by Bill Barrow,
The Times-Picayune
BATON ROUGE --
State Health Secretary Alan Levine, speaking after the Louisiana State
University System Board of Supervisors last week rejected a teaching hospital
deal he helped negotiate, floated the idea of a medical center that is not
legally affiliated with the school at all.
Though not an
official proposal, it could be considered by Gov. Bobby Jindal's
administration if LSU and Tulane
University cannot agree
on how to run the proposed $1.2 billion teaching hospital slated for
construction in lower Mid-City, Levine said.
LSU System
President John Lombardi, Tulane President Scott Cowen and other
representatives from the two schools have spent almost a year in on-again,
off-again negotiations that assume a new hospital would be operated by a
not-for-profit corporation affiliated with LSU.
But the schools
have yet to agree on the makeup of the corporation's governing board, with
LSU rejecting the latest model that emerged from private negotiations that
Levine mediated between Lombardi and Cowen, along with board members from the
schools.
Levine said an
independent entity, with both LSU and Tulane as stakeholders but neither as
the owner or chief operator, could quiet LSU officials' concerns that the
university might have too much invested in the facility with too little
control.
Schools urged
to try again
The health
secretary said he does not know what the next move in the process will be.
But he called on the two schools to re-engage. The Jindal
administration already has announced that it is ceasing land acquisition work
for the hospital pending a deal.
LSU has said the
next move should be Tulane's, with Lombardi and his board members calling on
Tulane's board to consider LSU's counteroffer. The Business Council of New
Orleans, meanwhile, has called on LSU's board to reconsider its rejection of
the Levine model.
Efforts to reach
LSU spokesman Charles Zewe on Monday were not
successful.
Cowen has declined
to comment publicly on LSU's vote pending the administration's next move.
Levine said,
"Leaders lead. It is time for us to get this thing done, and it won't
get solved until the leaders of those two campuses decide to solve it."
The construction
budget for the successor of Charity and University Hospitals
assumes at least $400 million in bond debt. That figure could go much higher
depending on the outcome of the state's dispute with the federal government
over Hurricane Katrina damage at Charity.
Under the
LSU-affiliate model, the bonds would be sold under the bonding authority
already granted to the LSU system, but they would be revenue bonds leveraged
against the hospital's future earnings, not the finances of the university
system.
System supervisors
last week said the debt -- whatever the final number and legal obligation --
is too much for them to accept the state-brokered model that called for a
12-person governing board: four seats for LSU, one each for Tulane and Xavier
University, one to rotate among other New Orleans schools whose students
would train at the hospital, and five "non-permanent" members with
no school affiliation.
Board is
sticking point
Levine said he
does not share the concern that "someone else is going to lunch on LSU's
credit card, " referring to the way Lombardi
characterized the deal to reporters. Levine also noted that LSU system
attorney Ray Lamonica told supervisors that LSU
would not be legally liable for the debt, though that was overshadowed in the
meeting by Lamonica's declaration that there would
be "a moral and practical obligation if LSU ever intends to issue bonds
again."
After rejecting
Levine's recommendation, LSU called instead for an 11-member board with five
LSU seats and three independent seats. The other schools' representations
would remain the same.
The vote in Baton Rouge came three
days after Tulane's governing board ratified the agreement.
Cowen has said
that he is content with having much less representation than LSU, provided
the independent board members form the largest bloc.
The two schools
agree on the distribution of medical residency slots and the name of the
facilities. The memorandum of understanding stipulates that the overall
complex would be the University
Medical Center.
The main building would be named for the Rev. Avery C. Alexander, the late
civil rights leader and legislator whose name the Legislature affixed to the
old Charity Hospital downtown several years ago.
An independent
corporation is in line with what House Speaker Jim Tucker, R-Algiers,
proposed in a bill this spring. Tucker originally called for a board with
none of the schools having representation. He later modified that to include
the schools, provided no single school controls the board. He abandoned the
bill after Levine announced the draft agreement that LSU later rejected.
http://www.nola.com/news/?/base/news-2/1246339233322750.xml&coll=1
[BACK TO TOP]
By MARSHA SHULER
Advocate Capitol
News Bureau
Physicians and
staff at LSU’s Earl K. Long Medical Center
are raising concerns about a potential deal that would move medical education
programs from the north Baton Rouge hospital
to the private Our Lady of the Lake
Regional Medical
Center across town.
State Sen. Sharon
Broome, D-Baton Rouge, in whose district the hospital sits, said medical
staff have been involved in two recent meetings and have shown “no momentum”
for joining forces with OLOL, commonly called the Lake.
“We are far away
from coming to a resolution,” Broome said.
LSU and the Lake are in negotiations for a cooperative endeavor
agreement that would lead to the ultimate closure of the Earl K. Long
facility on Airline Highway.
Known as EKL, the
LSU hospital cares for the poor and uninsured. Under the proposal LSU’s
physician training programs would move to the Lake
as well as the patients they serve.
Broome said the
continuing complaint among those who train future physicians and deliver
patient care at EKL is that they have been excluded from discussions.
“When you make a
major change, sometimes there’s a little resistance,” Broome said.
Broome said EKL
physicians “don’t like the programs being disbursed” as proposed in the
agreement.
Physicians are
also fearful that LSU will no longer have independent physician training
programs, Broome said.
In addition,
Broome said, “They had mixed emotions about the quality of care at Our Lady
of the Lake and the quality of care their
patients would get there,” Broome said.
Dr. Paul Perkowski, president-elect of the Capital Area Medical
Society, said physicians who practice at EKL as well as the Lake
— as he does — have lots of questions because they have been kept in the dark
by the top officials.
At EKL, Perkowski said the concern is “how resident education,
medical student education and care of the indigent population will be
affected or suffer if it’s carried out in a private setting.”
Meanwhile, Perkowski said physicians at the Lake
are concerned “about an influx of uninsured patients. Who’s going to be
responsible for them. How do you handle the
emergency room?
“Right now the
doctors I talk to don’t have any idea what’s going to happen,” said Perkowski, a vascular surgeon.
Broome has
organized two sessions between LSU executives and EKL staff — the most recent
was Friday afternoon and was attended by about 50 physicians and other
hospital staffers.
LSU System Vice
President Fred Cerise said LSU will start bringing physicians and other
hospital staff into discussions.
LSU wanted to get
an idea of whether the finances needed to support such a public-private
partnership could come together before getting into details of how medical
education programs will fit, Cerise said.
