Saturday, May 21, 2005
Mexicans Go To Arizona for Medical Help
(USA Today, May 17, 2005)
"Along the border from Chula Vista, Calif., to Brownsville, Texas, U.S. hospitals serve as a medical safety net for undocumented immigrants and residents of northern Mexico. Each year, their care costs American medical centers, consumers and taxpayers hundreds of millions of dollars...After years of pressure from the health care industry, the federal government last week announced a plan to repay hospitals across the USA for up to 30 percent of the unpaid bills they rack up for such patients from now through 2008."
The action took the form of a "final guidance" published by CMS indicating that it would start making payments to hospitals out of the $1 billion that was authorized by the 2003 Medicare reform law (§ 1011, Pub. Law No. 108-173). See also CMS' "Section 1011 Page." [tm]
Preparing for the Inevitable:
Bioterriosm and Emerging Infectious Diseases
June 9th, 2005
8:30 AM-12:30 PM
Member Room, Jefferson Building
Library of Congress
Washington, DC 8:30 - 9:00 a.m. Continental Breakfast
8:30 - 9:00 a.m. Continental Breakfast
9:00 – 9:45 a.m. Session I - Unfinished Business: Facing the Dual Threat of Bioterrorism and Emerging Infectious Disease Senator Lieberman and Representative Cox
9:45-10:00 a.m. Coffee Break
10:00 -11:45 a.m Session II Countermeasures and Responses to Bioterror and Emerging Infectious Diseases: Realistic Assessment of National Preparedness and Next Steps
Assessment of Preparedness, Realistic Scenarios: Attack, Outbreak, Response, Quarantine and Isolation, Hard Choices. Randall Murch, Associate Director for Research Program Development, Virginia Tech Expert Panel Discussion: Preparedness and Response: Where are we? Where do we need to go? How do we get there? Moderator: Tara O’Toole, MD, MPH, President and CEO, Center for Biosecurity,University of Pittsburgh
Expert Panel Discussion: Preparedness and Response: Where are we? Where do we need to go? How do we get there? Moderator: Tara O’Toole, MD, MPH, President and CEO, Center for Biosecurity,University of Pittsburgh
Panel: George Poste, D.V.M., Ph.D., Director, Arizona Biodesign Institute, Arizona State University; Richard Falkenrath, PhD, Visiting Fellow, Brooking Institution; former Deputy Homeland Security Advisor and Deputy Assistant to the President; Michael McDonald, Dr..P..H., President, Global Health Initiatives; Elin A. Gursky, Sc.D., Principal Deputy for Biodefense, National Strategies Support Directorate
ANSER; James G. Hodge, Jr., J.D., LL.M., Associate Professor, Johns Hopkins Bloomberg School of Public Health and Executive Director, Center for Law and the Public’s Health; Randall Murch, Associate Director for Research Program Development, Virginia Tech
11:45 A.M. - 12:30 P.M. Session III – Preparing for the Inevitable: a New Paradigm
for Security and Health Senator Barr and Senator Clinton
Summary and Conclusions: Ambassador Cynthia P. Schneider PhD., Pfizer Medical Humanities Scholar in Residence, Distinguished Professor in the Practice of Diplomacy, Public Policy Institute and School of Foreign Service, Georgetown University
12:30 p.m. Adjourn
RSVP by June 6th [email protected]
Co-Sponsors: Public Policy Institute, Georgetown University
Center for Law & The Public's Health at
Georgetown and Johns Hopkins University
Virginia Tech, Office of the National Capital Region
Center for Biosecurity, University of Pittsburgh Medical Center
Friday, May 20, 2005
Rebecca J. Cook, Professor and Faculty Chair in International Human Rights, and Co-Director of the International Programme on Reproductive and Sexual Health Law in the Faculty of Law at the University of Toronto.University of Toronto, has written a new article entitled, "Exploring Fairness in Health Care Reform" that appears in the Journal for Juridical Science, Vol. 29, No. 3, pp. 1-27, 2004. The abstract follows: This article considers the increasing challenge of the fair allocation of scarce public health care resources by focusing on services for women and girls. It considers different ways of thinking about fairness in health care reform, the role of courts in promoting fairness, and the use of affirmative action measures to remedy health disparities. The health of individuals and populations is shown to be affected by clinical services, the organization and functioning of health systems, and underlying socio-economic determinants. Different theories of justice are addressed that affect assessments of fairness, considering availability, accessibility, acceptability of and accountability for services. The transition in judicial dispositions is traced, from deference to governmental resource allocation decisions to evidence-based scrutiny of governmental observance of constitutional and human rights legal obligations. The appropriate use of affirmative action measures to improve equality in health status is explored, given the increasingly unacceptable disparities in health among subgroups of women within countries. The full article is available here. [bm]
