HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Saturday, October 11, 2008

Oklahoma Is Sued Over Required Ultrasounds for Abortions

The New York Times reports that an advocacy group is suing over an Oklahoma law that prohibits a woman from having an abortion unless she first has an ultrasound and the doctor describes to her what the fetus looks like.  The New York Times writes,

Gavel3In the lawsuit filed Thursday in Oklahoma County District Court, the Center for Reproductive Rights says that the requirement intrudes on privacy, endangers health and assaults dignity.

The law, set to go into effect on Nov. 1, would make Oklahoma the fourth state to require that ultrasounds be performed before a woman can have an abortion and that the ultrasounds be made available to the patient for viewing, according to the Guttmacher Institute, a health research organization based in Washington. The other states are Alabama, Louisiana and Mississippi.

Backers of the lawsuit say Oklahoma is the only state to require that the ultrasound screen be turned toward the woman during the procedure and that the doctor describe what is on the screen, including various dimensions of the fetus.

Elizabeth Nash, public policy associate with the Guttmacher Institute, said the Oklahoma law appeared unique in that its intent was that the woman seeking an abortion view the ultrasound images.

Lawmakers overrode Gov. Brad Henry’s veto to pass the anti-abortion legislation in April. Mr. Henry, a Democrat, said he vetoed the bill because it did not exempt victims of rape or incest from the ultrasound requirement.

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October 11, 2008 | Permalink | Comments (0) | TrackBack (0)

Cancer Vaccine Used by 25% of Girls 13 to 17

The New York Times reports that one in four teenage girls have received the relatively new vaccine against cervical cancer, Gardasil, according to federal health officials.  The New York Times writes,

Gardasil_vaccineThe figures represent the government’s first substantial study of vaccination rates for the vaccine, Gardasil, which is Merck & Company’s heavily advertised three-shot series that goes after the sexually transmitted human papillomavirus, or HPV. The vaccine protects against strains of the virus that cause about 70 percent of cervical cancers.

Health officials recommend that girls get the shots when they are 11 or 12, if possible, before they become sexually active. Also, 11 is the age when children are generally due for a round of vaccinations.

The survey covered children only from 13 to 17.

Proponents of the vaccine had been hoping for much higher vaccination rates, saying the shots could significantly reduce the nearly 4,000 cervical cancer deaths that occur each year in the United States.

Patti E. Gravitt, a Johns Hopkins University associate professor of epidemiology, said many families were cautious about the safety of new vaccines.

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October 11, 2008 | Permalink | Comments (0) | TrackBack (0)

Friday, October 10, 2008

Law Equalizes Coverage For Mental, Physical Care

The Washington Post reports that an estimated 113 million Americans, including hundreds of thousands in the Washington region, will receive better insurance coverage for their mental health and substance abuse problems because of landmark legislation that for the first time requires mental and physical illnesses to be treated equally.  Chris L. Jenkins writes,

Gavel4The law is a culmination of a decade of lobbying and negotiating among advocates for the mentally ill, the insurance industry, the business community -- including the U.S. Chamber of Commerce -- and doctors' groups. The change, which was included in the economic rescue package signed by President Bush last week, will take effect Jan. 1, 2010, for most plans. Businesses with 50 or fewer employees would be exempt.

For decades, insurance companies could offer less coverage for the treatment of depression, anxiety and bipolar disorder than of such diseases as cancer and diabetes -- so people with mental illness or substance abuse problems often had to pay for expensive treatment and medication out-of-pocket.

The new law bars companies from setting higher co-pays or deductibles for mental health and substance abuse treatment. Plans also will be prohibited from lowering benefit levels or restricting the number of outpatient therapy sessions or hospital treatment days. And if a health plan allows out-of-network visits for the treatment of physical illnesses, it will also have to offer identical out-of-network coverage for mental health care.

Advocates and experts said the change represents a fundamental shift in how the mentally ill are treated and could bring medical parity to tens of millions of people.

"This is absolutely milestone legislation for those people who have mental health and substance abuse problems," said Doug Walter, counsel for legislative and regulatory affairs at the American Psychological Association. "It ends the discrimination against people who have long needed the help."

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October 10, 2008 | Permalink | Comments (0) | TrackBack (0)

John McCain and Barack Obama on Healthcare

The Los Angeles Times discusses the presidential candidates' health reform plans.  Susan Brink writes,

Health_reform_plans_wwwlatimescomJohn McCain and Barack Obama's health reform plans are different both in their approaches to solving problems and their potential effects on voters. But to choose wisely, you have to do some homework. To help, we offer a guide to online resources that analyze how well the candidates' proposals might work.

