LSU Hospitals

Media Sweep

 

Tuesday, July 21, 2009

 

Secretary says new VA hospital may break ground within a year

WWL-TV | 07.20.09

 

LSUHSC's Nichols to use LSD and fruit flies to identify novel genes for psychosis/schizophrenia

With $1.4M grant from NIH

EurekAlert | 07.20.09

 

Feds award $1.4M to N.O. professor who gives LSD to rats

New Orleans CityBusiness | 07.20.09

 

Health-care plan criticized at forum

The Advocate | 07.21.09

 

Gov. Jindal voices health-care concerns using national stage

The Advocate | 07.21.09

 

Democrats call on people to share health care stories with lawmakers

Shreveport Times | 07.21.09

 

Jindal blasts Demo health plan

The Times-Picayune | 07.21.09

 

Letter: Only fair and just

The Advocate | 07.21.09

 

Uninsured locals eagerly awaiting health care reform

WWL-TV | 07.20.09

 

Lawmaker surprised by Jindal’s veto

The Daily Comet | 07.20.09

 

Hurricane payments stand to affect Medicaid

WXVT-15 | 07.20.09

 

Obama's Health Care Reform Battle Heats Up

WBZ-TV | 07.21.09

 

Obama pushes for health care vote before August recess

The Times-Picayune | 07.21.09

 

RNC’s Steele: Obama’s Health Care Plan Akin to Socialism

The Wall Street Journal | 07.20.09

 

Considering Longer Chemotherapy

The New York Times | 07.20.09

 

When Weight Is the Issue, Doctors Struggle Too

The New York Times | 07.20.09

 

 

Secretary says new VA hospital may break ground within a year

WWL-TV | 07.20.09

Meg Farris / Eyewitness News

 

NEW ORLEANS – The nation's top veterans affairs chief said on Monday the new VA Hospital is closer to reality than some people might think.

 

That's despite the numerous delays and state struggles over who will control the adjoining replacement for Charity Hospital.

 

Eric Shinseki, the U.S. secretary of Veterans Affairs, spoke to Eyewitness News exclusively about the future of the massive downtown project.

 

"The only thing that I have to complain about is we have no hospital. There is not one shovel of dirt turned for a new hospital and we desperately need one," an older veterans said in front of a cheering audience at a town hall meeting.

 

"I just want to tell you we are going to build a hospital that serves the veterans in this area," answered  Shinseki from the stage to a clapping audience.

 

Shinseki was in Reserve Monday morning answering questions at a rural town hall meeting, one of four Obama cabinet members taking questions on a wide range of topics. Before the meeting he explained the plans for a new VA Hospital.

 

"We anticipate finishing final design and beginning to break ground next spring, spring of 2010," Shinseki said.

 

Shinseki said the hospital will open in 2013. Construction will employ 3000 people. Once open, the health care workforce will be more than double that of the VA Hospital pre-Katrina, employing 2200 men and women with an average income of $90,000 a year.

 

"Money has been put aside; about $600 million already set aside. But we expect, when it's done, this will be a $900 million project," Shinseki said.

 

He said 39,000 veterans live in the area. By the time the hospital opens in 2013, 70,000 here will depend on it. A state teaching hospital, the new so-called Charity, is supposed to share those services. Are the delays in that project hurting the VA's plans?

 

"What happens with the state side is not affecting the VA from moving forward with its original plans downtown,” he said. “We're going to build downtown.”

 

And the cost-saving of doing a duel model is important to the VA?

 

"Absolutely, absolutely. First, we get it right because we will be affiliated with two great medical schools, Tulane and LSU," Shinseki said.

 

The secretary toured the veterans clinic in Reserve, along with the mobile health care unit and veterans transportation bus. He said two more clinics will open in southeast Louisiana, bringing the total to eight. It's all in an effort to bring doctors to the veterans to help them heal physically and mentally.

 

"They're in a combat zone one day and the next day they might be back in the states having family issues they are dealing with, just getting to know their family again, maybe after having been away for so long. It can be very stressful for them," said Dr. Michelle Milonas, a licensed mental health counselor with the Veterans Resource Center in Kenner. 

 

The two new clinics will be opening in Bogalusa and Franklin. Also, the VA has raised travel reimbursement from 11 cents a mile to 41.5 cents a mile.

 

http://www.wwltv.com/topstories/stories/wwl072009adva.5dffc953.html

 

[BACK TO TOP]

 


LSUHSC's Nichols to use LSD and fruit flies to identify novel genes for psychosis/schizophrenia

With $1.4M grant from NIH

EurekAlert | 07.20.09

 

New Orleans, LA – Charles Nichols, PhD, Assistant Professor of Pharmacology at LSU Health Sciences Center New Orleans, has been awarded a grant in the amount of $1.4 million over four years by the National Institutes of Health's National Institute of Mental Health to find and characterize novel genes involved in psychosis and schizophrenia, using novel research methods.

 

Dr. Nichols' approach is innovative, combining discovery studies with functional and behavioral studies in two different models to determine how mental disorders like psychosis and schizophrenia develop. By studying both a new rodent model of psychosis that he is co-developing, which involves treating rats with the powerful hallucinogenic drug lysergic acid diethylamid (LSD), and the fruit fly, Drosophila melanogaster, analysis of gene function relative to whole animal behavior can be accomplished more rapidly than with traditional rodent models alone.

 

"We believe that changes in gene function, influenced by abnormal activity in specific regions of the brain regulated by the neurotransmitter serotonin, contribute to neuropsychiatric disorders. The effects of LSD can be very similar to aspects of psychosis in people, but no one really understands how LSD works other than it changes how serotonin functions in the brain," notes Dr. Nichols.

 

In preliminary studies, Dr. Nichols has shown that, remarkably, both serotonin and hallucinogenic drugs like LSD influence many complex behaviors in the fly directly relevant to those that are abnormal in humans with psychosis and schizophrenia, including aggression, learning and memory, social interaction, and sensory perception.

 

The LSUHSC research team will probe specific regions of rat brains that correspond to key cognitive centers of the human brain using advanced genomic and proteomic methods to identify abnormally functioning genes and proteins. Additional studies will translate these results to the fruit fly, where the functional role of both the native and mutant forms of the fly version of these genes and proteins will be examined in behaviors relevant to psychosis. Genes and proteins that are abnormally turned on or off by LSD in the rat brain, and found to participate in causing relevant behaviors in the fruit fly, may represent novel therapeutic targets for neuropsychiatric disorders.

 

Schizophrenia is a debilitating neuropsychiatric disorder that affects about one out of every 100 Americans, and mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Major mental disorders cost the nation at least $193 billion annually in lost earnings alone, according to a 2008 study funded by the National Institute of Mental Health. The World Health Organization has identified schizophrenia as one of the ten most debilitating diseases affecting human beings. While treatments are improving, there are still people who do not respond or only partially respond.