Rebecca J. Cook, Professor and Faculty Chair in International Human Rights, and Co-Director of the International Programme on Reproductive and Sexual Health Law in the Faculty of Law at the University of Toronto.University of Toronto, has written a new article entitled, "Exploring Fairness in Health Care Reform" that appears in the Journal for Juridical Science, Vol. 29, No. 3, pp. 1-27, 2004. The abstract follows:
This article considers the increasing challenge of the fair allocation of scarce public health care resources by focusing on services for women and girls. It considers different ways of thinking about fairness in health care reform, the role of courts in promoting fairness, and the use of affirmative action measures to remedy health disparities. The health of individuals and populations is shown to be affected by clinical services, the organization and functioning of health systems, and underlying socio-economic determinants. Different theories of justice are addressed that affect assessments of fairness, considering availability, accessibility, acceptability of and accountability for services. The transition in judicial dispositions is traced, from deference to governmental resource allocation decisions to evidence-based scrutiny of governmental observance of constitutional and human rights legal obligations.
The appropriate use of affirmative action measures to improve equality in health status is explored, given the increasingly unacceptable disparities in health among subgroups of women within countries.
The full article is available here. [bm]
As many of you are probably aware, specialty hospitals have been a subject of dispute over the past year. As the eighteen-month moratorium on physician referrals to such hospitals in which they have an owership interest sets to expire, we see new a proposal to make such a moratorium permanent for future specialty hospitals. Last week on May 11, 2005, Senators Grassley and Baucus introduced legislation that would prohibit physicians from referring Medicare and Medicaid patients to new speciality hospitals in which they hold an ownership interest. According to the brief summary provided by the American Health Lawyers Association,
The Hospital Fair Competition Act of 2005 would essentially exclude specialty hospitals from the "whole hospital" exemption in the Stark physician self-referral law. Opponents of specialty hospitals have argued that these types of limited service facilities are more akin to a whole hospital subdivision than a whole hospital and therefore should fall outside the protection of the whole hospital exemption. . . .
The permanent ban in the bill would not apply to hospitals already in operation or under development before November 18, 2003. These "grandfathered" specialty hospitals would, however, be subject to certain restrictions on increasing their number of physician investors and expanding their scope of services, according to a summary of the bill.
For text of the legislation, please click here. [bm]
Thursday, May 19, 2005
While all eyes have been turned to North Korea and the nuclear weapons that country may or may not have - South Korea has been working on developing something a little different. According to the New York Times, South Korea has advanced the process for future human cloning. The article states,
In what scientists say is a stunning leap forward, a team of South Korean researchers has developed a highly efficient recipe for producing human embryos by cloning and then extracting their stem cells.
Writing today in the journal Science, they report that they used their method to produce 11 human stem cells lines that are genetic matches of patients aged 2 to 56.
Previously, the same group, led by Dr. Woo Suk Hwang and Dr. Shin Yong Moon of Seoul National University, produced a single stem cell line from a cloned embryo, but the process was so onerous that scientists said it was not worth trying to repeat it, and some doubted the South Koreans' report was even correct. Now things have changed.