John McCain would . . .
Eliminate current tax exclusion for employer-paid health insurance.

Provide refundable tax credits of $2,500 for individuals or $5,000 for families, for everyone who obtains private health insurance -- employed or not. If insurance costs less than the value of the credit, the remaining funds could be deposited in a health savings account.

Provide a variety of insurance choices, national and across state lines, that would not be dependent on a job.
Work with state governors to increase insurance pools for people uninsurable on the individual market.

Deregulate insurance markets, allowing insurers to sell across state lines. People could buy less costly, less comprehensive policies in states with fewer mandates.

Pass medical malpractice reform.

For more details, see McCain's full healthcare plan.

Barack Obama would . . .

Require employers (some small businesses would be exempt or subsidized) to either offer health insurance to employees or pay a tax that would be used to help uninsured people get insurance.

Provide subsidies for low-income Americans to help them afford coverage.

Create a new national health plan, similar to Medicare, for the uninsured and small businesses.

Require that all children have health insurance.

Regulate private insurance plans to end risk-rating based on health status -- a system that can render people like cancer survivors or diabetes patients uninsurable.

Establish a federal reinsurance program to protect businesses against the costs of workers' expensive medical episodes.

For more, details see Obama's full healthcare plan.

October 10, 2008 | Permalink | Comments (0) | TrackBack (0)

Thursday, October 9, 2008

F.D.A. Says Cancer Test Failed to Get Its Approval

The New York Times reports that the FDA has told the Laboratory Corporation of America that it is illegally marketing OvaSure, a blood test to detect ovarian cancer.  Andrew Pollack writes,

Stethescope6The test, introduced in June, has raised hopes among women and their doctors because it promises to detect ovarian cancer at an early stage, when it is still treatable.

But some outside experts, including the Society of Gynecologic Oncologists, have said the test had not been proved accurate and might cause women to have unnecessary surgeries to remove their ovaries. The F.D.A. itself, in a previous letter to LabCorp, said the test “may harm the public health.”

In its new letter, which was sent Sept. 29, the F.D.A. said the test, called OvaSure, required agency approval before it could be marketed.

Typically, the agency has not regulated tests that are developed and performed by a single laboratory, as opposed to test kits that are sold to hospitals, laboratories and doctors. But the F.D.A. said that OvaSure did not qualify for this exemption because the test was developed at Yale University, not at LabCorp, and the materials for the test were not manufactured by LabCorp.

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October 9, 2008 | Permalink | Comments (0) | TrackBack (0)

Financial Crisis May Increase Mental Health Woes

The Washington Post reports on the World Health Organization's warning that the global financial crisis is likely to cause increased mental health problems and even suicides as people struggle to cope with poverty and unemployment.  Stephanie Nebehay writes,

Medicare_3Hundreds of millions of people worldwide are already affected by mental problems such as depression and bi-polar disorders and the current market meltdown could exacerbate feelings of despair among people vulnerable to such illnesses.

The United Nations agency said the impact could be especially marked for those living in low and middle income countries where access to treatment is often limited.

"We should not be surprised or underestimate the turbulence and likely consequences of the current financial crisis. As it is we are seeing a huge gap in taking care of people in great need," WHO director general Margaret Chan told a meeting of mental health experts.

Poverty and its associated stresses including violence, social exclusion and "constant insecurity" are linked to the onset of mental disorders, she said.

"It should not come as a surprise that we continue to see more stresses, suicides and mental disorders," Chan warned.

Chan denounced the "abysmal lack of care" for some mental health patients, especially in low and middle income countries, home to three out of four sufferers. Governments must make mental health a vital part of primary health care, she said.

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October 9, 2008 | Permalink | Comments (2) | TrackBack (0)

Wednesday, October 8, 2008

Congress Vows $100 Million to Red Cross After It Asks for Aid

The Washington Post reports that Congress will give the American Red Cross $100 million in emergency funding to replenish its disaster relief reserves, which were depleted as the charity plunged into debt to provide shelter, food and other services during a string of hurricanes this summer.  Philip Rucker writes,

American_red_cross_2In an unusual move, the Red Cross asked Congress for $150 million last month. The nonprofit organization, which operates largely on private donations, last turned to the federal government for help in responding to disasters in 2004, when it received $70 million in federal aid after four hurricanes hit Florida. Some critics say that by seeking federal assistance, it risks blurring its status as an independent charity.

