HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Thursday, April 30, 2009

Tracking the Flu

Here it is - if you like your data in charts, the Swine Flu Tracker will not disappoint.

April 30, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, April 29, 2009

First Swine Flu Death in US

Reuters reports on the first swine flu death in the United States and states,

A 23-month-old child has died in Texas from the new H1N1 swine flu, becoming the first death in the United States from the virus, a U.S. Centers for Disease Control and Prevention official said on Wednesday.  A Houston health official said the child was a Mexican who traveled to the city for medical treatment. . . .     She said she did not know which part of Mexico the child came from. . . .

Besser of the CDC had predicted that as they searched for cases, CDC experts would find severe infections and deaths in the United States, even though most of the patients had mild illness.  "As we look, we're going to find more cases. We're going to find more severe cases and I expect that we'll continue to see additional deaths," Besser told NBC's "Today" show.   He said additional details would be released by Texas authorities. . . .

April 29, 2009 | Permalink | Comments (0) | TrackBack (0)

Sebelius Confirmed, Sworn In, Busy at Work

Mark Silva describes the whirlwind confirmation and more of the new HHS Secretary.  He writes,

After the Senate confirmed the last of President Barack Obama's Cabinet appointees today, the president immediately swore in Health and Human Services Secretary Kathleen Sebelius in the Oval Office this evening.  Then he sent her to work: At a Situation Room meeting on the swine flu outbreak.

The White House had maintained that none of the administration's work on the flu outbreak was hampered by the lack of a confirmed HHS secretary -- that Homeland Security Secretary Janet Napolitano has been running point on the problem, and she in turn has said that communications with career service officers has been fine, including the acting Centers for Disease Control director, who works for HHS.

But Obama suggested there was no time to waste tonight, with 64 confirmed cases of the flu -- up from 20 Monday morning when he stepped out to say that the flu situation is cause for concern but not alarm -- and the disease spreading to six states.

The president interrupted a closed-door Blue Room reception for his other Cabinet members tonight to swear in the final one, Sebelius, the governor of Kansas who had drawn some controversy for her stances on abortion rights. The Senate had confirmed her hours before, she resigned as governor and flew to Washington. . . .

April 29, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, April 28, 2009

The Daily Show and Snoutbreak '09


Just to keep things slightly on the lighter side, here is the Daily Show take on the cable news coverage of the swine flu.  He does a great job demonstrating how they speak out of both sides of their mouth.  Click here for the links to the video.

April 28, 2009 | Permalink | Comments (0) | TrackBack (0)

WHO Phase 4 Described

DemFromCt has a helpful overview (including charts) of the WHO's recent decision to raise the pandemic alert to phase four.  Here is a brief excerpt:

. . .   There's a confirmed human outbreak overseas (several, actually - US, Canada, Spain and Mexico). And to clarify things further, WHO has redefined what their phases mean:

Phase 4 is characterized by verified human-to-human transmission of an animal or human-animal influenza reassortant virus able to cause "community-level outbreaks." The ability to cause sustained disease outbreaks in a community marks a significant upwards shift in the risk for a pandemic. Any country that suspects or has verified such an event should urgently consult with WHO so that the situation can be jointly assessed and a decision made by the affected country if implementation of a rapid pandemic containment operation is warranted. Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. [my bold]

The Wall Street Journal also has some helpful discussion of the situation here.

April 28, 2009 | Permalink | Comments (0) | TrackBack (0)

Sebelius Confirmation VoteToday

Today, the Senate will consider Governor Kathleen Sebelius' nomination for Secretary of HHS.  You would think with the swine flu issue still causing concern that this would be a time for quickly confirming the President's choice for this position.  You would be slightly wrong.  Greg Sargent writes,

So Kathleen Sebelius will get her confirmation vote as Health and Human Services secretary tomorrow in the Senate — but even with the flu outbreak, her confirmation will still have to clear a big hurdle, requiring 60 votes.  So says the office of GOP Senate leader Mitch McConnell, anyway.

As you know, Senate Republicans have been filibustering Sebelius over lingering questions about her views on late-term abortions and some campaign contributions she received from an abortion doctor. Late last week, the Senate Dem leadership announced that in the face of GOP opposition, they had agreed with Republicans to bring Sebelius’ confirmation to the floor for a vote tomorrow that would indeed require the 60 votes.

