HealthLawProf Blog

Editor: Katharine Van Tassel
Akron Univ. School of Law

A Member of the Law Professor Blogs Network

Thursday, March 19, 2009

COBRA Revised

D  Wreck at DailyKos helpfully provides a brief overview of some of the recent changes in COBRA.  It might come in handy when discussing such lovely revisions with your health law class.  The author writes,

    There are nearly 48 million Americans without medical insurance.  Since September 2008, 3.3 million      jobs have been lost.  For the newly unemployed, COBRA provides an opportunity to maintain                 insurance coverage while out of work.  But the cost of COBRA can be staggering, especially in a              household running on limited income.

    In an effort to stem the growth of the uninsured during this recession, the American Recovery and             Reinvestment Act (ARRA) provides up to 9 months of reduced COBRA premiums for workers who are     involuntarily terminated from employment between September 1, 2008, and December 31, 2009. . . .

D Wreck then reviews some of the important provisions, including:

    ARRA provides for a 65% reduction in premium costs for certain COBRA eligible workers for up to nine     months.  Workers who are involuntarily terminated from their employment between September 1, 2008,     and December 31, 2009, are eligible for these reduced premiums.

    Eligible individuals who elect COBRA coverage will pay 35% of the normal COBRA premium.  The         Kaiser Family Foundation 2008 Health Benefits Survey pegs the average single rate at nearly $400 per     month, with family coverage averaging over $1,000 per month.  A 65% reduction equates to an average     savings between $2,340 and $5,850 over a 9 month period. . . .

There is more on the webiste.  I need to so some more reading myself but it does give a person a good starting place.

March 19, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, March 18, 2009

Medical Malpractice Reform

The Wall Street Journal's Health Blog notes a potential stumbling block on the road to health reform - medical malpractice reform.  Sarah Rubenstein writes,

The issue of medical malpractice lawsuits is among the touchiest in the debate over rising health-care costs. Doctors are burdened by the high cost of malpractice insurance and say they’re forced to practice “defensive” medicine, while lawyers say the suits are a check in the system meant to protect patients. The debate has been relatively quiet in recent months, but it’s now rising to the surface, Politico reports

Trial lawyers plan to distribute a 29-page research document saying the suits aren’t behind the rising cost of care, Politico says. Meantime, the American Medical Association is saying it can’t see how a health-reform bill would control costs without tort-reform measures in it. . . .

President Obama and other Democrats are signaling they’re open to some changes, though the details aren’t clear. Take a look at a perspective piece that Obama co-wrote with Hillary Clinton a few years ago in the New England Journal of Medicine. Their recommendation: “Instead of focusing on the few areas of intense disagreement, such as the possibility of mandating caps on the financial damages awarded to patients, we believe that the discussion should center on a more fundamental issue: the need to improve patient safety.” . . .

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

The House's Health Care Reform Team

The New York Times' Robert Pear discusses the working group in the House of Representatives that is quietly working to build a consensus around a health reform proposal.  He writes,

Three powerful House committee chairmen have agreed to work together on legislation to overhaul the health care system, starting with the view that most employers should help finance coverage and that the government should offer a public health insurance plan as an alternative to private insurance.  . . . 

The three chairmen, George Miller and Henry A. Waxman of California and Charles B. Rangel of New York, all Democrats, have a combined total of more than 100 years of service in the House.  Mr. Miller, chairman of the Education and Labor Committee, which has jurisdiction over employee benefits, said the three lawmakers had decided to “try and work as one committee to produce a comprehensive health care bill this summer.  In a letter to President Obama, the chairmen said, “Our intention is to bring similar legislation before our committees.”  Mr. Waxman, chairman of the Energy and Commerce Committee, said, “We intend to work from a single bill, and have that bill considered by the House before the August recess.”  The Senate committee chairmen responsible for health legislation, Max Baucus of Montana and Edward M. Kennedy of Massachusetts, both Democrats, have outlined a similar schedule.

Such agreements, while no guarantee of success, could help build momentum for a bill. A united front could make it harder for lobbyists to derail legislation. White House officials welcomed the prospect of cooperation by House leaders, saying it increased the chances of passing a bill to expand coverage this year, a top priority for Mr. Obama. . . .

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

LATCRIT Annual Conference: Call for Papers and Panels

CALL FOR PAPERS & PANELS

OUTSIDERS INSIDE:  CRITICAL OUTSIDER THEORY AND PRAXIS IN THE POLICYMAKING OF THE NEW AMERICAN REGIME

American University-Washington College of Law

Washington, D.C.

October 1 - 4, 2009

Please join us at LatCrit XIV, the Fourteenth Annual LatCrit (Latina and Latino Critical Legal Theory, Inc.) Conference, which will take place in Washington, D.C., from Thursday, October 1 through Sunday, October 4, 2009.

LatCrit/SALT Junior Faculty Development Workshop

The Seventh Annual Junior Faculty Development Workshop, sponsored jointly with the Society of American Law Teachers (SALT), will begin at 9:00 am, Thursday, October 1st and continue through Friday morning.

