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Tuesday, July 07, 2009 LSU
official in charge of hospital system moved Shriners Hospital in Shreveport to remain open Dr. Robert Barish: LSUHSC earns high marks in research Letter: European versus U.S. health care Hospitals, Democrats near deal on health care;
announcement could come as soon as Wednesday The Associated Press | 07.07.09 Louisianians have waited long enough for investigative
records of Memorial Medical Center deaths after Katrina NIH Pleases Scientists With New Rules for Stem-Cell
Research The Chronicle of Higher Education |07.07.09 Letter: Mental health services will be better, cheaper,
Secretary Levine says Who's the fattest of them all? Louisiana is almost
there. Attack ads hit moderates on health reform White House Open to Deal on Public Health Plan Wall Street Journal | 07.07.09 An M.D. On How Money Drives Medical Testing Wall Street Journal | 07.07.09 Senate Seeks to Pare Tab for Health Overhaul Wall Street Journal | 07.03.09 |
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LSU official in charge of hospital system moved
The Advocate | 07.07.09
Michael
Butler has been replaced as chief of the LSU division that oversees most of
the state’s public hospitals, including LSU’s LSU
System Vice President Fred Cerise said Monday he transferred LSU System health-care
executive Roxane Townsend into The
personnel moves are part of LSU’s efforts to reorganize the way it manages
and operates 10 public hospitals and two medical centers. Cerise
said the action was brought by changes in the public health-care climate,
including uncertain state funding and federal health-care reform efforts. Seven
of the public hospitals fall within the LSU’s Health Care Services Division,
which He
will concentrate “full-time” on beefing up disease management programs, which
are becoming a major thrust of new federal efforts to improve patient health
and reduce costs, Cerise said. “It’s
taking an area he is very strong in that’s going to be very important for us
going forward,” Cerise said. Cerise
said Townsend will help with a review of operations of the Health Care
Services Division to investigate where change could be made to improve
efficiencies. A
report, with recommendations, is expected to be made to the LSU Board of
Supervisors in the next couple of months, Cerise said. “We
are looking at the status of the Health Care Services Division. … I’ve asked
Roxane to look at it and make some recommendations. … We are taking a hard
look at the organization from a system perspective,” Cerise said. Cerise
alerted hospital administrators, medical directors and Health Care Services
Division central office staff of the job changes in a Thursday memo — the day
before the long Fourth of July holiday weekend. “Change
such as these invariably raise many questions and cause anxiety,” Cerise
wrote. “The
changes being enacted and being contemplated at LSU are directed toward
strengthening us as a system of two health science centers, ten hospitals and
associated clinics so we can further our patient care, education and research
missions.” Cerise
noted “uncertainties” surrounding the future of LSU’s two largest campuses in
On
the federal level, he said health-care reforms “would put added emphasis on
clinical performance and sound, efficient business practices” and LSU must be
ready. http://www.2theadvocate.com/news/50093582.html?showAll=y&c=y
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In
this April 2, 2009 file photo, Senate Finance Committee Chairman Sen. Max
Baucus, D-Mont., left, and the committee's ranking Republican Sen. Charles
Grassley, R-Iowa talk on Capitol Hill in |
WASHINGTON
-- Key Senate Democrats and the White House are closing in on a deal with
hospitals to help pay for President Barack Obama's proposed expansion of
health coverage, at the same time they hope for a comprehensive agreement
with Republicans on a bipartisan bill.
Several
officials said Monday that after talks involving the White House and Sen. Max
Baucus, the chairman of the Senate Finance Committee, the nation's hospitals
were on the verge of signing off on a deal to reduce their anticipated
payments from Medicare and Medicaid by about $155 billion over a decade. The
government then would be free to use the money to help provide health
coverage to millions who now lack it.
The
officials said a formal White House announcement was possible as early as
Wednesday, with Vice President Joseph Biden standing in for a traveling
president. The officials spoke on condition of anonymity, citing the
confidential nature of the discussions.
Separately,
Baucus and other Democrats on his panel have been negotiating for days with
Iowa Sen. Charles Grassley and a small group of other Senate Republicans in
hopes of agreeing on a bill that could command bipartisan support.
Baucus,
a Montana Democrat, is under pressure to draft legislation quickly so
Democrats can keep to a timetable calling for a vote in the Senate within the
next several weeks.