 

"Our results may lead to new avenues for therapeutics to treat such devastating diseases as schizophrenia and psychosis," says Dr. Nichols.

 

http://www.eurekalert.org/pub_releases/2009-07/lsuh-lnt072009.php

 

[BACK TO TOP]

 


Feds award $1.4M to N.O. professor who gives LSD to rats

New Orleans CityBusiness | 07.20.09

by CityBusiness staff reports

 

NEW ORLEANS - It's about to get trippy in rat land.

 

Dr. Charles Nichols, assistant professor of pharmacology at LSU Health Sciences

 

Center New Orleans, has been awarded a National Institutes of Health grant totaling $1.4 million over four years to discover the genes involved in psychosis and schizophrenia.

 

Nichols' unique approach involves dosing rats and flies with the powerful hallucinogenic drug lysergic acid diethylamid, also known as LSD.

 

"The effects of LSD can be very similar to aspects of psychosis in people, but no one really understands how LSD works other than it changes how serotonin functions in the brain," Nichols said.

 

In preliminary studies, Nichols has shown that serotonin and hallucinogenic drugs like LSD influence many complex behaviors in fruit flies directly relevant to those that are abnormal in humans with psychosis and schizophrenia, including aggression, learning and memory, social interaction and sensory perception.

 

Genes and proteins that are abnormally turned on or off by LSD in the rat brain, and found to cause relevant behaviors in fruit flies, may represent novel therapeutic targets for neuropsychiatric disorders.

 

"Our results may lead to new avenues for therapeutics to treat such devastating diseases as schizophrenia and psychosis," Nichols said.

 

http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=25835

 

[BACK TO TOP]

 


Health-care plan criticized at forum

The Advocate | 07.21.09

By SARAH CHACKO

Advocate Capitol News Bureau

 

                   PATRICK DENNIS/THE ADVOCATE

 

Secretary of Veterans Affairs Eric Shinseki, Labor Secretary Hilda Solis, Agriculture Secretary Tom Vilsack and Health and Human Services Secretary Kathleen Sebelius, from left, answer questions during a ‘Rural Tour’ stop Monday at the Army National Guard Readiness Center in Reserve. The tour is designed to give federal officials insight on the needs of rural communities.

 

RESERVE — The heads of four federal agencies tried to assure Louisiana residents Monday that health-care changes being proposed in the U.S. Congress would lower medical costs, increase access to care and provide jobs.

 

But residents who spoke at a forum said they were concerned about the misuse of government money, unequal coverage and the lack of health-care resources.

 

The forum was part of the Obama administration’s “Rural Tour,” touted as a way for residents of rural communities to weigh in on how best to rebuild and revitalize their areas.

 

The officials — U.S. Human and Health Services Secretary Kathleen Sebelius, Department of Agriculture Secretary Tom Vilsack, Labor Secretary Hilda Solis, and Veterans Affairs Secretary Eric Shinseki — each announced millions of federal stimulus dollars would be coming to the state to help rural areas.

 

“Not one shovel of dirt has turned for a new hospital,” said Marine Corps veteran Robert Lance, of Terrytown, who was referring to the new Veterans Administration Hospital planned to open in New Orleans. “And we need one.”

 

The old hospital closed from hurricane damages in 2005. People in the crowd started yelling “Reopen the hospital.”

 

Shineski said dirt should be moving in the spring, with a new hospital opening in 2013.

 

“We are going to build a hospital that serves the veterans in this area,” he said.

 

Meanwhile, Shinseki said his department is dedicating $250 million in competitive grant funds to improve services for veterans in rural areas.

 

“In 2013, they can come to my grave and tell me the hospital is open,” Lance said after the forum.

 

While the crowd of about 400 clapped for almost all questions and answers, criticisms of the Obama administration’s plan received louder applause.

 

One man, who said he spoke for 50 million aborted babies, asked if the members of Congress were going to be covered by the plans being proposed.

 

Sebelius said the proposals do not dismantle coverage plans, which would include the congressional plan, but give a choice to people who are under-insured or uninsured.

 

“Some people are more equal than others, that’s all,” the man replied.

 

Before the meeting, several people stood outside the meeting with signs that said “Abortion is not health care.”

 

State Rep. Sam Jones, D-Franklin, said the protesters told him they were asked by the Republican Party to attend the forum.

 

“They certainly have the right to do that,” Jones said. “I just hope it didn’t take away from people who really had rural questions to ask.”

 

When asked about the claims that abortion will be a covered medical procedure during a pre-forum news conference, Sebelius said the bills announced by the U.S. House and two Senate committees do not define benefit packages.

 

Those decisions on what would be covered would be left to a separate medical advisory committee, she said.

 

“It’s wise to let science guide what the best health-care package is,” Sebelius said.

 

The administration is looking to expand Medicaid, the government-run health insurance program for the poor, which will initially be paid for with extra federal dollars, Sebelius said.

 

“We know states don’t have a residue of funds,” she said. But states are absorbing tremendous costs with uninsured and unhealthy workers who do not use preventive care, she said.

 

In a pre-forum tele-conference, U.S. Rep. Charles Boustany, R-Lafayette, said nothing substantive in the proposed bill from the House addresses rural health care.

 

He said he is hearing from congressional colleagues that the reimbursement structure for the government option is based on Medicare rates and will stay linked to them.

 

“That currently is already causing access problems because many of our physicians in rural America currently are having trouble meeting cost, and that’s why we are seeing a number of physicians opting not to practice in rural communities,” Boustany said.

 

The federal officials noted that stimulus dollars are expected to help rural areas health-care needs.

 

Sebelius said the state will receive $25 million in federal money for community health centers.

 

Vilsack said the USDA has committed $2.5 billion, which he expects will leverage another $6.5 billion in loan guarantees, the majority of which is mandated to go to rural and underserved areas for broadband. Broadband will allow those areas to offer tele-medicine and distance learning, he said.

 

http://www.2theadvocate.com/news/51271922.html

[BACK TO TOP]

 

 


Gov. Jindal voices health-care concerns using national stage

The Advocate | 07.21.09

Advocate Capitol News Bureau

 

Gov. Bobby Jindal said he scheduled national cable television appearances Monday night and this morning to discuss health-care issues.

 

In his first nationally televised appearance in many months, Jindal appeared Monday night on “The Sean Hannity Show,” which airs on  Fox.

 

Jindal said Monday that he also has appearances today on the morning shows on both CNN and Fox News.

 

In late February, Jindal gave a widely-panned Republican response to a speech by President Barack Obama.

