February 5, 2005
FDA Hints at Approval for Implant to Treat Depression
Wow! The New York Times reports on a new device called the VNS Pulse 102 manufactured by Cyberonics. The VNS Pulse 102 may be approved by the FDA as a form of therapy for chronic depression that is resistant to other treatmentsapparently treats depression. The Times describes the device as follows:
"The device, which is called the VNS Pulse 102 and is the size of a pocket watch, is implanted in the upper chest and connected via thin wires to the vagus nerves in the neck. It sends pulses through the nerves into parts of the brain associated with the diseases being treated.
'It's sort of a pacemaker for the brain," said Dr. Peter Whybrow, an expert on depression at the University of California, Los Angeles.'"
I am not clear on whether this same technology may be used in modified forms to treat other mental disabilities but it is interesting to see alternatives to the current medications that are usually prescribed. [bm]
February 4, 2005
Horwitz Appointed NBER Faculty Research Fellow
I am not moonlighting as Michigan Law School's director of publicity, but their publicity operation is doing a great job getting out word of the school's activities, and here's another that is worthy of note. Assistant Professor Jill Horwitz has recently been appointed a faculty research fellow with the National Bureau of Economic Research. According to the press release, Prof. Horwitz' research and teaching interests include health law, nonprofit corporations, empirical research methods, law and economics, and torts. [tm]
News of the Truly Amazing
Some advances in science and health are hard to believe. The NewScienctist.com reports that Dr. Vardi, chief of the neurological unit at Rambam, a professor of urology at the Technion Israel Institute of Science, and head of the Armon Center for Sexual Dysfunction, has discovered a method to measure libido. In a story on the same development, Israeli21C states,
"Now, for the first time, an Israeli-developed test can scientifically determine the level of a person's libido. The method - developed by a team led by Prof. Yoram Vardi of Rambam Hospital in Haifa - can enable medical professionals to determine the root cause of diminished sexual desire, and whether medication or treatment is being effective.
'What we've developed is a test that objectively measures the subject's amount of interest in sex - it rates their libido,' Vardi told ISRAEL21c. , , , ,
His study was designed to provide preliminary data on the use of brain waves for objectively quantifying the level of interest in sexual content. Twenty two healthy volunteer subjects with normal sexual function participated in this study (11 females and 11 males, with a mean age of 26.8 years).
'Our methodology is not a new one. We produced brain waves by giving auditory stimuli and measure them through electrodes placed on the head. We then examine the p300 waves - these are brain waves that are delayed by 300 milliseconds.'"
Well, this should prove to be interesting. I cannot wait to see the advertisements for this service. [bm]
Thanks to the website MrSun.us for the references.
No More Scooter Store Commericals
Tired of those Scooter Store commercials? Did you ever wonder when you watched them whether they could possibly really mean that Medicare would cover a scooter for individuals who still seemed perfectly capable of walking on their own? Well, wonder no more because the Center for Medicare and Medicaid Services (CMS) has announced new proposed guidelines for motorized scooters purchases under Medicare. According to the CMS news release
"Medicare’s proposed coverage criteria would rely on clinical guidance for evaluating whether a beneficiary needs a device to assist with mobility, and if so, what type of device is needed. This new approach would replace an older, more rigid standard that relied on whether a patient was “nonambulatory” or “bed or chair confined.” The analysis begins with whether the beneficiary has a mobility limitation that prevents him or her from performing one or more mobility-related activities of daily living in the home. This evaluation includes consideration of whether or not an assistive device – whether a simple cane or a sophisticated power wheelchair or anything in between ‑ would improve the beneficiary’s ability to function within the home. The criteria also take into account any conditions, such as visual or mental impairment, that would affect the beneficiary’s ability to use the mobility equipment effectively."
The CMS release states that the new guidelines continue to protect Medicare coverage and payment for power wheelcairs and scooters, while also protecting Medicare and taxpayers from abuse. Mmmmm - I don't think that we will be seeing quite the same Scooter Store commercials in the future. [bm]
Thanks to Jim Tomaszewski for the link!