"It is a tremendous advance," said Dr. Leonard Zon, a stem cell researcher at Harvard Medical School and president of the International Society for Stem Cell Research, who was not involved in the research.
The method, called therapeutic cloning, is one of the great hopes of the stem cell field. It produces stem cells, universal cells that are extracted from embryos, killing the embryos in the process, and, in theory, can be directed to grow into any of the body's cell types. And since the stem cells come from embryos that are clones of individuals, they should be exact genetic matches. Scientists want to obtain such stem cells from patients to study the origin of diseases and to develop replacement cells that would be identical to ones a patient has lost.
. . . . .
But not everyone is excited.
Dr. Leon Kass, chairman of the President's Council on Bioethics, said in an e-mail message that "whatever its technical merit, this research is morally troubling: it creates human embryos solely for research, makes it much easier to produce cloned babies, and exploits women as egg donors not for their benefit. "
The United States Conference of Catholic Bishops shares those concerns, said Richard Doerflinger, director of pro-life activities there. He added that he also worried that a cloned baby might be next.
"Up until now, people were beginning to wonder whether human cloning for any purpose was feasible at all," Mr. Doerflinger said. "This development makes it feasible enough to be a clear and present danger."
Yikes! I am not sure whether to be excited or scared by these developments. [bm]
David Plotz has written a short editorial in the New York Times concerning the FDA's recent regulations concerning sperm donors. He finds that not only are such regulations unnecessary, they miss what he believes to be the real issue that arises with sperm donation and that is anonymity.
. . . . New F.D.A. safety and screening standards for sperm banks, which take effect next Wednesday, include strict requirements for testing and retesting donors for H.I.V. But the F.D.A. has also published an accompanying "guidance" document advising banks to bar as donors men who have had sex with other men in the last five years, on the grounds that these men are at high risk for H.I.V. Though the guidance doesn't carry the force of regulation, many sperm banks have indicated that they will follow it. Gay groups including the Lambda Legal Defense and Education Fund and Human Rights Campaign have protested, but so far in vain.
This is a case of government trying to solve a problem that no longer exists - because the free market already solved it. . . .
With its late and largely unnecessary obsession with sperm safety, the government is missing the real issue in the sperm bank world: donor anonymity. Thousands of Americans are born every year without the right to know who their father is.
The editorial raises some interesting issues not only about how to regulate sperm banks in the most effective and nondiscriminatory manner, but also concerning anonymity and whether pscyhologically it is harmful not to know one's genetic parents. [bm]
Wednesday, May 18, 2005
Cheating doesn't pay and some people never learn are two thoughts that come to mind when reading the following story. The New York Times reports today on the $76.5 million that Staten Island University Hospital has agreed to pay in settlement of fraud claims that Attorney General Eliot Spitzer had been investigating against the hospital. He will not be bringing criminal prosecutions against the hospital executives. According to the Times,
This is the second time in seven years that the hospital, the largest on Staten Island, has been investigated and fined for improperly billing Medicaid, the state's health care program for the poor. In September 1999, the hospital agreed to repay New York Medicaid $45 million and provide $39 million in free care for indigent patients, for bills it had improperly submitted in a separate scheme.
But even as that settlement was being negotiated, the hospital's executives were knowingly embarking on a new plan to profit illegally from Medicaid, according to a criminal complaint against the hospital to be released today by Attorney General Eliot L. Spitzer's office. And though the hospital's own lawyers warned the executives to stop, the illegal billing continued unabated, the complaint says.
Hospital executives and lawyers also repeatedly lied to State Department of Health regulators, as well as investigators in the Medicaid Fraud Control Unit in the state attorney general's office, trying to cover up the scheme, the complaint says.
"The magnitude and the depth of this fraud, and the willingness of the leadership there to tolerate it, was unusual," Mr. Spitzer said yesterday in an interview.