The Lake does not want to be home for EKL’s
obstetrics program and there are questions about emergency services.
In addition, the Lake agreement would not cover prisoner care which is
done at EKL.
“It’s time to get
into more of the detail of what’s going to happen with emergency medicine,”
and other issues, Cerise said. “Before we were more certain about the overall
direction, we didn’t want to work through all these details.”
“There’s a
spectrum of support to opposition with a lot of uncertainty in the middle,”
Cerise said. As more questions are asked and answered, Cerise said people
hopefully will “get more comfortable with it.
“Some people are
not going to be happy not having a separate hospital that serves the
population,” he said.
http://www.2theadvocate.com/news/49472487.html
[BACK TO TOP]
John C. Howland
Re:
"Resolving the hospital impasse," Our Opinions, June 25.
I am concerned
that casting the hospital impasse as a turf war between LSU and Tulane hides
the real issue: establishing a quest for excellence for all aspects of
medical training that demands the best from all institutions, private and
public, as well as from medical professionals.
The concept of
excellence has dropped from the conversation to be replaced by parochial
squabbles about unilateral control, land grabs and which hospital gets the
patients with health insurance.
I am relieved that
the LSU Board of Supervisors shot down the hospital governance agreement,
because we all need to step back and take a breath. The quest for excellence
needs to get back into our conversation.
Our institutions
need to be working with our congressional delegation to ensure that
provisions are written into the emerging heath reform legislation that make for a financially viable hospital project. We need to
impress on the LSU Board that it has an important role in medical education,
but not the only role.
I believe that a
network of interdependent institutions, public and private, striving for
excellence can lead to an internationally recognized center for research and
medical care that we would all like to see.
John C. Howland
Covington
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1246339242322750.xml&coll=1
[BACK TO TOP]
New Orleans CityBusiness |
06.29.09
by Mark Singletary
Publisher
New Orleans wants to build an economic base around the
health care industry. That strategy for economic growth has served many
rebounding economies quite well and it could work well for us.
Often referred to
as the biomedical corridor, plans have been laid to reconstruct a new
teaching hospital owned by the Louisiana State University System. The
hospital site will be adjacent to LSU’s medical school and a new Veterans
Affairs hospital.
All the
preliminary drawings are complete, but plans are still bubbling in the
caldron that is our state government.
The hospital site
remains controversial. Many feel renovating the existing Charity hospital
would be a faster and much more friendly use of the
historically significant building. LSU and, more importantly, Gov. Bobby Jindal want to build a new facility, and until very
recently the state was pushing to make the new hospital happen.
But in a
surprising announcement last week, Louisiana Commissioner of Administration
Angele Davis said there will be no more land purchases for the new University Medical
Center in New Orleans until LSU can reach a
compromise on the hospital’s governance with the other schools involved.
Does this mean the
new teaching hospital planned for Mid-City is dead or at least on life
support? Who knows? And who is in charge?
According to a CityBusiness report last week, the LSU Board of
Supervisors approved a governance structure that provides the state school
with more seats on the nonprofit board that will run the medical facility,
altering a proposal Jindal’s administration
brokered recently involving LSU, Tulane and Xavier universities.
LSU leaders have
plans for an 11-member board with five representatives for the school, while
the governor’s proposal outlines a board with 12 members, including four LSU
seats.
“The governance
structure is a critical step toward developing a financing model for the new
facility,” Davis
said in a prepared statement. “There remains no agreement on the proposed
governing structure and it is critical that we make an intensified effort to
reach an agreement before the state acts to purchase the property.”
Everyone seems to
want in on the planning.
Earlier this
month, Louisiana House Speaker Jim Tucker, R-Algiers, introduced and then
abandoned a bill that would have drastically changed the hospital’s board
structure. He apparently thought earlier memos of understanding among LSU,
the state and several participating colleges needed to be set aside and his
guidance was necessary. Or maybe he was just trying to force a final
decision.
Again, who knows?
All the while, we
are depending on the federal government to continue with its plan to build a
new VA hospital in the same neighborhood.
There are no
indications any of the local rancor has affected VA plans — yet.
We have no way of
knowing whether there is any timidity inside the VA’s construction plans. But
who would blame them if they begin to question the decision to spend hundreds
of millions here while uncertainties continue to swirl around the LSU
teaching hospital?
A new teaching
hospital, tied to some form of charity-based health care system, is the key
component to any real biomedical complex in downtown New Orleans. All of the indecision and lack
of progress puts this fundamental economic development plan at risk.
There are many
questions about any successful strategy that could possibly add thousands of
jobs for downtown New Orleans.
The best questions don’t involve who sits on the governing board or who has
veto power.
There are work
force issues every participant in the health care site will have to answer.
How do we train and recruit nurses, technicians and maintenance staff for the
hospitals and teaching facilities? If the state’s leadership is this
wishy-washy on who sits on the board of directors, imagine the fights when it
comes down to who gets to train the nurses and lab technicians needed for the
new facilities to operate efficiently.
Every college and
technical center will want to participate in the training programs. Now it
looks as though any participation by any training center might yield another
round of bickering over who’s in charge.
Sadly, all too
often, it looks like no one is in charge, and that’s led us to where we are
right now, caught between what might be and what could be.
Not exactly a
great place for our biomedical future.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=25503
[BACK TO TOP]
Interview aired on
June 24, 2009
Host was Rob Couhig
Levine responses
are designated “A.L.”
Text: Talkin' sports
leader. The create date seven DW WL and now WWL and
ask them at 1053. Garland Robinette show to climb inside garlands thing --
Call 5042601870. Or 66889. -- seventy now from the
heart of New Orleans.
Sears Garland."
“Rob Cuhig
continuing the adventurer in music no wait that's not me. I am actually
handling garlands work as he continues to luxuriate in London. Where officially (0.42) it's a lot
better weather. I'm going to let you off the hook this morning we’re not gonna talk about Iran we’re not gonna talk about the north Koreans. At least for the
first hour or two. Because we gonna talk about a
war that's taken place here that has perhaps even more dramatic effect over
the future of the city of New Orleans.
And I used the term advisedly calling it a war. What I hope it is as a simple
disagreement that can be resolved and to try and help us understand it we
have, we are lucky enough to have Alan Levine who's the secretary of health
and hospitals for the state of Louisiana.