The outbreak of the flu epidemic had led some Dems to hope that the GOP would drop their filibuster, which would mean the 60 vote threshold would no longer apply. And even GOP Senator Susan Collins called for the Senate to expedite her confirmation today.

But McConnell spokesperson Don Stewart tells me she’ll still have to clear the 60 vote threshold. The question is, Whose fault is this? . . .

Bottom line: The filibuster over an abortion controversy is still throwing a hurdle in the way of this nomination, despite the flu epidemic.

April 28, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, April 27, 2009

Domestic Cow Genome

The St. Louis Post-Dispatch reports on the completion of the cow genome.  The article provides,

The cow is the first livestock mammal to have its genetic blueprint sequenced and analyzed. The research was unveiled Thursday in the journal Science.  “The cattle industry is extremely important for U.S. agriculture with more than 94 million cattle in the United States valued at $49 billion,” said U.S Agriculture Secretary Tom Vilsack. “Understanding the cattle genome and having the sequence will allow researchers to understand the genetic basis for disease in domestic cattle and could result in healthier production of meat and milk while reducing producers’ dependence on antibiotics.” . . .

Blogbioethics has some further thoughts here and expresses hope for the quick development of a healthy milkshake. 

April 27, 2009 | Permalink | Comments (0) | TrackBack (0)

Swine Flu Update

The New York Times reports on the public health emergency declared by the US in response to the spread of the swine flu from Mexico to other countries, including the US.  The article provides,

Responding to what some health officials feared could be the leading edge of a global pandemic emerging from Mexico, American health officials declared a public health emergency on Sunday as 20 cases of swine fluwere confirmed in this country, including eight in New York City.  Other nations imposed travel bans or made plans to quarantine air travelers as confirmed cases also appeared in Mexico and Canada and suspect cases emerged elsewhere.

Top global fluexperts struggled to predict how dangerous the new A (H1N1) swine flu strain would be as it became clear that they had too little information about Mexico’s outbreak — in particular how many cases had occurred in what is thought to be a month before the outbreak was detected, and whether the virus was mutating to be more lethal, or less.  “We’re in a period in which the picture is evolving,” said Dr. Keiji Fukuda, deputy director general of the World Health Organization. “We need to know the extent to which it causes mild and serious infections.” . . .

American investigators said they expected more cases here, but noted that virtually all so far had been mild and urged Americans not to panic. The speed and the scope of the world’s response showed the value of preparations made because of the avian flu and SARS scares, public health experts said.  The emergency declaration in the United States lets the government free more money for antiviral drugs and give some previously unapproved tests and drugs to children. One-quarter of the national stockpile of 50 million courses of antiflu drugs will be released. . . .

In the meantime, it would be helpful if Congress approved the HHS nominee so that perhaps we could also have a new CDC director. 

April 27, 2009 | Permalink | Comments (0) | TrackBack (0)

Sunday, April 26, 2009

Digital Medical Records

Business Week provides an overview of some of the discussions and debate taking place over digital medical records.  Here is a brief excerpt:

The high cost and questionable quality of products currently on the market are important reasons why barely 1 in 50 hospitals has a comprehensive electronic records system, according to a study published in March in the New England Journal of Medicine. Only 17% of physicians use any type of electronic records.  Hospitals and medical practices that plugged in early have experienced pricey setbacks and serious computer errors. Suddenly dumping more money on hospitals, which will then funnel the cash to tech vendors, won't necessarily improve the situation, say many doctors and administrators.

Studies have shown that some large networks, such as the Veterans Administration and the Kaiser Permanente system, based in Oakland, CA, have used electronic records to help cut costs and improve care. But so far there's little conclusive evidence that computerizing all of medicine will yield significant savings. And improvements to patient care may be modest. An analysis of four years of Medicare data published in March in the scholarly journal Health Affairs found only marginal improvement in patient safety due to electronic records—specifically, the avoidance of two infections a year at the average U.S. hospital. "Health IT's true value remains uncertain," wrote Stephen Parente and Jeffrey McCullough, researchers at the University of Minnesota.

Part of the problem stems from a fundamental tension. Info tech companies want to sell mass-produced software. But officials at large hospitals say such systems, once installed, require time-consuming and costly customization. The alterations often make it difficult for different hospitals and medical offices to share data—a key goal. Meantime, the health IT industry has successfully lobbied against government oversight. . . .

