Wednesday, April 22, 2009

News Clipping Archives

 

Maryland / Regional

Va. Home to Area's 6th Measles Case (Washington Post)

Maryland among worst in disciplining physicians (Washington Post)

U-Md. May Protect Alcohol Samaritans (Washington Post)

 

National / International

NYC takes lead in setting next food target – salt (Washington Post)

2 Kids Mysteriously Contract Swine Flu (AOL News online)

Health insurance subsidy for laid-off workers has holes (USA Today)

 

Opinion

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Maryland / Regional

 

Va. Home to Area's 6th Measles Case

 

By Tara Bahrampour

Washington Post

Wednesday, April 22, 2009

 

A sixth case of measles has been reported in the Washington Area, this time in Prince William County, the first sign of the disease in Virginia this year.

 

The Virginia Department of Health announced the case yesterday, a day after D.C. officials reported finding the highly infectious disease in a District man who contracted it during a recent three-week trip to India. There is no known link between the Virginia case and the others in the region, health officials said. The source of the measles virus in the Virginia resident has not been identified.

 

Denise Sockwell, the Virginia Department of Health's epidemiologist for Northern Virginia, said the man "did not have a history of travel outside the United States."

 

The Prince William resident works at the Harris Teeter in Tysons Corner, said Jennifer Thompson, director of communications for the supermarket chain.

 

"The person is fine now," Thompson said, adding that the store sent voice mail messages yesterday to 1,074 customers who had shopped at the store during the man's shifts April 10-14, alerting them to possible exposure. She said no other employees have contracted the disease, and the man has not returned to work.

 

The man also visited several places where unimmunized people might have been exposed, including a Safeway and 7-Eleven in Woodbridge, an IHOP in Falls Church, and a CVS in Fairfax Station. People who think they might have measles should contact their doctor's offices before going in, Sockwell said, so that precautions can be taken to prevent others from being exposed.

 

Measles germs can linger in the air for up to two hours, putting at risk people who have not been vaccinated. In the United States, that includes babies younger than 1 year old who are too young for the vaccine, people who have moved to the region from countries where the vaccine is not prevalent, and people who decide against getting it for religious or other reasons.

 

People born before 1957, when the vaccine was not available, are generally considered to be immune because they are assumed to have contracted the disease as children, health officials said. "In those days, it was thought of as a disease of childhood," Sockwell said. According to the 2007 Virginia Immunization Survey, 94 percent of kindergartners and 98 percent of sixth-graders in Virginia are vaccinated, she said.

 

The virus spreads through coughing and sneezing. Most people fully recover, but it can lead to complications such as ear infections, pneumonia and death. Symptoms include a rash, high fever, cough, runny nose, and red, watery eyes, which can start seven to 21 days after exposure and last about a week.

 

Six cases in a region in a short period is rare, Sockwell said, noting that before one reported case last year, the state had not had a case in six years.

 

Copyright 2009 Washington Post.

 

Maryland among worst in disciplining physicians

 

Associated Press

Washington Post

Wednesday, April 22, 2009

 

WASHINGTON - Maryland is among the worst states in the country in disciplining physicians, a study by a consumer watchdog group found, while Washington is one of the most improved jurisdictions.

 

Public Citizen's annual ranking of state medical boards found that the rate of disciplinary action for doctors last year was 21.5 percent lower than in 2004. That's 2.92 serious discipline actions per 1,000 doctors in 2008 compared with 3.72 actions per 1,000 in 2004.

 

Actions can include license revocations, surrenders, suspensions and probations or restrictions.

 

"The overall national downward trend of serious disciplinary actions against physicians is troubling because it indicates many states are not living up to their obligations to protect patients from bad doctors," said Sidney Wolfe, a physician and director of Public Citizen's health research group.

 

Maryland is ranked 45th. It has been among the worst 10 states for the past six rankings, Wolfe said. Virginia is ranked 28th. Washington is among the five most improved. It was ranked 42nd in 2003 and 17th in 2008.

 

"The progress in these states is commendable because the medical boards have figured out ways ... to improve the protection for patients from doctors who need to be disciplined but, in the past, were disciplined much less rigorously," Wolfe said.