And of course I'm talking about the fact that this that the LSU and Tulane
folks are having trouble getting together on this new hospital and more
particularly the fact that the commissioner of administration has ordered a
secession in terms of acquiring property. Secretary thank you so much for
joining us this morning.
A.L. –“Good
morning. I appreciate your good work.”
“Well I appreciate
that sir. Let me ask you, just to kind of get to
that the kernel of it, last Friday or Thursday I was very hopeful. It appeared
to me that some compromise had come about between the LSU and Tulane folks,
enough so that both sides left the meeting with you. And in my experience as
a negotiator and as a mediator, you generally have agreement that both sides
are going to go back to their respective boards, and recommend. The common
agreement that was found at the table not that anybody was bound by it, but
that the participants in the negotiations would recommend. Is that where you
guys were last week?"
A.L. “Yeah I think that we were there. I think
that that both to LSU and Tulane worked very hard and I’m convinced that both
sides really do want something to work that works here, and so I don't think
it that either side is giving up. But I do believe, I think we were all a little
disappointed on Monday when we found there was not going to be an agreement.
Although I think I prefer rather than being cynical, prefer to be optimistic.
The fact is that LSU did support virtually the entire agreement with the
exception of one thing. Now that one thing is important and relevant. So I
remain hopeful and we're continuing the dialogue. I spoke yesterday to a
couple of board members at LSU, trying to see what- to get the bottom of what
the concern is so that we can try to address it."
“Well and then the commissioner of
administration came forward and stopped the actual acquisition of land for
the hospital. Well that obviously had to be a decision the governor was part
of that you were aware of. Is the plan simply to try and
put more pressure on everybody?"
A.L. “Well I think it's a combination of issues.
I think first of all, the idea of expropriating people from their homes is a
serious matter. It's not something you do lightly and in that the
constitution has some very strict prohibitions about how that's done. And I
think that the concern was, in order to get this project done, a few things
have to happen: number one you got to get the federal money, which we’re
working on, and part of the issue with getting that money is the federal
government wants to see that what we’re going build will be successful and
that frankly there’s support for it. And so getting the federal money is one
thing. The second piece which is extremely important we’re going to have to
borrow at least 400 million dollars for this project to happen. So the
question is who's going to borrow that money, and the state is not in a
position to borrow it because we're very close to our statutory debt limit,
our constitutional debt limit. And so therefore the creation of this
nonprofit enterprise that's going to borrow the money is very important. Now
back to the issue of expropriations. Expropriating property before you even
have an agreement on having this nonprofit corporation that's going to borrow
the money, it's- one thing has to happen before the other, and the thing that
has to happen is we have to have an agreement on what organization is going
to borrow this money without that, there is no money being borrowed and
therefore there is no hospital. So why would you expropriated property before
you have that agreement, and I think that's the concern the governor
has."
“But -- let me let me interrupt just for a
moment and ask this question, I could be wrong, but haven't you guys, or
haven't they been expropriated property?"
"
No what's been
happening is they've been putting together offers for property, and those
offers have not yet been made although they were preparing to make the offers
and so we said hold off on that til we get this
resolved. Look I’ll tell you a case, I don’t know if you’ve heard of the Kelow case-” “Yes very much.” “If you go back and do the homework on that
and I have to go back and do it too, but my recollection was, and this
happened in Florida,
where I’m from. The local government decided to expropriate people's
property, they took the property, and years later, they never developed it.
So people were bought out of their homes that didn't want to give up their
homes, they were forced to give up their properties for development, or for
any economic development project that never occurred. And so, that's serious,
that's very serious, and so I think the governor's concern is: let's get this
agreement done and then let's move forward with the process when we know
we’re going to have an enterprise that’s actually going to go out and finance
this. And we want this to happen, we’ve worked very
hard for this to happen. The governor, I think his perspective is: let’s get
first thing first, let’s get this governance agreement done so we can move
forward. And keep in mind that you know the legislature,
the House passed a bill to create the enterprise. The indications I got from
the Senate was that they did not want to take up this bill. So it was sort of
put on us to try to come up with a resolution. And I give both LSU and Tulane
a lot of credit for coming to the table and having serious dialogue and I
think that will wind up with something with something that's good."
“We are talking to
secretary Alan Levine is secretary of health and hospitals for the state of Louisiana. Secretary
Levine my problem is this -- and I know the key location you can’t
expropriate for just economic purposes but in this case we have a health
related purpose. But we’re four years post-Katrina here. There is a growing
momentum that LSU has in effect shut people out of the discussion about the
re creation of the old charity into a new hospital. And I'll leave that to
the side. But in this town, when we stop any forward movement the inertia
that sets in is almost worse then before we started the project and my fear
is that by in effect the governor called a halt, LSU and Tulane now two and a
half years into these discussions not able to come to an agreement. I mean it
sounds wonderful to say that well they're close. But do you think folks in Baton Rouge understand how important this hospital
complex is to the future of the city of New
Orleans from an economic standpoint?"
A.L. "Listen I don't think anybody
understands it more than the leadership in Baton Rouge. I think- look I mean you have to just look at
the record. The governor you know fought hard for the saints, you know for
the economic reasons that you just cited against opposition from other parts
of the state. I mean there’s- it's clear that this economic development,
economic growth is something that this administration is very committed to.
But I have to also say that- I mean look at I'll use an example. If you go to
Texas Medical Center.
Texas Medical
Center has the home to MD Anderson, Rice University,
Baylor University,
University
of Texas. Several
large, 47 different institutions."
“I was going to
say you know they said there’s a whole school of economists that say that the
growth of Houston
relied more on the growth of that medical complex than on the oil and gas
industry."
A.L. “And do you know that the governance model
for Texas
medical Centre is such that no one academic institution has total control
over it. It's a completely independent board. And the reason, I talked to the
guys over Texas
Medical Center
and the reason for that is: universities have their own interests, and
they’re good interests, they’re interests that we support, they’re academic
interest. Hospitals, medical institutions their primary interest has to be
their own financial self sufficiency. They’ve got to be able to survive. And
so you've got to have a board that can separate the interest of each of the
university's from the hospital's own interests. And that is what has made
Texas Medical Center thrive so much and if you go to other major institutions
university of Minnesota there's another one, 11 of their clinical programs
are ranked by US news and World Report as top fifty in the nation."