At
the same time, Grassley faces political pressure from some Republicans opposed
to handing Obama and the Democrats a bipartisan victory on such a key issue.
One
key sticking point has involved the demand by some Democrats for the
government to offer insurance in competition with private companies.
Republicans strongly oppose the idea. Possible compromises include creation
of a nonprofit cooperative to compete with insurance companies, rather than
empowering the federal government to do it.
Democrats
and Republicans also would have to agree on what, if any, requirement the
legislation would impose on individuals to purchase insurance, and on large
employers to subsidize it for their workers.
A
second Senate committee is expected to complete work on its version of health
care legislation within several days.
Separately,
Democrats in the House hope to unveil a revised bill of their own later this
week.
Any
legislation is expected to require insurance companies to sell insurance to
any customer, without denial or higher rates because of pre-existing medical
conditions. Government subsidies would help the poor afford coverage.
As
many as 50 million Americans now lack insurance, and Obama has said he wants
to assure coverage for as many as possible. At the same time, he has set a
goal of slowing the growth of health care overall.
The
legislation has moved in fits and starts, and while it is unlikely any bill
makes it to the president's desk for months, Obama and his aides have been
cheered by two public developments in recent weeks.
In
the first, the nation's pharmaceutical companies agreed to an $80 billion
package to help close a gap in prescription drug coverage under Medicare and
defray the cost of any legislation that passes.
Last
week, Wal-Mart, the nation's largest private employer, broke with other big
firms and said it supports a requirement for many companies to offer health
care to their workers.
http://www.nola.com/news/index.ssf/2009/07/hospitals_democrats_near_deal.html
Louisianians have waited long enough for investigative records of
Memorial Medical Center deaths after Katrina
Times – Picayune | 07.07.09
The
Louisiana Supreme Court has generally protected the public's right to access
government records. That's why it's puzzling that the justices punted in a
case seeking the release of investigative files related to post-Katrina
deaths at
Former
Attorney General Charles Foti's probe led to 2006
charges that Dr. Anna Pou had euthanized patients
at the Uptown hospital. But a
The
Supreme Court, however, ordered 19th Judicial District Court Judge Donald
Johnson to decide whether any future charges against Dr. Pou
"can be reasonably anticipated" before the justices determine
whether the investigation's file should be released. Chief Justice Catherine
"Kitty" Kimball wrote the majority opinion, and Justices Bernette Johnson and John Weimer concurred.
The
justices' question, however, was answered two years ago.
The
attorney general's office and the Orleans Parish district attorney's office
both said in 2007 that they would not pursue the matter further. And after a
five-day trial in 2007, Judge Johnson said no additional prosecution could be
reasonably anticipated. Nothing has changed to suggest the contrary.
So
the Supreme Court in essence set a ruling on the public's access aside only
to order a repeat of the same process Judge Johnson held two years ago.
That's an unnecessary delay. As Justice Jeffrey Victory wrote in a dissenting
opinion, there is no reason to hold a hearing on that issue again.
Instead,
the justices should have ordered the immediate release of the investigative
documents. Almost four years have passed since the patients died at the hospital.
That's a long time for Louisianians to wait for
access to the records of the investigation.
The
public has a right to see what's in those documents. So do the relatives of
the patients who died and those who defended the actions of the medical personnel.
The
Supreme Court missed a chance to recognize that public right. The justices
should not miss that opportunity again when the case returns to their court.
http://blog.nola.com/editorials/2009/07/louisianians_have_waited_long.html
NIH Pleases Scientists With New Rules for
Stem-Cell Research
The Chronicle of Higher Education |07.07.09
By
PAUL BASKEN
Federal
regulators on Monday set new rules for government financing of stem-cell
research. The rules will allow such work if a review panel determines that
couples gave the necessary “informed consent” for the use of their embryos.
Scientists will get the chance to demonstrate to the review panel that older
cell lines, created during the past decade and crucial to continuing
research, meet this ethical standard.
The
creation of a review panel, as part of final guidelines for stem-cell
research issued by the National Institutes of Health, resolved one of the
major complaints of scientists awaiting the implementation of President
Barack Obama’s March 9 promise to allow expanded federal support of stem-cell
research.
The
new federal policy “will greatly expand opportunities for stem-cell research
and will ensure that NIH-funded research using human embryonic stem cells
will be conducted in an ethical and responsible way,” said Raynard S. Kington, acting
director of the NIH, in a briefing for reporters.