 

The Washington Post found in 2005 that the D.C. medical board rarely punished doctors. This was true even after they were disciplined in Maryland and Virginia for questionable medical care, criminal wrongdoing or substance abuse problems.

 

The Post's report prompted District officials to allocate more funding for staff and improved technology.

 

"We are one of the most improved boards in the country," said Feseha Woldu, senior deputy director of the District's Health Regulation and Licensing Administration.

 

The report ranks Alaska first in disciplining doctors.

 

Irving Pinder, executive director of the Maryland Board of Physicians, called the findings flawed.

 

"I've always argued that Public Citizen's statistics are very misleading because ... they assume the pool of doctors is the same in every state," Pinder said. "Maryland has some of the best doctors ... in the country. If you need to go in for major surgery, would you want to be in Alaska or Maryland?"

 

Copyright 2009 Washington Post.

 

U-Md. May Protect Alcohol Samaritans

Proposal Encourages Calls for Help

 

By Susan Kinzie

Washington Post

Wednesday, April 22, 2009

 

University of Maryland students have long complained that school rules deter them from calling for help when they are concerned about the health or safety of a student who has been drinking heavily.

 

If they have been drinking themselves, or have alcohol in their rooms, underage students risk being booted from campus housing or receiving a permanent mark on their academic transcripts -- major penalties for undergraduates.

 

Schools across the country are addressing the same issue as they try to avoid sending a message of permissiveness about illegal underage alcohol use and binge drinking without scaring students into inaction when a situation becomes dangerous.

 

About 100 colleges, including George Washington University and the University of Virginia, have good Samaritan rules that provide either a break or amnesty to students who seek help in a medical emergency.

 

At Maryland, the issue has particular resonance because of the death seven years ago of student Danny Reardon. His father said fraternity brothers delayed calling emergency medical services after Reardon drank himself unconscious.

 

Maryland students told a committee researching the policy last month that they had seen friends flee a dorm party after someone downed eight to 10 shots, slammed his head and was gushing blood. One student with emergency medical training said his friends called him, instead of an ambulance, after a friend drank 11 shots in four minutes. Another described blacking out for two hours, saying friends waited 90 minutes before calling an EMT.

 

"There were times when students were unconscious and nobody ever called. I wouldn't have expected anyone to call for help for me," a student said at a public forum where undergraduates were promised anonymity. "Our rationale for making those decisions was that there was a 95 percent chance that they'll sleep it off."

 

Now a good Samaritan proposal, pushed by students for the past two years, is making its way to the university senate, which is scheduled to vote on it tomorrow. The proposal could lessen the penalties for violating university alcohol rules if a student is caught because he called authorities out of concern for someone's safety.

 

The proposal would not protect students who break the law or engage in egregious conduct, but disciplinary or residence hall charges would be dismissed if the student met with administrators and completed an alcohol intervention program, if necessary, said John Zacker, director of student conduct.

 

"We are providing limited relief," he said. "We're not willing to overlook that you are in violation of a university rule and state law. . . . We're not going to completely ignore it, but we will modify our response."

 

Students 21 or older are allowed to drink in their rooms but not in common areas in dorms, according to university policy.

 

Students began advocating a new policy in 2007, but the issue died in committee at the university senate, whose 166 voting members include faculty, students and staff members. Many senators were vehemently opposed, saying a new policy would create a more permissive environment for drinking, said Brad Docherty, a senior and a member of the senate who led the working group on the issue.

 

Attorneys for the university had major reservations about the wording of that policy, said Associate Professor Elise Miller-Hooks, chair-elect of the senate.

 

Some faculty members said the school should hold students accountable for their choices and questioned whether the university would, in effect, be letting the worst offenders off the hook.

 

The committee's research showed overwhelmingly that students aren't as concerned about criminal charges as they are about university sanctions, said Reka Montfort, director of the university senate. They are worried about having to scramble for housing in the middle of an academic year or receiving a mark on a transcript that could hurt their chances of admission to graduate school.

 

"This protocol does not protect them at all from law enforcement action," she said. "That does not concern them at all. Their primary concern was university sanctions."