“Secretary Levine,
I agree and I think to that all rational observers agree but -- we watch this
parochial fight. And I watch the attorney for the LSU board of supervisors
say well you know we have to be very careful we have to control it. Cause at the end of the day, the state's money won't be up
and the people will depend on the LSU board or the LSU system to in effect
make sure that the debt is paid and the like, and that sounds like the cogent
argument. My point is, how do you get- I mean you had them together today,
you herded the cats as they say. They had an agreement. And now it seems to
me as an outsider that it's broken down into the very thing that the University of Minnesota
got away from, Texas
got away from. And I don't understand it and I’ve tried to understand it. Why
folks can't understand that look I got to put aside a little bit of my
parochialism in order to make this work."
A.L. “Well and I think that's, you know what,
that this is a process and sometimes the process is a little bit messy and
that's okay. I mean that's the nature of what we're going through. But I'd I
think in the mistake that we can all make would be that we just say let's
just give up. I don’t think that's a good idea, and I think we're going to
keep working on it. And let me get to what you just said about the assertion
that LSU would be responsible and let's be clear, LSU is a state institution
of itself, and you know at the end of the day when these hospitals need
money, it's the state that comes up with it. So the state, we talk about
using people’s credit card, it's the state's credit card,
it's not any one institution’s credit card. And I think we've got to be very
mindful that the state does have an interest here and you know I think it
will be important thing for us all to understand is that you’ve got extremely
capable and good leadership at Tulane and LSU. And with strong leadership
comes, you know personalities that have their own opinions. And in you know
what that's a good thing for those institutions and so we just have to work
through that. It's not insurmountable. I think it can be resolved. And I
think you've got some very cool heads on the boards of both institutions as
well the presidents who really do want this to be resolved, and so I’m not gonna look at the negative here, I’m gonna
look at the positive”
“Let me let you
look at the positive, but let me ask you one question and then I'll let you
go. When you and I had this conversation at the first of October, all of this
little internecine stuff is behind us and we're going forward?"
A.L “I hope so.”
“Well we all hope
so."
A.L. "I’ll tell you something, I mean what
would- I think what would be great for this state is if LSU and Tulane could
leave the rivalry on the football field and focus on working together in
terms of medical education. Cause let me tell you something, Tulane and LSU
are not each other's biggest competition in terms of the medical field.” “No,
it’s Houston and Birmingham” “Exactly, we’ve got to get past
this parochial stuff and focus on the real competition out there, and it's
these other major institutions. So look I mean let's leave the disputes on
the table and let's focus on working together and going forward. I think
we'll get there, I really do."
“They are now I'm gonna let you leave on that optimistic promise, or hope.
Secretary of health and hospitals for the state of Louisiana Alan Levine. I
know you’re very busy I appreciate you taking the time to let our listeners
know, thank you sir.
End of Alan Levine
interview
[BACK TO TOP]
Joseph “Butch” Passman, president
Too many people
are rushing to meet a political deadline to fix health care. The risk in
that? Sometimes the wrong answer is worse than no answer at all.
At the very least,
we owe it to our grandchildren’s children not to mortgage their futures, too,
with another trillion dollars spent badly.
That doesn’t mean
this is not an urgent issue. It is. Health-care costs will likely double
again in five to seven years, and no one can afford that.
We can act quickly
and still act wisely. There are a number of important things that can be done
with little or no impact on the taxpayer. Most major reform proposals
acknowledge the importance of personal accountability, usually proposed as an
individual coverage requirement.
We have watched
growing numbers, armed with their health and the knowledge that federal law
guarantees their emergency care, simply choose not
to take coverage even when their employer pays for most of it.
Let’s start with
those who can clearly afford it but simply choose to go bare and see how this
impacts the cost shift we all absorb from the uninsured, and find out if we
can even enforce an individual mandate.
Employers have to
“step up,” too! Employers (although not the very small) need to offer at
least a health savings account or a flexible spending account (which doesn’t
even require a health plan), and both have proven they more than repay the
small administrative cost they create.
Then slightly
larger employers need to at least offer by payroll deduction an individual
health plan to their employees, if they do not offer group coverage.
We are not
proposing an employer mandate to provide or pay for coverage. We are
proposing using the tax codes to empower consumers and using the workplace to
organize access and maximize purchasing power. After all, most of the
uninsured are connected to the workplace in some way — as an employee or
dependent.
Even the smaller
ideas such as these, taken together can make a big difference and can tell us
a lot about what will and will not be successful. But we don’t propose stopping
there.
There are many
more ideas such as these in our health-care reform plan as there are in
others. For more about the “10 Point Plan for Health Reform” by the Louisiana
Business Group on Health, go to http://www.lbgh.org.
Let’s try these
first, before introducing controversial proposals such as a competing
national health plan and new taxes to create subsidies that drive coverage
expansion.
Remember former
President Lyndon Johnson saying Medicare would never cost more than $500
million? We can’t afford to be that wrong again.
Joseph “Butch” Passman, president
Louisiana Business
Group on Health
Baton Rouge
http://www.2theadvocate.com/opinion/49471457.html#
[BACK TO TOP]
By SARAH CHACKO
Advocate Capitol
News Bureau
Despite missteps
by some key Republicans and party losses the last few years, U.S. Rep. Bill
Cassidy said Monday that the GOP still has a strong future ahead.
The Baton Rouge
Republican also discussed health-care issues with the Press Club of Baton
Rouge. He is hosting a town-hall meeting, primarily to discuss health-care
issues, at 5:30 p.m. today at Our Lady of the Lake Regional
Medical Center.
Cassidy said the
Republican Party is still united on core issues, such as being against the stimulus
package and abortion. Republicans have multiple plans for health care.
Meanwhile, he
said, the public is watching the national debt increase under President
Barack Obama and the Democratic Party.
“The American
people are concerned about spending, as rightly they should be,” Cassidy
said.
In May, a Gallup
Poll showed Republican Party affiliation among Americans has declined in
nearly every major demographic subgroup.
The most recent
blow to the GOP came when South
Carolina’s Republican governor admitting cheating
on his wife over the Father’s Day weekend.
Cassidy said after
his talk that he has not looked at poll data but believes the public will not
paint the GOP with a wide brush.
“For 20 years,
I’ve busted my rear end trying to bring health care to the people in my
district,” said Cassidy, a gastroenterologist at Earl K. Long Medical
Center.
A person’s life’s
work is a better testament to who they are than a position statement, he
said.
Cassidy said he
has not yet seen a real solution for health care but political proposals
“under the fig leaf” of private enterprise and access for all.