LATCRIT XIV THEME

OUTSIDERS INSIDE:  CRITICAL OUTSIDER THEORY AND

PRAXIS IN THE POLICYMAKING OF THE NEW AMERICAN REGIME

In October 2009, LatCrit will meet inside the Beltway for the first time in its history amidst a tectonic shift in American government.  With the January inauguration of President Barack H. Obama, the nation’s first “outsider” president, we also saw the ascendance of a new progressive governance philosophy in Washington.  As a biracial former law professor with working class and immigrant roots and an international and multicultural upbringing, Mr. Obama ran a progressive campaign that echoed many core LatCritical values, including internationalism and global-mindedness, the valorization of human rights and multidimensional diversity, the centrality of antidiscrimination work, a commitment to rigorous interrogation of longstanding dominant assumptions and norms, and a preference for discourse and dialogue over militarism.  Notably, President Obama’s Yes We Can! campaign slogan has its roots in the ¡Si Se Puede! rallying cry coined by Dolores Huerta of the United Farm Workers movement and invoked in more recent progressive and mostly Latino/a political actions.

The new Presidential administration and enlarged bicameral Democratic majority in Congress account only for part of the historic paradigmatic transition in American national government.  The ongoing deterioration of the American and world economies also has catalyzed an aggressive reassessment by moderate and even some conservative thinkers of the wisdom of the Reagan Revolution’s uber alles dependency on the private marketplace for the realization of the public good – an antiregulatory disposition that dominated federal government through the last seven presidential administrations.  In the United States, the failure of the government’s dominant antiregulatory disposition to prevent the ensuing economic meltdown has catalyzed a new, aggressive Federal response in the form of much more statist economic interventions, including the de facto nationalization of key economic components. To add irony, it was the administration of President George W. Bush – the loudest in exalting the power of unbridled private marketplaces to regulate themselves – that laid the foundation for the national takeover of large sectors of the financial services and banking industries.

These quantum changes in the leadership and driving philosophies of American government present unique and in some cases unprecedented opportunities for scholars engaged in critical outsider scholarship to influence and inform national policy and legislation. The new executive and legislative branch incumbents have telegraphed early receptivity to the instantiation of LatCritical and other progressive theories and principles in the tangible products of Federal government (i.e., legislation, regulation, presidential directives, and, of course, caselaw). As President Obama’s aspirational campaign continues to transition into the nouveau regime at the helm of the most powerful government on Earth, millions of Americans expect the vague Yes We Can promise to become the Yes We Are reality. 

 

But with these openings come potential pitfalls.  Although the ascendance of a putatively progressive president and likeminded Congressional majority indeed may open up new opportunities to bridge the theory/praxis chasm, it also may pose serious challenges to the independence and even legitimacy of progressive critical theory movements. Should the cooption or even distortion of conservative theory by militaristic, extremist partisan politicos serve as a cautionary tale in the formation of new relationships between the progressive government and outsider critical theorists? More specifically, what if the first year in office of the Yes We Can presidential candidate unfolds into more of a No We Won’t disappointment?  What if the exigencies of governing to and from the middle – which many pundits insist is the sine qua non for reelection viability – result in the sacrificing of Obama’s progressive promise?  What roles should outsider critical legal scholars and their scholarship assume then? More generally, what should the incarnation of progressive theory in the new American regime look like? And what prevents that theory from being co-opted and corrupted by the corroding influences of insider power?

 

The LatCrit XIV Host Committee invites the submission of proposals for panels and papers related to this open-textured theme and encompassing the fullest array of theoretical and doctrinal topics and approaches.  Because we will be in Washington, DC, we encourage the submission of paper and panel proposals propounding prescriptive critiques of discrete areas of law, policy and regulation of specific relevance to outsider communities, including (but by no means limited to) economic justice, international and comparative law, criminal law and the death penalty, civil rights and constitutional law (including gender and LGBT equality, reproductive and disability rights), feminist legal theory, immigration, political and electoral (dis)enfranchisement, communications policy and intellectual property, healthcare, education, employment, tax policy, and the environment.  We also, of course, welcome proposals for more theoretical panels and papers, particularly (but not exclusively) in areas linked to the challenges posed by progressive governance and the ascendance of outsiders to positions of ultimate authority. 

 

Please submit your panel and paper proposals through the online process at the LatCrit website (www.law.du.edu/latcrit/index.htm) no later than MONDAY, APRIL 27, 2009.  Please note that although paper proposals for work-in-progress sessions may be submitted now, we will continue to accept those proposals through mid-July (please refer to LatCrit website for forthcoming additional details).   