 

In a compromise reached earlier this spring, the senate will review a proposal that would not officially rewrite the student code of conduct, but would guide the way the current policy is implemented. After a year, the senate would decide whether to rewrite the policy.

 

Zacker, the student conduct director, said that school administrators consider individual circumstances of such incidents and treat a call for help as a mitigating factor but that students aren't aware of it.

 

The proposal would present a two-pronged approach to solving the problem, he said, telling students, in effect: "You're not going to get in trouble by calling. We want you to call, and here's what to look for." It would include public education, to be sure students know the rules and when a drunk student needs medical help.

 

The board of regents doesn't have a policy on the topic, said University System of Maryland spokesman Paul Stackpole. About a decade ago, it directed individual campuses to develop policies.

 

The senate's endorsement would be sent to University President C.D. Mote Jr., who could approve it, disapprove it or do nothing, in effect letting it stand.

 

Docherty said the proposal is "far from perfect. But it's a step in the right direction. I hope that if the administration sees it works -- and I think it will work, saving student lives on campus -- that it will expand protocol into policy. And eventually expand it to drugs, because right now it only covers alcohol."

 

Copyright 2008 Washington Post.

 

National / International

 

NYC takes lead in setting next food target - salt

 

Associated Press

By Stephanie Nano

Washington Post

Wednesday, April 22, 2009

 

NEW YORK -- First, it was a ban on artery-clogging trans fats. Then calories were posted on menus. Now the New York City health department is taking on salt. City officials are meeting with food makers and restaurants to discuss reducing the amount of salt in common foods such as soup, pasta sauce, salad dressing and bread.

 

About three-quarters of the salt Americans eat comes from prepared and processed food, not from the salt shaker. That's why New York officials want the food industry to help cut back.

 

"It's very hard for an individual to do this on their own," said Dr. Lynn Silver, an assistant commissioner in the health department.

 

The department has shown its clout with bans on artificial trans fats and rules forcing chain restaurants to post calorie counts. To comply, fast food chains changed their recipes nationwide, and other cities and states have enacted similar policies.

 

Some manufacturers said getting rid of trans fats took work, and reducing salt has its own difficulties.

 

Unlike sugar, there's no substitute for salt. Cream soups - like that casserole favorite cream of mushroom - are the biggest challenge, said George Dowdie, head of research and development for Campbell Soup Co. The soup maker, which has been cutting salt for years, is in the talks with New York.

 

By fall, Campbell Soup plans to have more than 90 lower-sodium soups available. That includes its first soup, tomato, which will have almost a third less salt.

 

The industry hopes salt reduction remains voluntary.

 

"Literally freight cars full of salt have been removed from these products gradually over time," said Robert Earl, vice president of science policy, nutrition and health for the Grocery Manufacturers Association. "It has to be done carefully - gradually and incremental over time."

 

Herbert Smith Jr. never paid much attention to how much salt was in food until he developed high blood pressure. His doctor at a Harlem health center put him on medication and told him to exercise and watch his diet.

 

The 54-year-old church receptionist said he was alarmed to see how much salt was in the instant soup packages that he liked. He wants the food industry to cut down.

 

"For those who want to use salt, they can add it themselves," he said.

 

Too much salt raises blood pressure, and high blood pressure raises the risk of heart disease. A recent analysis showed that for every gram of salt cut, as many as 250,000 cases of heart disease and 200,000 deaths could be prevented over a decade.

 

"Very, very small changes in diet could have dramatic effects," said Dr. Kirsten Bibbins-Domingo, a researcher with the University of California, San Francisco.

 

For its salt initiative, New York has recruited public health agencies and medical groups across the country. The campaign - with a goal of cutting salt intake by at least 20 percent in five years - is modeled on a plan carried out in Britain. That effort set voluntary salt reduction targets for 85 categories of processed foods.

 

"Companies have been very innovative," said Corinne Vaughan, of Britain's Food Standards Agency. "And they have been very good at making what are quite huge reductions in salt levels."

 

Salt in pasta sauces has been cut by nearly a third, and soups by about one-quarter, she said. Some foods have been more challenging, she said, citing bacon, cheeses and packaged bread. With less salt, the dough is sticky and harder to process, she said. Salt is used mostly for flavoring but can also help preserve some foods and gives others texture.