Congress appropriated $100 million last week for the Red Cross, to be distributed through the Department of Homeland Security. Although Congress did not meet the full request for $150 million, Red Cross officials said they are relieved to receive any federal aid, considering both chambers have been grappling with upheaval in the financial markets.

Red Cross President Gail J. McGovern said she "crawled around on my hands and knees begging" on Capitol Hill for federal aid. She said senators and representatives thanked her in meetings for the Red Cross's response to the latest hurricanes.

"I really was stunned with how pleased Congress was with how we were performing, particularly in the post-Katrina world," McGovern said.

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October 8, 2008 | Permalink | Comments (0) | TrackBack (0)

Small Type and Large Loopholes in New Labeling Laws

The New York Times reports on the new labeling laws that will give retailers until March 30 to label the country of origin for different fruits and meats.  Marian Burros writes,

FruitsAFTER six years of political skirmishing, labeling laws that are supposed to tell shoppers whether their tomatoes, apples or chicken are homegrown or imported have taken effect.

The new law gives retailers until March 30 to label the country of origin for foods including fruits, vegetables, beef, lamb, chicken, goat meat, ginseng, peanuts, pecans and macadamia nuts. Until now, only seafood has been subject to the labeling rule.

Some proponents say the labels will help consumers avoid products from countries like China, where food safety has been a problem.

But an inspection of how seafood is sold in many New York stores suggests that the law contains a significant loophole that, when coupled with a lack of resources for enforcement, raises questions about how great an effect the rules have.

Any stores that sell less than $230,000 worth of fresh and frozen fruits and vegetables are not required to label imports.

That immediately eliminates all fish markets as well as butcher shops, of which there are a considerable number in New York City. It also eliminates small grocery stores.

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October 8, 2008 | Permalink | Comments (0) | TrackBack (0)

Tuesday, October 7, 2008

Food Stamp Participation Increases as Economy Lags

The Washington Post reports that latest federal statistics indicate that participation in the low-income nutrition supplement program has risen sharply, highlighting economic troubles.  Michael E. Ruane writes,

Food_stampsAlmost a million more people participated in the federal government's food stamp program for the needy between April and July, according to the U.S. Department of Agriculture, which oversees the program.

The latest federal statistics indicate that nationally, participation in the low-income nutrition supplement program rose from 28.08 million in April to 29.05 million in July, the last month for which the figures are available, a department spokeswoman said.

The July figure is the highest since the all-time peak of 29.8 million in November 2005, in the wake of Hurricanes Katrina and Rita, spokeswoman Jean Daniel said.

She said the current national numbers probably reflect economic troubles, such as the spring flooding in the Midwest, that were at work in the early summer and spring. There often is a delay of a few months after a crisis before people sign up for the program.

"From a historical perspective, it's usually a lag time of two to three months," she said.

Experts said yesterday that the figures also reflect the broader national economic distress.

"The economic downturn is the obvious reason that most people are turning to the food stamps program at this point," said Colleen M. Heflin, an assistant professor at the Truman School of Public Affairs at the University of Missouri. "I think it's a much better barometer of the pain on Main Street than the larger economic barometers."

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October 7, 2008 | Permalink | Comments (0) | TrackBack (0)

Supreme Court Seeks Consultation on Food Labeling Law

The Los Angeles Times reports that the U.S. Supreme Court asked the Justice Department on Monday for advice on a bid by the nation's largest grocery chains to block customers from suing over violations of government food-labeling rules.  The Los Angeles Times writes,

Gavel4Supermarkets led by Supervalu Inc., Safeway Inc. and Kroger Co. contend that only government regulators, and not customers, can enforce federal and state labeling laws. The companies are seeking to stop a suit accusing them of concealing that salmon they sold contained artificial coloring. The California Supreme Court cleared the customer suit to go forward.

In their appeal, the supermarkets said the California court ruling was "an open invitation to private plaintiffs nationwide to bring class actions."

The high court's request, directed to U.S. Solicitor Gen. Gregory Garre, signals that the justices may add the case to their 2008-09 docket.

The central question for the court in the new case is whether the Food, Drug and Cosmetic Act, which governs food labeling at the federal level, bars private efforts to enforce similar state laws.

October 7, 2008 | Permalink | Comments (1) | TrackBack (0)

Monday, October 6, 2008

Bailout Provides More Mental Health Coverage

The New York Times reports that more than one-third of all Americans will soon receive better insurance coverage for mental health treatments because of a new law that, for the first time, requires equal coverage of mental and physical illnesses.  Robert Pear writes,

Stethescope3The requirement, included in the economic bailout bill that President Bush signed on Friday, is the result of 12 years of passionate advocacy by friends and relatives of people with mental illness and addiction disorders. They described the new law as a milestone in the quest for civil rights, an effort to end insurance discrimination and to reduce the stigma of mental illness.