 

Jindal said he put off multiple requests for interviews from the national networks during the legislative session, which began in April. But he is “very concerned about heavier government involvement” in national health care, particularly putting government bureaucracy between the patients and physicians, Jindal said.

 

The president’s health-care plan was a chief topic at the National Governor’s Association summer meeting this year in Biloxi, Miss.

 

Governors of both parties used the three-day meeting held over the weekend to raise concerns about the plan to expand Medicaid. The cost of providing health care under Medicaid for the poor and uninsured is shared by state and federal governments.

 

Jindal did not attend  sessions at the Mississippi Coast Coliseum and Convention Center and the Beau Rivage hotel and casino, roughly two hours from Baton Rouge by car.

 

“We’ve got a lot of work to do here in Louisiana,” Jindal said of his absence.

 

Instead, Jindal said he focused last weekend on his economic development “working tour” of the state and the kickoff of the Louisiana Restaurant Association’s 56th Annual Louisiana Foodservice EXPO in New Orleans.

 

Several of the nation’s more prominent governors — Arnold Schwarzenegger of California, Tim Pawlenty of Minnesota, and Mark Sanford of South Carolina — also skipped the meeting.

 

http://www.2theadvocate.com/news/51270317.html

[BACK TO TOP]

 

 


Democrats call on people to share health care stories with lawmakers

Shreveport Times | 07.21.09

By Melody Brumble

 

Mollie Corbett and Sheila Carrigan find themselves on opposite sides of the health care reform debate.

 

Both women attended a news conference Monday morning in Shreveport put on by Organizing for America, a project of the Democratic National Committee. OFA is encouraging people to press U.S. senators and representatives to support a health care reform bill pending in Congress.

 

Two of three House committees have approved their portions of the bill, while one of two Senate panels have acted.

 

Conservative Democrats have raised objections to some elements of the legislation, and efforts in the Senate to reach a bipartisan agreement have yet to bear fruit.

 

President Obama's attempt to impose an early August deadline on both the House and Senate for passage of legislation is in jeopardy, although administration officials still hope for bills to be passed before an August recess.

 

"We want to focus on how people are personally impacted by health care," said Steven Walker, head of the Louisiana OFA group.

 

Corbett, of Bossier City, and Carrigan, of Shreveport, have received care the government provides to military members, veterans and their families — but that's the only thing they have in common.

 

Corbett believes Tricare, the public-private partnership that provides military health care, demonstrates that a nationwide government-subsidized health insurance program could be effective.

 

"The people outside the military community don't understand this," Corbett said. "They should talk to their military neighbors about this issue."

 

Carrigan said she had bad experiences with the care provided through the military.

 

"My dad died in the VA hospital, and that's government care," Carrigan said.

 

Corbett was among 10 people calling for support of the bill. Carrigan and two others attended the event to express their concerns.

 

Nationally, supporters and opponents of the reform bill are rolling out ad campaigns and speaking about their views as lawmakers wrangle over plan.

 

http://www.shreveporttimes.com/article/20090721/NEWS01/907210313

 

[BACK TO TOP]

 


Jindal blasts Demo health plan

The Times-Picayune | 07.21.09

By Bill Barrow

Staff writer

 

Fresh off a legislative session that he dominated, Republican Gov. Bobby Jindal injected himself Monday into the national discussion on health care, blasting the idea of a public insurance plan pushed by congressional Democrats and the Obama administration.

 

In an online column published at Politico.com, Jindal, widely viewed as a future presidential candidate, repeated many criticisms that Republicans and health insurance executives have leveled at the plans moving through Congress.

 

House Democrats' version, Jindal said, would eventually run private insurance companies out of business, leaving the country with "government-run health care."

 

"The plan . . . is a radical restructuring of health care in America," Jindal wrote. "You may like it, you may not, but it is just that; there is no denying or sugarcoating it."

 

The column marks the 38-year-old governor's reappearance on the national stage after curtailing his visibility for the legislative session and following his widely panned national address in February. Tapped to deliver the GOP's official response to President Barack Obama's first address to Congress, Jindal drew bad marks -- mostly on style, but also on substance -- from both sides of the aisle.

 

Widely traveled since taking office in January 2008, Jindal has appearances on cable news networks scheduled this week, along with a guest op-ed in the Wall Street Journal.

 

Though the Politico column was ostensibly about health care, Jindal used the piece to tout Louisiana and cast a generally negative light on everything coming out of Democratically controlled Washington.

 

"Things in Louisiana are looking up," Jindal wrote. "We are announcing major economic development wins and private capital investment and reducing government spending in order to live within our means. "We trimmed government spending, protected vital services and refused to raise taxes."

 

As for Washington, Jindal criticized the Troubled Asset Relief Program, which passed under the Republican Bush administration, and the subsequent bonuses to CEOs of the program's corporate beneficiaries. He also blasted rising unemployment, the House-passed energy plan, federal intervention in the auto industry and "a nearly trillion-dollar stimulus that has not stimulated."

 

"These actions are all problematic individually, but taken as a whole, they are devastating," Jindal wrote.

 

Jindal did not mention Obama by name, though he did identify less popular Democrats: House Speaker Nancy Pelosi and former Vice President Al Gore.

 

The governor did not note that the budget deal Louisiana lawmakers crafted last month depended on almost $1 billion from the same stimulus bill he criticized in the column. The state has reserved hundreds of millions of dollars more in federal aid to balance the fiscal 2011 budget.

 

The governor also made no mention of the state's $50 million investment of taxpayer money to help reopen a shuttered chicken processing plant in north Louisiana. Jindal has maintained that the deal is not a "bailout" on par with the federal plans for financial institutions and auto makers, because the money is helping a new firm, Foster Farms, purchase and reopen a plant that was to close under its previous operator.

 

Jindal often states that Louisiana's economy has "outperformed" the national economy, and he's taken credit in recent public appearances for creating more than 32,000 "direct and indirect" jobs since taking office in January 2008.

 

Unemployment rolls in Louisiana, as elsewhere, have swelled in recent months during the national recession. The state recorded 59,012 more jobless people in May than when Jindal took office, and the state's unemployment rate has increased from 3.8 percent to 6.6 percent during that time.

 

The national unemployment rate in May was 9.4 percent.

 

http://www.nola.com/news/t-p/capital/index.ssf?/base/news-7/124815365087840.xml&coll=1

 

[BACK TO TOP]

 


Letter: Only fair and just

The Advocate | 07.21.09

Jim Kelly

 

It is only fair and just that when the president and Congress push through the legislation for the new health-care reform to be paid for by the taxpayers that all government employees,        including the president and members of Congress, should give up their current taxpayer-funded health care and be covered by the new and improved health care proposed by President Barack Obama and some Democrats.

 

It is only fair and just.