Continue reading

March 18, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 17, 2009

AIDS in Washington DC

The Washington Post reports on the AIDS epidemic in Washington, DC and notes that the spread of AIDS is most likely more widespread than current surveys show.  Darryl Fears and Jose Antonio Vargas write,

A report showing that 3 percent of D.C. residents are infected with HIV or AIDS is probably an undercount, and the prevalence of the disease is probably worse than is known, according to Shannon L. Hader, director of the city's HIV/AIDS Administration.  Hader said the city will work harder to administer testing, which is key to knowing the true number of residents with HIV and to diagnosing the illness before it develops into AIDS.   "These are people who are diagnosed and alive in our city," Hader said. "If you're not getting tested . . . we don't have a way of making you part of the response."

Mayor Adrian M. Fenty officially released the report at a news conference yesterday in Ward 7, one of several wards where the prevalence of HIV and AIDS is high. He called it a wake-up call for the District and one of the "most serious problems" facing the city. The report confirmed for the first time that at least 15,120 residents -- about 3,000 per every 100,000 over the age of 12 -- have HIV or AIDS.  The mayor also released a study on heterosexual behavior by George Washington University's School of Public Health and Health Services saying that residents in parts of the city with the highest AIDS prevalence and poverty rates engaged in sexually risky behavior that fuels the spread of the disease. . . .

The Centers for Disease Control and Prevention reported that the District is one of the top three jurisdictions in the country in conducting the most HIV tests and identifying the greatest number of HIV-infected residents. . . .   But, Hader said, "it's not the whole story." The report counted residents who were tested and had HIV and AIDS diagnosed, but not residents who had HIV but don't know it. . . .

Continue reading

March 17, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, March 16, 2009

Regulating Medical Tourism

BNA's Health Law Reports has an interesting article on the increasing popularity of Medical Tourism and the need to address the risks posed by such medicine.  Thom Wilder writes,

While medical tourism continues to become a tremendous growth industry as U.S. patients seek cheaper medical care abroad, it poses several possible risk and legal factors that must be addressed not only by patients, but also providers in both countries, experts in the field said Feb. 27.  In 2007, nearly 750,000 Americans engaged in medical tourism—defined as travel across international borders for the express purpose of receiving medical care—a number expected to swell to 6 million by 2010, representing $16 billion to $19 billion in expenditures, said J. Mark Waxman, a partner with Foley & Lardner LLP, Boston, during a BNA teleconference, titled, “Medical Tourism: From Idea to Implementation.’’

This growth has been fueled not only by the uninsured and underinsured seeking less expensive options for surgical care, but also by employers seeking to drive down costs by seeking health care in places such as India, Turkey, Dubai, and approximately 30 other countries, . . . .    These foreign medical centers—essentially promising world-class care at Third-World prices—are more cost-effective for several reasons, including lower facility construction costs and time, lower labor costs, an absence of legacy systems, very low medical malpractice and liability costs, and a corporate culture that is “better, faster, cheaper, and hungrier’’ than in the United States, according to Helfrick.  Most of that care has focused on elective procedures such as orthopedics (hip replacement, knee replacement, and spinal surgery), cardiovascular surgery (bypass surgery, valve replacements), cancer diagnosis and management, cosmetic surgery, and bariatric surgeries, Helfrick said. Dentistry also has risen in prominence in recent years, Waxman noted. . . .
In the end, it is all about money, Waxman said. For example, while heart bypass surgery in the United States can cost between $70,000 and $133,000, the same surgery would cost an average of $22,000 in Thailand and an average of $7,000 in India, Waxman said. The figures Waxman cited are from Patients Beyond Borders, a book on medical tourism authored by Josef Woodman, president of the Healthy Travel Media Co. (see chart).  But cost is not the only factor involved in deciding to seek care abroad, Dagi said. Part of this growth is a “real or perceived’’ lack of services available in the United States, or limitations imposed on care by payers or regulatory agencies, Dagi said. . . .
Dagi agreed, noting that while medical tourism is a legitimate choice, it does carry risks. Most of the medical centers abroad being sought out by Americans are “world-class facilities,’’ he said, but prospective patients must exercise some diligence in choosing where they seek treatment as not all foreign medical centers meet U.S. standards. In some instances there is variability and differences in training of medical and allied health professionals, in standards for medical institutions, and in interpretation of test results and indications for treatment, he said.
Other risks include a lack of follow-up and support networks, differences in physician/patient communication practices exacerbated by language and cultural barriers, accuracy and completeness of medical records, and possible exposure to endemic diseases, Dagi said . . . .

March 16, 2009 | Permalink | Comments (0) | TrackBack (0)

Sunday, March 15, 2009

Physicians Respond to Wyeth Ruling

AmNews has a brief story discussing physicians' responses to the Supreme Court's recent ruling in Wyeth state court warning label lawsuits against drug manufacturers are not preempted.  Amy Sorrel writes,

Some physicians say a recent U.S. Supreme Court ruling preserves a key safeguard in holding pharmaceutical manufacturers accountable for drug safety -- the courts.  But other doctors worry the decision could stifle drug access if juries are allowed to second-guess scientific determinations on the risks and benefits of certain medications.

