Wednesday, April 15, 2009

News Clipping Archives

 

Maryland / Regional

The Deamonte Driver Project with Sayo Adunola (School of Public Health – University of Maryland )

Going to the Mattress (Washington Post

Budget lobbying efforts intensify in final days of session (The Gazette)

Budget ax spares biotech tax credit (The Gazette)

Group brings fight against chronic diseases to Maryland (Baltimore Sun)

Mikulski asks VA to upgrade Cumberland veterans clinic (Baltimore Sun)

Former Tri-State health center doctor files $1M suit (Cumberland Times-News)

Turning her life and others' around (Annapolis Capital)

State passes bills, but some didn't make the cut (Annapolis Capital)

Adventist seeks state approval of hospital (Montgomery County Gazette)

AstraZeneca CEO says U.S. needs less ‘sick care’ (Daily Record)

More low-income students eating breakfast at school (Prince George’s Gazette)

Poultry outlook positive (Salisbury Daily Times)

 

National / International

Atypical antipsychotics: too hard a sell? (Baltimore Sun)

As Pills Treat Cancer, Insurance Lags Behind (New York Times)

A Deadly Polio Vaccine, Bed Bugs and Medical Marijuana (New York Times)

Study Finds Risk of Dementia Increases After Hypoglycemia (New York Times)

Novel Approach to Health Plans Gains Traction (Wall Street Journal)

 

Opinion

Food Safety, One Pistachio at a Time (New York Times Editorial)

Early warning (Baltimore Sun Editorial)

Health woes part of economic fallout (Frederick News-Post Editorial)

 

 

Maryland / Regional

 

The Deamonte Driver Project with Sayo Adunola

 

By Bobby McMahon

School of Public Health – University of Maryland

Tuesday, April 14, 2009

 

Healthy Turtle contributor and senior PCH student Sayo Adunola is planning to attend dental school next year, and so for today's article, she is addressing the ongoing efforts to improve dental health here in PG County--particularly those inspired by the tragic death of Deamonte Driver. For more on Driver and the program he inspired, go here and here for recent news articles.

----

The Story of Deamonte Driver

 

Deamonte Driver, a twelve-year-old boy from Prince George’s County, Md. died on February 25, 2007 because of a brain abscess caused by bacteria from an untreated infected tooth. This tragic event could have been prevented, since there are proven measures to prevent tooth decay. Even at this late stage of his dental disease, as little as eighty dollars spent on a timely extraction could have saved his life. This is a story of both access to professional health care and of the need to inform the public about self-care and community programs.

 

Deamonte’s story is tragic and has illuminated the issue of oral health care for disadvantaged children. This situation cannot be overlooked because there are many others like Deamonte who lack access to care. Also, since his death other deaths of children attributable to dental diseases have been reported.

 

In an effort to address oral health issues, Governor O’Malley, Secretary Colmers, and the General Assembly created a Dental Action Committee in June of 2007. The Dental Action Committee provides recommendations for Maryland to improve its oral health services. Currently, fewer than one in three of Maryland’s 500,000 children who are Medicaid recipients received any dental services last year.

 

The reasons for this are many. One important reason is the limited participation of Maryland dentists in Medicaid--of about 5,500 dentists in the state of Maryland, only about 900 accept Medicaid patients. This is primarily due to low reimbursement rates and to the demands of the bureaucratic aspects of the Medicaid program. On the public’s side, oral health does not register among their top concerns. Other factors such as poverty, cultural differences, transportation issues among others contribute to barriers that affect both self-care and access to professional care.

 

The Deamonte Driver Dental Project

 

The story of Deamonte Driver has lead to the development of new dental projects and laws regarding children’s oral health both locally and nationally. The Deamonte Driver Dental Project was launched in November 2008 by Dr. Hazel J. Harper, Dr. Belinda Carver-Taylor, and other committed dentists who aimed to eliminate health disparities by expanding access to quality oral health care. The mission of the project is “to provide grassroots solutions to children’s’ dental health crisis…stamp out the epidemic of tooth decay by increasing access and providing early intervention…[and] to create a successful, sustainable model program for other counties.” The project is sponsored by Robert T. Freeman Dental Society Foundation, a professional association comprised of African-American dentists from Prince George’s County and Washington, DC. Also, Governor Martin O’Malley, the Department of Health and Mental Hygiene (DHMH) Secretary John Colmers, and members of the Dental Action Committee support the Deamonte Driver Dental Project.

 

Notable government departments and organizations are also providing financial support. The Department of Health and Mental Hygiene has committed $288,000 for the purchase of a fully equipped mobile van. Also, the Aetna Foundation has offered a $31,500 grant for the project. Also, as a result of recommendations made by the Dental Action Committee, Governor O’Malley put $14 million in the FY09 budget, in state and federal funds, to raise reimbursement rates for dentists treating Medicaid children. The governor realizes that it is critical to provide routine but potentially life-saving care for children.

 

The mobile van will serve nine schools: the Foundation School (Prince George’s County), the Foundation School (Montgomery County), Adelphi Elementary, District Heights Elementary, Morningside Elementary, William Beanes Elementary, Seat Pleasant Elementary, Concord Elementary, and Mathew Henson Elementary. Children will be provided with diagnostic, preventive, and simple restorative dental services on the van. If a child needs urgent care and if services cannot be provided on the van, the Project Coordinators have enlisted dentists to provide services in their private offices.

 

The Deamonte Driver Dental Project will provide services to Medicaid-eligible and uninsured children in Prince George’s County. Currently, dentists that are part of the project are screening children in local schools. After the screenings, each child receives a dental report card to take home that indicates needed follow-up dental services-either preventative, routine, or emergency.

 

The dentists are hoping to complete all the screenings by the end of April.

----

Thanks to Sayo Andunola for contributing this article.

 

Copyright 2009 School of Public Health – University of Maryland.

 

Going to the Mattress

 

By Dana Milbank

Washington Post

Wednesday, April 15, 2009; A02

 

The enemy is stealthy and bloodthirsty. It attacks innocent victims without warning, while they sleep.

 

Fortunately, the federal government is on the case. In a hotel ballroom in Crystal City yesterday, the Environmental Protection Agency convened the first-ever National Bed Bug Summit -- a veritable Yalta Conference for the species Cimex lectularius. With help from the Centers for Disease Control and Prevention, the Department of Housing and Urban Development, and even the Pentagon, the EPA assembled scientists, state and local officials, and a colony of exterminators to buzz about such topics as "Bed Bug Perspectives," "Bed Bug Basics" and "Government Responses to Bed Bugs."

 

"These insects can have a life-altering impact," warned panelist Richard Cooper of Cooper Pest Solutions.

 

"They are showing up in some of the finest hotels," contributed Saul Hernandez, an aide to the congressman who introduced H.R. 6068, "The Don't Let the Bed Bugs Bite Act of 2008."

 

All this for an insect the size of an apple seed that has a painless bite and is not known to spread disease?

 

University of Kentucky entomologist Mike Potter called the bedbug nothing less than "the most difficult, challenging pest problem of our generation." Tossing out phrases such as "doomsday scenario" and "perfect storm," he ventured: "In my opinion, we are not going to get out of this thing" -- the bedbug thing -- until we "allow the pest-control industry to go to war."

 

The layman might think that in an age of bin Laden and Ahmadinejad, not to mention pandemic flu and poisonous peanut butter, the threat posed by the tiny insect might be rather manageable. But that is not the prevailing view at this week's National Bed Bug Summit.

 

"A year ago I thought bedbugs were a thing from a couple of centuries ago and maybe in a children's bedtime rhyme," testified Joan Quigley, a New Jersey state representative. "I had no idea they were a modern scourge." But when she scratched the surface, she found the bedbug matter to be "a can of worms," so to speak. "I had no idea how many stakeholders there were in the bedbug issue."

 

An official from the New Jersey Apartment Association (Jersey is a hotbed of bedbug activity) concurred. "I hesitate to use the words 'It became a sexy issue,' but it became a cause celebre," said the official, Conor Fennessy. "It kind of got legs for a while."

 

Actually, six legs and two antennae, according to the eight-inch drawing of a bedbug on the sign outside the Sheraton ballroom yesterday announcing "National Bed Bug Summit -- Please Sign In." The sign-in area was well stocked with coffee (sleep disruption is common in bedbug circles). Inside the ballroom, 200 people, some in military uniform, others in Orkin Man-style uniform, listened as Lois Rossi, from the EPA's pesticide division, spoke of "the size of the problem we have with bedbug infestations."

 

Bedbugs had been all but eradicated decades ago, panelist Potter explained, but thanks to increased travel, pesticide bans and resistance, we've "let bedbugs get back in the game."

 

Now, said Hernandez, the congressional staffer, "bedbugs invade luggage, burrowing deep into clothes, and are transported back home, where they infest their victims' homes . . . and the affected people have no choice but to trash their furniture, clothes and linen."

 

Audience members were squirming and scratching by the time Cooper told them of where he's found bedbug infestations: "behind picture frames or other wall hangings, or inside the bindings of books or on stuffed animals. Or how about an entire reproducing population with over 30 eggs inside the head of an adjustable wrench?" On the projection screen, the bugs in his presentation looked to be about three feet long.

 

After a representative of the National Pest Management Association divulged the "startling" fact that, in the pest-control business, the bedbug has surpassed the fire ant and is closing in on the flea, Harold Harlan, from the Armed Forces Pest Management Board, described the savage beast's method of attack. "They have piercing, sucking mouth parts -- that's important," said Harland, who boasted of the "trained" bedbugs he keeps in his lab. "They feed only on blood" -- known as a "blood meal" in the bedbug community.