 

Jim Kelly

electrical engineer

Baton Rouge

 

http://www.2theadvocate.com/opinion/51269457.html

[BACK TO TOP]

 

 


Uninsured locals eagerly awaiting health care reform

WWL-TV | 07.20.09

Susan Edwards / Eyewitness News

 

Watch the video:  http://www.wwltv.com/medical/stories/wwl072009cbhealtchcare.5e4b4e56.html

 

NEW ORLEANS – The debate over health care reform will take the national spotlight this week, with President Barack Obama calling a prime-time news conference Wednesday.

Video: Watch the Story

 

And while many are torn as to which proposal is the right one, many agree thousands of New Orleans' uninsured residents are in dire need of help.

 

"I have a heart murmur, thyroid growths on my ovaries and I have trouble with my legs – but I still go to work," said 55-year old Evelyn Harp.

 

Harp works two jobs, but with health insurance too high, she does not always get the medical treatment she needs.

 

"Sometimes I can afford it, sometimes I can't afford it," she said of doctor visits and medical tests.

 

Harp is hoping that will eventually change.

 

There are several separate health care reform bills up for debate this week in Washington, which aim at an overhaul for the health care system. The goals include delaying the pace of rising medical costs and guaranteeing coverage to Americans like Harp, who would otherwise go uninsured.

 

Dr. Don Erwin, CEO of St. Thomas Community Health Center, said a policy that can provide more access for the low-income population here, is a win.

 

"The death rate for cancer, for heart disease, for diabetes, asthma, teen pregnancy--all of these things are documented to be worse for the patients who are low income by definition of less than 200 percent federal poverty guidelines," he said.

 

Erwin said he believes such results could help recruit more health care professionals to an area that has suffered from a physician shortage – thus, improving the quality of care for many.

 

"In this area, in this city, this state, this would be a boon to the uninsured population," said Erwin.

 

But the ideas up for discussion have as many critics as supporters.

 

"I think you are hearing it from many moderate Democratic House members, many Republican Senators," said Gov. Bobby Jindal. "I do have concerns about this idea about somehow that the government running things will magically make our health care system better."

 

Congressman Steve Scalise, R-New Orleans, is calling for less ambitious changes to the current health care system. He said allowing workers to take insurance plans from job to job, making it easier for people to buy insurance offered in other states, and protecting doctors from frivolous lawsuits are all ways to cut back on costs, while making health insurance more feasible for those who need it most.

 

"A lot of us are strongly opposed to a government takeover of our health care system – especially one that is backed by hundreds of billions of dollars in new taxes on American families and small businesses," he said.

 

If Obama gets to sign a health care overhaul this fall, a timeline of the health care bill shows the uninsured won't be covered until the year 2013.

[BACK TO TOP]

 

 


Lawmaker surprised by Jindal’s veto

The Daily Comet | 07.20.09

Jeremy Alford

Capitol Correspondent

 

BATON ROUGE — State Rep. Dee Richard said it's unusual Gov. Bobby Jindal didn't want to implement an early-retirement program for state workers, especially given the $1.3 billion shortfall facing the state.

 

Richard's House Bill 513, which applies to members of the Louisiana State Employees' Retirement System, known as LASERS, was vetoed last week by Jindal.

 

The program had been on the books for about six years. It was routinely passed into law after being pushed by former Rep. Warren Triche, D-Chackbay, before Richard, a Thibodaux lawmaker with no party affiliation, agreed to take up the cause.

 

In his veto letter, the governor says the program reaches too far.

 

"While I fully support the goal of the bill which adds to existing law allowing for early retirement and the abolition of positions," Jindal states, "I am concerned that the proposed legislation exempts three hospitals but does not include current law's exceptions for critical positions that have a direct impact on patient care or for critical positions that have a direct impact on public safety, such as state troopers."

 

Richard's legislation called for many of the positions vacated through the program to be permanently abolished.

 

According to an analysis conducted by the Legislative Fiscal Office, the potential fiscal impact would have been negligible.

 

"I find it unusual that this is the same law that has been passed for years," Richard said. "I guess they just wanted more control."

 

The way job cuts are being handled during the national recession has become a bone of contention for Jindal and lawmakers.

 

The current budget calls for more than 1,300 state jobs to be eliminated, although only 200 were actually filled with people — meaning more than 1,100 of these targeted positions were vacant.

 

To have more of a say in the process, lawmakers slipped in a last-minute budget amendment directing the administration commissioner "to develop a comprehensive study of the state workforce encompassing each department, agency and program of state."

 

The amendment also called for the commissioner to recommend further reductions to state employment based on the completed study.

 

Since the next regular session of the Legislature won't convene until next year, the administration would have been forced to submit its findings to the Joint Legislative Committee on the Budget by Nov. 1.

 

The governor scuttled those plans by vetoing the line item, sending a clear sign to lawmakers that his office will control those kinds of decisions in coming fiscal years, when more billion-dollar shortfalls are expected.

 

Richard's legislation would have impacted state workers 50 and older with at least 10 years of service. Those taking part in the early retirement program, however, would have faced benefit reductions.

 

It would have also prohibited reestablishing, over a five-year period, more than 10 percent of vacant positions.

 

There were a few exceptions in the bill for agencies protected from the job cuts, like the LSU Health Science Center in Shreveport, E.A. Conway Medical Center in Monroe, Huey P. Long Medical Center in Pineville, and the Department of Public Safety and Corrections.

 

http://www.dailycomet.com/article/20090720/ARTICLES/907209970/-1/NEWS18?Title=Lawmaker-surprised-by-Jindal-s-veto

[BACK TO TOP]

 

 


Hurricane payments stand to affect Medicaid

WXVT-15 | 07.20.09

Associated Press

 

KENNER, La. (AP) - Gov. Bobby Jindal says he hopes to work out a solution with federal officials over Louisiana's looming $1 billion Medicaid problem stemming from post-storm damage payments following hurricanes Katrina and Rita.

 

Medicaid, which serves the poor and uninsured, calculates payment schedules to the states based on per-capita income. That figure goes far beyond wages and salaries - including all payments to all sources.

 

As a result of insurance payments and Road Home money, Louisiana has had a sharp increase in its per-capita income. But Jindal says that doesn't reflect the number of people who need the Medicaid program.

 

Jindal says Louisiana's reimbursement rate will drop from as high as 73% to 60% - forcing cuts to either public health or higher education.

 

http://www.wxvt.com/Global/story.asp?S=10758046&nav=menu1344_2

 

[BACK TO TOP]

 


Obama's Health Care Reform Battle Heats Up

WBZ-TV | 07.21.09

 

WASHINGTON (CBS) President Obama pushed back hard against Republican critics of his health care overhaul plan Monday, vowing to fight "the politics of the moment" but gave ground on his tight timetable for passage of legislation. (File)

 

 President Barack Obama is defending his relentless campaign for a health care bill before Congress's August recess, saying "the default in Washington is inaction and inertia." The Republican Party chairman assailed it as an "excessive push."

