NEW ORLEANS – The nation's top veterans affairs chief
said on Monday the new VA Hospital is closer to reality than some people
That's despite the
numerous delays and state struggles over who will control the adjoining
replacement for CharityHospital.
Eric Shinseki, the
secretary of Veterans Affairs, spoke to Eyewitness News exclusively about the
future of the massive downtown project.
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," answeredShinseki 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.
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
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?
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.”
cost-saving of doing a duel model is important to the VA?
absolutely. First, we get it right because we will be affiliated with two
great medical schools, Tulane and LSU," Shinseki said.
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 VeteransResourceCenter
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.
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
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.
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.
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.
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.
may lead to new avenues for therapeutics to treat such devastating diseases
as schizophrenia and psychosis," says Dr. Nichols.
NEW ORLEANS - It's about to get trippy in rat land.
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.
approach involves dosing rats and flies with the powerful hallucinogenic drug
lysergic acid diethylamid, also known as LSD.
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.
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.
may lead to new avenues for therapeutics to treat such devastating diseases
as schizophrenia and psychosis," Nichols said.
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
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 VeteransAdministrationHospital planned to open in New Orleans. “And we
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.
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
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
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.
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
Those decisions on
what would be covered would be left to a separate medical advisory committee,
“It’s wise to let
science guide what the best health-care package is,” Sebelius
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,
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
“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.
officials noted that stimulus dollars are expected to help rural areas
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.
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 onFox.
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
health-care plan was a chief topic at the National Governor’s Association
summer meeting this year in Biloxi,
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
Jindal did not attendsessions 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.
Mollie Corbett and
Sheila Carrigan find themselves on opposite sides
of the health care reform debate.
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
senators and representatives to support a health care reform bill pending in
Two of three House
committees have approved their portions of the bill, while one of two Senate
panels have acted.
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.
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
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.
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
Corbett was among
10 people calling for support of the bill. Carrigan
and two others attended the event to express their concerns.
supporters and opponents of the reform bill are rolling out ad campaigns and
speaking about their views as lawmakers wrangle over plan.
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
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.
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.
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
"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."
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.
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.
unemployment rate in May was 9.4 percent.
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
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.
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
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.
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.
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.
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.
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.
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.
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."
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
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.
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.
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
There were a few
exceptions in the bill for agencies protected from the job cuts, like the LSUHealthScienceCenter
in Shreveport, E.A.ConwayMedicalCenter in Monroe, Huey P. Long Medical Center in
Pineville, and the Department of Public Safety and Corrections.
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
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
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
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.
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,
deadline isn't being set by me," he said. "It's being set by the American
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."
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.
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."
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?"
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.
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
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."
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
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.
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.
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.
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
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.
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
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
"I'd like it
to go higher than it is," Pelosi told CBS News partner Politico on
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
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.
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
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."
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.
disclosed the cost of the campaign on condition of anonymity, as the numbers
have not been made public.
Accompanied by members of Congress and medical
professionals, President Barack Obama delivers remarks on health care reform,
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
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.
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
Asked why he felt
so strongly about the timeline, Obama replied, "because if you don't set
a deadline in this town, nothing happens."
deadline isn't being set by me," he said. "It's being set by 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
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
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
Obama's meeting at
the White House with House Energy panel Democrats follows a committee
drafting session that lasted past
Monday as panel members slogged through numerous amendments, with majority
Democrats turning back Republican attempts to change the bill.
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
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.
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.
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.
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,
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.”
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
“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.
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.”
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.
prognosis for cancer may be longer chemotherapy.
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.
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
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
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.
executives, and many doctors, say there is a good rationale for maintenance
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.
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.
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.AndersonCancerCenter
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
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.
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.
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
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.”
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
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
“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.”