April 26, 2009 | Permalink | Comments (0) | TrackBack (0)

Saturday, April 25, 2009

Swine Flu

The Washington Post reports on the recent outbreak of a new strain of swine flu.  Rob Stein and David Brown write,

An unusual strain of swine flu has been detected among victims of a large outbreak of a severe respiratory illness in Mexico, prompting global health officials, fearful of a potential flu pandemic, to scramble yesterday to try to contain the virus. . . .

The outbreak heightened alarm among health officials in the United States, where at least eight cases of swine flu have been detected along the U.S.-Mexican border, and elsewhere.

"It's alarming and very concerning," said Sari Setiogi, a spokeswoman for the World Health Organization in Geneva, which began an investigation of the cause and scope of the outbreak.

President Obama has been briefed about the illness, spokesman Reid Cherlin said, adding: "The White House is taking the situation seriously and monitoring for any new developments." . . .

You can learn more about the swine flu from the FluWiki website.  The CDC website provides excellent health information and guidance and is continually updating its information.

April 25, 2009 | Permalink | Comments (0) | TrackBack (0)

Friday, April 24, 2009

Further Delay/Potential Filibuster on Sebelius Nomination

The Washington Post reports on the continued delay in the Senate on the approval of Governor Sebelius nomination to be the Secretary of HHS.  Ceci Connolly writes,

President Obama will have to wait a bit longer to round out his Cabinet. Senate Republicans refused today to allow a confirmation vote on his health secretary nominee Gov. Kathleen Sebelius (D-Kan.). She is the last Cabinet member awaiting Senate approval.

At the start of the session today, Senate Majority Leader Harry Reid (D-Nev.) proposed taking a vote after five hours of debate. But Senate Minority Leader Mitch McConnell (R-Ky.) objected, arguing that lawmakers needed more time to consider her "fairly contentious" selection. . . .

In the Senate Finance Committee Tuesday, eight of 10 GOP members opposed her nomination. Two Republicans, Sens. Pat Roberts of Kansas and Olympia Snowe of Maine, voted to confirm her.  . . .

Reid spokesman Jim Manley said today that, if necessary, the Democratic leader intends to pursue the procedural maneuvers needed to overcome a Republican filibuster. That would likely push a confirmation vote into next week.  "We're confident there will be the 60 votes needed to confirm her," Manley said.

This afternoon, McConnell's office clarified in a statement that the nomination is "not stymied, she's just not getting confirmed today" and said that concerns about a filibuster are premature.

April 24, 2009 | Permalink | Comments (0) | TrackBack (0)

Upcoming Presentation on Health Law and Policy

Beazley Institute for Health Law and Policy


We invite you to attend an address by health law and policy faculty on:

The Current State of Health Care Reform

Friday, May 1, 2009
7:00 - 9:00 pm

Ceremonial Courtroom at Loyola Law Center
Tenth Floor ~ 25 East Pearson Street ~ Chicago, Illinois

Join us for hors d'oeuvres and cocktails following the address.

Kindly RSVP by April 27.

April 24, 2009 | Permalink | Comments (0) | TrackBack (0)

Thursday, April 23, 2009

Plan B Available to 17 Year Olds w/o Prescription

The Associated Press reports that the FDA has changed course and will be permitting young women to obtain Plan B without a doctor's prescription.  The article provides,

Food and Drug Administration, reversing field, will now let 17-year-olds get the 'morning-after' birth control pill without a doctor's prescription, a government health official said Wednesday.

The official, who spoke on condition of anonymity, said the agency will announce that it is complying with a federal judge's order that overturns a Bush administration policy. The official was not authorized to speak publicly before the FDA announcement, expected later Wednesday.

Last month, U.S. District Judge Edward Korman ruled in a New York lawsuit that Bush administration appointees let politics, not science, drive their decision to allow over-the-counter access to these pills only for women 18 and older. Korman ordered the agency to let 17-year-olds get the medication, and separately to evaluate whether all age restrictions should be lifted. . . .

April 23, 2009 | Permalink | Comments (0) | TrackBack (0)

What good services do your tax dollars provide?

Nuisance Industry, writing at DailyKos, has an article about water contamination and cancer in a community outside Chicago.  The website provides,

Corruption is in Cook County, Illinois, and it is endangering residents.  This week, the Chicago Tribune reported on a scandal more than 20 years in the making.  

Like every town across the nation, south suburban Crestwood tucks a notice into utility bills each summer reassuring residents their drinking water is safe. Village leaders also trumpet the claim in their monthly newsletter, while boasting they offer the cheapest water rates in Cook County.