 

Dini Miller of the Virginia Polytechnic Institute reported her findings that a particularly nasty strain of insecticide-resistant super-bedbug has taken up residence in Arlington. "It's pretty amazing how tough these bugs are," she said, showing a spray can of "Bedlam" aerosol. "Very determined, these bedbugs."

 

But what about that article two weeks ago in the Journal of the American Medical Association finding "little evidence" that the bugs transmit disease?

 

Well, consider the "mental health aspects" of the bedbug. "When you've got bedbugs, your bed is not your comfort," explained Tom Neltner of the National Center for Healthy Housing. "It can have a tremendous impact on the mental health of people."

 

Potter, who boasted that he's spent "the last three years of my life digging deep into the history of bedbug management," offered a challenge: "I'd like to take anybody who thinks bedbugs is not a big deal, and we'll sprinkle a few in their house and see what they think."

 

The rest of us can sleep tight, knowing our government is doing all it can not to let the bedbugs bite.

 

Copyright 2009 Washington Post.

 

Budget lobbying efforts intensify in final days of session

With session over Monday, executives work to keep programs funded

 

The Gazette

Wednesday, April 15, 2009

 

With the legislative clock ticking loudly, business executives lobbied lawmakers this week to save pet programs from the budget ax as a joint House and Senate committee continued to meet Thursday to hammer out differences in the state's $13.8 billion operating budget.

 

Among the programs on the chopping block is the Maryland Economic Development Assistance Authority and Fund, which has been used for more than $160 million in loans, grants and other aid to help companies expand or relocate to the state since forming about a decade ago. Beneficiaries have included telecommunications company Comcast Corp. and Rockville biotech Novavax.

 

Legislators target that fund for about $10 million less this fiscal year, which ends in June, and another $10 million cut in fiscal 2010. The latter reduction would essentially come when the fiscal year begins in July, leaving the fund only about $7 million to work with next fiscal year, said Jim Henry, managing director of finance programs for the state Department of Business and Economic Development, which runs the program.

 

'That wouldn't give us a lot of room,' Henry said.

 

DBED officials said they had not heard from legislators about a determination for the fund as of Thursday. Henry called the program the 'workhorse of our funds.'

 

The conference committee agreed to reduce another DBED program that provides grants for nanobiotechnology research by $500,000. That recommendation was not binding, however, and DBED had not heard Thursday of a final decision, DBED spokeswoman Karen Glenn Hood said.

 

Biotechnology executives were still contacting House members of the conference committee, seeking full $6 million funding of the biotechnology investment tax credit program, which the committee also had not finalized by Thursday afternoon. The House voted to cut $2 million from that program, while the Senate recommended full funding.

 

The program helps create high-paying jobs that will help lead the state out of the recession, said Richard A. Zakour, executive director of MdBio, a division of the Tech Council of Maryland. 'It is vital to Maryland's biotech industry that this program is fully funded,' he said.

 

Legislators face a deadline to finish the budget negotiations by Monday, when the regular session ends.

 

State funding for stem cell research could also be cut significantly. The Senate wants to slash $13 million, while the House wants to retain the full $18.4 million.

 

In addition, the program started last fall to help subsidize small employers' health insurance costs faces a $13 million cut. The program has not had as many participants as officials expected, largely due to the stagnant economy, said Nicole Stallings, chief of government relations and special projects for the Maryland Health Care Commission.

 

Some business owners have said the requirements are too restrictive. Legislation that would expand eligibility, such as allowing businesses with as many as 19 employees to participate, passed the Senate this week after the House approved a version in March. Business groups such as the Maryland Chamber of Commerce support the bill.

 

The health care commission will make some changes, such as increasing the subsidy amounts available, Stallings said. The proposed funding reduction will not affect enrollment in the program, she said.

 

Business executives more pessimistic

 

The budget cuts come on the heels of a survey released Thursday by PNC Financial Services Group that showed greater pessimism by Maryland business owners. Some 41 percent of business owners in the state surveyed said they were pessimistic about their company's prospects for the next six months, up from 27 percent last fall.

 

The telephone survey of 160 executives with small and mid-sized Maryland businesses was conducted by Artemis Strategy Group of Fairfax, Va., from Jan. 26 to March 4.

 

Some 22 percent said they planned to reduce the number of full-time employees in the next six months, up from 13 percent in October, while 79 percent said they will reduce capital spending. Some 12 percent said they would increase hiring.

 

Most owners said the new federal stimulus program would have at least some benefits.

 

Copyright 2009 The Gazette.

 

 

Budget ax spares biotech tax credit

But DBED funding program, stem cell research are cut

 

By Kevin James Shay

The Gazette

Monday, April 13, 2009

 

Bioscience industry leaders got their wish for full funding of the state's biotechnology investment tax credit, as the House on Saturday passed a $13.8 billion operating budget that included $6 million for the popular program.

 

The House earlier voted to slash that fund by $2 million. But the Senate approved the full funding, and a compromise by a House-Senate conference committee included $6 million for the biotech tax credits.

 

The full Senate planned to vote Monday — the final day of the legislature's regular 90-day session — on the final version of the budget, but it is not expected to reduce the biotech tax credit. Owners of biotech companies, led by the Tech Council of Maryland, launched a campaign to lobby for full funding of the program.

 

The tool, which formed in 2006, allows investors in Maryland biotechnology companies to take a 50 percent credit against state income taxes. The biotech that receives the investment must have headquarters in Maryland, have fewer than 50 employees and be in business less than 12 years.

 

Last July, the credits ran out on the first day applications were taken, with $8.5 million worth requested by local biotechs, officials said.

 

However, other programs of interest to Maryland business executives were slashed by the conference committee. The Maryland Economic Development Assistance Authority and Fund, which has provided more than $160 million in loans, grants and other aid to help companies expand or relocate to the state since forming about a decade ago, is expected to see a $6 million reduction in both this year and next fiscal year.

 

That is less than the $10 million cut legislators originally set for that program, whose beneficiaries include telecommunications company Comcast Corp. and Rockville biotech Novavax. The fund is the "workhorse" tool that the state Department of Business and Economic Development uses to retain and attract companies, said Jim Henry, managing director of finance programs for DBED.

 

Funding for stem-cell research next fiscal year was reduced by the House-Senate committee by $3 million to $15.4 million, although the Senate sought a larger cut. The state arts council saw its funds reduced by $3 million.

 

In addition, the program started last fall to help subsidize small employer's health insurance costs for workers was reduced by the House-Senate committee by $13 million. The program has not had as many businesses sign up as officials expected, largely due to the flagging economy, said Nicole Stallings, chief of government relations and special projects for the Maryland Health Care Commission.

 

Some business owners have said the requirements are too restrictive. Legislators passed a bill that would expand eligibility, including a provision to let businesses with as many as 19 employees tap the subsidies.

 

Copyright 2009 The Gazette.

 

Group brings fight against chronic diseases to Maryland

State has high rate of such illnesses, according to Partnership to Fight Chronic Disease

 

By Meredith Cohn

Baltimore Sun

Tuesday, April 14, 2009

 

A national group that aims to prevent and more effectively treat chronic diseases such as heart disease, cancer and diabetes launched a local chapter Tuesday in Maryland, where the number of people suffering from one or more of the conditions exceeds the national average.

 

The Partnership to Fight Chronic Disease is a coalition of patients and provider associations, business and labor organizations and health policy groups that are promoting early intervention to stem the rise in problems that now cause seven in 10 deaths nationwide and cost 75 cents of every health care dollar.

 

The problems affect the healthy and the sick, said Richard H. Carmona, chair of the group and a former U.S. surgeon general.

 

"We have a sick care system, not a health care system," Carmona said today during a news conference at the National Aquarium. "People only get care after they are sick. I realized when I was a trauma surgeon that most people I cared for had preventable problems, but we never talked about prevention."

 

Chronic diseases include heart disease, asthma, cancer, diabetes, hypertension, stroke, mental disorder and pulmonary conditions, and they are the nation's leading causes of death and disability, according to the group. They are also costly in financial terms, accounting for three-quarters of the approximately $2 trillion spent on health care in 2005, the latest data available.

 

Much of that cost was passed on to all participants in health care plans, helping to push up premiums in employer-sponsored coverage by 87 percent since 2000, the group says.

 

Maryland ranks 27th in the number of sufferers overall and spends $25.7 billion annually on treatment and lost productivity, the group says. By 2023, the number is expected to grow to $81.1 billion. African Americans are disproportionally affected, so Baltimore City and Prince George's County have higher rates of chronic illness, according to Sharon Allison-Ottey, a local chair of the group and executive director of The COSHAR Foundation, a nonprofit group aimed at improving health care.

 

"We need to meet people where they are," she said. That means going to churches, community groups and doctors' offices to spread the message about diet, exercise and health screenings.

 

Nearly 40 other local groups have signed on to support the mission, including health care organizations, the Maryland State Conference of NAACP branches, the Greater Baltimore Committee and the Maryland Chamber of Commerce.

 

Copyright © 2009, The Baltimore Sun.

 

Mikulski asks VA to upgrade Cumberland veterans clinic

 

Associated Press

Baltimore Sun

Wednesday, April 14, 2009

 

U.S. Sen. Barbara Mikulski has asked the Department of Veterans Affairs to upgrade mental health services at its outpatient clinic in Cumberland.

 

The Maryland Democrat released a letter Monday that she sent to the director of the regional VA medical center in Martinsburg, W.Va., seeking action on complaints last week by a Vietnam veterans group in Cumberland.

 

The vets are concerned about the VA's decision to stop contracting with a private clinic for mental-health care and add services at the local VA clinic.

 

The letter made seven specific requests, including more VA counselors and a 24-hour hotline in Cumberland.