On March 4, the high court ruled 6-3 that federal law does not preempt state claims against drugmakers over allegedly inadequate warning labels, despite approval of those labels by the Food and Drug Administration.  "Congress did not intend FDA oversight to be the exclusive means of ensuring drug safety and effectiveness," Justice John Paul Stevens wrote for the majority. "The FDA has limited resources to monitor the 11,000 drugs on the market, and manufacturers have superior access to information ... as new risks emerge." . . .

Some doctors said the threat of liability has helped ensure drug manufacturers monitor their drugs and report new or revised safety information to doctors and the FDA.  "Many times the manufacturer is the only one with that information," said Francisco Silva, California Medical Assn. vice president and general counsel. "Most importantly, the ruling does not shift the burden to physicians," who could be left liable if patients had no recourse against drug manufacturers. . . .

But other doctors fear juries are not equipped with the expertise that trained medical professionals and regulators possess to decide safe and effective medication use.  "If that [duty] is switched over to a court or jury, it creates significant variability and uncertainty" that could interfere with physicians' medical judgment, said Brian F. Keaton, MD, past president of the American College of Emergency Physicians, which filed a brief in the case.  The decision also could result in commonly used drugs, such as Phenergan, becoming so tightly regulated "that it takes it out of [doctors'] hands," Dr. Keaton said.  Wyeth attorney Bert W. Rein said in a statement that FDA experts "are in the best position" to weigh medication benefits and risks, and convey them in warning labels. . . .

March 15, 2009 | Permalink | Comments (0) | TrackBack (0)

Saturday, March 14, 2009

Million Women Study

The Guardian UK has an article about concerning the million women study being conducted by scientists at Oxford University.   Sarah Boseley writes,   

Oh, the lure of a glass of chilled white wine at the end of a hard day. Or a goblet of luscious red by a leaping fire on a winter's evening. Or a gin and tonic, poured over cracking ice and lemon. Can't you hear it calling as you tramp home, tired, head buzzing with the day? Well, maybe not any more - if you heeded the recent study which warned that even a small glass of wine a day increases a woman's risk of breast cancer.

In all likelihood, most women just shrugged and reached for the corkscrew. There are, after all, so many conflicting stories about what is good and bad for you these days. Unfortunately, this is not some easily dismissed, pie-in-the-sky trial involving a couple of hundred people.  It is the Million Women Study, run by some very senior scientists at Oxford University. In research, size really does matter - and this is the biggest project of its kind on the planet. . .

The survey was started by Professor Valerie Beral, head of Oxford University's cancer epidemiology unit. When she began planning it in 1993, she quickly realised the study would have to be massive to answer the thorny and still controversial questions over HRT and possible links to cancers and other diseases. But enrolling a million women meant they would be able to tackle a lot of other issues too, and the answers are slowly coming in.  And yes, she says, it is intended to provide a definitive blueprint for women's health, spotlighting all the issues from the pill, to alcohol, to diet, to childbearing, to the menopause.  "That's what we plan to do, slowly and reliably over time," says Beral. "We're interested in not creating false stories, so it is totally reliable information - the sort of information that women want to know about their health."  . . . .

With this much data, the scientists will be able to investigate a whole range of issues. Maybe those who enjoy painting or music in their spare time or who go to church are less stressed and happier than those with little social activity to report. And are those who say they eat five portions of fruit and vegetables a day really healthier? . . . .

Even so, Professor Sheila Bird of the MRC's biostatistics unit and the Royal Statistical Society, sounds a cautious note. Big in itself does not necessarily mean free of bias. One in four of the population in the age group signed up - but, she asks, "How different are the quarter who volunteered from the rest?" First they accepted breast screening and then they agreed to be part of the Million Women Study. Does that mean, for instance, that they are middle-class women more concerned about breast cancer?

Avoiding and then adjusting for any such bias, however, is at the heart of the work of the Oxford cancer epidemiology unit. And Walker points out that the Million Women Study is under constant scrutiny from the best scientists in this field - facing rigorous peer review, first to get funding from Cancer Research UK and the MRC, and then to get each scientific paper published as they are completed. The findings have all appeared in leading medical journals, such as the Lancet.

So what do the study's findings really mean for each of us as individuals? Should we all be following Beral's developing blueprint to the letter? The answer is, not necessarily. We may all run an increased risk of cancer if we drink, but how serious that is depends on how high or low a risk we had to start with.  Walker puts it well: "What they are coming out with is risks across the population that they are studying. Each of us as individuals will have been born with a greater or lesser risk of a cancer because of the genes we have inherited and, on top of that, our lifestyle has to be factored in.  "We may have only one vice and it may be drinking three glasses a night, but if we had 10 children before the age of 30, it is not going to make much difference. One needs the whole picture."

And each of us may have a different perspective on acceptable risk. As a herd, we have a 9.5% chance of getting breast cancer before we are 75. Drinking every day raises that risk to 10.6%. If we think we have no other major risk factors lurking, such as a mother or sister who died of the disease, but we believe a drink a day significantly improves our life, we might choose to go with the extra risk. The great thing about the Million Women Study is that it is giving us the information with which to make an informed choice . . . .