Obama is proposing
to increase the number of people eligible for Medicaid, the government’s
health insurance plan, Cassidy said. Most states are having financial
problems with Medicaid, he said.
“That means we
would increase federal and state liability as we grow a program that’s
already making us go bankrupt,” he said.
Cassidy said he
believes the solution is to make the patient central to their health care.
If health care is
free, patients have no inhibition in what they ask for, he said. But when
they are faced with a $100 prescription, they will ask for the cheaper
generic, he said.
Cassidy noted that
people with health savings accounts, called HSA, have 30 percent less costs
than those with fee-for-services health insurance plans.
HSA is a special
account owned by an individual used to pay for current and future medical
expenses. The account can grow through investment earnings.
An HSA also
removes the cost on primary-care physicians to bill insurance companies,
which means they would earn more and charge less, Cassidy said.
“In real life,
people are doing these things and it’s working to control costs and improve
care,” he said.
Critics of the
high-deductible plans, including the American Public Health Association, say
some people cannot afford to cover the high deductibles and skip treatment
until they are very ill.
The plans may
actually be increasing health-care costs as a result.
http://www.2theadvocate.com/news/49472367.html
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"Help is Here Express" bus in New
Orleans
area to give patients in need access to prescription medicines
by The
Times-Picayune
The "Help is
Here Express" bus is in New Orleans and Jefferson Parish through
Thursday to help uninsured and financially struggling residents access
information on programs that provide prescription medicines for free or
nearly free.
Today's schedule
includes a visit to the Martin Luther King Charter School, 1617 Caffin Ave., 9-10 a.m.; and as well as to the Jefferson
Parish Human Services Authority, 5001 Westbank
Expressway (corner of Barataria and Westbank Expressway), Marrero, from 2-3 p.m.
On Wednesday, the
bus will be at the Grace Episcopal Church, 3700 Canal St.,
from 1-6 p.m. U.S. Rep. Anh "Joseph" Cao
will be present.
Thursday's
schedule includes a visit to the Mary Queen of Vietnam Church,
14001 Dwyer Blvd.,
from 9-11 a.m.
Participants
should bring identification, their Medicare card, if applicable, and a list
of prescriptions. Help will be available in Spanish, Vietnamese, French and
other languages.
http://www.nola.com/news/index.ssf/2009/06/help_is_here_express_bus_in_ne.html
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Student Health
Center specialty fees to be abolished
Jennifer Raines
Contributing
Writer
The Student Health Center’s
Specialty Clinic additional fees will be abolished beginning in the fall 2009
semester.
The current
additional fees are $10 per initial visit and $5 for a follow-up visit, on
top of the student health service fee, which is included in each student’s
fee bill every semester.
The elimination of
the fees are a way to enhance the scope of services included in the student
health fee and increase the accessibility to health care for LSU students,
said Julie Hupperich, associate director of the
Student Health Center.
“The current fees
are far less than comparable services in the community,” said Hupperich. “Our students are able to see some of the
premier specialists in the Baton
Rouge community for $10 per initial visit versus
$100-$150 per initial visit in another clinic.”
The services
available to students at the Specialty Clinic are dermatology, ophthalmology,
orthopedics and ear, nose and throat.
Dental screenings
are available at no additional charge, except for special procedures.
International
Studies senior Jean-Paul Oswald said he feels it is convenient and more
logical for him to go to the dermatologist at the Student Health
Center instead of going
to another clinic. “Getting preventative health care now for less can
hopefully lower the cost down the road.”
The dermatology
clinic is the most used service in the Specialty Clinic. In response to
student demand over the years, the Student
Health Center
hosts the dermatology clinic for the greatest number of hours each week, said
Hupperich.
“We feel really
fortunate to have the caliber of specialists who come into the Student Health Center
on campus to hold clinic for our students,” said Hupperich.
“It provides an invaluable service to them, one that few other student health
centers in the country offer.”
http://www.lsureveille.com/news/student-health-center-specialty-fees-to-be-abolished-1.1770594
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By Kia Hall Hayes
St. Tammany bureau
Moving forward
with plans to build a regional cancer center, Slidell Memorial
Hospital has selected a
financial institution to sell $17.5 million in bonds.
Slidell Memorial,
which received an AA rating from Standard and Poor's and an A+ rating from
Fitch, earned the highest bond rating in the state for municipal bonds. The
hospital's Board of Commissioners, which received bids from four financial
firms, awarded the bond to Morgan Keegan and Co. at a 4.18 percent interest
rate.
The hospital's
bond ratings, as well as its Gulf Opportunity Zone bond classification, will
save the taxpayers more than $4 million in interest over the life of the
bond, officials said. The money will pay for the hospital's cancer center,
which voters approved in a 2003 bond that was renewed in December 2007.
The regional
cancer center, projected to be completed in the fall of 2010, will host
advanced technologies such as image-guided radiation therapy, nanotechnology
for drug delivery, specialized ultrasound, and genetic testing. The public is
invited to the center's groundbreaking, which will be held Aug. 5 at 8:30
a.m. next to the SMH
Founders Building
at 1150 Robert Blvd.
http://www.nola.com/news/t-p/metro/index.ssf?/base/news-34/124633981115710.xml&coll=1
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Boustany
takes lead role in pushing GOP health care agenda
By Deborah B.
Berry
Gannett Washington
WASHINGTON -- Republican Rep. Charles Boustany recently stepped to a lectern in the Capitol and
vowed on behalf of his party to help overhaul the nation's health care
system.
He's also
delivered a GOP radio address on the issue, talked about the party's plan on
TV and hosted a teleconference town hall.
Boustany, a surgeon, has taken a leading GOP role
on one of the most pressing issues before Congress.
"It's been
pretty much a non-stop endeavor on health care," said Boustany of Lafayette. "It's the issue of the
day."
He isn't the only
Republican doctor from Louisiana.
Freshmen Reps.
John Fleming of Minden and Rep. Bill Cassidy
of Baton Rouge
also are doctors and members of their party's health care caucuses.
"We've had a
lot of input" with Republican leaders, said Fleming, who still runs a
family practice in Minden.
"We relate to them all the day-to-day experiences that we deal with that
are so important to this debate."
Boustany, serving his third term, has more
seniority and serves on the powerful Ways and Means Committee, which has
jurisdiction over health care and Medicare.