 

Copyright 2009 Associated Press.

 

Former Tri-State health center doctor files $1M suit

 

By Kevin Spradlin

Cumberland Times-News

Wednesday, April 15, 2009

 

CUMBERLAND - A former physician is seeking $1 million in U.S. District Court from partners in the local health system for breach of contract, fraud and civil conspiracy.

 

Dr. Robert Shapiro was fired as an obstetrician and gynecologist at Tri-State Community Health Center’s women’s center in Memorial Hospital in November. He claims he was hired to fill a need and agreed to work for Dr. Dale Wolford and “the busiest OB practice in town,” according to a Feb. 13, 2008, e-mail to Shapiro from Thomas Dowdell of the Western Maryland Health System.

 

But shortly after being hired, Shapiro told his supervisors about his limited patient base while Dr. Wolford sees “70 to 100 patients per day and deliver(s) nearly 50 patients per month,” he wrote in an Oct. 20 letter to Dr. James Raver, chief medical officer for WMHS.

 

“This is not even close to the national averages for private ob/gyn providers, according to the most recent statistics from the American College of Obstetrics and Gynecology,” Shapiro said, noting the average was 78 patients per week and 140 deliveries per year.

 

On Sept. 17, Shapiro reported there were 12 new “in-takes,” 11 of which were assigned to Wolford and the 12th to Dr. Ziad Haidar. Five days later, Wolford was assigned nine new patients and had 44 total office visits, according to an e-mail from Shapiro, who had one new patient and only one other office visit.

 

The week of Oct. 17, Shapiro said Wolford saw 228 patients - Shapiro, just 20, while 17 new patients were assigned to Wolford and eight to Shapiro. The week of Nov. 7, Shapiro reported that Wolford saw 247 patients while he saw only 11.

 

In an October interview with the Times-News, Shapiro said he was appalled at the patient distribution. He was told during recruitment that “I’d be very busy when I came here,” he said, but “I’m not doing much at all.”

 

Shapiro even called Wolford’s volume of patients “unsafe” and told supervisors in Hancock he was concerned about patients’ quality of care. Shapiro blamed a large part of the patient distribution on the fact that Dr. Wolford’s wife, Jackie Wolford, served as office manager and assigned patients to doctors.

 

Shapiro declined to comment further, following the advice of his attorney, H. Gregory Skidmore. Repeated phone calls to Skidmore’s Cumberland office were not returned.

 

Shapiro, of Keyser, W.Va., has requested a jury trial that is to be heard by Judge William M. Nickerson in Baltimore. The civil suit was filed April 7 and names Wolford, who oversees the medical staff at the center, as well as his wife, Jackie, and the Western Maryland Health System.

 

The suit comes after Shapiro was notified Nov. 13 that he was being terminated for cause. He began working only three months prior to that. Tri-State’s acting Executive Director Sheila DeShong wrote a letter to Shapiro saying he “provided false information in connection with your recruitment and credentialing with TSCHC and Western Maryland Health System.”

 

The letter said that Shapiro indicated that he had never been the subject of a medical malpractice claim “when, in fact, a legal action was commenced against you on June 6, 2008.”

 

In an October interview with the Times-News, Shapiro said he signed his contract on April 21, nearly two months before a Uniontown, Pa., woman filed preliminary court documents against him. Attorneys for the complainant decided to discontinue the case, according to an Aug. 13 letter to Shapiro from his attorney.

 

Steven J. Forry, attorney from White and Williams LLP, said Tuesday that no claim of medical malpractice was made against his client.

 

“There’s nothing of record,” Forry said. “In Pennsylvania, you can file a case by filing a writ of summons. There is no complaint ever filed against Dr. Shapiro. Under Pennsylvania rules, there is no reporting requirement until the complaint is filed, because there is no way to tell what they’re suing him for.”

 

“There was never a formal lawsuit,” Forry said.

 

But that’s not all of Shapiro’s alleged violations, according to the Nov. 13 letter from DeShong to the physician.

 

“In addition, you represented that you were a Fellow of the American College of Obstetrics and Gynecology when, in fact, you were only a Junior Fellow in Practice,” DeShong wrote. “Moreover, you failed to cooperate with TSCHC’s privileging procedures, failed to comply with TSCHC policies and procedures, and otherwise have failed to fulfill your responsibilities to TSCHC.”

 

Indeed, Shapiro’s resume includes his listing as a Fellow and not a Junior Fellow.

 

In the Nov. 13 letter, DeShong said the center was willing to offer 60 days’ severance pay and to waive the non-compete clause of Shapiro’s contract. It’s unknown whether Shapiro agreed to the terms of the letter.

 

Attempts to reach a representative at Tri-State Community Health Center’s main office in Hancock were unsuccessful. Jackie Wolford said Tuesday she was unaware of the lawsuit but that she and her husband might be available to comment after discussing the situation.

 

The issue could bring to light a number of personnel changes in the last year. In May, the center fired its medical director, Dr. Matthew Hahn, who worked in Hancock. Another ob-gyn, Dr. Fauzia Baqai, was let go about the same time as Shapiro. Former Executive Director Leslie Colbrese resigned after repeated requests from medical staff to do so.

 

Contact Kevin Spradlin at kspradlin@times-news.com.

 

Copyright © 1999-2008 cnhi, inc.

 

Turning her life and others' around

Women team up to help the homeless

 

By Ryan Justin Fox

Annapolis Capital

Wednesday, April 15, 2009

 

In a small back-road apartment a stone's throw from two cemeteries in Annapolis, Priscilla Montague is setting up an oasis for those like herself who are navigating their way out of dark despair and homelessness.

Joshua McKerrow — The Capital Pat Montague fought off drug addiction and is now helping others transition out of homelessness. She helped Florine Griffin, in the background, move off the street and into a townhome on Johnson Place. The Friendly Haven organization, which Montague is establishing with business partners Jean Adams and Geraldine Cash, has three other homes and hopes to open more soon.

 

The Johnson Place townhome isn't much compared to the lavish dwellings found elsewhere in the city, but its confines are a palatial, heaven-sent escape for its residents.

 

Through Friendly Haven, an organization she is setting up with business partners Jean Adams and Geraldine Cash, Montague secures stable, low-income rental units for area homeless people who are trying to get back on their feet.

 

"I know how hard it was for me when I was out there," Montague said. "I have a lot of sympathy for them."

 

Her trademark affection and sincerity greet all those genuinely looking for an exit from the harsh life of the streets.

 

The 58-year-old Montague, or Pat as she is affectionately called, was a transient for a time, bouncing from public housing to acquaintances' couches and floors while addicted to cocaine.

 

"I liked getting high," she said. "I liked the taste more than anything."

 

Montague, who grew up on Spa Road, said she started using cocaine when she moved to Los Angeles for a prominent job with a record company in the early 1980s.

 

A boyfriend she met on the West Coast introduced her to free-basing, or inhaling liquefied cocaine, she said.

 

Her drug use continued when she moved back to Annapolis in 1994. She said she even began dealing out of her apartment in public housing.

 

Montague said she was content with the lifestyle she was living until she was diagnosed with HIV four years ago at a mobile medical clinic stationed in the Harbour House community.

 

"I was devastated. I wasn't a promiscuous person and I didn't (share needles)," she said. "I just couldn't believe it."

 

Turning to God

There was a brief period of denial before support and church groups convinced Montague that her life was not over.

 

Montague said she decided to turn her life over to God. She volunteered at Arundel House of Hope, a homeless-resource center based in Glen Burnie. That's where she ran into Adams, a classmate at Annapolis High School in the late 1960s.Adams told Montague about the Friendly Haven transition homes she and Cash were trying to establish.

 

"I didn't even know her history," Adams said of Montague. "I couldn't believe it when I found out."

 

Cash volunteers at local food pantries and homeless shelters as well, but had to scale back her participation in the organization when her husband fell ill, Adams said.

 

Adams sensed Montague's sincerity and decided to bring her aboard Friendly Haven.

 

"(In some cases) people will tell me they need help and are trying to get better, but she will tell me not to believe them, 'I used to use the same words.' "

 

On a dreary mid-March afternoon, Montague stopped by the Johnson Place home that Friendly Haven manages.

 

Inside, Florine Griffin was lounging on a couch, watching television. Griffin had been living with her brother after she suffered a stroke resulting from a battle with drug use. Montague was able to get Griffin into a Friendly Haven home after Griffin's brother fell ill.

 

Griffin would be waiting in long lines at local shelters or temporarily crashing at an acquaintance's home if it wasn't for Friendly Haven.

 

"The main thing is to have a roof over your head," Montague said.

 

'… Could be me'

 

Montague said that many people battling addiction, bad luck or both want to improve their situation, but find it nearly impossible when much of their day is spent figuring out where they're going to sleep at night.

 

"When you're out on the streets, that leads to all the other nonsense," she said.

 

Anne Arundel County accounts for nearly one-fifth of the state's homeless population, according to 2007 Census data. Officials estimate that 2,000 of the 10,000 homeless people in the state are in Annapolis and Anne Arundel County. Those numbers are expected to increase as the country's economy worsens and the recession continues.

 

"We're all one paycheck away (from homelessness)," Adams said. "Once you meet the homeless and hear their story, you start to feel sorry for them. And you think, 'That could be me.' "

 

Adams said many of the homeless people she comes into contact with are not necessarily in their position because of drugs or alcohol. Many are released from jail without anyplace to go. Others lose their jobs and have nobody to help them through their rough patch.

 

Friendly Haven has two homes on Pleasant Street in Annapolis in addition to two homes on Johnson Place. There are plans to secure several more.