March 14, 2009 | Permalink | Comments (0) | TrackBack (3)

Friday, March 13, 2009

Congratulations to Professor Burris

The Temple University's Beasley School of Law  website reports on the great news:

Temple University 's Beasley School of Law has been selected by the Robert Wood Johnson Foundation to manage a new $19 million national program that will fund interdisciplinary research exploring legal and regulatory solutions to pressing health challenges such as chronic diseases, and health emergencies including floods, bioterrorism and epidemics.

The Public Health Law Research program will operate under the direction of Temple Law professor Scott Burris, an internationally recognized authority on how law influences public health.

"The Public Health Law Research program brings long-needed funding and attention to the crucial role of law in public health," said Burris, who also co-directs Temple Law's new Center for Health Policy, Law and Practice. "Law can be a powerful tool for improving public health. Laws have contributed to reductions in smoking and they have increased use of seat belts." But, he explained, laws and law enforcement practices can also endanger health. . . .

A Temple Law faculty member since 1991, Burris is one of the founders of modern public health law and a pioneer in the use of empirical research in the discipline. He published the first law review article detailing the public health law issues raised by HIV/AIDS and led the effort to create the first comprehensive legal analysis of the epidemic. His work has been funded by the U.S. Centers for Disease Control and Prevention and the National Institutes of Health. He is currently working with the United Nations to reduce policy barriers to the treatment of pain and drug dependency.

Burris is also a senior associate at the Johns Hopkins Bloomberg School of Hygiene and Public Health, where he is associate director of the Center for Law and the Public's Health. Before joining the Temple Law faculty, Burris worked for the American Civil Liberties Union of Pennsylvania, where he represented people with HIV in cases addressing discrimination, privacy, and access to care in prison.  He has played a leading role in developing privacy and confidentiality legislation in Pennsylvania. . . .

March 13, 2009 | Permalink | Comments (0) | TrackBack (0)

Sacrificing for Others

The Boston Globe has a feel-good story about Paul Levy, the CEO of Beth Israel Deaconess Medical Center. Kevin Cullen writes,

Paul Levy, the guy who runs Beth Israel Deaconess Medical Center, was standing in Sherman Auditorium the other day, before some of the very people to whom he might soon be sending pink slips. In the days before the meeting, Levy had been walking around the hospital, noticing little things. He stood at the nurses' stations, watching the transporters, the people who push the patients around in wheelchairs. He saw them talk to the patients, put them at ease, make them laugh. He saw that the people who push the wheelchairs were practicing medicine. . . .

And so Paul Levy had all this bouncing around his brain the other day when he stood in Sherman Auditorium. . . ."I want to run an idea by you that I think is important, and I'd like to get your reaction to it," Levy began. "I'd like to do what we can to protect the lower-wage earners - the transporters, the housekeepers, the food service people. A lot of these people work really hard, and I don't want to put an additional burden on them.  "Now, if we protect these workers, it means the rest of us will have to make a bigger sacrifice," he continued. "It means that others will have to give up more of their salary or benefits."

He had barely gotten the words out of his mouth when Sherman Auditorium erupted in applause. Thunderous, heartfelt, sustained applause. . . .

The consensus was that the workers don't want anyone to get laid off and are willing to give up pay and benefits to make sure no one does. A nurse said her floor voted unanimously to forgo a 3 percent raise. A guy in finance who got laid off from his last job at a hospital in Rhode Island suggested working one less day a week. Another nurse said she was willing to give up some vacation and sick time. A respiratory therapist suggested eliminating bonuses. . . .

Paul Levy is onto something. People are worried about the next paycheck, because they're only a few paychecks away from not being able to pay the mortgage or the rent. But a lot of them realize that everybody's in the same boat and that their boat doesn't rise because someone else's sinks.  Paul Levy is trying something revolutionary, radical, maybe even impossible: He is trying to convince the people who work for him that the E in CEO can sometimes stand for empathy.

March 13, 2009 | Permalink | Comments (0) | TrackBack (3)

Thursday, March 12, 2009

Wisconsin Health Reform

Governor Jim Doyle, Governor of Wisconsin and co-host of an upcoming White House Forum on Health Reform, has an interesting post at the Huffingtonpost website discussing his state's health reform and how it may be a template for the one that President Obama should consider.  He writes,

I applaud President Obama for having the courage to take on this crisis, even during these tough economic times. It is not only the right thing to do, it makes fiscal sense. Unless we reform this broken system we will continue to saddle our children and grandchildren with increasing debt. . . .

It is important that any meaningful attempt at reform includes measures to cut costs. But we must not forget the 46 million Americans who, today, lack access to basic health insurance. Even during this tight budget, there are paths available to Washington for universal health care access. All they need to do is examine what states like Wisconsin have done through our national leading BadgerCare Plus program.