He said Republican
leaders asked him this month to lead GOP lawmakers in delivering the party's
health care message. So he's helping craft the GOP counterproposal to the
plan pushed by Democrats, who outnumber Republicans on the Ways and Means
panel 26-15.
Pollster Bernie Pinsonat said it's natural for Boustany
to take a leading role.
"He's
practiced medicine. He's been in the system," Pinsonat
said. "If you want someone to articulate health care, he obviously is
someone who is very well qualified."
Boustany is a former cardiothoracic surgeon and has
been in the medical field more than 20 years. He's worked at community health
centers and in the charity hospital system.
House Minority
Leader John Boehner, R-Ohio, said Boustany's
medical background and experience give him credibility on the health care
issue.
Republicans
outlined a plan last week that would offer health care tax credits to
low-income and moderate-income families and small-business owners. It also
would allow dependents up to 25 years old to remain on their parents' health
care policies. The plan lacked specifics, including cost.
Boustany said he doesn't support President Barack
Obama's proposal to create a government-run health insurance program that
would compete with private insurers. Such a program would take the
decision-making out of the hands of doctors and patients and would cost too
much, he said.
Fleming agreed.
"The
government-run health care system is just a non-starter," he said.
"We practicing physicians see ... that (Medicare) is draining resources.
We're terrified that if we go to a larger system, it's only going to drain
resources more."
Democratic leaders
want Congress to vote on a bill by the end of the year that would provide
insurance coverage for an estimated 46 million uninsured people.
"Of course,
there's no chance that the Republican alternative will be adopted," said
Richard Himelfarb, a political scientist at Hofstra University in New York who specializes in health care.
"But it does take away any arguments that Obama and the Democrats (have)
that Republicans are a bunch of nay-sayers who
don't want to do anything about health care."
And taking a lead
role will only help Boustany's political career, Pinsonat said.
"Louisiana is seeing
one of its own on the national stage," he said.
"He's certainly capable of being somebody who not only represents Louisiana, but the
rest of the country."
Democrats note
that Boustany voted against a measure this year to
expand the federal health insurance program for low-income children.
"Congressman Boustany's so-called 'answer' to the health care crisis
that is driving costs up for hardworking Americans is to 'just say no' and
protect the status quo," said Jessica Santillo,
a spokeswoman for the Democratic Congressional Campaign Committee.
Boustany said he hopes to capitalize on the
attention.
"I believe
public opinion is going to drive a lot of what happens," he said.
"We will have a substantive proposal. We hope to have a lot of our ideas
incorporated into the final package."
http://www.thetowntalk.com/article/20090629/NEWS01/906290310
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Louisiana Medicaid program under review
New Orleans CityBusiness |
06.29.09
by The Associated
Press
BATON ROUGE —
Private health-care providers who treat Louisiana's poor are facing a $180 million
cut in the government health insurance program that pays them.
The amount is far
less than originally expected. But the cut's impact will be hard to measure
until the state Department of Health and Hospitals drafts new rules.
"We are
trying to figure out what this does or doesn't do," Louisiana Hospital
Association President John Matessino said of the
situation. "People keep wanting me to give them
a percentage they are going to be cut."
But Matessino said he won't know until DHH comes up with new
rules that would tell how much private providers
would be paid for the care they render to Medicaid patients.
Some private health
care providers worry that the cuts could result in private physicians leaving
the Medicaid program and hospitals reducing services and laying off
employees.
The budget for the
Medicaid program that pays private providers - hospitals, physicians, pharmacists
and others - is expected to be $4.25 billion for the fiscal year, which
begins Wednesday.
It had been $4.43
billion.
But those
calculations are based on an initial review of what happened on the last day
of the session.
Medicaid is the
government insurance program that provides medical care
to the lower income and some elderly, roughly one out of four Louisiana residents.
DHH Secretary Alan
Levine said he has sent his agency's fiscal staff back to the drawing board
to develop new rules detailing the size cuts required to stay within the
dollars provided.
"I'm going to
try to target these reductions in a way that preserves access" to
primary care, Levine said.
http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=25500
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By Nick Guillory
SHREVEPORT, LA (KSLA) - Louisiana Governor Bobby Jindal has until Tuesday to make a decision on the
Medicaid cuts in proposed House Bill 881.
The program could
see triple digit cuts and several home healthcare providers in the Ark-La-Tex
are worried for their patients.
The bill calls for
more 230 million dollars in cuts to the program that refunds providers. They
say it may be tougher to operate under even less funding than they already
get now.
"Medicaid is
already limited to how much they will fund home health for patients and
patients who are on home health at this time," Cammi
Jorio of Stat Home Health said.
She's talking
about how hard it will be to continue to provide adequate services for her
patients.
She knows all too
well what less funding will mean.
"More hospitalizations, more in and out of the hospitals and more
time with family having to help take care of these patients."
Not only will home
health feel the effect if the bill is signed into law but, the Louisiana
Ambulance Alliance said the bill reflects more than 7 percent reduction to
ambulance providers and will mean the elimination of an estimated 110 jobs.
"We have to do rule making and get
federal approval which will take a little while to figure out specifically
what the cuts are going to be but, home health did take the cut also,"
Under Secretary of Health and Hospitals Charles Castille
said.
Castille said the Governor has a lot of options to
weigh before he makes his decision. He also said the state program will have
to see cuts because the next couple of years are going to be rough.
http://www.ksla.com/Global/story.asp?S=10615037&nav=menu50_2
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Alexandria Political Buzz Examiner | 06.29.09
Jung Lee
AP
Photo/Jacquelyn Martin
Thursday, June 25, 2009, on Capitol Hill in Washington.
In the past GOP
has always argued less government in everyday life. That seems to be changing as Democrats in
the past two elections have picked up votes from suburbanites, moderates, the
educated, and the younger generation.
Democrats have also gained ground in the West, the Midwest,
and the South. GOP on the other hand
gained votes only from less-educated whites and highly religious voters. These voters increased majorly in areas
consisting of Appalachia and the South. This is why commentators, as well as GOP
insiders, are worried the GOP will turn into the party of the South and the
religious right.
This statistic
alone could be one of the primary reasons why GOP has grudgingly have gone
along with trying to help Obama reform the hectic health care industry. Rep. Charles Boustany
Jr. (R-Louisiana), who is a doctor and member of the House Republican Health
Care Solutions Group, said the GOP is "convinced" that Democrats
and Republicans can both work together to resolve the issue of rising health
care costs by approaching it from a similar platform.