 

Haven's rules

Friendly Haven homes do have rules. Residents are required to keep their places neat and clean. They are not allowed to have any visitors. They also are strongly encouraged to attend church services. If applicable, residents must attend drug or alcohol counseling and remain clean while staying in a Friendly Haven home.

 

In addition to shelter, Friendly Haven helps its residents apply for Section 8 housing or other public assistance so they can move into places of their own.

 

Local churches also adopt Friendly Haven homes. Parishioners drop off food and supplies, and visit with residents.

 

But the path to redemption is not without its bumps and roadblocks. Funding for Friendly Haven is spotty at best. Several churches have stepped in to help with security deposit costs and furniture, and landlords have been flexible with payment arrangements. Residents also are expected to help with rent when they can.

 

Adams and Cash are in the process of trying to obtain nonprofit, tax-exempt status for Friendly Haven - a challenging task for two women with little experience navigating bureaucratic red tape and applying for grants.

 

Montague said she knows that obstacles are only temporary in the larger scheme of things. After being absent from her family for a period of time, she was finally able to witness the birth of her granddaughter last month.

 

"I'm not proud of what I've done," she said. "I'm proud of what I've become."

 

Copyright 2009 Annapolis Capital.

 

State passes bills, but some didn't make the cut

 

By Kathleen Miller

Annapolis Capital

Wednesday, April 15, 2009

 

ANNAPOLIS, Md. (AP) — While roughly 800 bills won the approval of the Maryland General Assembly by midnight Monday, more than 1,500 measures went nowhere.

For at least another year, Maryland still has no public campaign finance system, doesn't allow gay marriage, and has no civil penalties for Medicaid fraud. Maryland governors can still appoint people to fill U.S. Senate vacancies, despite attempts by some lawmakers to take that power away after the allegations against former Illinois Gov. Rod Blagojevich scared state legislators across the country.

 

Democratic Gov. Martin O'Malley backed several bills that weren't approved by the Democratic-controlled legislature, including penalties for people who make false health claims and requiring law enforcement to request drivers in fatal accidents take an alcohol breath test.

 

In addition, a House committee on Saturday rejected O'Malley's high-profile effort that would have given state regulators more authority to direct utilities to build new power plants and restore some of the rules lost when Maryland deregulated in 1999.

 

The House Economic Matters Committee voted 21-2 against the bill after many members said they did not get enough time to review the legislation and felt rushed to make a complicated and wide-ranging decision.

 

O'Malley said Tuesday the state has spent two years examining the issue.

 

"It's hardly new to anybody, and those that complained that they hadn't read the bill should have sat down and read the bill," O'Malley said. "So hopefully over the summer they will, because there's not going to be any energy relief for people until we give the Public Service Commission more authority to compel the issue of generation."

 

The governor, like advocates for other failed measures, promises the bill will be back next year.

 

Lawmakers also did not close a loophole in federal law that requires fur garments to be labeled, unless there's less than $150 worth of fur used in the clothing. The bill sponsored by Sen. Catherine Pugh, D-Baltimore, means one could be wearing Fido's fur — not faux fur — for another year without realizing it.

 

Opponents tried to paint the bill as animal rights legislation, but supporters said it was commonsense for all consumers.

 

"It's a little bill that was right there and lost by one vote in a House committee vote," Pugh said. "You think about children and allergies, and more clothing coming into this country with fur trim and that's why I saw this as something I needed to champion to protect people."

 

Some lawmakers worried other measures left behind could have even greater consequences.

 

Senators delayed debate on a bill that would limit liability of buildings and corporate entities that make defibrillators available for use when somebody goes into cardiac arrest, and the clock ran out before the measure could come up for a vote. Currently, only facilities that have their defibrillators registered with the Maryland Institute for Emergency Medical Services Systems can receive immunity from lawsuits.

 

"We need to use defibrillators more often because they really do save lives," Sen. Jennie Forehand, D-Montgomery, said. "This bill would have encouraged people not to be afraid to do so."

 

State lawmakers made it easier to take guns from domestic abusers, but resisted efforts to make it easier for victims to get handgun permits themselves. The House of Delegates also rejected a bill that would have allowed people to expunge requests for domestic protective orders from public records, if the orders against them are ultimately dropped.

 

And for the second year in a row, there was no action in either chamber on a gay marriage measure or a bill that would ban discrimination against transgender people in housing and employment.

 

"We're very sad they didn't pass this year," said Kate Runyon, executive director of gay rights group Equality Maryland, but she added that the group will continue to pursue the issues. "We want to continue moving forward. We want our entire community to be liberated and also seen as equal in this state."

 

Copyright 2009 Annapolis Capital.

 

Adventist seeks state approval of hospital

Clarksburg site would serve growing populations in northern Montgomery and southern Frederick counties

 

By Susan Singer-Bart

Montgomery County Gazette

Wednesday, April 15, 2009

 

This story was corrected on April 15, 2009.

 

With letters of support from local politicians and Frederick Memorial Healthcare System in hand, Adventist HealthCare formally asked a state commission Friday for approval to build a hospital in Clarksburg.

 

Adventist filed a certificate of need with the Maryland Health Care Commission to build a 100-bed hospital as the first piece of a planned health care campus. A hospital cannot be built in Maryland without a state-approved certificate of need.

 

Adventist bought land in Clarksburg between Clarksburg Road and Interstate 270 eight years ago and has been planning to build a medical campus on the 60-acre site. Holy Cross Hospital made a surprise announcement in August that it wants to build a 93-bed hospital on the Montgomery College campus in Germantown and has already filed its certificate of need.

 

Adventist has received county land use approvals; Holy Cross has not.

 

The state is unlikely to approve two hospitals in the upcounty.

 

A Holy Cross spokeswoman did not return several phone calls seeking comment for this report.

 

The packet includes a letter of support from County Executive Isiah Leggett, who also sent a letter of support for the Holy Cross proposal.

 

"We will support the need for additional medical services in those areas but will not weight in on a particular proposal," Charles L. Short, special assistant to Leggett, said. "I think the state will recognize that at least one, if not two, facilities will be needed as we go into the next 20 years."

 

Adventist's Clarksburg Community Hospital would have all private rooms, an 18-bed obstetrics unit and an emergency department. The campus would have doctors' offices, outpatient treatment facilities, a day care center and a nursing home. The plan includes a health care clinic for low-income and uninsured residents and a prenatal clinic for low-income women.

 

The campus adjoins a planned senior housing community.

 

Adventist says its site is ideally located in the heart of the growing Clarksburg and Urbana communities.

 

"Given the projected population growth in southern Frederick County and northern Montgomery County, particularly along the I-270 corridor, the placement of this new hospital in Clarksburg is a preferable location, which minimizes the impact on existing services," Thomas Kleinhanzl, president and chief executive officer of Frederick Memorial Healthcare System, wrote in a letter of support.

 

The two medical organizations are talking about ways they can work together.

 

One of the criteria the commission will weigh is the economic viability of a proposal.

 

"We expect the Maryland Health Care Commission to make a decision based on the economics of the hospitals and speak to the issue of economic viability," Uma Ahluwalia, director of the county Department of Health and Human Services, said.

 

Adventist argues that it has the more cost-effective proposal.

 

The Adventist hospital would cost $202 million to build or $2 million per bed, according to the Adventist proposal. The Holy Cross hospital cost is projected at $267 million or $3.3 million per bed.

 

Adventist's Clarksburg Community Hospital could open in 2013 if the certificate is granted, hospital officials have said.

 

Copyright 2009 Montgomery County Gazette.

 

AstraZeneca CEO says U.S. needs less ‘sick care’

 

By Richard Simon

Daily Record

Wednesday, April 15, 2009

 

With an aging population, the health care industry has become increasingly synonymous with “sick care.”

 

That’s what David Brennan, the newly elected board chairman of the Pharmaceutical Research and Manufacturers of America, said Tuesday at a Greater Baltimore Committee breakfast and lecture at the Center Club.

 

Brennan’s speech coincided with the announcement of a newly formed partnership with organizations statewide to fight chronic disease.

 

“We would like to transform our system from a ‘sick care’ system to a ‘health care’ system that’s focused on health and not just sick care,” said Brennan, chief executive officer of the international pharmaceutical giant AstraZeneca.

 

Chronic diseases such as diabetes and heart disease are

responsible for seven out of every 10 deaths in the United States and are one of the primary reasons why there has been a rise in health care costs, according to statistics released by the Centers for Disease Control and Prevention.

 

A Milken Institute study found that the total treatment costs among seven common chronic diseases was nearly $5.2 billion in Maryland in 2003.

 

Brennan said that companies across the country are adopting workplace wellness and disease management programs to try and help their employees achieve long-term financial relief and better health.

 

“I think for health care reform to be successful it needs to create new kinds of incentives that previously, I don’t think existed in the same way to try and promote wellness,” Brennan said.

 

Donald C. Fry, president of the GBC, said that the issue of health care is of prime importance for area businesses in this ailing economy.

 

“You have the cost issue and the productivity issue,” Fry said.

 

“You want your employees to have a high quality of life. Everybody in business has these issues and that’s why it’s so important to us as we move forward. … Fighting chronic disease, which accounts for 75 percent of all of our health care costs … that’s something you would want to be attacking.”

 

Fry added that Baltimore’s proximity to Washington, D.C., has

made “Maryland a very important state in this matter.”

 

Roberto Allen, a lawyer who specializes in business law and tech/biotech, attended the lecture, and said that soaring health care costs can have a negative impact on startup companies and individuals considering launching their own businesses.

 

“That will affect the kinds of companies that are starting now and the technologies that investors will put their money into,” he said.