The
NIH guidelines, which take effect Tuesday, won immediate endorsement from
researchers and university groups, including the Association of American
Medical Colleges and the Association of American Universities.
The
policy reflects “a thoughtful and balanced approach,” said David T. Scadden, co-director of the Harvard Stem Cell Institute.
Embryonic
stem cells, because of their potential to grow into any of more than 200
types of tissue in the body, raise the possibility of cures for a range of
ailments that include cancers, diabetes, and heart disease.
Former
President George W. Bush, siding with those who believe any potential human
life form should be preserved, ruled on August 9, 2001, that federal money
could not be involved in any projects using embryonic stem cells created
after that date. Mr. Obama announced his intention to overturn Mr. Bush’s
policy in March and asked the NIH to draft detailed rules for stem-cell use.
Those
new rules say that, from today forward, the government will provide money for
embryonic-stem-cell research only when the couple who produced the embryo can
be shown to have fully understood the scientific implications and have given
clear approval.
For
stem-cell lines that originated before Tuesday, the NIH will establish a
review committee of about 10 science and ethics specialists who will decide
whether the embryonic stem cells were “derived responsibly,” Dr. Kington said.
The
reviews will determine whether principles of informed consent “have been met
even if every specific detail outlined in the final policy was not followed,”
Dr. Kington said. In the case of stem-cell lines
from foreign sources, the committee will determine if the country’s consent
standards “are at least equivalent” to the
The
result is a policy “much more workable and practical” than scientists had
feared, Dr. Scadden said. “The panel still needs to
be named,” he said, “but experience thus far suggests that this
administration appoints those with substantive credentials.”
The
NIH will also establish a registry of approved lines. “That will make the
process much simpler for institutions and individual investigators,” Dr. Scadden said.
The
federal government is now spending about $88-million a year to support
embryonic-stem-cell research. The spending could actually decline this year
because of delays while awaiting the new NIH policy but should then grow
substantially in future years, Dr. Kington said.
Letter: Mental health services will be better,
cheaper, Secretary Levine says
Times-Picayune | 07.07.09
Re:
"Jindal slashes mental health," Other Opinions, July 2.
The
policy decision to consolidate inpatient services of
Thirty-seven
percent of the people treated at SELH are from the south shore already, and
services at SELH cost half of what NOAH costs per day. Simply, the same
inpatient services will be available at a savings to taxpayers of nearly $10
million annually.
The
advocacy by some, including Rep. Neil Abramson, to gut the funding of NOAH by
nearly $6 million, and move an additional $10.2 million away from SELH would
result in the potential loss of as many as 50 inpatient beds in the region.
The same people also advocate cutting $4 million from intensive outpatient
programs, which are serving families and children in a 17-parish region,
including
Gov.
Jindal's veto pen stopped what would have been a
terrible decision made only in the frantic last hours of the Legislature and
without public debate on the damage it would do.
After
the tragic death of Officer Nicola Cotton brought the systemic failure and
neglect of the
These
programs are serving hundreds of people, while the inpatient beds at NOAH
only served 70 children last year at a daily cost of twice the other mental
health institutions. The fact is, by thinking differently, we can serve the
same number of inpatients while expanding critical outpatient services.
Proper
stewardship is not about making popular decisions. It's about looking at the
facts and asking how we can do it better based on the evidence.
Alan
Levine
Secretary,
Department
of Health and Hospitals
http://www.nola.com/news/t-p/letterstoeditor/index.ssf?/base/news-14/1246944041117990.xml&coll=1
Who's the fattest of them all? Louisiana
Times – Picayune | 07.07.09
We
might feel downright svelte compared to
But
It
will take more than improving what children eat during the school day to
address the national obesity epidemic. People of all ages need to eat better
and exercise more. But American adults are poor role models on this issue,
and schools should play an active role in helping children grow up healthy
and physically fit.
http://blog.nola.com/editorials/2009/07/whos_the_fattest_of_them_all_l.html
Attack ads hit moderates on health reform
Washington
Democrats
beware! If you're not fully supporting President Obama's health care
overhaul, liberal advocacy groups have you in their sights.
As
the August congressional recess looms and the final details of the health
care plan take shape, the groups have unleashed a series of hard-hitting
attack ads against Democrats while mostly ignoring Republicans.