 

The fault lines in the debate emerging as Topic A in the capital remained intact Tuesday as Obama defended the deadline, saying the American people want the overhaul done quickly, and GOP Chairman Michael Steele demanded: "Take your time!"

 

At the same time, Obama remained noncommital on a surtax to pay for the overhaul, which some experts have said could cost over $1 trillion in the next several years to reconstitute and incorporate some 46 million uninsured into the system.

 

The president noted in an interview on NBC's "Today" show that "the House has put forward a surtax." And he repeated his feeling that wealthier Americans, "such as myself," should pitch in and help reinvent the system to spread coverage to those now without it.

Obama has said that people making over $250,000 a year should have to pay more, and he defended his insistence on getting a bill from lawmakers before they leave next month on their summer recess. Asked why he felt so strongly about the timeline, he replied, "because if you don't set a deadline in this town, nothing happens."

 

"And the deadline isn't being set by me," he said. "It's being set by the American people."

 

Whatever the pressure points in the argument, Steele said it's all happening too fast.

 

"It took a year and a half for us to create the Medicare system. Now we're going to do the entire health care system in two weeks or six weeks," he said Tuesday on CBS's "The Early Show."

 

"It is urgent and it is indisputable," Steele said. "The problem that I have with it is the rush that is under way here."

 

Obama acknowledged in the interview that lawmakers right now are "not where they need to be." He has invited Democrats on the House Energy and Commerce Committee to a meeting at the White House later Tuesday and he has a primetime news conference scheduled for Wednesday night.

 

Asked about statements some Republicans have made indicating they think health care will damage his standing, Obama replied, "It's typical. ... Somehow people think this is about me. This is all about politics. ... All I can say is, this is absolutely important to me, but this is not as important to me as it is to the people who don't have health care. I've got health care."

 

White House officials admit there is no easy way to pay for the kind of health care the president wants, but they say he'll push hard to get it. As one official told CBS News senior White House correspondent Bill Plante of Obama: "Do you realize how competitive he is?"

 

Without mentioning his critic by name, the president recounted South Carolina Republican Sen. Jim DeMint's comment that stopping Mr. Obama's bid for health care overhaul could be the president's "Waterloo," a reference to the site of Napoleon's bitter defeat in 1815.

 

"This isn't about me," Mr. Obama responded. "This isn't about politics. This is about a health care system that is breaking America's families, breaking America's businesses and breaking America's economy."

 

Striking a more populist tone than in past remarks, the president complained that "health insurance companies and their executives have reaped windfall profits from a broken system."

 

"Let's fight our way through the politics of the moment," Mr. Obama said. "Let's pass reform by the end of this year."

 

That reflects a shift in a timetable he has stressed repeatedly. Mr. Obama had said previously that he wanted the House and Senate to vote on legislation before lawmakers leave town for their August recess, with a comprehensive bill for him to sign in October.

 

"I want this done now. Now, if there are no deadlines, nothing gets done in this town," Mr. Obama told PBS's "The NewsHour." "If somebody comes to me and says 'It's basically done, it's going to spill over by a few days or a week,' you know, that's different."

 

He said too much of the focus has been on what has not been accomplished instead of on a coalition of health companies, professionals and constituents. Later in the day, aides organized a conference call for Obama to speak with liberal bloggers and rally them behind the White House's broad outline for overhaul.

 

"One of the things that I know the blogs are best at is debunking myths that can slip through a lot of the traditional media outlets and a lot of the conventional wisdom," he said, according to audio of the call posted on Web sites. "And that is why you are going to play such an important role in our success in the weeks to come."

 

Steele accused Mr. Obama of conducting a risky experiment that will hurt the economy and force millions to drop their current coverage.

 

"Obama-Pelosi want to start building a colossal, closed health care system where Washington decides. Republicans want and support an open health care system where patients and doctors make the decisions," Steele said in a speech at the National Press Club.

 

Asked whether Mr. Obama's health care plan represented socialism, Steele responded: "Yes. Next question."

 

Mr. Obama has said he does not favor a government-run health care system. Legislation taking shape in the House envisions private insurance companies selling coverage in competition with the government.

 

The president is struggling to advance his trademark health care proposal after a period of evident progress. Two of three House committees have approved their portions of the bill, while one of two Senate panels have acted. A Washington Post-ABC News survey released Monday shows approval of Mr. Obama's handling of health care overhaul slipping below 50 percent for the first time.

 

The president, who spent most of last week making his plea for health care overhaul, was pressing his case hard again this week, first at the children's hospital, and later this week in a prime-time news conference Wednesday and a town hall in Ohio on Thursday. On Tuesday he planned to meet with Democrats on the House Energy and Commerce Committee, the one House committee that hasn't yet acted on the bill.

 

Energy and Commerce members worked into the night Monday, but besides numerous objections raised by Republicans the committee has a bloc of conservative Democrats who've raised objections to some elements of the legislation. However, there were signs Monday that some of their concerns were being addressed. Rep. Bart Stupak, D-Mich., who with other anti-abortion Democrats had threatened to oppose the bill over concerns it would fund abortions, said a compromise was being worked out.

 

As the Energy and Commerce meeting wrapped up after midnight Monday, the panel chairman, Rep. Henry Waxman, D-Calif., announced it would not reconvene until Wednesday. He didn't mention the White House appointment but said he'd been having good discussions with panel members that he wanted to pursue.

 

Meanwhile Pelosi is floating an idea that could make proposed tax increases more palatable to fiscally conservative Democrats. She would like to limit income tax increases to couples making more than $1 million a year and individuals making more than $500,000.

 

The bill passed by the House Ways and Means Committee last week would increase taxes on couples making as little as $350,000 a year and individuals annually making as little as $280,000.

 

"I'd like it to go higher than it is," Pelosi told CBS News partner Politico on Friday.

 

The speaker would like the trigger raised to $500,000 for individuals and $1 million for families, "so it's a millionaire's tax," she said. "When someone hears, '2,' they think, 'Oh, I could be there,' because they don't know the $280,000 is for one person.

 

In the Senate, negotiators seeking a bipartisan compromise reported progress Monday. Finance Committee Chairman Max Baucus, D-Mont., said there's tentative agreement on four big policy issues out of a list of about one dozen. He would not elaborate.

 

Separately, senators are discussing a variation on the idea of taxing high-cost health insurance benefits. The proposal would not raise taxes on individuals and families. Instead, insurers and employers who offer the benefits would pay the tax. Advocates say such a tax would encourage people to be thriftier consumers of health care. Prospects are uncertain.