 

Some British companies have also put "traffic light" labels on package fronts - green for low-salt, for example - so shoppers can "make a choice at a glance," Vaughan said.

 

Everyone needs some salt - or sodium chloride - for good health. The daily recommended amount for Americans is about a teaspoon, or 2,300 milligrams of sodium. But many people consume twice that amount. A Big Mac alone has 1,040 milligrams.

 

A recent government report showed that seven out of 10 adults should be eating even less than the recommended amount - about 1,500 milligrams. That includes anyone with high blood pressure, everyone over 40, and African-Americans, who are at greater risk than whites for high blood pressure.

 

The prospect of government intervention bothers some, and some critics note that not everyone is sensitive to salt. A few others contend there is not enough scientific evidence that reducing salt really drives down heart problems or deaths.

 

But many in the medical and public health field are firmly behind the idea.

 

"When you've got groups ... all saying we need to reduce salt, the evidence is exceedingly strong, you don't do more trials," said Dr. Stephen Havas, an adjunct professor at Northwestern University's medical school and a former American Medical Association vice president.

 

In the meantime, the Food and Drug Administration is considering a request that the government regulate salt content. An Institute of Medicine committee is also looking at ways to reduce salt consumption. The FDA says it is waiting for that committee report, due next year, before deciding the regulation issue.

 

Bibbins-Domingo, the University of California researcher, and her colleagues say their findings support efforts to lower salt levels, either voluntarily or through regulation.

 

She said her patients with high blood pressure struggle to cut down on salt. They give up potato chips, french fries and salty nuts, but end up eating processed foods like soups and pasta that can also have a lot of salt, she said.

 

"I realized how hard it is for patients who want to make those changes," she said.

 

New York resident Kristle Thompkins, 37, has been trying to make those changes herself.

 

She started reading labels and limiting salt a few years ago because of her high blood pressure. Now she's adjusted to eating less salt - although she still misses potato chips.

 

The macaroni and cheese she made for an Easter gathering now tastes "too salty."

 

"My salt tolerance has lowered," Thompkins said.

 

On the Net:

New York City Department of Health:http://www.nyc.gov/health

 

British salt program:http://www.salt.gov.uk

 

© 2009 The Associated Press.

 

2 Kids Mysteriously Contract Swine Flu

 

By Mike Stobbe

AOL News online

Wednesday, April 22, 2009

 

ATLANTA (April 22) - Health officials alerted doctors Tuesday to a unique type of swine flu diagnosed in two California children, but it's unclear whether many people will be susceptible to the infection. The children were diagnosed last week. One was a 10-year-old boy in San Diego County, and the other a 9-year-old girl in neighboring Imperial County. Both recovered.

 

U.S. Centers for Disease Control and Prevention officials said there's no reason for the public to take unusual measures against it.

 

"CDC is concerned, but that's our job," said CDC spokesman Tom Skinner.

 

Health officials have long feared the emergence of a deadly form of flu. They have not noted a spike in flu cases or a rash of severe illnesses. But they are continuing to investigate the genetics of the virus and track down and test people who may have been in contact with the children.

 

Both children became sick in late March and experienced fever and cough. The boy also vomited.

 

The two had not been in contact with each other, CDC officials said.

 

The boy's mother and brother also had a flu-like illness recently, as did a brother and a cousin of the girl. None of those relatives were tested for flu at the time of their illness.

 

The San Diego County boy and his 8-year-old brother flew from California to Dallas in early April and are currently with relatives in Texas. Health officials also are trying to contact the plane's flight crew and two children who sat near the boys, CDC officials said.

 

In the past, CDC received reports of approximately one human swine influenza virus infection every one or two years. But more than a dozen cases of human infection with swine influenza have been reported since late 2005.

 

Most cases occur in people who were exposed to pigs. Neither child had touched a pig, according to their families, although the girl had been at an Imperial County agricultural fair four weeks before she got sick.

 

The jump in cases in the past few years could be because of technological improvements and expansion of public health laboratories, which have improved testing capacity. But genetic mutations could also play a role.

 

The new flu contains a unique combination of gene segments that have not been seen in swine or human flu viruses before, CDC officials said.

