classes, joined the mommy chat
rooms and still had no idea what she was in for. So, like countless expectant
mothers before her, Ms. Sloan typed “childbirth” into YouTube’s search
engine. Up popped thousands of videos, showing everything from women giving
birth under hypnosis, to Caesarean sections, to births in bathtubs.
“I just wanted to see the whole thing,” Ms. Sloan said.
And see it she did, compliments of women like Sarah Griffith, a 32-year-old
from the Atlanta
area who, when she gave birth to her son Bastian, invited her closest friends
to join her. One operated the camera, capturing Ms. Griffith’s writhing
contractions, the baby’s crowning head and his first cries. Afterward, Ms.
Griffith posted an hour of footage on YouTube in nine installments, which
have since been watched more than three million times. “Childbirth is
beautiful, and I’m not a private person,” Ms. Griffith said.
Mom-and-pop directors like Ms. Griffith think of their
home movies as a way to demystify childbirth by showing other women — and
their weak-kneed husbands — candid images they might
not otherwise see until their contractions begin. If YouTube can illustrate
how to solve a Rubik’s Cube, pick a lock and poach an egg, maybe it can also
demonstrate how to give birth. Recently, a British couple became tabloid
fodder after the woman gave birth, assisted only by her husband using a
YouTube birthing video as tutorial.
Inevitably most childbirth videos are graphic, challenging
not just YouTube’s rules but also societal conventions on propriety.
“Nudity is generally prohibited on YouTube,” said Victoria
Grand, the site’s head of policy. “But we make exceptions for videos that are
educational, documentary or scientific.” YouTube employees regularly review
graphic videos and, depending on the content, may decide to leave a video up,
restrict access to those 18 and older or remove the video altogether.
Explicit medical videos are among the exceptions, allowing cyberpatients and other viewers 18 and over to watch
videos of colonoscopies, appendectomies and open-heart surgery. Most
childbirth videos are age restricted.
At first Ms. Sloan says she felt timid watching. She
remembers one video featuring a couple speaking Dutch or German in which the
man embraced the woman gently from behind while she crouched and swayed.
Soon, Ms. Sloan was in tears. “It was really moving,” she said. “The videos
are so unsensational, they’re largely unedited and
people aren’t making money off of their videos. And so the purpose seems very
genuine.”
Women logging onto YouTube to watch birth is a natural
inclination, said Eugene Declercq, a professor at
the Boston University School of Public Health. “A hundred and fifty years ago
women viewed birth on a pretty regular basis — they saw their sisters or
neighbors giving birth,” he said, adding that it wasn’t until the late 19th
century that birthing moved out of living rooms and bedrooms and into
hospitals. “But now, with YouTube, we’ve come back around and women have this
opportunity to view births again.”
Every day Ms. Griffith signs into YouTube to answer
comments and questions that viewers post in response to her videos of
Bastian’s birth. She says her comments section breaks down like this: excited
and apprehensive moms-to-be; a few comments so obscene she refuses to post
them; and lastly, comments from those Ms. Griffith calls “repetitive guys.”
“They’re always like, ‘Whoa, I’m so glad I’m not a woman,’ ” she said.
Ms. Griffith’s footage is difficult to watch. Bastian
weighed almost 11 pounds at birth, and she did not edit out the close-ups,
the screaming, groaning and cussing. “My goal is not to scare anybody,” she
said. “But if someone is pregnant and they haven’t wrapped their head around
the fact that there is pain involved, then they might want to start.”
The graphic nature of public childbirth videos makes them
controversial. In an online forum run by Parenting Magazine, a user recently
posted the question, “Mom Debate: Birth Videos on YouTube? What do you think
— great, or gross?” Responses split between the gross (“My question is why do
these people feel the need to post it on the Internet?!”), and the great (“I
think it’s great for moms to see all the different and real ways women give
birth”).
Childbirth videos have been screened at birthing classes
since the 1970s. But those videos tend to be highly edited, and they can be
dated, says Jeanette Schwartz, president of the International Childbirth
Education Association, which certifies childbirth class instructors. YouTube
videos could change the way classes are taught, Ms. Schwartz said: “This
creates a wonderful opportunity to show free, real life, candid videos in a
classroom setting.”
The majority of childbirth videos on YouTube are home
births, recorded inside living rooms, bedrooms or bathtubs. In the United States,
many hospitals and doctors forbid patients to record births because of
liability concerns, so few American hospital birth videos appear on YouTube.
The thousands of online childbirth videos, garrulous mommy
chat rooms and endless pregnancy blogs are changing the dynamic between
pregnant women and their attendant medical professionals.
“The more information you have, the more sources you have,
the more informed you are, the better questions you ask,” said Eileen Ehudin Beard, an adviser for the 6,500-member American College of Nurse-Midwives. But videos
of complicated or difficult births could be detrimental, Ms. Beard said, especially if they made women more fearful of delivering
a baby.
Providence Hogan insists she is “not a YouTube person.”
Still, Ms. Hogan, 42, who owns a day spa in Brooklyn,
has been logging long hours watching birthing videos in preparation for the
August arrival of her second child. If Ms. Hogan’s birth goes as planned (at
home in a birthing tub), she intends to have her 7-year-old daughter, Sophia,
present. After prescreening videos on YouTube and another site, birthvideos.tk, Ms. Hogan started showing Sophia the less
graphic ones.
“At first she was like, ‘That’s weird, that’s ugly,’ ”
said Ms. Hogan of her daughter’s response. “Now it’s ‘Oh, what a cute baby!’
”
Eleven months ago in Mountain
View, Ms. Sloan recorded the birth of her son,
Urban. She says she feels a little squeamish about putting it on YouTube, and
she’s not sure what her husband would say. Still, eventually she thinks her
video will become one more public testament to the agony and beauty of birth.
“I found it so helpful to see those videos,” Ms. Sloan
said, “and I am so grateful to the families that shared them I feel like I
want to return the favor.”
http://www.nytimes.com/2009/06/11/fashion/11BIRTHS.html?_r=1&ref=health
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