Change
Congress is raising money to go after Sen. Mary L. Landrieu, Louisiana
Democrat, using one of her own constituents to ask, "Will Landrieu sell
out
"Our
pressure campaign targeting Landrieu has great momentum, but so far, her
public position has not moved. So we have a choice: Walk away from the fight
or escalate the pressure? For us, the choice is easy," the group told
supporters.
The
new ad stars Karen Gadbois, an uninsured
"For
me, this issue is personal. So when I see Mary Landrieu take $1.6 million
from health and insurance companies and then oppose the public option for my
daughter and me, I have to ask: Whose side are you on?" she says,
looking straight into the camera with scenes of vacant New Orleans homes
behind her on the screen.
The
most contentious sticking point concerns the public option Mr. Obama says he
wants included in the plan — which has a more than $600 billion price tag.
Republicans
call a public option a deal breaker, while many conservative Democrats are
backing away from the idea — favored by liberals — for fear it would harm
private insurance companies.
Landrieu
spokesman Aaron Saunders declined to comment on the ads but said his boss is
reviewing all the proposals on the table. Mr. Saunders said Ms. Landrieu is
open to compromise but "supports a predominantly private system that
features a federal backup plan that serves as a safety net" and added
that she "does not believe that health care reform starts with a public
option."
He
also noted that since the ads have started, the majority of calls to her
office have been in opposition to a public option, not in favor of one.
Advocacy
groups such as MoveOn.org and Democracy for
When
asked by The Washington Times about the ads last week, White House Press
Secretary Robert L. Gibbs said the president doesn't have "much to
say" about the groups' efforts.
A
few days later, the White House was forced to intervene, and Mr. Obama
reportedly told members of Congress on a conference call that the ads aren't
helpful.
"The
president had the right tone, telling people this has to be more about the
bigger challenge of continuing to make the case for why health care reform is
needed," said Sen. Mark Warner, a freshman Democrat from Virginia.
Mr.
Warner told The Times he has heard from liberal groups that strongly want a
public option and opponents who call that government-run health care, though
he hasn't been targeted specifically yet because he hasn't staked out a firm
position on that element of the proposal.
He
said he doesn't think the ads against conservative Democrats were helping.
"I'm
not sure that's going to switch anybody's vote," he said.
But
in at least one case, the targeted campaigns seem to be working — MoveOn scrapped plans to attack freshman Sen. Kay Hagan
of North Carolina when she reversed her position and now says she will back
the bill that includes a public option.
MoveOn Executive Director Justin Ruben went
as far as thanking Ms. Hagan, saying the group's members in
But
Change Congress hasn't relented in its campaign against Ms. Landrieu and
found success in targeting Sen. Ben Nelson, a conservative Democrat from
Democrats
also are using intensely personal stories to sell the plan, putting everyday
people in front of the camera to talk about their experience losing health
insurance.
"My
son has cerebral palsy and epilepsy. He's four," one woman says in the
Organizing for
Mr.
Warner said the public option argument is semantical
and lawmakers and advocacy groups should be more focused on costs and cutting
the deficit.
He
predicted the president will sign a bill in the fall but it might not be
perfect the first time around.
"Whatever
bill is passed, chances are there is going to be a need to come back and take
a look at it and fix it," Mr. Warner said. "You're not going to get
this 100 percent right the first time out of the chute, but the option of
doing nothing … just isn't an option."
Mr.
Warner said he's still closely examining the bill as it takes shape on
Capitol Hill, and he noted his interest in seeing a mixed public and private
plan that encourages competition on a level playing field. Some larger
employers such as Safeway and Delta are even crafting their own benefit
plans, he said.
He
said many Republicans are "trying to frighten people" that the
Obama plan forces people to change their current health care plan even though
it actually gives them an option to switch or keep plans they like.
White House Open to Deal on Public Health Plan
Wall Street Journal | 07.07.09
By
LAURA MECKLER and JANET ADAMY
"The
goal is to have a means and a mechanism to keep the private insurers
honest," he said in an interview. "The goal is non-negotiable; the
path is" negotiable.
President
Barack Obama has campaigned vigorously for a full public option. But he's
also said that he won't draw a "line in the sand" over this point.
On Tuesday, the White House issued a statement reiterating his support for a
public plan.