 

The same virus has not been detected in any California pigs. "But we don't test every pig for influenza, so we don't know all the strains that are circulating," said Dr. Gil Chavez, California's state epidemiologist.

 

Early tests indicate this type of flu is resistant to amantadine and rimantadine, two common antiviral medications. It is not unique in that respect — a more common virus that's been infecting people this flu season also is resistant to those drugs.

 

Health officials think the current seasonal flu vaccine may not protect against it.

 

Swine flu is an infamous disease in public health circles. In 1976, health officials were frightened by unusual cases of swine flu in soldiers at Fort Dix, N.J. The virus appeared to be similar to a deadly flu that killed millions around the world in 1918 and 1919.

 

Federal officials vaccinated 40 million Americans during a national campaign. The pandemic never materialized, but thousands who got the shots filed injury claims, saying they suffered a paralyzing condition and other side effects from the vaccinations.

 

The government is more sophisticated now in how it diagnoses and tracks diseases, said Dr. Lyn Finelli, a CDC epidemiologist.

 

Copyright 2009 The Associated Press.

 

Health insurance subsidy for laid-off workers has holes

 

By Sandra Block

USA Today

Wednesday, April 22, 2009

 

A new federal subsidy designed to help laid-off workers pay for health insurance could be out of reach for thousands of jobless workers because they worked for a small company or their former employer has gone out of business.

 

The subsidy, part of the economic stimulus package enacted earlier this year, covers 65% of COBRA premiums for individuals laid off between Sept. 1, 2008, and the end of this year. The subsidy is available for up to nine months.

 

COBRA allows individuals who leave their jobs to continue their former employer's health coverage for up to 18 months. In the past, though, individuals had to pay 102% of the premiums, making COBRA unaffordable for most jobless workers. For a family, the average cost of unsubsidized COBRA premiums exceeds $1,000 a month. With the subsidy, the average family will pay $377 a month, according to the Kaiser Family Foundation.

 

Companies were required to notify former workers about the subsidy by April 18. The White House estimates more than 7 million unemployed workers will qualify. Reasons some will not:

 

•Their former employer has gone out of business. If an employer terminates its group health plan, former employees are ineligible for COBRA, says Michael Langan, principal with Towers Perrin, a human resources consultant. That makes them ineligible for the subsidy, too, he says.

 

During the last four months of 2008, the most recent data available, 11,645 businesses filed for Chapter 7 bankruptcy protection, up 70% from the same period in 2007, according to the Administrative Office of the U.S. Courts.

 

•They worked for a small company and live in a state that doesn't provide extended COBRA coverage. The federal COBRA law only applies to companies with 20 or more workers. Some 39 states and Washington, D.C., have enacted "mini COBRA" laws that require small companies that provide group coverage to allow former employees to continue that coverage. Still, gaps between the federal and state laws remain, leaving laid-off employees with a reduced subsidy or none at all. "There are a lot of people who can't avail themselves" of the full COBRA subsidy, says Ron Pollack, executive director of Families USA.

 

Jobless workers who haven't received a notice or have questions about their eligibility should contact the company that administers their employee benefits program, Langan says. The Department of Labor also has a fact sheet about the subsidy at www.dol.gov/ebsa/cobra.html.

 

Find this article at:

http://www.usatoday.com/money/industries/health/2009-04-22-cobra-subsidy-limits_N.htm

 

Copyright 2008 USA TODAY, a division of Gannett Co. Inc.

 

Opinion

 

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Maryland / Regional

 

Medical society offers no cost prescriptions

 

Associated Press

Salisbury Daily Times

Thursday, April 23, 2009

 

WILMINGTON, Del. (AP) — Thousands of Delaware residents without health insurance will be able to get free prescription medicines through a new pilot program.

 

The Medical Society of Delaware is working with mail-order pharmacy Welvista on the program and they expect 2,000 people to receive 5,000 prescriptions in the first year. Only people at or below 200 percent of the federal poverty limit can participate.

 

Welvista created the program in South Carolina before expanding it to Texas and New Jersey

 

Copyright ©2009 The Daily Times.