February 3, 2005
State of the Union - Brief Health Care Summary
Well, the President's speech was long on social security reform but did also contain some information about his view of health care. This extended beyond his call for tort reform. His big proposal of the evening involved the consumer-driven Health Savings Accounts. (See our blog - January 31, 2005) for more information on these accounts). To address the problem of the high number of uninsured and the increasing cost of health insurance, the President proposed Health Savings Accounts as well as Association Health Plans for small businesses, civic groups, and community organizations. In addition, he discussed the possibility of tax credits for low-income families. He did mention medical liability reform, and also discussed a goal of electronic health records for most Americans within 10 years. I will keep you updated as I learn about the Democratic response to the President's health proposals. [bm]
Antitrust Suit against SmithKline Beecham
Yesterday, plaintiff class action lawyers filed for attorney's fees of over $19 million after they reached a proposed settlement with SmithKline Beecham in a suit concerning antitrust violations. SmithKline Beecham has agreed to pay $65 million to settle the antitrust suit brought by consumers who alleged they paid inflated prices for Paxil, an anti-depressant drug. In the suit, plaintiffs lawyers had alleged that SmithKline attempted to monopolize the Paxil market by filing "sham" patent litigation against two genetic drug manufacturers, Apotex Inc. and TorPharm Inc., after the generic manufacturers notified SmithKline that they were seeking approval from the Food & Drug Administration to copy Paxil. According to the court records, each filing of a patent suit delays any generic version of a drug from reaching the market for an additional 30 months.
Update on the Uninsured and Bankruptcy (III)
Here's the link to the article on the Health Affairs web site: http://content.healthaffairs.org/cgi/content/abstract/hlthaff.w5.63. It's possible you will only have access to the abstract, unless you are a subscriber. [tm]
February 2, 2005
Update on the Uninsured and Bankruptcy
As an update to Tom's post about the New York Times piece discussing Elizabeth Warren's article, here is a link to the National Public Radio story concerning that article. http://www.npr.org/templates/story/story.php?storyId=4475013. [bm] .
State of the Union
Here is the State of the Union address - in case you either cannot or will not watch it. He actually has said quite a bit about health care and health care reform so you might want to take a quick peek. He discussed briefly some health care reform proposals right around 9:20pm eastern time (if that is helpful for your scrolling to find them). If you don't want to watch the rest of the speech - there is always Duke v. Wake Forest! [bm]
Even the Insured Run Risk of Bankruptcy Due to High Health Bills
The NY Times reports today on an article in Health Affairs by Harvard Law School's Elizabeth Warren and others on the relationship between health care costs and bankruptcy. The upshot: "About 30 percent of people said they filed for bankruptcy because of an illness or injury, even though most of them had health insurance when they first got sick." I'll provide a link to the on-line abstract as soon as it is available. [tm]
February 1, 2005
Interested in Privacy and Security Issues
A new blog run by Hughes and Luce called privacyspot.com provides information concerning current privacy law and data protection topics. If you are working to comply with the April deadline for HIPAA security, you may want to see if it contains any helpful information. [bm]
Outsourcing Health Care . . .
The Guardian has an interesting article on a new form of tourism involving people traveling overseas for a variety of health-related reasons. No, it isn't travel to the luxury spa for relaxation treatments, it is much more. The article relates the story of George Marshall, who bypasses the wait in Britain for a heart bypass operation for an immediate operation in India. The article reports,
"Three months ago George Marshall fretted about the choice offered by his doctor in Britain. Diagnosed with coronary heart disease, the violin repairer from Bradford was told he could either wait up to six months for a heart bypass operation on the National Health Service or pay £19,000 to go under the scalpel immediately.
In the end, Mr Marshall chose to outsource his operation to India. Last month he flew 5,000 miles to the southern Indian city of Bangalore where surgeons at the Wockhardt hospital and heart institute took a piece of vein from his arm to repair the thinning arteries of his heart. The cost was £4,800, including the flight.
"Everyone's been really great here. I have been in the NHS and gone private in Britain in the past, but I can say that the care and facilities in India are easily comparable," says Mr Marshall, sitting in hospital-blue pyjamas. "I'd have no problem coming again."
The article reports that India hopes to build up a big business by providing health care to others along with tourist packages. It is an interesting read. Thanks to the washingtonmonthly.com for the link.[bm]
Public Health Abstracts or Panels Wanted
I am posting an e-mail I received about an opportunity to share any of your recent public health research or papers:
Dear Health Law Forum members and friends,
There are only 8 days left to submit an abstract or a panel to the Health Law Forum for the 2005 American Public Health Association Annual Meeting. The Annual Meeting will take place November 5-9, 2005, in New Orleans. Topics for individual abstracts and panel discussions may include Bioterrorism and Emergency Preparedness; Human Rights and Public Health; Obesity Law and Policy; Patient Safety & Professional Liability; Pharmaceutical Regulation; Public Insurance (Medicare, Medicaid, sCHIP); Research Law Policy & Ethics (including HIPAA); and Vaccines and the Flu Pandemic. Details about the call for papers and a link to the abstract submission forms can be found at http://apha.confex.com/apha/133am/hlf.htm.