But those pronouncements hide a troubling reality: For more than two decades, the 11,000 or so residents in this working-class community unknowingly drank tap water contaminated with toxic chemicals linked to cancer and other health problems, a Tribune investigation found.

In many ways, Crestwood is a Republican success story, a place where taxes are low despite being situated in one of the most urbanized counties in the United States.  The village prides itself on having among the lowest municipal taxes in the country. In the shadow of Chicago, it is a tax haven that Grover Norquist could brag about.

How did Crestwood achieve this?  Norquist would be proud of the ways in which the village ignored regulators and endangering the health of its citizens for years.  The Illinois EPA informed the village in 1986 that its municipal well had been contaminated by dry cleaning solvents, including the highly toxic chemical vinyl chloride.  . . .    Given this information from the EPA, local officials might have moved to close the well, or to clean it up.  That did not happen. . . .

The well wasn't shut off for good until December 2007, after the Illinois Environmental Protection Agency tested the water for the first time in more than 20 years. The agency found not only that the well was still contaminated but that Crestwood had been piping the water, untreated, to residents.

This decision had consequences.  Local residents have reported incidences of cancers, including brain tumors and kidney cancers.  Now the Illinois Attorney General Lisa Madigan is investigating why this well was used for more than 20 years after regulators brought its dangers to the attention of local officials. . . .

April 23, 2009 | Permalink | Comments (0) | TrackBack (0)

Wednesday, April 22, 2009

Convincing the Already Insured about the Need for Health Reform

The Seattle Times has an editorial by Froma Harrop discussing a difficult group to convince that health reform is necessary.   The author writes about some potentially helpful arguments to convince these individuals,

The hardest group to sell on national health reform is those who don't desperately need it. That would include Americans who already have coverage through a workplace, about 160 million in all, and are reasonably happy with their deal.

The comfortably insured are always the target for scare-talk about rationing, loss of choice, higher taxes and government takeovers of health care. After all, they're the ones with something to lose, or so they've been led to believe. . . .

To win, reformers must avoid wonkery and answer this simple question: "What's in it for me?" . . . .

For starters, more money. Your company health plan does not come free. Part of your compensation package, its cost gets subtracted from your paycheck. Employer-provided health coverage cut cash wages by nearly 8 percent last year, according to the Bureau of Labor Statistics. . . .

Any rational program would also curb waste. America spends $8,000 per person on health care, about twice the rich-country average. There's lots of room to save money without sacrificing quality. Bear in mind that America's tendency to over-treat people does not produce outcomes superior to the best European systems. And lowering premiums ends up as money in your pocket. . . .

What about freedom to choose providers and treatments? Well, private insurance also sets rules on what it will cover and typically provides lists of preferred doctors and hospitals. If your plan lets you go out of the network, you have to pay extra for the privilege. Nothing wrong with that, but we must drop the romantic notion that private coverage affords total freedom at popular prices.

So what's in it for me, the contentedly covered? If the plan is done right, I am left healthy and wealthier. And if I ditch my job — or my job ditches me — I can find affordable coverage. That should not be a hard sell to anybody.

Thanks to DemFromCt for the link.

April 22, 2009 | Permalink | Comments (0) | TrackBack (0)

Sebelius Wins Approval from Senate Committee

Governor Kathleen Sebelius won Senate Finance Committee approval and a vote on her appointment as Secretary of Health and Human Services could be soon.   It is about time as President Obama had his first Cabinet meeting yesterday.  According to an Associated Press story, 

Sen. Max Baucus, D-Mont., the Finance Committee chairman, said he would "push for immediate action by the full Senate so that she can finally roll up her sleeves and get down to helping out on this critical work of reforming the health care system." The committee vote came after several Republicans voiced concerns in recent days about Sebelius' ties to Dr. George Tiller, a late-term abortion doctor who is under investigation by the Kansas medical board. The GOP also questioned her commitment to ensuring that the government doesn't try to interfere with the doctor-patient relationship. . . .

Sebelius had offered assurances that she believed it was the job of doctors, not the government, to prescribe care. That wasn't enough for some GOP lawmakers worried that the Obama administration's plans to overhaul the nation's costly health care system could move the country toward a government-operated health care system. . . .