 

Following the event, Brennan and U.S. Surgeon General Richard H. Carmona joined state leaders at the National Aquarium in Baltimore to launch the Partnership to Fight Chronic Disease, which calls for comprehensive health care reform.

 

Two universal health care bills were introduced at this year’s General Assembly, but neither bill reached the House or Senate floors.

 

Copyright 2009 Daily Record.

 

More low-income students eating breakfast at school

Since state report card, more in county are taking advantage of program

 

By Marcus Moore

Prince George's County Gazette

Wednesday, April 15, 2009

 

French toast, milk and orange juice are among items available to students in the Montgomery County Public Schools breakfast program.

 

More Montgomery County children are eating free breakfasts, after a recently released report ranked the county near the bottom of the state in the number of eligible students who take advantage of the free meals.

 

The county, with 42 percent of its low-income students participating in the food program, ranked 19th in the state out of 24 jurisdictions, according to the report released in January by the nonprofit Food Research and Action Center in Washington, D.C.

 

In March, 12,478 elementary school students in the county ate breakfast for free. Of those students, 8,643 — or 69 percent — were eligible for free or reduced priced meals, according to school system data.

 

In middle schools and high schools, 6,399 students ate free breakfast, the data show. Of those students, 4,711 — or 74 percent — were eligible for free or reduced-priced meals.

 

Many of the eligible students who don't take advantage of the free food are opting to eat breakfast at home, said Kathleen C. Lazor, the school system's director of food and nutrition services.

 

Last school year, 44 percent of Maryland students eligible for free or reduced-price breakfast took advantage of the program, slightly below the national average, according to the nonprofit's annual School Breakfast Scorecard.

 

During the 2006-2007 school year, some 43 percent of eligible students throughout the state took advantage of the breakfast program, according to the report.

 

Overall, the state ranked 24th out of 50 in the number of low-income students who took advantage of the free or reduced-price meals last year, according to the report. The state ranked 26th during the 2006-2007 school year.

 

New Mexico, with 61 percent of its low-income students participating in the federal food program, was first in the nation. New Hampshire, with just 34 percent of those students eating free or reduced-price meals, ranked last.

 

Last summer, Montgomery County launched a free lunch program for students at John F. Kennedy High School, Argyle Middle School, and Georgian Forest, Strathmore and Bel Pre elementary schools in Silver Spring.

 

For years, national school leaders have factored nutrition into the persistent achievement gap between black and Hispanic students and their white and Asian-American peers. Typically, students who do not eat regularly have trouble focusing in class, officials said.

 

"If children have breakfast in the morning, they have better attendance and less visits to the school nurse," said Kimberley Chin, director of Maryland Hunger Solutions, which measured the state's participation in the school breakfast program.

 

Some schools in the state serve breakfast on exam days to help boost achievement. While that is helpful, breakfast should be served to students throughout the year, Chin said.

 

Participation in free or reduced-price meal plans varied throughout the state, according to the report.

 

Somerset County led the state, with 71 percent of low-income students participating in free or reduced-price breakfast or lunch plans. Howard County ranked last; some 20 percent of eligible students participated in the meal plans last school year.

 

Howard, Calvert, Charles and Carroll counties are among the wealthiest counties in the country, but they ranked near the bottom because of their inability to reach low-income children and get them the food services, according to the report.

 

Baltimore city began a universal breakfast program last school year for all children, regardless of income. Despite the program, it ranked 20th out of 24, as only 38 percent took advantage, according to the report.

 

Leaders of its school system have introduced "breakfast boxes" and reached out to principals to help increase participation, according to the report.

 

Copyright © 2009 Post-Newsweek Media, Inc./Gazette.Net.

 

Poultry outlook positive

At banquet, DPI urges regulations that are fair to growing, environment

 

By Deborah Gates

Salisbury Daily Times

Wednesday, April 15, 2009

 

SALISBURY -- The Delmarva Poultry Industry Inc. served up a prosperous outlook for poultry on the Eastern Shore, but its leaders warned political leaders at the group's annual banquet on Tuesday that survival of the region's leading industry requires regulatory measures that are fair to both chicken growing and the environment.

 

This year's event, the 53rd for the 2,000-member or more DPI, drew several hundred guests that included state and local elected officials and business leaders from both Maryland and Delaware along with poultry growers and poultry standouts Perdue Farms, Mountaire Farms and Allen Family Foods.

 

One thing's for certain, Delaware Sen. Tom Carper told the audience, "People always have to eat."

 

Bill Satterfield, DPI executive director, said the continued success of the poultry industry depended on cooperation by government officials, institutions and industry members. He also cited partnerships, including a $50,000 marketing project with the Delmarva Soybean Board that is unveiling a T-shirt campaign, "No Farms, No Food."

 

Satterfield also said a partnership between DPI and the owner of a local Arby's fast-food franchise is offering 99 cent chicken coupon sandwiches. Coupons will be distributed at the June 19 and 20 Delmarva Chicken Festival in Centreville, Md.

 

The DPI presented medals of achievement to Maryland Sen. Richard Colburn, R-37-Dorchester, as a supporter of the chicken industry who is pushing legislation in Annapolis that would relax or eliminate proposed farming management practices that involve the spreading of manure that would minimize bay pollution.

 

"(The industry) is always under fire, especially in the state of Maryland," Colburn told the audience, and suggested that the Environmental Protection Agency name Maryland Secretary of Agriculture Roger Richardson to implement measures of the proposed regulatory Confined Animal Feeding Operations, or CAFO, to assure safe poultry and environmental practices. "You control the EPA; we ask you to be fair, reasonable."

 

Also recognized was Robin Morgan, a dean and scientist at the University of Delaware whose research has benefited the industry.

 

The J. Frank Gordy Sr. Delmarva Distinguished Citizen Award went to Henry Engster, an expert in poultry nutrition and vice president at Perdue Farms.

 

Delegate Jim Mathias, D-38B-Worcester, called CAFO a critical issue facing the industry that state and federal environmental officials are grappling with to assure farming equity and enviromental protection.

 

"That's our biggest concern now," Mathias said in an interview, and added that Gov. Martin O'Malley has agreed to not impose CAFO permits on Maryland farmers if they are not required in Delaware.

 

Copyright 2009 Salisbury Daily Times.

 

National / International

 

Atypical antipsychotics: too hard a sell?

Use of drugs such as Abilify, Seroquel and Zyprexa for treatment-resistant depression is gaining ground. Some see an 'unmet need' for medication. Others worry about side effects.

 

By Melissa Healy

Baltimore Sun

Tuesday, April 14, 2009

 

About a year ago, patients began trooping into the office of UCLA psychiatrist Andrew Leuchter, asking whether an antipsychotic drug called Abilify "might be right for them." Few appeared to be delusional, plagued by hallucinations or suffering fearsome mood swings. Mostly, they were depressed or anxious, and frustrated by the pace of their recovery.

 

Leuchter wondered what was up: Depressed patients didn't usually seek out drugs used to quell psychiatry's most disturbing symptoms.

 

What was up, he soon discovered, was spending on a new advertising campaign touting Abilify as an "add-on" treatment for depression. For the first time since the arrival of a new generation of antipsychotic medications -- six drugs called the "atypicals" because they work differently from the earlier generation of antipsychotic drugs -- the makers of one, Abilify, had been granted the legal right to market to a vast new population of patients beyond those with schizophrenia or bipolar disorder.

 

This week, a Food and Drug Administration advisory panel recommended that the agency should grant the makers of a second atypical antipsychotic drug -- Seroquel XR -- similar latitude. The drug giant AstraZeneca wants permission to market the drug as a treatment for depression or anxiety that has not yielded to antidepressants alone.

 

But this time, it wasn't quite so easy a sell. The panel did say the drug was safe and effective for such purposes when used with other drugs, recommending approval for its use as an "add-on" treatment. But the panel recommended against the drug as a stand-alone treatment. And this time, the panel -- echoing an issue expressed by the FDA in convening the meeting -- cited safety concerns about the drugs' use in a greatly expanded population of patients.

 

Mounting research has made clear that the atypical antipsychotics are not only less safe than originally thought; they are not, on balance, any safer or more effective than older drugs for schizophrenia. And for the population of depressed or anxious patients that some are now proposed to treat, studies suggest the benefits are extremely modest.

 

The accumulated findings on the larger group of drugs had prompted the FDA to ask its advisory panel whether expanding the population of patients taking Seroquel XR would be wise. Like other members of this class of drugs, Seroquel has been linked to weight gain extreme enough to cause diabetes and to an often irreversible disorder characterized by involuntary tics and jerking movements.

 

As for Abilify, Sonia Choi, a Bristol-Myers Squibb spokeswoman, said the company "is continually monitoring the safety of Abilify, including the metabolic data, as part of our regular practice and is committed to disclosing clinical trials results" on the medication as they become available.

 

The concerns expressed by the FDA and its advisory panel, many public health experts say, come too late. In less than a decade, physicians have embraced the broad use of the atypical antipsychotics to treat mental disorders far less severe than schizophrenia and bipolar disorder -- afflictions such as anxiety, sleep difficulties, depression, attention deficit disorder and autism. First prescribed almost exclusively to adults, the drugs are now often used in the treatment of adolescents and kids as young as 2.

 

The sales of atypical antipsychotics have skyrocketed in recent years, propelling overall sales of antipsychotic drugs past all other classes, to $14.6 billion in 2008, according to IMS Health, a private firm that tracks drug trends. In 2008, 50 million prescriptions for antipsychotics, mostly the new ones, were filled in the U.S. -- a 5% hike in one year alone.

 

In the process, the spreading use of these costly drugs is raising -- for the nation as well as individual patients -- the rates and the risks of weight gain, diabetes, strokes, fatal heart attacks, an array of movement disorders and potentially, suicide, according to a wide range of critics.