For more information, please contact:
Program Chair, APHA Health Law Forum
Washington Post Article on Tax-Exempts' Billing & Collection Practices
Ceci Connolly had a longish Page 1 story in the January 29 Washington Post on tax-exempt hospitals - their finances, their billing and collection practices, and the 46 lawsuits in 22 states (not counting copycat suits filed in various state and federal courts) that challenge the hospitals' prices and charity care policies.
The article draws the battle lines early. Lead plaintiffs' lawyer Richard Scruggs claims the hospitals hassle uninsured people who cannot pay fulled bill charges in the hope that those patients won't ever come back. Connolly also mentions that defendant hospitals include "a California hospital with $1 million in an offshore bank account, another in Louisiana that owns a luxury hotel and health clubs, and a Georgia hospital that flew its executives on private jets to meetings in the Cayman Islands and Florida's Amelia Island."
On the hospitals' side, AHA spokesmen say that nonprofit hospitals are exceedingly generous when it comes to the amount of free care they provide and that the problem with hospital bills and the squeeze felt by the uninsured is a societal problem, not a local one that can be adequately addressed through individual lawsuits.
Late in the article, Ms. Connolly attempts to describe the complex relationship among full billed charges, government and health-plan discounts, charity care, bad-debt write-offs, and the tax benefit of exempt status.
As a review of the big issues in these cases, as well as the legal developments, it's a good article. [tm]
January 31, 2005
Health Savings Accounts Are on Their Way
According to an article in today's LATimes, the administration is planning to move swiftly to approve more Health Savings Accounts (HSAs) and put an end to the current employer-provider health insurance model. The LATimes reports,
"Emboldened by their success at the polls, the Bush administration and Republican leaders in Congress believe they have a new opportunity to move the nation away from the system of employer-provided health insurance that has covered most working Americans for the last half-century.
In its place, they want to erect a system in which workers — instead of looking to employers for health insurance — would take personal responsibility for protecting themselves and their families: They would buy high-deductible "catastrophic" insurance policies to cover major medical needs, then pay routine costs with money set aside in tax-sheltered health savings accounts."
The article provides a good introductory overview to HSAs and some of the pros and cons of the growing push to switch to this form of insurance for all Americans. I am not a fan of the accounts and wasn't aware that they had become so popular with certain segments of society. The LATimes states that the adminstration is farther along in its planning for HSAs than it is on social security reform so we may be seeing proposals for change in the near future. [bm]
109th Congress Health Issues
The AMNews has a brief overview of some of what are expected to be the big health law topics in the 109th Congress. Of course, tort reform is at the top of the agenda for many lawmakers, as well as medicare and medicaid reforms and potential cut-backs. [bm]
CMS' Final Rules for Drug Benefit and Medicare Advantage Published in Fed. Reg.
Friday's Federal Register contains two important final rules from the Centers for Medicare and Medicaid Services:
- Medicare Advantage, the successor to the late and unlamented Medicare+Choice program, 70 Fed. Reg. 4587–4741 (HTML) (PDF)
- Medicare Prescription Drug Benefit, 70 Fed. Reg. 4193–4585 (HTML) (PDF)
January 30, 2005
U of Mich Law School Opens Pediatric Advocacy Clinic
The University of Michigan Law School recently announced the creation of The Pediatric Advocacy Clinic. The clinic offers students the opportunity to work with medical professionals to help low-income families with legal issues, including:
• Applying for food stamps or cash assistance.
• Litigating against landlords of substandard housing that cause health problems.
• Providing referrals and representation for victims of domestic violence.
• Navigating the special education system to ensure children receive legally required services.
The school says that the clinic is "one of the first known law school-connected, medical-legal collaborative clinics of its kind in the nation—offers advice and representation to those in need." The clinic is the result of a collaboration between the law school's clinical assistant professor Anne Schroth and associate dean for clinical affairs Bridget McCormack, as well as between the law school and the Michigan Poverty Law Program, the U-M Ypsilanti Health Center, and the U-M C. S. Mott Children's Hospital. [tm]