While many states are cutting back on health care programs, here in Wisconsin we are moving forward, expanding access to health care at an unprecedented rate. In February 2008, we ensured that every child in our state has access to affordable health insurance. In July, we will provide 98 percent of our residents with health care coverage by expanding BadgerCare Plus to low income individuals that don't have dependent children. When it's complete, we'll have the second largest percentage of residents insured of any state.  In both cases, we built upon existing successful programs. Simplification and cost-effectiveness drove our efforts.

Often, complex programs deter individuals from enrolling. In Wisconsin, we have cut bureaucracy and shortened our BadgerCare Plus application form to one page. We also now accept more than 30 percent of our applications online.  In addition, we have shown creativity in controlling costs while expanding access. . . .

Here in Wisconsin, we have shown that the moral issue of health care -- the crisis of the uninsured -- is something we can successfully address. We look forward to working with federal policymakers to make basic, affordable health care a reality for all Americans.

March 12, 2009 | Permalink | Comments (0) | TrackBack (0)

Health Care Crisis: One Reporter's Up-Close Story on the Underinsured

Time Magazine runs a moving story by reporter Karen Tumulty about what she learned when her brother was diagnosed with severe kidney disease and suddenly learned that his health care coverage was not what he thought.  She discusses her difficulties in figuring out why his short-term health insurance failed to provide coverage for his condition and how many people may not realize that they will not have coverage when they need it.  She writes,   

The unforeseen was exactly what turned up when Pat went in for a physical on Nov. 30, 2007, his first in five years. . . .  That's when Pat, who is now 54, learned that his kidneys were failing.

The diagnosis was only the first shock. The second came a few weeks later, in an Aug. 5 letter from Pat's health-insurance company. For six years — since losing the last job he had that provided medical coverage — Pat had been faithfully paying premiums to Assurant Health, buying a series of six-month medical policies, one after the other, always hoping he would soon find a job that would include health coverage. Until that happened, "unexpected illnesses and accidents happen every day, and the resulting medical bills can be disastrous," Assurant's website warned. "Safeguard your financial future with Short Term Medical temporary insurance. It provides the peace of mind and health care access you need at a price you can afford."

Kidney failure would seem to be one of those disastrous "unexpected illnesses" that Pat thought he was insuring himself against. But apparently he was wrong. When my mother, panicked, called to tell me that the insurance company was refusing to pay Pat's claims, I told her not to worry; bureaucratic mix-up, I assumed. I said I'd take care of it, bringing to bear my 15 years of experience covering health policy, sitting through endless congressional hearings on the subject and even moderating a presidential candidates' forum on the issue.  Confident of my abilities to sort this out or at least find the right person to fix the problem, I made some calls to the company. I got nowhere. That's when I realized that the national crisis I'd written so much about had just hit home. . . .

The Underinsured
. . . .  But Pat represents the shadow problem facing an additional 25 million people who spend more than 10% of their income on out-of-pocket medical costs. They are the underinsured, who may be all the more vulnerable because, until a health catastrophe hits, they're often blind to the danger they're in. In a 2005 Harvard University study of more than 1,700 bankruptcies across the country, researchers found that medical problems were behind half of them — and three-quarters of those bankrupt people actually had health insurance. As Elizabeth Warren, a Harvard Law professor who helped conduct the study, wrote in the Washington Post, "Nobody's safe ... A comfortable middle-class lifestyle? Good education? Decent job? No safeguards there. Most of the medically bankrupt were middle-class homeowners who had been to college and had responsible jobs — until illness struck."

Ms. Tumulty was also featured on Fresh Air earlier this week and a podcast of the story can be found here.

March 12, 2009 | Permalink | Comments (0) | TrackBack (3)

Wednesday, March 11, 2009

New FDA Commissioner: Dr. Margaret A. Hamburg

According to various press reports, the new FDA Commissioner will be Dr. Margaret A. Hamburg.  Mark Gardiner of the New York Times reports,

President Obama intends to nominate Dr. Margaret A. Hamburg, a former New York City health commissioner, to lead the Food and Drug Administration, sidestepping a battle between drug safety advocates and the drug industry, people briefed on the decision said. . . .

Dr. Hamburg, 53, will succeed Dr. Andrew C. von Eschenbach, who led the beleaguered agency from 2005 until last January and often had to deflect critics who accused the Bush administration of letting politics play too forceful a role in science policy.  . . .

The F.D.A. is arguably the most important public health agency in the country, but its budget has lagged far behind those of agencies like the Centers for Disease Control and Prevention. A growing list of scandals has led a bipartisan chorus on Capitol Hill to demand major changes and larger budgets, with some legislators advocating that the F.D.A. be split in two. . . .

Dr. Hamburg, who was appointed by Mayor David N. Dinkins as acting commissioner in 1991 and became commissioner the following year, was one of the few top officials asked to remain when Mayor Rudolph W. Giuliani took office in 1994. She was best known for developing a tuberculosis control program that produced sharp declines in the incidences of the disease in New York. Under her tenure, child immunization rates rose in the city.   She left New York in 1997 to become assistant secretary for planning and evaluation at the federal Department of Health and Human Services, where she created a bioterrorism initiative and led planning for pandemic flu response . . .