 

"This is very worrisome; frankly I have serious concerns about these drugs," says Dr. Steven Nissen, who is chairman of the Cleveland Clinic's cardiovascular medicine department and serves as an ad hoc advisor for FDA panels. Studies point to a "very questionable balance between efficacy and safety" for the class, he said. But that message, he said, has been lost in an apparent "marketing bonanza" for the companies that make the medications. A recent report by the consulting firm Decision Resources found the makers of the atypicals spent $993 million in 2006 to promote the drugs to doctors and patients.

 

That's not to say the drugs haven't helped people.

 

Leuchter, who has prescribed Abilify for some with treatment-resistant depression, says that for certain patients and in certain circumstances, it works. "These are very effective medications, and like all medications, they have side effects," he says. But he adds: "I wouldn't want people to think this is the first thing they should reach for when a patient doesn't respond well to first-line antidepressants."

 

Newer drugs 'safer'

 

Introduced through the 1990s and early 2000s, the atypical antipsychotics -- drugs marketed as Abilify, Seroquel, Zyprexa, Geodon, Clozaril and Risperdal -- were widely hailed as superior to older schizophrenia drugs such as Thorazine and Haldol, which began to be used in the 1950s and 1960s, respectively. The first-generation antipsychotics could be highly effective at taming hallucinations and delusions. But some studies indicated that as many as 1 in 5 who took them developed involuntary tics and muscle movements called tardive dyskinesia, a condition that frequently cannot be reversed.

 

The newer drugs were supposed to be safer and more effective. That claim has now been roundly challenged.

 

A landmark 2005 study concluded that the drugs have brought marginal improvements at much greater expense than traditional antipsychotics in their primary use of treating schizophrenia. The CATIE study (for Clinical Antipsychotic Trials of Intervention Effectiveness) compared four of the atypicals -- Zyprexa, Geodon, Seroquel and Risperdal -- with the first-generation antipsychotic perphenazine (Trilafon), a drug costing on average a tenth the price of the newer drugs. It found the risk of tremors and tardive dyskinesia to be the same for all. And while all the antipsychotics are associated with weight gain, it was more frequent and more likely to be extreme among patients taking atypicals -- leading many to develop diabetes.

 

Last December, the British journal Lancet published a comprehensive analysis that further punctured the new drugs' claims to superiority. A separate study found Seroquel by many measures to be no more effective in treatment of schizophrenia symptoms than Haldol. And a 2008 study on Abilify found it was little better at banishing depressive symptoms than a placebo.

 

"The results are extremely unimpressive," said Dr. Daniel Carlat, a Massachusetts psychiatrist who publishes a respected monthly report on psychiatric research. "They just squeak by."

 

Many forces -- chief among them medical need and commercial imperatives -- have converged to make the atypical antipsychotics the prescription drug of the moment.

 

Psychiatrists and patients, disappointed in the effectiveness of antidepressants, have been hungry for treatments capable of curing depression, not just easing its hold on patients. Atypical antipsychotics influence different brain chemicals than do most current-generation antidepressants; their mode of action is thought to complement the ways in which standard antidepressant drugs affect the brain, and boost their effects on mood.

 

"There certainly is an unmet need out there," says UCLA's Leuchter, who has conducted extensive research on antidepressants' effectiveness. "Only about half the patients [on antidepressant drugs] will improve, and fewer than a third will get well with the first antidepressant they try."

 

That "unmet need" represents a potentially huge business opportunity for drug firms. Each year, as many as 10 million to 12 million depressed Americans could still be seeking relief after trying an antidepressant -- many more than the number who suffer from schizophrenia (2.4 million adults) and bipolar disorder (5.6 million adults). About 6.8 million adults suffer from generalized anxiety disorder.

 

"The story's pretty clear, and pretty embarrassing for the profession of psychiatry, which has allowed itself to be led by marketing," says Robert Rosenheck, a psychiatrist at Yale University who has studied the effectiveness and expanded use of the atypical antipsychotics. "We know now what these companies' strategies are: The number of people with schizophrenia is limited, so the road to profitability goes through soccer moms. They need to market these drugs to ordinary people who have dissatisfactions in life."

 

Side effects

 

In the run-up of use across the nation, weight gain and metabolic changes quickly emerged as a worrisome side effect. And in August 2008, the FDA, responding to a flurry of new research, required all antipsychotics to carry the agency's most urgent warning: The drugs' use in geriatric patients with dementia (by then very common) would raise their risk of dying from any cause.

 

Recent research has darkened the drugs' safety profile even further.

 

* Early this year, a Lancet Neurology study concluded that Alzheimer's disease patients given the drug to control aggression were nearly twice as likely to die of any cause than those not given the drug.

 

* Another study published in August 2008 -- this one in the British Medical Journal -- concluded that taking any antipsychotic medication raises a patient's likelihood of suffering a stroke, and added that "the risk of stroke might be higher in patients receiving atypical antipsychotics."

 

* Then, in January, the New England Journal of Medicine delivered a further blow to the new class of drugs. A federally funded study compared the rate of fatal heart attacks in patients taking the newer class of antipsychotic drugs, those on the older class, and patients taking neither. Patients on any antipsychotic drug -- new or old -- were twice as likely to die of a heart attack as those not on such medications.

 

Although drug makers are forbidden to promote, market or advertise drugs for any indication other than those approved by the FDA, that hasn't stopped physicians from legally writing "off-label" prescriptions. Rosenheck estimates roughly 60% of prescriptions for atypical antipsychotics have been written off-label.

 

In January, Eli Lilly & Co., which makes the atypical antipsychotic Zyprexa, was ordered by the Justice Department to pay more than $1.4 billion in penalties in connection with alleged illegal off-label marketing efforts. The company admitted no wrongdoing. The attorneys general of several states have sued the makers of Seroquel and Risperdal, alleging they've unlawfully marketed their medications to state Medicare and Medicaid agencies. The suits, still pending, allege that widespread prescribing of the drugs, encouraged by pharmaceutical companies that downplayed risks, caused harm to patients and unjustified cost to taxpayers.

 

One spokesperson for AstraZeneca, which makes Seroquel, says the company "fully supports the work of the FDA" in assessing the drug's benefits and risks in the treatment of depression and anxiety.

 

Responding to allegations made in several states' suits, another spokesman, Tony Jewell, said Seroquel's detailed package insert "has always provided adequate and appropriate information and warnings based on available data."

 

Currently, of all the atypical antipsychotics, only Abilify -- the drug that Leuchter's patients began asking about -- may legally be promoted as a treatment for psychiatric conditions other than schizophrenia and bipolar disorder. In November 2007, the FDA granted permission to its maker, Bristol-Myers Squibb, to promote the drug as a treatment for depression that has failed to respond to one or more antidepressants.

 

The FDA's decision on Abilify came without calling a hearing of its advisory panel on psychopharmacological drugs. In considering AstraZeneca's petition for Seroquel's new use, however, the FDA proceeded with greater caution, asking the committee to sift through the evidence and offer its recommendation.

 

Copyright © 2009, The Los Angeles Times.

 

As Pills Treat Cancer, Insurance Lags Behind

 

By Andrew Pollack

New York Times

Wednesday, April 15, 2009

 

Chuck Stauffer’s insurance covered the surgery to remove his brain tumor. It covered his brain scans. And it would have paid fully for tens of thousands of dollars of intravenous chemotherapy at a doctor’s office or hospital.

 

But his insurance covered hardly any of the cost of the cancer pills the doctor prescribed for him to take at home. Mr. Stauffer, a 62-year-old Oregon farmer, had to pay $5,500 for the first 42-day supply of the drug, Temodar, and $1,700 a month after that.

 

“Because it was a pill,” he said, “I had to pay — not the insurance.”

 

Pills and capsules are the new wave in cancer treatment, expected to account for 25 percent of all cancer medicines in a few years, up from less than 10 percent now.

 

The oral drugs can free patients from frequent trips to a clinic to be hooked to an intravenous line for hours. Fewer visits might save the health system money as well as time. And the pills are a step toward making cancer a manageable chronic condition, like diabetes.

 

But for many patients, exchanging an I.V. bag for a pill is a lopsided trade because the economics and practice of cancer medicine have not caught up with the convenience of oral drugs.

 

Start with the double ledger of drug insurance. Drugs that are infused at a clinic are typically paid for as a medical benefit, like surgery. Pills, though, are usually covered by prescription drug plans, which are typically much less generous; for expensive cancer pills, patients might face huge co-payments or quickly exceed an annual coverage limit. Sometimes, as in Mr. Stauffer’s case, a single insurer is involved.

 

Many times, though, a separate company — a so-called pharmacy benefit manager — provides the prescription drug coverage.

 

The growing use of cancer pills is also thrusting patients and doctors into new roles they have not yet fully mastered. Without a physician’s direct supervision, side effects can be missed. Some patients do not take all their medicine, raising the risk their cancer will worsen. Others take too many pills, risking toxic reactions.

 

For doctors, the new drugs also pose financial challenges. Physicians can profit from infusing drugs in their offices but not from writing prescriptions that are filled at a pharmacy.

 

With oral cancer drugs, “the technology has outstripped the ability of society to integrate it into the mainstream in a smooth fashion,” said Carlton Sedberry, a pharmacy expert at Medical Marketing Economics, a consulting firm.

 

Oregon, partly in response to Mr. Stauffer’s case, has passed a law requiring insurance companies to provide equivalent coverage of oral and intravenous cancer drugs. Some other states are now considering similar measures.

 

So far the health reform debate in Washington has not drilled into specifics like cancer pill coverage.