"I
am pleased by the progress we're making on health care reform and still
believe, as I've said before, that one of the best ways to bring down costs,
provide more choices, and assure quality is a public option that will force
the insurance companies to compete and keep them honest," the president
said in the statement. "I look forward to a final product that achieves
these very important goals."
The
jockeying over the public plan came as the Senate Finance Committee pushed
for a bipartisan deal. To help pay for the package, the committee planned to
announce an agreement Wednesday with hospitals and the White House for $155
billion over a decade in reductions to Medicare and charity-care payments for
hospitals, according to a person familiar with the agreement. That will help
pay for the legislation, expected to cost at least $1 trillion over 10 years.
One
of the most contentious issues is whether to create a public health-insurance
plan to compete with private companies.
Mr.
Emanuel said one of several ways to meet Mr. Obama's goals is a mechanism
under which a public plan is introduced only if the marketplace fails to
provide sufficient competition on its own. He noted that congressional
Republicans crafted a similar trigger mechanism when they created a
prescription-drug benefit for Medicare in 2003. In that case, private
competition has been judged sufficient and the public option has never gone
into effect.
The
deal with the hospitals follows a similar agreement with brand-name drug
companies. And insurance companies were talking to Senate negotiators about
cuts worth at least $100 billion over 10 years, according to two officials
with knowledge of the negotiations.
Congressional
negotiators and the White House hope to lock in support from the industry
groups, which are backing a health bill in general terms but have opposed
past efforts.
Hospitals
and insurers hope to gain some degree of control over cuts to their federal
payments. In principle, a health-care overhaul could benefit both groups by
raising the number of Americans who buy and have health insurance.
"They've
made an assessment reform is going to happen, so it's better to be part of
that than not," Mr. Emanuel said.
However,
insurers, and most Republicans, strongly oppose creation of a government-run
insurance option, saying it would ultimately drive them out of business. Most
Democrats support a public option.
The
president and his aides already have signaled a willingness to consider an
alternative to a public plan under which a network of nonprofit cooperatives
would compete with for-profit insurance companies. That is the leading idea
in the Senate Finance Committee.
The
Senate Health, Education, Labor and Pensions Committee, meanwhile, has put
forward its own version of a government-run plan, closer to what most
liberals and the White House favor.
On
Monday, Mr. Emanuel said the trigger mechanism would also accomplish the
White House's goals. Under this scenario, a public plan would kick in under
certain circumstances when competition was judged to be lacking. Exactly what
circumstances would trigger the option would have to be worked out.
Some
Democrats pushing for a vigorous public plan say the trigger idea isn't good
enough. Sen. Charles Schumer (D., N.Y.) said in an interview, "If it's
not there on day one, those of us who support a public option have a real
problem with it."
Write
to Laura Meckler at laura.meckler@wsj.com and Janet Adamy
at janet.adamy@wsj.com
http://online.wsj.com/article/SB124692407982802911.html
An M.D. On How Money Drives Medical Testing
Wall Street Journal | 07.07.09
Some
familiar subjects are worth revisiting — like the fact that paying doctors
for every test and procedure they do provides an incentive to do more tests
and procedures. Sandeep Jauhar,
a cardiologist, reflects on the subject in an essay in this morning’s New
York Times.
Jauhar’s main job, at academic medical center,
gives him a bit of a buffer against the financial pressures faced by docs in
private practice. But he recently began moonlighting on Saturday mornings at
a private practice, and the new gig is a stark reminder of the way medicine
is a business — and the business does better when doctors do more tests. He
writes:
A
patient comes in with chest pains. It is hard not to order a heart-stress
test when the nuclear camera is in the next room. Palpitations? Get a Holter monitor — and throw in an echocardiogram for good
measure. It is not easy to ignore reimbursement when prescribing tests,
especially in a practice where nearly half the revenue goes to paying
overhead.
Health
wonks have been trying for years to figure out a way to change the financial
incentives for doctors, so that they’re paid more if they give better care,
not if they give more care. That issue has become particularly pressing with
this year’s push to expand health insurance coverage while controlling the
costs of health care.