March 11, 2009 | Permalink | Comments (0) | TrackBack (1)

Europeans Debate Castration For Sex Offenders

The New York Times reports on the European debate on sex offenders and castration and whether such a strong response actually reduces the incidence of repeat offenders.  Dan Bilefsky writes,

Pavel . . . invited a 12-year-old neighbor home. Then he stabbed the boy repeatedly.  His psychiatrist says Pavel derived his sexual pleasure from the violence.

More than 20 years have passed. Pavel, then 18, spent seven years in prison and five years in a psychiatric institution. During his last year in prison, he asked to be surgically castrated. Having his testicles removed, he said, was like draining the gasoline from a car hard-wired to crash. A large, dough-faced man, he is sterile and has forsaken marriage, romantic relationships and sex, he said. His life revolves around a Catholic charity, where he is a gardener.  “I can finally live knowing that I am no harm to anybody,” he said during an interview at a McDonald’s here, as children played loudly nearby. “I am living a productive life. I want to tell people that there is help.” . . .

Whether castration can help rehabilitate violent sex offenders has come under new scrutiny after the Council of Europe’s anti-torture committee last month called surgical castration “invasive, irreversible and mutilating” and demanded that the Czech Republic stop offering the procedure to violent sex offenders. Other critics said that castration threatened to lead society down a dangerous road toward eugenics. . . .

Now, more countries in Europe are considering requiring or allowing chemical castration for violent sex offenders. There is intense debate over whose rights take precedence: those of sex offenders, who could be subjected to a punishment that many consider cruel, or those of society, which expects protection from sexual predators. . . .

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March 11, 2009 | Permalink | Comments (0) | TrackBack (3)

Tuesday, March 10, 2009

Living in the Genetic Age - March 20, 2009

Healthlaw_toc SAINT LOUIS UNIVERSITY SCHOOL OF LAW's  21st Annual Health Law Symposium - Living in the Genetic Age will take place on  Friday, March 20, 2009 -- 8 a.m. to 4 p.m.  William H. Kniep Courtroom.

Brief Overview: Advances in genetic technology raise a broad range of legal, social and ethical concerns. Fear of genetic discrimination remains an issue, as evidenced by the Genetic Information Nondiscrimination Act of 2008 limiting the use of genetic information by employers and healthi nsurance providers. Other concerns include the meaning and uses of genetic knowledge in the face of uncertain choices; the significance of genetic information for ideas of self, family and community; and the challenges of genetic enhancement and personalized genomic medicine. This Symposium gathers leading experts and scholars from fields including law, medicine and anthropology to discuss these and other challenges of living in the genetic age.

Details and registration:

Call:       Mary Ann Jauer (314) 977-3067

Click:     law.slu.edu/genetics

Write:    jauerma@slu.edu

March 10, 2009 | Permalink | Comments (0) | TrackBack (1)

Diane Rehm Show on Stem Cell Executive Order

The Diane Rehm show today reviews the changes that the President's new Executive Order will bring and some of the controversy over the use of embryonic stem cells that remains.

10:00Federally Funded Stem Cell Research

President Obama has overturned Bush administration restrictions on federal funding for human embryonic stem cell research. A look at the new policy and its implications.

Guests

Dr. Harold Varmus, co-chairman of the White House Council on Science and Technology, president, Memorial Sloan-Kettering Cancer Center, former director of the National Institutes of Health, and the author of "The Art and Politics of Science".

Dr. John Gearhart, Director, Institute for Regenerative Medicine, at the University of Pennsylvania

Sheryl Gay Stolberg, White House correspondent, "The New York Times"

Richard Doerflinger, associate director, secretariat for pro-life activities for the U.S. Conference of Catholic Bishops

March 10, 2009 | Permalink | Comments (0) | TrackBack (0)

Friday, March 6, 2009

Obama Will Issue New Executive Order on Stem Cells

The Washington Post is reporting that President Obama plans to sign a new executive order governing federal funding for stem cell research on Monday.  Rob Stein writes,

President Obama is planning to sign an executive order on Monday rolling back restrictions on federal funding of human embryonic stem cell research, according to sources close to the issue.  Although the exact wording of the order has not been revealed, the White House plans an 11 a.m. ceremony to sign the order repealing one of the most controversial steps taken by his predecessor, fulfilling one of Obama's eagerly anticipated campaign promises.

The move, long sought by scientists and patient advocates and opposed by religious groups, would enable the National Institutes of Health to consider requests from scientists to study hundreds of lines of cells that have been developed since the limitations were put in place -- lines that scientists and patient advocate say hold great hope for leading to cures for a host of major ailments.