 

Infused drugs, of course, can also be frightfully expensive and under some insurance plans — including Medicare — can carry big co-payments. But it is the oral drugs that seem to be causing a disproportionate number of financial problems for cancer patients. The Patient Advocate Foundation, an organization that helps people make insurance co-payments for cancer drugs, says oral medicines accounted for 56 percent of the cases in which it helped Medicare patients last year, even though far more cancer patients were on intravenous drugs.

 

One oncology practice in central Pennsylvania has a nurse assigned full time to dealing with patients on oral drugs and arranging insurance or charity payments for the pills. “Trying to obtain this drug for the patient — that’s my struggle, every single day,” said the nurse, Jane Flenner.

 

Although drug makers are developing oral versions of some infused cancer medications, most of the new pills and capsules have no intravenous equivalent.

 

The oral exemplar is Gleevec from Novartis, which since its approval in 2001 has helped turn chronic myeloid leukemia as well as gastrointestinal stromal tumors into manageable diseases for many patients.

 

Douglas Jenson, 75, of Canby, Ore., has taken Gleevec for 10 years for leukemia. He goes for a blood test once every three months and sees his oncologist every six months, but is healthy enough to go whitewater rafting.

 

Making it even easier, Mr. Jenson gets his Gleevec free because he participated in an early clinical trial of the drug. Otherwise it would cost more than $40,000 a year.

 

While Mr. Jenson has been diligent about taking his five capsules every day at lunchtime, research indicates that many patients on the oral drugs do not consistently take the proper dose. One study, for example, found that Gleevec patients, on average, were taking only 75 percent of their prescribed doses.

 

Some cancer patients skip pills or stop taking them completely — whether because of costs, forgetfulness, side effects, complicated regimens or other factors.

 

“When I first started looking into this, I thought, ‘People with cancer have too much to lose, how can they not take their drugs?’ ” said Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute in Boston.

 

Some other cancer patients, meanwhile, end up taking too many pills.

 

Gayne Ek of Allen, Tex., said he once skipped all of his Gleevec capsules for six weeks. Then, with the stockpile of capsules he accumulated, he took twice the prescribed dose for six weeks, hoping it would be more effective. It was not.

 

For many patients, though, the main challenge is not taking their pills, but paying for them. Under Medicare, most oral cancer drugs are covered by the Part D prescription drug program, which has a 25 percent co-payment. It also has the annual “doughnut hole” — reached when a patient’s total drug costs hit $2,700, after which the patient must shoulder the next $3,000 or so before coverage resumes.

 

Mary Francis Thomas of Camp Hill, Pa., reached the doughnut hole on her very first prescription of the year. Ms. Thomas, 86, had to pay $4,300 in January for a month’s supply of Revlimid, to treat a disorder that can lead to leukemia. Having now passed through the doughnut hole, she must pay 5 percent of the cost of the drug for the rest of the year — which still works out to $377 a month.

 

Drug companies say they provide free drugs for some patients and give money to charities for co-payment assistance. And Lee Newcomer, senior vice president for oncology at UnitedHealthcare, the big insurer, said many commercial policies capped total annual out-of-pocket expenditures, so patients should not have huge co-payments month after month.

 

But nurses and patient advocates say that many patients still have trouble paying for the drugs.

 

Mr. Stauffer, the Oregon farmer, is no longer one of them, though. After his daughter, Heather Kirk, told his story to Peter Courtney, the president of the state senate, Oregon enacted in late 2007 the nation’s first state law requiring insurers to provide equivalent reimbursement for oral and intravenous chemotherapy drugs.

 

Mr. Stauffer’s insurer, Regence Blue Cross Blue Shield, even reimbursed him for the money he had already spent on Temodar. Several other states, including Colorado, Hawaii, Minnesota, Montana, Oklahoma and Washington, are now considering similar legislation.

 

 

Copyright 2009 The New York Times Company.

 

A Deadly Polio Vaccine, Bed Bugs and Medical Marijuana

 

By Roni Caryn Rabin

New York Times Morning Rounds

Wednesday, April 15, 2009

 

U.S. Holds First National Bed Bug Summit

The Environmental Protection Agency organized the first-ever National Bed Bug Summit yesterday, a three-day conference that drew health experts, housing officials and others together to discuss a resurgence in the critters that invade beds and hotel rooms, The Associated Press reports. Increasing international travel has helped spread bedbugs, and there are few effective pesticides approved for use in eradicating them, experts said.

 

Organ and Face Donor Was Son of Holocaust Survivors

The man whose face was donated to a victim of a disfiguring accident earlier this month was the son of Holocaust survivors, The Boston Globe reports. Joseph Helfgot was 60 when he died after heart transplant surgery, and his family agreed to donate his nose, the roof of his mouth, his upper lip, facial skin, muscles and nerves for use in the nation's second face transplant.

 

Health Reform Advocates Organize the Uninsured

If the country's uninsured organized politically, they would have more members than the AARP and clout to match, but they have never banded together to exert influence in Washington, D.C.,The Associated Press reports. Now a group called Health Care for America Now wants to organize the estimated 50 million Americans who lack health insurance into a potent lobbying force to march on Washington and to press Congress to guarantee coverage.

 

Advocates for Medicinal Marijuana Square Off With Government Lawyers

Government lawyers and advocates for the medicinal use of marijuana squared off before a federal appeals court panel on Tuesday, the Los Angeles Times reports. While a government lawyer argued the administration does not have to support its claim that marijuana has "no currently accepted medical use," advocates for the use of pot said it eases the pain and anxiety of chronic illness, and that the government should stop spreading "false information." The advocates represent Americans for Safe Access, which is suing the government under a law that bars it from disseminating inaccurate information.

 

Deceased Minnesota Patient Was Infected With Polio From Live Virus

Minnesota health officials say a patient with a weakened immune system who died in March was infected with polio from a live virus found in an oral vaccine no longer used in this country, the Star Tribune reports. It was the second such case in the state in four years, but health officials said there was no need for alarm.

 

Copyright 2009 The New York Times Company.

 

Study Finds Risk of Dementia Increases After Hypoglycemia

 

By Roni Caryn Rabin

New York Times

Wednesday, April 15, 2009

 

People with Type 2 diabetes may be at increased risk for developing dementia as they age, several studies have suggested. Now researchers say the higher odds may be linked to life-threatening drops in blood sugar, or hypoglycemia, usually caused by excess insulin.

 

A long-term study of thousands of older patients with Type 2 diabetes in Northern California found that those who had experienced even one episode of hypoglycemia serious enough to send them to a hospital were at higher risk for developing dementia than diabetic patients who had not experienced such an episode. With each additional episode, the risk of developing dementia increased, the study found.

 

The findings, to be published on Wednesday in the Journal of the American Medical Association, are significant given the high rates of Type 2 diabetes around the world, and the expectation that dementia rates will increase as the population ages.

 

“We’ve known for some time that patients with Type 2 diabetes are at greater risk of dementia and cognitive problems,” said Rachel A. Whitmer of the Division of Research at Kaiser Permanente in Oakland, Calif., one of the authors. “This adds to the evidence that balance of glycemic control is important, and that trying to aim for a very low glycemic target might not be beneficial and might even be harmful.”

 

The study found that the risk of dementia among patients who had experienced a single episode of hypoglycemia that required hospitalization was 26 percent higher than the risk for patients who had never had an episode.

 

Patients who had experienced two episodes faced an increased risk of 80 percent, while those who had experienced three episodes or more had a 94 percent increase in risk, or almost double the odds of developing dementia.

 

“To see an effect after just one episode is remarkable,” said Dr. Alan M. Jacobson, a researcher at the Joslin Diabetes Center in Boston. An earlier study of Type 1 diabetes and dementia found no connection, Dr. Jacobson noted.

 

Researchers gathered their data from 16,667 Kaiser Permanente patients with Type 2 diabetes. They used hospital data to determine how many had experienced severe hypoglycemic episodes from 1980 to 2002 and how many had first received a diagnosis of dementia from 2003 to 2007, when their mean age was 74 to 78.

 

Copyright 2009 The New York Times Company.

 

Novel Approach to Health Plans Gains Traction

Hospitals and Nonprofits Offer Packages of Basic Care Directly to Small Businesses

 

By Sarah Rubenstein

Wall Street Journal

Wednesday, April 15, 2009

 

As the Obama administration wrestles with how to expand health-care coverage to the millions of uninsured Americans, some local organizations are finding creative ways to help cover one of the most affected groups -- employees of small businesses.

 

The programs typically involve collaboration between business owners, nonprofit groups and local hospitals, which offer enrollees a range of medical services at a reduced rate. The plans keep costs down partly by bypassing the extra costs that come with traditional insurance. That can be a big help for small-business employees who can't afford traditional insurance. But for patients with costly chronic diseases or catastrophic illnesses, the coverage would likely be inadequate.

 

In Galveston, Texas, the University of Texas Medical Branch hospital recently began providing coverage to more than 430 employees of small businesses at a cost to individuals of $60 a month, plus copayments -- far less than many traditional insurance plans. Nonprofit groups, including ones in Duluth, Minn., and Pueblo, Colo., have started similar programs. In Muskegon, Mich., one such program called Access Health currently covers about 1,100 small-business employees.

 

Gail Peterson, who owns a small printing company in Galveston, says she has offered to help her employees get insurance by paying half the monthly cost of about $300 per person. But the workers weren't willing to participate for that price. Instead, Ms. Peterson enrolled her company in the UTMB plan, and all five of her employees have signed up. Ms. Peterson also dropped her own traditional individual-insurance plan, which had cost her $400 a month, in favor of the UTMB coverage.