"Let me be
clear, Republicans want to work with President Obama and other Democrats to
ensure that every American has access to affordable, high-quality health
coverage," Boustany said. "Despite our
differences, we are convinced there are areas of common-sense agreement on
health care reform among Republicans and Democrats. This issue is just too
important to let partisanship or blind ideology get in the way. Let’s all
work together to do the right thing for the American people."
It was only since
May that the Republican National Committee (RNC) wanted to re-brand the
Democrats to 'Democrat Socialist Party,' and was to hold an actual vote to do
so. However, even though GOP used
widespread "scare tactics," implying Obama would
"socialize" the health care industry and that it would be a
"government take-over," American citizens still believed Democrats
more than Republicans when it came to health care reform. According to a Gallup poll taken on June 17, 58 percent of
Americans trusted Obama when it came to health care reform along with
Congressional Democrats who had 42 percent over Congressional Republicans who
finished with just 34 percent. Doctors
in the meanwhile, had the highest percentage of voter trust when it came to
health care reform at 73 percent.
Under Obama's
health care reform plan, Obama promised that Americans will not have to
change their health care coverage if they do not want to. He even reiterated it when a local did not
understand.
"When I say
that you don't have to change plans," Obama orated, "What I'm
saying is the government is not going to make you change plans under health
reform."
There is a big
dilemma however when it comes to health care reform. It is projected to cost $1.6 trillion
dollars in government spending to reform the current health care system. The question is, if it's worth it. Republicans working in bipartisan effort
with Democrats have seemingly lowered the projected cost of health care
reform to $1 trillion. Much of it
dealing with scaling back on proposed subsidies to help individuals and
businesses obtain insurance. Yet,
Democrats think it is vital that a government insurance plan be created to
compete with private organizations.
Republicans are strongly opposed to this idea along with doctors and
insurers saying a government plan will run private organizations out of business.
For one, a
government run insurance plan would drive the administrative costs and
profits down in the private sector making health insurance coverage more
affordable for most Americans. Second,
a government plan would break the monopoly two insurance companies hold over
a third of the entire national market and are enjoying record profits while
the administrative overhead is booming as the fastest growing component of
health spending at 12 percent per year.
Not to mention, CEOs of these insurance companies have received
multi-million dollar bonuses while premiums have shot up 87 percent over the
last 6 years. Republicans would still
try to denounce a government run insurance plan.
"Let me put
it this way. Having the government compete against the private sector, it's
kind of like my seven-year-old daughter's lemonade stand competing against
McDonald's," Rep. Paul Ryan, R-Wis., said.
"It's the government being the referee and player in the same
game."
The only
difference is the jobs the $1.6 trillion creates would secure a higher education
for the future. Children have grown up
and gone through college only to end up in a worst position than they have
began with before college. This is
another dilemma Obama is tackling with right now.
"Every day I
wish I had never gone to college," [Hernan]
Castillo said. "It has been the biggest mistake of my life. Sometimes I wish I had gone to prison
instead of college. At least I would
have learned a trade or two and started being independent once I got
out."
For Hernan Castillo, working a warehouse job even though he
has a degree qualifying him to be an accountant is life. Hernan sees
little hope of leaving his warehouse job.
Now Hernan has a $5,200 credit card debt and
a $30,000 debt from student loans. All
the while, he's making payments on time.
Much of the reason why people like Hernan
cannot find a job is due to lack of jobs in a bad economy. If $1.6 trillion is poured into health care
reform, jobs and industries in medicine and research will be created. From there, the money will pour into other
industries such as public awareness which will stem the media and provide for
other jobs that actually require a higher education. Not a McDonald's job nobody wants. People like Hernan
will be able to find a proper job as an accountant and in turn the economy
will be stimulated as people have respectable jobs. Education will be a success and deemed as
valuable as people always have said it to be.
However, many
people would like to think of it as a lemonade stand verses a McDonalds. If in fact, a lemonade stand were to face a
McDonalds, where would be the cronyism in that?
"Millions
upon millions of middle-class families will see themselves pushed into the
ranks of the uninsured — and possibly into bankruptcy — unless someone helps
them financially," says Princeton
economics Professor Uwe E. Reinhardt. "But it
is doubtful that it can be done if the 10-year budget cost of the proposed
health reform bill is constrained to $1 trillion or less."
http://www.examiner.com/x-12338-Alexandria-Political-Buzz-Examiner~y2009m6d29-Who-is-really-affected-by-health-care-reform
[BACK TO TOP]
The New York Times | 06.29.09
By TARA
PARKER-POPE
Stuart
Bradford
Last week, a team
of eight cyclists completed the coast-to-coast bike marathon called the Race
Across America in record time. It was quite an achievement under any
circumstances, but what made it extraordinary was something all eight of them
had in common: Type 1 diabetes.
Type 1, sometimes
called juvenile diabetes, poses special challenges for athletes. A person
with Type 1 can’t produce insulin and must take regular injections to control
blood sugar. But exercise can also lead to precipitous, even deadly, drops in
blood sugar. (Type 2 diabetes, by far the more common form of the disease,
typically develops later in life, often linked to poor eating habits and
weight gain; exercise is often prescribed as a way to keep blood sugar low.)
The
accomplishments of the cyclists, who have a corporate sponsor and ride as
Team Type 1, have become a source of inspiration for the estimated three
million Americans with Type 1 diabetes, and especially for worried parents
confronting a diagnosis of the disease in their children.
But the victory
also offers lessons for the rest of us, underlining the benefits of daily
vigilance when it comes to health. Because people with Type 1 produce no
insulin, they cannot survive without injecting it before each meal, and they
must wear a monitor or test their blood several times a day to check their
glucose levels. Meals, snacks, exercise and medication are carefully
balanced. This meticulous regimen is necessary to prevent diabetes
complications, which can include kidney failure, blindness and death. But
closely controlling blood sugar can also result in an enviable level of
weight management and overall health.
“We’re showing
people that diabetes is our strength, and because of it we can do some pretty
amazing things,” said Phil Southerland, 27, a cyclist and runner from Atlanta who founded the
team with another cyclist with Type 1, Joe Eldridge. (Both men rode in the
race in 2006 and 2007, but did not compete this year.)