 

Mr. Obama and Democratic leaders face a new batch of ads.

 

Republican officials said they were supplementing Steele's speech with a round of television advertising designed to oppose government-run health care. The 30-second commercial, titled "Grand Experiment," criticizes recent government aid to the auto industry and banks as "the biggest spending spree in our history" and warns similarly of "a risky experiment with our health care."

 

The U.S. Chamber of Commerce, the nation's largest business group, planned to announce ads of its own Tuesday criticizing the government-run insurance proposal, saying it would threaten employer-provided coverage.

 

R. Bruce Josten, the group's top lobbyist, said the campaign would begin with a $2 million budget and include newspaper and Internet ads, as well as efforts to drum up public support across the country. The ads will appear in Capitol Hill newspapers beginning Tuesday, then in coming days in newspapers in Arkansas, Louisiana, Colorado, Nebraska and other states where lawmakers are wavering.

 

Citing liberal and labor groups that have run ads criticizing Democrats who have not endorsed the health care effort, Josten said, "It's time to push back a little bit."

 

Separately, the insurance industry, which challenged then-President Bill Clinton's health care effort in the early 1990s, launched a $1.4 million ad campaign, its first TV ads of this year's health care fight. The multimillion-dollar campaign, being aired nationally on cable stations, restates the industry's support for an overhaul that provides universal coverage and its offer to cover people who are already sick. The ad campaign does not mention the insurers' strong opposition to creating a government-run insurance option.

 

An official disclosed the cost of the campaign on condition of anonymity, as the numbers have not been made public.

 

http://wbztv.com/national/health.care.reform.2.1094250.html

[BACK TO TOP]

 

 


Obama pushes for health care vote before August recess

The Times-Picayune | 07.21.09

by Erica Werner, The Associated Press

 

                     Ron Edmonds/AP file photo

 

Accompanied by members of Congress and medical professionals, President Barack Obama delivers remarks on health care reform, Wednesday, July 15, 2009, in the Rose Garden of the White House in Washington. Sen. Christopher Dodd, D-Conn., acting chairman of the Senate Health, Education, Labor and Pensions Committee, is second from left.

 

WASHINGTON (AP) -- President Barack Obama continued to insist Tuesday that Congress approve a health care bill before its August recess -- a timetable Republicans see as excessive.

 

The fault lines in the debate remained intact as Obama said the American people want the overhaul done quickly, and Republican Chairman Michael Steele demanded: "Take your time!"

 

The United States is the only developed nation that does not have a comprehensive national health care plan for all its citizens, leaving about 50 million of America's 300 million people without health insurance.

 

Obama has made overhauling health care his top domestic priority and it has become the pivotal issue of his young presidency. But Republicans and even some Democrats have been wary of the costs of hastily prepared legislation.

 

The president acknowledged in an interview broadcast Tuesday on NBC television that lawmakers right now are "not where they need to be." He has invited Democrats on the House Energy and Commerce Committee to a meeting at the White House later Tuesday and he has a news conference scheduled for Wednesday night.

 

Asked why he felt so strongly about the timeline, Obama replied, "because if you don't set a deadline in this town, nothing happens."

 

"And the deadline isn't being set by me," he said. "It's being set by the American people."

 

Steele, the Republican Party leader said it's all happening too fast.

 

"It took a year and a half for us to create the Medicare system," Steele said, referring to the government health care plan for the elderly that was established in the 1960s. "Now we're going to do the entire health care system in two weeks or six weeks."

"It is urgent and it is indisputable," Steele said, speaking Tuesday on CBS television. "The problem that I have with it is the rush that is under way here."

 

Asked about statements some Republicans have made indicating they think health care will damage his standing, Obama, a Democrat, replied, "It's typical. ... Somehow people think this is about me. This is all about politics. ... All I can say is, this is absolutely important to me, but this is not as important to me as it is to the people who don't have health care. I've got health care."

 

A new poll, meanwhile, showed that large numbers of Americans are worried about whether they will have future health coverage, with nearly one in four concerned that family medical bills will drive them into bankruptcy.

 

The survey of 508 people was conducted in June by the nonpartisan Robert Wood Johnson Foundation and had a margin of sampling error of plus or minus 4.4 percentage points.

 

Obama's meeting at the White House with House Energy panel Democrats follows a committee drafting session that lasted past midnight Monday as panel members slogged through numerous amendments, with majority Democrats turning back Republican attempts to change the bill.

 

But Committee Chairman Henry Waxman's bigger difficulties were with his own party, particularly a bloc of fiscally conservative Democrats who oppose the legislation in its current form over costs and other issues.

 

The House bill would, for the first time, require all individuals to have health insurance and all employers to provide it. The poor would get subsidies to buy insurance and insurers would be barred from denying coverage based on pre-existing conditions.

 

Prior to his meeting with the lawmakers Tuesday, Obama planned brief remarks on health care, something that's become a near-daily occurrence as the president has moved swiftly from hands-off to deeply engaged on his top domestic priority.

 

Obama's increased personal involvement comes with Republican criticism sharpening and outside groups growing more strident in the wake of a bleak prognosis from the Congressional Budget Office last week saying lawmakers' health proposals wouldn't hold down costs.

 

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

 

[BACK TO TOP]

 


RNC’s Steele: Obama’s Health Care Plan Akin to Socialism

The Wall Street Journal | 07.20.09

Susan Davis

 

Republican National Committee Chairman Michael Steele today charged that President Barack Obama’s health care plan was akin to socialism and would dramatically hurt the U.S. economy.

 

“Yes. Next question,” Steele quipped when asked by if the president’s plan represents socialism today during a Q-and-A session following a speech on health care at the National Press Club in Washington, D.C.

 

Steele was pressed further on the issue—noting that Republicans in 1965 offered similar apocryphal assessments of the creation of Medicare.

 

“I think that there’s a legitimate debate there about the impact that Medicare and Medicaid are having on the overall fabric of our economy,” he responded. “I think, though, in this case, unlike 1965, the level of spending, the level of government control and intrusion is far greater and much more expansive than anything we’ve ever seen.”

 

He continued: “So I think that what we’re talking about here is something far beyond anything we’ve seen in 1965 or since 1965. This is unprecedented government intrusion into the private sector, period. And you can sweeten that any way you want, but it still tastes bitter. And I think the American people know that.”

 

Steele’s speech comes as Obama and congressional Democratic leaders are working toward completion of a health care overhaul before the August recess. Steele’s speech was highly critical of Democrats, although Republican leaders in Congress have not yet offered a significant alternative. Echoing other GOP leaders, Steele said Democrats are moving to fast to enact such sweeping legislation.

 

“So slow down, Mr. President. We can’t afford to get health care wrong. Your experiment proposes too much, too soon, too fast. Your experiment with our health care could change everything we like about our health care, and our economy as well,” he said.