 

Small-business employees make up a disproportionate share of the country's uninsured. Some 15% of U.S. residents, or about 46 million people, were uninsured as of 2007, the latest data available, according to the Census Bureau. Meanwhile, 32% of workers at U.S. companies with fewer than 25 employees were uninsured in that year, and 21% of employees at firms with 25 to 99 workers had no coverage, according to the Kaiser Family Foundation.

 

"If you get a person into primary care where an issue can be identified at its earliest stages, then you can ...have an impact on it before it becomes a huge issue, a catastrophic-type case," says Jim Rodriguez, executive director of the UTMB plan.

 

Delia Melendez, a 42-year-old employee at a small dental laboratory in the Galveston area, says she wasn't going for medical check-ups when she was uninsured. But diabetes runs in her family and she wanted to get checked every so often to make sure she's not developing it herself. Signing on to her husband's workplace health plan would have cost the couple about $350 a month. So, after her employer joined the UTMB plan, she enrolled at a cost of $60 a month.

 

"For the price and for what it does cover, I felt it was a reasonable amount for me to have," Ms. Melendez says.

 

The UTMB plan in Galveston pays for 20 doctor visits a year and covers maternity care, visits to the emergency room, medical imaging such as CT scans and MRIs, and surgery. Enrollees can go only to UTMB and its staff doctors, and the coverage limits are lower than those of most employer-sponsored insurance plans: $1,200 per year for drugs, for instance, and a lifetime cap of $250,000. Family members aren't covered.

 

These types of plans are called 3-Share, because employers and workers who participate each pay a third of the cost and the nonprofit groups find other sources of funds for the balance. The nonprofits generally look to government, foundations and hospitals as possible sources of money.

 

Traditional insurance last year cost on average $382 a month per employee at businesses with fewer than 200 workers, according to Kaiser. The total cost for the UTMB plan is $180 a month. Employers and workers each pay $60 of that, and the rest is paid for by UTMB and the Houston Endowment, a philanthropic foundation.

 

Such plans are a middle ground between traditional insurance coverage and so-called limited-benefit plans, says Randy Giles, chief executive for South Texas of UnitedHealthcare, an insurance unit of UnitedHealth Group Inc. Limited-benefit plans tend to have sharply reduced coverage limits and are often marketed to part-time or temporary workers.

 

The UTMB plan avoids directly competing for patients with traditional insurers -- for instance, it markets only to small businesses that haven't offered health coverage to workers in the prior 12 months.

 

Under state law, the UTMB plan isn't categorized as "insurance." That means it isn't subject to state requirements for how much money it must have available in case claims shoot up. It also isn't required to cover certain types of care, such as inpatient mental-health care or inpatient alcohol- and drug-dependency treatments.

 

Patients also have fewer protections than with traditional insurance. If the UTMB plan were to go under, patients won't be protected by a coverage fund to which insurers are required to contribute. Patients also aren't able to appeal to state insurance regulators if they have disputes with the plan over whether specific services should be covered.

 

Groups involved in organizing 3-Share plans say they are trying to maintain standards of care similar to those mandated for insurers, and to reserve sufficient funds if claims should shoot up.

 

UTMB says it doesn't expect to make a profit from the program. Still, the hospital hopes the coverage plan will save it money by helping it collect co-pays and premiums from patients who often used to pay little to nothing when they came to the emergency room and UTMB clinics as uninsured patients.

 

For some patients, the coverage isn't sufficient. Anthony Rios, 47, started on the UTMB plan last August. But he blew past the $1,200 annual limit on drug coverage in January when he began a regimen of three HIV drugs that cost a total of $2,000 a month. He also worries about how quickly he would exhaust the $250,000 lifetime cap if his health were to worsen significantly.

 

"A young person who doesn't have any health issues, they'd be OK with that kind of coverage," Mr. Rios says. "But it's not for a person who is a high-risk patient."

 

Mr. Rios is looking for new options, including a state assistance program that helps pay for HIV drugs and an insurance plan through the state's "high-risk pool" for patients who are unable to buy insurance on their own because of health problems. The risk-pool plan would cost him 10 times as much, $600 a month, but it has a $2 million lifetime coverage limit.

 

"Some of it does have to come down to what's doable versus what's ideal," says Connie Crawford, an assistant county attorney in El Paso, Texas, and a member of the TexHealth Coalition, a collaboration of nonprofit groups and others aiming to set up additional 3-Share plans around the state. "Hopefully you can avert catastrophic things by providing a medical home and primary preventive care."

 

Write to Sarah Rubenstein at sarah.rubenstein@wsj.com

 

Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved.

 

Opinion

 

Food Safety, One Pistachio at a Time

 

New York Times Editorial

Wednesday, April 15, 2009

 

For those concerned about food safety, one of the most encouraging events in years was the recent blanket warning from the Food and Drug Administration about salmonella in pistachios. The agency advised consumers to store or throw out pistachios while investigators figured out which health bars, granola products or nuts were tainted.

 

It seemed a simple enough advisory. But the announcement also sent a powerful signal to those in the food business that the F.D.A. planned to focus more urgently on the safety of consumers.

 

“We’re going to try to stop people from getting sick in the first place, as opposed to waiting until we have illness and death before we take action,” Dr. David Acheson, the agency’s associate commissioner for foods, promised last week.

 

This is encouraging news. But a recent report from the Centers for Disease Control and Prevention suggests that the agency still has a long way to go. Food safety, the report says, has not improved over the last three years, largely because of failures at the F.D.A.

 

The Department of Agriculture, which shares oversight of food safety with the F.D.A., has waged a more vigorous and successful campaign to reduce contamination in meat and poultry. In contrast, the F.D.A., which monitors produce, seafood and other foods, has too few inspectors and too little clout to deal with an increasingly global food supply.

 

The latest outbreak of salmonella in peanut products, which left hundreds sick and contributed to nine deaths, illustrates the problem. Inspections delegated to state officials missed critical safety failures at a Georgia peanut plant. And the F.D.A. had trouble getting detailed records in a timely fashion.

 

Even though the Obama F.D.A. appears to be doing a better job, Congress needs to beef up the agency’s staff and broaden its recall authority. Longer term, Congress and the White House need to keep promises to take a deeper look at food safety. It is time to think seriously about establishing one federal agency to coordinate and enforce food-safety regulations — and give consumers the protections they need and deserve.

 

Copyright 2009 The New York Times Company.

 

Early warning

Our view: A measles outbreak threatens the region's immigrant communities

 

Baltimore Sun Editorial

Wednesday, April 15, 2009

 

Measles, long a scourge of childhood before the development of effective vaccines, has practically disappeared in the United States. Today, most Americans either were vaccinated as children or got the disease before they entered school and are now immune.

 

That's not the case for people who weren't born in this country, however, many of whom remain vulnerable. That's why health department officials are taking urgent steps to contain an outbreak of measles in Montgomery County, where four cases were reported this year. That may not sound like a lot, but because measles is very contagious, every precaution must be taken to keep it from spreading through the area's large immigrant community.

 

Prevention requires identifying and isolating victims so they can't infect others. Officials have linked three of the four victims to a traveler from China who brought the disease back with him; they have yet to determine how the fourth victim, a Hispanic woman, got infected. In each case, health workers contacted anyone who may have come in contact with the virus. They also alerted area medical personnel to be on the lookout for patients with measles symptoms, such as runny nose, fever and skin rashes.

 

Maryland's uptick in measles parallels those in other states. Pennsylvania reported half a dozen confirmed cases this year, and officials there are taking similar precautions. It's a reminder that although modern medicine has virtually eradicated many once-common illnesses, it's a small world after all and international travel can bring diseases to our shores within a matter of hours that put whole communities at risk.

 

Copyright 2009 Baltimore Sun.

 

Health woes part of economic fallout

 

Frederick News-Post Editorial

Wednesday, April 15, 2009

 

The ramifications of a sour economy seem to be as vast as the numbers associated with the jobless rate or the dollar amounts being thrown around by politicians and economists. Here's the latest: As diabetics lose health insurance and a paycheck, more of them are either cutting back or forgoing doctor visits, insulin prescriptions and blood-sugar testing equipment.

 

The Associated Press recently performed an analysis, interviewing patients and doctors, and found that sales of the top-selling drugs and related diabetes products have dropped since last fall when the economy started its slide. Yet the number of diabetics in the country has gone up. According to the AP, 1.6 million Americans were diagnosed in 2007 alone.

 

Although skipping medications to save money is not unique to this disease, the consequences of not treating diabetes brings on the threat of amputations, loss of vision, stroke and death.

 

The AP interviewed M. Eileen Collins, 48, of Indianapolis, who cut back on her medication when her husband lost his job last fall. Instead, she asked for free samples from her doctor and took advantage of the $4-a-month generic programs that some stores offer. Still, to stretch her budget, she stopped taking most of her prescriptions.

 

"I truly did not think I was putting my life in danger," Collins said in the story. "I thought if I was just real careful with what I ate ... I'd be all right."

 

Not so. By the day before Thanksgiving, "Collins was vomiting blood and rushed to a hospital. Doctors diagnosed her as malnourished, anemic and in diabetic ketoacidosis, a life-threatening condition caused by lack of insulin and sky-high blood sugar. She spent a week in the hospital."

 

The AP pointed out that her story is hardly unusual.

 

They interviewed Dr. Steven Edelman, an endocrinologist at the University of California at San Diego who runs a free clinic staffed by medical students. He has seen a 30 percent spike during the past six months in patients seeking free diabetes medicines and supplies. The clinic has had to ration what they have to these patients who for the most part are middle class, but since the downturn have lost jobs and benefits.

 

And the ripples of this recession continue.

 

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