Most employers and group health plans provide less coverage for mental health care than for the treatment of physical conditions like cancer, heart disease or broken bones. They will need to adjust their benefits to comply with the new law, which requires equivalence, or parity, in the coverage.

For decades, insurers have set higher co-payments and deductibles and stricter limits on treatment for addiction and mental illnesses.

By wiping away such restrictions, doctors said, the new law will make it easier for people to obtain treatment for a wide range of conditions, including depression, autism, schizophrenia, eating disorders and alcohol and drug abuse.

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October 6, 2008 | Permalink | Comments (1) | TrackBack (0)

Infertility Patients Caught in the Legal, Moral and Scientific Embryo Debate

The Los Angeles Times reports that an estimated 500,000 embryos are in cryopreservation in the US, showcasing the debate about what to do with unused embryos and the ambiguity of when life actually begins.  Shari Roan writes,

Embryo_debate_wwwlatimesSix years of frustration and heartbreak. That's how Gina Rathan recalls her attempts to become pregnant.

Finally, she and her husband, Cheddi, conceived a daughter, now 3, through in vitro fertilization. About a year later, she became pregnant with a second child, naturally. Their family was complete.
Then, a year ago, the Fountain Valley couple received a bill reminding them that their infertility journey wasn't quite over. They owed $750 to preserve three frozen embryos they'd created but hadn't used.

"I don't see them as not being life yet," says Gina Rathan, 42, a pharmaceutical sales representative. "I thought, 'How can I discard them when I have a beautiful child from that IVF cycle?' "

Many other former infertility patients also appear to be grappling over the fate of embryos they have no plans to use: An estimated 500,000 embryos are in cryopreservation in the United States.
As with the Rathans, this unexpected conundrum often arises well after the infertility crisis has passed, triggering impassioned and highly personal debates about the science and ethics of human life. The discussion boils down to a fundamental question: What is this icy clump of cells smaller than a grain of sand?

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October 6, 2008 | Permalink | Comments (0) | TrackBack (0)

Sunday, October 5, 2008

EPA Makes No Rule On Chemical in Water

The Washington Post reports that the EPA has refused to set a drinking-water safety standard for perhclorate, finding that in 99% of public drinking water systems, perchlorate was not at levels of public health concern.  Juliet Eilperin writes,

Drinking_waterThe Environmental Protection Agency formally refused yesterday to set a drinking-water safety standard for perchlorate, a chemical in rocket fuel that has been linked to thyroid problems in pregnant women, newborns and young children.

With little fanfare, the agency issued a news release yesterday afternoon saying that it had "conducted extensive review of scientific data related to the health effects of exposure to perchlorate from drinking water and other sources and found that in more than 99 percent of public drinking water systems, perchlorate was not at levels of public health concern. Therefore, based on the Safe Water Drinking Act criteria, the agency determined there is not a 'meaningful opportunity for health risk reduction' through a national drinking water regulation."

Last month, The Washington Post reported that White House officials had extensively edited the EPA's perchlorate rule-making documentation to remove scientific data highlighting some of the risks associated with the chemical, which has been found in water in 35 states. The Defense Department and Pentagon contractors who face legal liability stemming from rocket fuel contamination have lobbied for six years to avoid a federal drinking-water standard for perchlorate.

In the document released yesterday, the EPA assumes that the maximum safe perchlorate contamination level is 15 times higher than what the agency suggested in 2002.

By that standard, the EPA estimates that more than 16 million Americans are exposed to the chemical at a level that is unsafe.

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October 5, 2008 | Permalink | Comments (1) | TrackBack (0)

Largest study of US children to begin in January

The Washington Post reports that the largest study of U.S. children ever performed, aiming to track 100,000 from conception to age 21, will start recruiting mothers-to-be in North Carolina and New York in January.  The Washington Post reports,

Stethescope6The ambitious National Children's Study aims to learn how the environment and other factors affect youngsters' health, especially development of such conditions as autism, asthma, learning disabilities, diabetes and obesity. Scientists will examine a range of factors, from the diets of pregnant women and young children to the effects of chemicals used in plastics.

Tight budgets from Congress have delayed the project, which in 2004 began selecting 105 locations where women and their children can participate.

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October 5, 2008 | Permalink | Comments (0) | TrackBack (0)