 

Asked why Republicans haven’t introduced an alternative, Steele responded: “Now, you know, the Republicans can get up tomorrow and introduce its own bill, but you and I know how Washington works. The bill that matters is the one that the leadership puts in place. The Democrats have the leadership.”

 

http://blogs.wsj.com/washwire/2009/07/20/rncs-steele-obamas-health-care-plan-akin-to-socialism/

 

[BACK TO TOP]

 


Considering Longer Chemotherapy

The New York Times | 07.20.09

By ANDREW POLLACK

 

                                                                                                                      Living Arts Enterprises/Photo Reseachers

 

LOOKING INSIDE This X-ray shows a mass in the upper lobe of the right lung. A clinical trial’s results are spurring a move toward maintenance therapy for lung cancer.

 

The newest prognosis for cancer may be longer chemotherapy.

 

Doctors and pharmaceutical companies are moving toward treating cancer patients with drugs continuously, even when they may not urgently need them. That would be a departure from the common practice of stopping treatment when the cancer is under control and resuming it only if the cancer worsens.

 

The strategy is called maintenance therapy — akin to periodic tune-ups aimed at preventing a car from breaking down. Doctors say it could prolong the time tumors are under control, helping to turn cancer into a chronic disease that is kept in check even if it is not cured.

 

While maintenance therapy is not entirely new, its use is growing, in part because some of the newer cancer drugs are more tolerable than the toxic ones of old and can be taken for longer periods.

 

At the recent annual meeting of the American Society of Clinical Oncology, for instance, doctors filled a huge auditorium for a debate on whether it is time to adopt maintenance therapy for lung cancer, the nation’s leading cause of cancer death. Other cancers for which maintenance therapy is being used or tried include ovarian cancer, multiple myeloma and non-Hodgkin’s lymphoma.

 

But some experts say that in many cases, the longer-term use of drugs has not been proved to prolong life.

 

Instead, it may just subject cancer patients to more side effects and tens of thousands of dollars in extra costs. There is also concern that tumors might become resistant to a drug used for a long time.

 

“Generally more is better, in both dose and potentially duration,” said Dr. Susan L. Kelley, chief medical officer of the Multiple Myeloma Research Foundation, which sponsors research on treatments for that disease. However, she said, “there are numerous kinds of cost to the patient, to the health system, to give these drugs over the longer term.”

 

Dr. Lawrence H. Einhorn, a professor at Indiana University, said much of the push for maintenance therapy was coming from pharmaceutical companies, which want their drugs “to be used as early as possible and as long as possible.”

 

And executives of these companies acknowledge that the therapy would mean bigger sales. “This is clearly a game-changing opportunity,” Brian P. Gill, vice president for corporate communications at Celgene, which is testing its drug Revlimid for maintenance treatment of multiple myeloma, told investors at a conference in March.

 

But the executives, and many doctors, say there is a good rationale for maintenance therapy.

 

Although treatment varies with the type of cancer, many patients now receive several initial cycles of chemotherapy. Then, if the cancer goes into remission, or even if the tumor simply stops growing, the therapy is stopped. It is resumed, usually with different drugs, only when the cancer starts worsening again.

 

That strategy evolved in part because the older chemotherapy drugs were so toxic that patients often needed to take a holiday from treatment.

 

“But if you think about it practically, you don’t really want to give the tumor a holiday,” said Colin Goddard, the chief executive of OSI Pharmaceuticals, which is trying to position its lung cancer drug Tarceva for use in maintenance therapy.

 

Some cancer patients welcome, or even demand, maintenance therapy, wanting to keep up the fight against their disease.

 

“I was one of those people who was frightened to stop chemo,” said Barbara Platzer, 71, of St. Louis, who has ovarian cancer.

 

So when her initial six cycles of chemotherapy ended with her cancer in remission, she enrolled in a clinical trial that provided her with 12 monthly maintenance treatments of an experimental drug called Xyotax. The results of the trial are not yet known, but Ms. Platzer’s cancer has remained in remission.

 

But Caryl Castleberry of Glen Ellen, Calif., who also has ovarian cancer, turned down maintenance therapy.

 

“I could hardly wait to be free from treatment, so the extra year they suggested was just not acceptable,” said Ms. Castleberry, 61, whose cancer has nonetheless remained in remission for six years.

 

Dr. Robert L. Coleman, an expert on ovarian cancer at the M. D. Anderson Cancer Center in Houston, said that because relapses tend to be fatal, there has been an urgent effort to prevent or delay them. But over the years, eight maintenance therapies failed in clinical trials.

 

Finally, a study published in 2003 showed that 12 monthly maintenance treatments of paclitaxel, a generic drug whose brand name is Taxol, delayed tumor progression by about seven months as compared with 3 monthly treatments with the same drug. But the difference in survival was not statistically significant, Dr. Coleman said, so there is still some debate about the merits of maintenance therapy for ovarian cancer.

 

For lung cancer, the move to maintenance therapy is being spurred by the results of a clinical trial of the drug Alimta that were presented at the oncology meeting in Orlando, Fla., in late May. Based on that trial, both the Food and Drug Administration and European regulators approved the use of Alimta for maintenance therapy earlier this month.

 

The trial, sponsored by Eli Lilly, which makes Alimta, involved 663 patients with advanced cancer whose tumors had shrunk or remained stable after the customary four cycles of initial chemotherapy. In typical practice, those patients would not be treated again unless their tumors resumed growing.

 

But in the trial, some patients got Alimta immediately after completing the initial, or first-line, chemotherapy. They lived a median of 13.4 months, significantly longer than the 10.6 months for those who got a placebo. And patients with the type of tumor for which Alimta works best lived a median of 15.5 months with maintenance therapy.

 

“This will change the treatment paradigm,” said Dr. Chandra P. Belani, deputy director of the Penn State Hershey Cancer Institute and the lead investigator in the trial.

 

But skeptics said the trial did not directly compare giving Alimta immediately with waiting until the tumor worsened. So it is not clear whether it was just the drug that provided the benefit, rather than the maintenance therapy. Two-thirds of the patients in the placebo group did get second-line therapy when their tumors worsened, but usually not with Alimta.

 

Alimta, also known as pemetrexed, costs about $4,000 per infusion given once every three weeks. Based on data from Lilly’s trials, patients getting the drug as maintenance therapy would receive an average of three more infusions than those getting the drug as second-line therapy.

 

Also, about 30 to 50 percent of lung cancer patients never get second-line chemotherapy, often because their condition worsens too much. So if Alimta were used as maintenance therapy, many more patients would get it.

 

For non-Hodgkin’s lymphoma, the drug used for maintenance is usually Rituxan, or rituximab, which is sold by Genentech and Biogen Idec.