But
finding a better way to pay doctors has proved tricky. As Jauhar
himself noted in an essay last fall, paying doctors based on performance is
harder than it sounds. He described a case in which a patient was quickly
prescribed a daily intravenous drug to treat pneumonia, in keeping with a
Medicare quality measure that requires treatment to begin quickly for patients
with pneumonia. The only problem was the patient didn’t have pneumonia, and
went on to develop a disease that may have been caused by the unnecessary antibiotics.
http://blogs.wsj.com/health/2009/07/07/an-md-on-how-money-drives-medical-testing/tab/print/
Senate Seeks to Pare Tab for Health Overhaul
Wall Street Journal | 07.03.09
By
JANET ADAMY
But
the total cost of the health-care overhaul is likely to increase
substantially once a key element to expand insurance coverage is added in.
Senate
leaders on Thursday unveiled fresh details of legislation aimed at carrying
out President Barack Obama's plans to cover the nation's 46 million
uninsured. The new provisions call for all but the smallest employers to
provide workers with health insurance or to pay the government an annual
penalty of up to $750 per employee. The measure also sketches out new details
of proposed government health insurance that individuals and small businesses
could buy.
Last
month, the Congressional Budget Office estimated an earlier draft of the bill
would cost $1 trillion over a decade, a sum deemed too high by many lawmakers
because it only decreased the number of uninsured by 16 million. Members of
the Senate Health, Education, Labor and Pensions Committee, which is drafting
the bill, reduced the cost by factoring in employers' contributions for
health insurance, as well as reducing the subsidies lower-income workers
would receive for purchasing health insurance.
The
revised proposal isn't expected to trigger an exodus of Americans from
employer-sponsored insurance, according to the CBO, as was the case with the
earlier draft. The new plan gives employers more incentive to provide
coverage, and prompts fewer people to buy coverage on their own because the
subsidies for that are lower.
The
new price tag is "a strong number that would allow us to achieve the
president's goals," said Sen. Chris Dodd (D., Conn.), who is leading the
panel in drafting the bill in the absence of committee Chairman Edward
Kennedy (D., Mass.), who has been undergoing treatment for a brain tumor.
The
latest proposal doesn't include provisions for a large number of uninsured
Americans whom lawmakers intend to cover by expanding Medicaid, the
state-federal health program for the poor, among other costs. The Senate
health committee doesn't have jurisdiction over the Medicaid expansion, and
it is relying on a parallel bill moving through the Senate Finance Committee
to account for those people. As a result, the measure produced by Mr. Dodd's
committee still leaves 34 million Americans without insurance.
"Expanding
Medicaid will come with an enormous price tag," said a spokesman for
Sen. Mike Enzi (R., Wyo.), the health committee's top Republican.
Mr.
Dodd and other senators wouldn't estimate the cost of the proposed Medicaid
expansion, and the Congressional Budget Office hasn't released those numbers.
Part of the problem is that the cost of expanding Medicaid depends on other
provisions still in the works in the finance committee.
Mr.
Obama's push to create a new public health-insurance plan has become one of
the most contentious aspects of the health overhaul. The latest draft of the
bill calls for a public plan where the Department of Health and Human
Services would have broad authority over how the plan pays health-care
providers and covers participants. Senators who drafted the bill say the plan
would be subject to many of the same rules as private insurers and would set
premiums based on local costs.
The
plan would pay health-care providers rates that are "no more than the
local average private rates -- but could be less," the committee said in
a summary of the plan. In a statement, Mr. Obama said the public option would
"make health care affordable by increasing competition, providing more
choices and keeping the insurance companies honest."
But
the CBO estimate suggests the public option might not deliver significant
savings to consumers. The public plan "was not projected to have
premiums lower than those charged by private insurance plans" available
to individuals and small businesses, CBO Director Douglas Elmendorf wrote in
a letter to Sen. Kennedy explaining the cost estimates.
The
health bill's requirement that employers provide insurance or pay a penalty
would raise an estimated $52 billion over a decade, according to the CBO.
Employers would pay an annual fee of $750 for each full-time worker and $375
for each part-time worker if they didn't cover at least 60% of their
employees' health-insurance premiums. The plan would exempt employers with 25
or fewer workers.
Some
employers had been expecting a more onerous requirement.
Randy
Johnson, senior vice president at the U.S. Chamber of Commerce, said the
business group still opposes any employer mandate, arguing that it would
cause employers to lower wages and cut jobs. "That money comes out of
somewhere else," he said.
http://online.wsj.com/article/SB124655200561386801.html
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Please email
questions and comments to lsuhospitals@lsuhsc.edu.
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