The entire article is an interesting read - if I turned these facts into an exam question, my students would not believe it. Thanks to Jim Tomaszewski for the update. [bm]
In this week's, Journal of the American Medical Association (subscription required), Larry Gostin, Professor of Law; Associate Dean (Research and Academic Programs); Director, Center for the Law and Public's Health, has an interesting article addressing the aftermath of the Terri Schiavo case. In the article, entitled, "Ethics, the Constitution, and the Dying Process: The Case of Theresa Marie Schiavo, he provides some ideas on how we can best address the many competing concerns that arise when individuals make end of life decisions. He concludes the article by stating, "If political leaders were truly committed to a culture of life they would pursue humanistic policies to dignify the manner in which people live and die." [bm]
Tuesday, May 17, 2005
Dream no more, apparently someone has developed a computer program that can actually grade student essay exams!! Ok, I admit this sounds too good to be true -- but at the same time as I look over my many student exams, there is something rather attractive about it as well. From the article,
Student essays always seem to be riddled with the same sorts of flaws. So sociology professor Ed Brent decided to hand the work off - to a computer.
Students in Brent's Introduction to Sociology course at the University of Missouri-Columbia now submit drafts through the SAGrader software he designed. It counts the number of points he wanted his students to include and analyzes how well concepts are explained.
And within seconds, students have a score.
It used to be the students who looked for shortcuts, shopping for papers online or pilfering parts of an assignment with a simple Google search. Now, teachers and professors are realizing that they, too, can tap technology for a facet of academia long reserved for a teacher alone with a red pen.
Of course, there are those who are a bit skeptical of this new techology. See Majikthise for more on this new grading program. [bm]
An article in today's Science section of the New York Times discusssing Elisabeth Lloyd's new study demonstrating the female orgasm doesn't really serve any evolutionary function provides an interesting read. According to the article,
Evolutionary scientists have never had difficulty explaining the male orgasm, closely tied as it is to reproduction.
But the Darwinian logic behind the female orgasm has remained elusive. Women can have sexual intercourse and even become pregnant - doing their part for the perpetuation of the species - without experiencing orgasm. So what is its evolutionary purpose?
Over the last four decades, scientists have come up with a variety of theories, arguing, for example, that orgasm encourages women to have sex and, therefore, reproduce or that it leads women to favor stronger and healthier men, maximizing their offspring's chances of survival.
But in a new book, Dr. Elisabeth A. Lloyd, a philosopher of science and professor of biology at Indiana University, takes on 20 leading theories and finds them wanting. The female orgasm, she argues in the book, "The Case of the Female Orgasm: Bias in the Science of Evolution," has no evolutionary function at all. . . . . .
The female orgasm, she said, "is for fun."
Wow! No wonder people are attacking Darwin and his theory of evolution --- women have sex for fun!! Certainly this is more controversial than our close genetic relationship with primates. [bm]
Monday, May 16, 2005
The Supreme Court has agreed to review two cases, United States v. Georgia, 04-1203, and Goodman v. Georgia, 04-1236, concerning whether states and counties can be sued under the Americans with Disabilities Act for not accommodating disabled prisoners. The Washington Post has a full discussion of the cases. [bm]
Sunday, May 15, 2005
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May 15, 2005 | Permalink
As you probably know by now, Dr. W. David Hager, member of the FDA's Reproductive Health Drugs Advisory Committee, received a not too flattering write-up in The Nation this past week. The article raises a number of issues about Dr. Hager and his work at the FDA, perhaps most importantly Dr. Hager's explanation (allegedly religious rather than scientific) for his decision to refuse over the counter status for 'Plan B' a form of emergency contraception. The article is a rather eye-opening read. NPR ran a story concerning Dr. Hager and noted that Senators Murray and Clinton were asking for further explanation of his Plan B vote. Effect Measure has further information. [bm]