 

A clinical trial showed that maintenance therapy with Rituxan did not help patients with an aggressive form of the disease. But a separate study, published recently in The Journal of Clinical Oncology, showed that it helped those with less aggressive forms of the disease.

 

After three years, cancer had not worsened for 68 percent of those who received the maintenance therapy. That was true for only 33 percent of those who did not receive the therapy. The survival difference was smaller, with 92 percent of those who got the maintenance therapy alive after three years compared with 86 percent of those who did not.

 

“We need more follow-up to see if it will improve overall survival,” said Dr. Thomas M. Habermann of the Mayo Clinic, an author of the study. Nevertheless, many doctors are giving patients maintenance treatment, usually four weekly infusions of Rituxan every six months for two years. That would cost about $30,000 a year.

 

For multiple myeloma, the drug being tried most often for maintenance therapy — Revlimid, or lenalidomide — is already being used for patients with relapses. It costs more than $6,000 a month and is taken as a once-a-day pill, making it particularly convenient for long-term use.

 

Right now it is used for an average of 10 months in the United States; with maintenance therapy that could grow to years, since remissions for multiple myeloma can last that long.

 

Trials are under way, but some doctors are not waiting. “We really need some randomized data to support it, but in the meantime it seems like a good idea,” said Dr. Brian G. M. Durie, chairman of the International Myeloma Foundation, an advocacy and research group that gets some financing from pharmaceutical companies.

 

Kevin, a graduate student with multiple myeloma, says he hoped a stem cell transplant would mark the end of his treatment. So he was taken aback when his doctor suggested taking Revlimid for two years as maintenance therapy as part of a clinical trial. He has been taking it a year so far, with some mild side effects like fatigue and upset stomach.

 

“I’m not enthusiastic about being on a drug like this indefinitely,” said Kevin, who spoke on the condition that his last name not be used because he did not want prospective employers to know about his illness. “But on the other hand, it’s a lot better than relapse.”

 

http://www.nytimes.com/2009/07/21/health/21canc.html?_r=1&ref=health

 

[BACK TO TOP]

 


When Weight Is the Issue, Doctors Struggle Too

The New York Times | 07.20.09

By PERRI KLASS, M.D.

 

The mother came out of the exam room to intercept me: she knew I would probably have to talk to her daughter about how she was gaining weight, she said, but please don’t use the word “fat,” or even “overweight.” Don’t make her feel bad about herself.

 

The girl was about 8, and when I plotted her growth chart, it was clear some balance had shifted over the past year, and her weight was increasing much too fast relative to her height. It was worth talking about.

 

But I was as conscious of my own body as I was of hers. How on earth, I was thinking, am I supposed to give sound nutritional advice when all they have to do is look at me to see that I don’t follow it very well myself? How to reconcile that with her mother’s reasonable request: Don’t make her feel bad about herself? And taking it all together, how am I supposed to help stem the so-called epidemic of childhood obesity when not a week goes by that I don’t break my own resolutions? What price the not-skinny doctor?

 

“The advice we’re supposed to give in pediatric clinic, it boils down to ‘Eat less, exercise more,’ ” said Dr. Julie C. Lumeng, an assistant professor of pediatrics at the University of Michigan Medical School and an expert in childhood obesity. “This is such blasphemy, but when I deliver this advice to families, my heart’s not in it, because I just feel like so often the families are just glazing over, and when that advice is delivered to me, I glaze over, too.”

 

What does it mean when the doctor clearly cannot follow the doctor’s own advice? I asked that question of Dr. David Ludwig, director of the Optimal Weight for Life Program at Children’s Hospital Boston, a multispecialty program for the care of overweight children.

 

“This is an issue that can cut in every possible direction,” he replied. “The doctor who is herself struggling with her weight will have the advantage of personal experience from the patient’s perspective — which may increase compassion and provide other insights that a primary-care practitioner without the problem may not have.

 

“On the other hand,” he continued, “the patient may view a doctor who is substantially overweight or unfit as lacking the basic understanding of the problem to put those principles into effect in his own life.”

 

The drumbeat of concern about childhood obesity has grown louder in recent years, with much new research and more and more clinical trials and interventions. But in the meantime, the children of America have gotten heavier, I have diagnosed Type 2 diabetes in too many of my patients, and I haven’t done any major shrinking myself.

 

We’ve learned more about risk factors. For example, a 2007 study by Dr. Lumeng found that the fewer hours of sleep children got in the third grade, the more likely they were to be obese in the sixth grade, regardless of other family factors. Her current research centers on how mothers’ beliefs about obesity and diet affect their children’s risk of obesity.

 

But Dr. Lumeng has struggled with her own weight — she says she lost 50 pounds in the past year after a gestational diabetes scare — and she understands how hard it is to translate her own beliefs into daily practice. When she gets home from a long day at work, she told me, she knows she really ought to tell her three children to turn off the television and ride their bikes, while she is cooking broccoli and salmon for dinner.

 

“I know it all, I do research in this,” she went on. “But in the moment I’m exhausted, it’s been a long day at work, everyone’s sort of irritable. You can know what you need to do, but when the moment comes ... .”

 

I could make the admittedly self-serving argument that it’s easier to find common cause with your patients when you understand their frailties. Talking to an adolescent who is experimenting with drugs, or a parent who is smoking around a young child, I can easily take on the paternalistic resonance of moral rectitude: How can you possibly persist in this destructive, dangerous behavior, now that I have told you how destructive and dangerous it is?

 

On the other hand, you could argue that when the doctor gives advice she obviously finds difficult to follow, there’s an underlying — and undermining — complicit wink: Now that I’ve told you about healthy eating, let’s have a cookie together — we’ll change our habits tomorrow!

 

In the end, Dr. Lumeng is left with the same advice that made her glaze over: “I’ve had patients who say to me, ‘Wow, doctor, you’ve really lost weight — how did you do it?’ And I have to say, ‘Well, I exercise more and I eat less!’ ”

 

Back in the exam room, with that 8-year-old, I took some early and unsure steps toward discussing the topic. I showed her her growth chart, on the pink (for girls) graph paper. See, I said, you’re growing — you’re getting taller, and you’re adding muscle to your body as you grow. But we need to give you time to get taller before you add more weight.

 

And we talked nutrition (cut back on sweet drinks, fast food, eating in front of the TV), and we talked exercise (how about tap dancing, soccer, swimming lessons?).

 

And finally I looked the mother in the eye and said, without planning to say it, “If this were easy, I would be thin and fit.”

 

http://www.nytimes.com/2009/07/21/health/21klas.html?ref=health

[BACK TO TOP]

 

 

 

Subscribe

Archives

Newsletter

 

 

Please email questions and comments to lsuhospitals@lsuhsc.edu.