“I think the rest
of the world can look at the team,” Mr. Southerland continued, “and say:
‘These guys just won a bike race, and they did it with diabetes. What can I
do with my life to live a healthier, better life?’ ”
The achievements of
the Type 1 athletes come at a time of growing concern about changing patterns
of the disease. While Type 2 diabetes is associated with an unhealthy
lifestyle, scientists do not yet know what causes Type 1, although
autoimmune, genetic and environmental factors appear to play a role.
With obesity and
poor health habits rising among adults and children alike, it is hardly
surprising that Type 2 diabetes has grown so prevalent. But now European
health officials are reporting an inexplicable rise in Type 1 as well. Last
month, the medical journal Lancet reported that the incidence was rising
about 4 percent a year among European children, particularly those under 5.
At that rate, the number of Type 1 cases will increase 70 percent in the next
decade. And the disease also appears to be gaining in the United States.
The rapid rise
suggests environmental influences, and researchers are looking at possible
factors that include Caesarean deliveries, viral infection and early-life
nutrition, including Vitamin D deficiency.
Type 1 diabetes
has many faces. Perhaps the most prominent spokeswoman is Mary Tyler Moore,
now 72; President Obama’s nominee for a vacancy on the Supreme Court, Judge
Sonia Sotomayor, 55, was given a Type 1 diagnosis
when she was 8.
And Jay Cutler,
the star quarterback who was recently traded to the Chicago Bears, learned he
had Type 1 at 24, after a rapid 35-pound weight loss and severe fatigue
originally attributed to stress. A team physical finally led to a diagnosis.
“When I found out
I think I was more relieved than anything else, just to know it could be
managed,” Cutler said in an interview. “You feel sorry for yourself for a
little bit, but you come to terms with it.”
Now when Cutler
heads to the sidelines during practices or a game, he is met by a trainer who
checks his blood sugar to make sure it hasn’t dropped to a risky level.
“The trainer is
there with my meter, they prick it, do the whole thing, tell me my number,”
he said. “If we’re good, we keep going. If I’m getting a little low I take
some Gatorade.”
During the Race
Across America, the Team Type 1 cyclists wore glucose monitors and traveled
with a doctor, eating or drinking when blood sugar levels begin to drop.
While all the athletes must take insulin regularly to prevent high blood
sugar, the intense exercise causes their medication needs to drop 60 to 75
percent during the first days of the race. As the body adjusts in the later
days of the race, the cyclists must generally increase their insulin
injections.
To complete the
race, the cyclists divided into two teams of four. The first four riders took
turns pedaling at full sprint for 10 to 15 minutes at a time, meaning each
individual rider took only a short break before having to ride again. After
about 150 miles of tag-team racing, the exhausted cyclists met up with the
second set of four riders, who took over, giving the first riders
time to eat and rest before they started again.
Despite mechanical
problems, the team, which started in Oceanside,
Calif., rolled into Annapolis, Md.,
a distance of 3,021 miles, in five days, nine hours and five minutes. Their
average speed was 23.41 miles per hour — 0.17 better than the winner last
year, a Norwegian cycling team made up of professionals.
http://www.nytimes.com/2009/06/30/health/30well.html?_r=1&ref=health
[BACK TO TOP]
The New York Times | 06.29.09
By DERRICK HENRY
About 47,000 older
Americans are treated in emergency rooms each year from falls associated with
walkers and canes, according to a study that suggests that there is room for
improvement in the use and design of walking aids.
“It’s important to
make sure people use these devices safely,” said Judy A. Stevens, an
epidemiologist at the Centers for Disease Control and Prevention and the
study’s lead author. “It gives them greater independence, but at the same
time it can be a hazard if not used properly.”
The study, which
was released Monday and is to be published in this month’s Journal of the
American Geriatrics Society, found that 87 percent of fall injuries involved
walkers and 12 percent involved canes.
Researchers
examined emergency-room medical records at 66 hospitals from Jan. 1, 2001,
to Dec. 31,
2006. They focused on patients 65 and older who had been treated
for 3,932 nonfatal, unintentional fall injuries in which a cane or a walker
was involved. A statistical analysis estimates that there are 47,312 falls a
year.
The study found that
fractures, bruises and abrasions were the most common injuries associated
with the falls. Almost a third of all injuries were to the lower trunk,
including the hips.
Sixty percent of
fall injuries associated with walkers and canes occurred at home, while 16
percent of falls involving a walker occurred at nursing homes, the study
said.
Authors of the
study said that doctors might consider taking more time to show patients how
to use walkers properly and that additional research could lead to design
improvements for walking aids.
http://www.nytimes.com/2009/06/30/health/30fall.html?_r=1&em
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The New York Times | 06.29.09
By SARAH ARNQUIST
The older people
become, the younger they feel and the more likely they are to see “old age”
as a time occurring later in life, according to a national survey on aging
released on Monday.
“There’s a saying
that you’re never too old to feel young, and boy, have older Americans today
taken that one to heart,” said Paul Taylor, executive vice president with the
Pew Research Center
and the survey’s principal author. He said this is the broadest survey the
nonpartisan research center has ever done to gauge Americans’ views on aging.
Currently, about
40 million Americans, or one in eight, are 65 and older. By 2050, one in five
American will be in that age group. The center surveyed about 3,000 adults 18
and older via land and cellular telephone lines in February and March of this
year.
The survey found
not just a gap between actual age and the age people say they feel, but also
that the gap between reality and perception increases with age.
Most adults over
age 50 feel at least 10 years younger than their actual age, the survey
found. One-third of those between 65 and 74 said they felt 10 to 19 years
younger, and one-sixth of people 75 and older said they felt 20 years
younger.
On average, survey
respondents said old age begins at 68. But few people over 65 agreed; they
said old age begins at 75.
Respondents under
30 said 60 marks the beginning of old age.
“Old age is always
a bit older than you are,” said Jeffrey Love, research director at AARP.
The researchers
also asked young adults what they expect aging to be like and older Americans
how it actually is. Younger people tend to think growing old will be worse
than the elderly report, the survey team found.
Older adults said
they had experienced the negative aspects of aging — including illness,
loneliness and financial difficulty — far less often than younger people
anticipated. But older participants also said they found less time for family
and leisure activities than younger adults expected they would when they
reach old age.
“Human beings have
trouble coming to terms with the unknown,” Mr. Taylor said. “Growing old is a
great unknown in the lives of everyone who is not yet old.”
http://www.nytimes.com/2009/06/30/health/30aging.html?ref=health
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