April 22, 2009 | Permalink | Comments (0) | TrackBack (0)

Tuesday, April 21, 2009

Not Caving on a Public Health Care Plan

Health Care reform advocates are a bit alarmed about the potential for "caving" on the health care reform agenda.  According to Ceci Connolly writing in the Washington Post,

As Congress returns to begin an intense debate over reshaping the nation's $2.2 trillion health-care system, prominent left-leaning organizations and liberal House members are issuing a warning to their Democratic allies: Don't cave on us. . . .

More than 70 House Democrats recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan.  "It's way too early" to abandon what it considers a central plank in health reform, said Andy Stern, president of the Service Employees International Union. He said the organization pulled out of the bipartisan Health Reform Dialogue because it feared its friends in the coalition were sacrificing core principles too soon. "You don't make compromises with your allies."

Last week, two top administration officials suggested that Obama is open to compromise on the public plan, comments that set off alarm bells in some corners of his party.  "That's what got the left nervous. I took that as a signal to Senator Grassley" that Obama is willing to negotiate around an issue Grassley has vehemently opposed, said Len Nichols, health policy director at the New America Foundation, a nonprofit think tank, referring to  Sen. Charles E. Grassley (R-Iowa). "It was the first time the president indicated he could live without it."

During last year's campaign, Obama proposed offering a government-sponsored plan as a low-cost alternative for Americans who are having trouble purchasing insurance in the private market. Proponents say it would reduce costs because it would not need to make a profit or pay large executive salaries. Many Republicans and industry executives say that any program modeled after Medicare -- with its power to set prices -- would have an unfair advantage over private-sector competitors and eventually force some companies out of business. "The sacred cow on the left and the right is the public plan," said former senator Thomas A. Daschle, who was Obama's first choice to oversee the reform effort.  . . .

April 21, 2009 | Permalink | Comments (0) | TrackBack (0)

Some Statistics on Delayed Health Care

Reuters reports on the findings of its new survey that shows one in five Americans have postponed medical care.  The article provides, 

Twenty percent of Americans say they have delayed or postponed medical care, mostly doctor visits, and many said cost was the main reason, according to a survey by Thomson Reuters released on Monday.

That figure is up since 2006, the last time the question was asked on the survey, when 15.9 percent of people said they had postponed or canceled medical care in the past year.

"The results of this survey have serious implications for public health officials, hospital administrators, and healthcare consumers," Gary Pickens of the Healthcare division of Thomson Reuters, who led the study, said in a statement. "We are seeing a positive correlation between Americans losing their access to employer-sponsored health insurance and deferral of healthcare." . . . .

Pickens and colleagues surveyed 12,000 Americans in February and March and said their findings were representative of the United States in general.  They found that 24 percent of people who canceled or postponed care said cost was the primary reason. 

More than 54 percent who skipped care said they missed a doctor visit. Eight percent said they delayed or skipped medical imaging of some sort.

Pickens and colleagues found the percentage of households with employer-sponsored insurance declined to 54.6 percent in 2009 from 59 percent in early 2008. The percentage of adults covered by Medicaid, the state-federal health insurance plan for the poor, rose to 14.5 percent in 2009 from 11.9 percent in 2008.

April 21, 2009 | Permalink | Comments (0) | TrackBack (0)

Monday, April 20, 2009

US News Rankings

Concurring Opinions' Dave Hoffman provides a look at the 2009 US News Rankings that we really don't care too much about . . . . although we do. 

April 20, 2009 | Permalink | Comments (0) | TrackBack (0)

Republican Health Care Plans??

I haven't posted much about what the Republicans in Congress plan to propose as an alternative to some of the Preisident's health reform efforts and policies.  This results from a certain lack of plans from the Republican party at this time.  Carrie Brown at reports,

Republicans look across the health reform battlefield and see the Democrats organized, energized and flush with cash — with several groups lined up to promote the president’s plan, and a message honed by years of preparation.  Then they look into their own camp — and get nervous.

There’s no Republican plan yet. No Republicans leading the charge who have coalesced the party behind them. Their message is still vague and unformed. Their natural allies among insurers, drug makers and doctors remain at the negotiating table with the Democrats. . . .

“I thought we would have been much farther along than we are,” said Rep. Michael Burgess (R-Texas), a physician who started the Health Care Caucus this year and wrote a 29-page “primer” for his colleagues. “Senator [John] McCain, for all his faults, had a program a year ago. People became pretty comfortable with McCain carrying the load on that and when he wasn’t successful in November, it left a big void.” . . .

April 20, 2009 | Permalink | Comments (0) | TrackBack (0)