Administration officials would not comment immediately other than to say "there will be a stem cell related event on Monday." But an email sent out yesterday from the White House stated that officials were planning a ceremony on Monday "on stem cells and restoring scientific integrity to the government process. At the event the president will sign an executive order related to stem cells." Sources close to the issue, asking not to be named because they were not authorized to discuss the plan, said the order would lift the restrictions on federal funding of human embryonic stem cells. . . . .

March 6, 2009 | Permalink | Comments (0) | TrackBack (0)

Obama's Health Summit

The Associated Press provides a quick summary of the health summit, stating,

President Barack Obama summoned allies, skeptics and health care figures of all stripes to the White House on Thursday to debate ideas for overhauling the nation's costly system and declared, "The status quo is the one option that is not on the table." The big Washington session — Obama called it a health care summit — and meetings to follow around the country show the new president's push for expanded health insurance will be more open and inclusive than the Clinton administration's failed attempt 15 years ago. . . .

The U.S. system is the world's costliest and leaves an estimated 48 million people uninsured. Although he wants coverage for all, the president suggested a willingness to compromise even if it means not fully meeting his goal. That, too, was a break from former President Bill Clinton's posture in the 1990s when he promised to veto any health-care measure that didn't give him what he sought. . . .

On Capitol Hill, Democratic leaders in both the House and Senate rallied behind him, saying Thursday that they hoped to have a health care reform measure passed by the end of the summer. . . .

The New York Times Opinionator blog provides some quick takes from the Health Summit. 
Also, NPR's morning edition and the NewsHour had some good overviews of some of the conversations that took place and the open minds that many seem to have about the ability to make health reform a reality. 

Here is some video from the Washingtonpost showing President Obama's speech at the summit. Ezra Klein provides pictures.

March 6, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, March 4, 2009

Wyeth v. Levine: No Preemption

In Wyeth v. Levine, the Supreme Court in a 6-3 vote held today that a drug manufacturer's compliance with federal (Food and Drug Administration) regulations did not preempt the ability of an injured plaintiff to sue that manufacturer in state court.   According to the Washington Post,

The Supreme Court on Wednesday upheld a $6.7 million jury award to a musician who lost her arm because of a botched injection of an anti-nausea medication. The court brushed away a plea for limiting lawsuits against drug makers.  In a 6-3 decision, the court rejected Wyeth Pharmaceuticals' claim that federal approval of its Phenergan anti-nausea drug should have shielded the company from lawsuits like the one filed by Diana Levine of Vermont. . . .   The decision is the second this term to reject business groups' arguments that federal regulation effectively pre-empts consumer complaints under state law.

A Vermont jury agreed with Levine's claim that Wyeth failed to provide a strong and clear warning about the risks of quickly injecting the drug into a vein, a method called IV push. Gangrene is likely if the injection accidentally hits an artery _ precisely what happened to Levine.  The company appealed and, backed by the Bush administration, argued that once a drug's warning label gets approval from the Food and Drug Administration, the label can't be changed without further FDA approval and consumers cannot pursue state law claims that they were harmed.

Justice John Paul Stevens, writing the majority opinion, said Wyeth could "unilaterally strengthen its warning."  Stevens said he was persuaded that until a recent change by the FDA, the agency "traditionally regarded state law as a complementary form of drug regulation" because it monitors 11,000 drugs.  Justice Clarence Thomas agreed with the outcome of the case, but did not join Stevens' opinion.  Justice Samuel Alito wrote a dissent that was joined by Chief Justice John Roberts and Justice Antonin Scalia. . . . 

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March 4, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 3, 2009

Opposition to Health Care Reform

Well, that didn't take long.  Politico.com reports on the group - Conservatives for Patients Rights -- and their media offensive against government-run health care.  Jonathan Martin writes,

Firing some of the first shots in the coming showdown over health care, a conservative group led by the former owner of the Hospital Corporation of America is beginning a multimillion-dollar campaign Tuesday in opposition to government-run coverage.

Conservatives for Patients Rights is going on TV, radio and the Web in the same week President Barack Obama hosts a health care summit at the White House. The group’s leader, Richard Scott, is hoping a pro-free-market message will rally the right to join the fray on what may be the most hard-fought policy battle in the first year of the new administration.

“If we have more government involvement we’re going to have dramatically worse health care,” said Scott, the wealthy health care executive who is overseeing the effort and seeding it with $5 million of his own cash.  Scott, a major GOP donor, is pushing for four principles to any health care reform package: individual choice, competition between carriers, giving patients’ ownership over their own coverage and rewarding those who make healthy lifestyle choices.  . . .

“Imagine waking up one day and all your medical decisions are made by a central national board,” Scott says in the radio ad. “Bureaucrats decide the treatments you receive, the drugs you take, even the doctors you see.”  He goes on to raise the prospect of “national boards” and “waiting lists” as in the nationalized systems of Great Britain and Canada. “That’s what some in Washington mean by reform,” Scott says in the spot. 

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March 3, 2009 | Permalink | Comments (0) | TrackBack (0)