 

As economic crisis goes on, financial fears can push some over the edge

 

By Stephanie Desmon and Scott Calvert

Baltimore Sun

Thursday, April 23, 2009

 

The headlines have had a similar ring: A Frederick County man underwater on his mortgage kills himself and his family. A man accused of financial improprieties does the same while staying at a Towson hotel. A top official with Freddie Mac, a company with major money woes, is found dead in an apparent suicide.

 

With the economic crisis showing little sign of easing - and with a known link between suicide and unemployment rates - experts warn that stressful life events such as losing a job, a home or savings can unhinge those who are vulnerable to harming themselves and others. The suicide rate, like the incidence of depression, rises when the economy falls.

 

"It is so regular a pattern among most of the industrialized countries of the world that it is virtually an economic indicator," said M. Harvey Brenner, professor emeritus at the Johns Hopkins Bloomberg School of Public Health. "It's a standard feature of recession."

 

Calls to suicide help lines are up. The Grassroots Crisis Intervention Center in Columbia has seen a 15 percent increase in calls this year from people who feel suicidal. In February, the center recorded a 300 percent spike over February 2008 in calls from people who said money was the main cause of their distress.

 

"Most folks coming in to see us these days really are at the end of the rope," said Brian Yost, director of crisis services. "We've had folks come in with $3,000 BGE bills because they've been behind six or seven months and late charges keep adding up. They don't know what they're going to do."

 

Yost said staff members deal first with a person's suicidal impulses. This year, the center has doubled the number of interventions, meaning an ambulance or the police had to be dispatched. But he said the center also tries to address underlying issues by making referrals to service agencies.

 

"What we're figuring out and what we're discovering is the financial stuff is just one more thing on the plate with everything else," said Timothy Jansen of Community Crisis Services, a nonprofit that runs three suicide hot lines in Maryland. "The challenge with it is there are so few solutions to it."

 

Suicide and financial strain have long been linked, at least in popular mythology. Legend has it that stockbrokers and bankers jumped to their deaths from their Wall Street windows after the Crash of 1929. It didn't happen, but the peak suicide rate on record was 1933, at the height of the Great Depression. Brenner expects that when the suicide rate for this recession is tallied, it will be high.

 

On Wednesday morning, David Kellermann, acting chief financial officer of Freddie Mac, the troubled mortgage giant, was found dead at his Northern Virginia home in an apparent suicide.

 

A Hopkins study last year showed that suicide was rising among middle-class whites. Brenner says those who are well off are often those with the most to lose when their money disappears. Creature comforts, social status - it can all be tied up in their personal net worth.

 

Of course, few who suffer a financial trauma commit suicide or kill their families.

 

"Stressors don't affect everyone in the same way," said Dr. James Potash, a psychiatrist at the Johns Hopkins Mood Disorders Center. "The rain falls everywhere, but not everyone gets wet. Some people have umbrellas. Some people are more vulnerable to stressors than others."

 

Little quantitative research has been done on people who kill their families before killing themselves, mostly because there have been so few cases, said Kristen Rand, legislative director for the Violence Policy Center in Washington, which has examined murder-suicides in general. But those numbers seem to be rising, she said.

 

Criminologist Jack Levin, who has studied mass killings for 25 years at Northeastern University in Boston, said men who kill their families and then themselves - and it is almost always men - are called "family annihilators."

 

Those who are not motivated by revenge may be driven by a perverse sense of altruism. They have suffered a catastrophic loss, and in hard economic times the losses can pile up fast. In this recession, Levin said, people have not only lost jobs but also much of their savings, something that may seem impossible to overcome.

 

"When neighbors and friends all describe the killer as a 'devoted father and dedicated husband,' that's exactly what he is," Levin said. "He feels responsible for them, and he believes this life is so miserable that they would all be better off reuniting in the hereafter. He certainly does not want to leave his family with the stigma of his own suicide or if he kills his wife, he doesn't want to leave his kids without parents."

 

Baltimore County police say that William Parente, a tax and estate lawyer from Long Island, N.Y., beat and asphyxiated his wife and two daughters before killing himself. On Monday, police found their bodies in their room at a Towson hotel. Federal authorities were investigating what happened to a client's $450,000 investment with Parente.

 

Last week, authorities say, Christopher Wood killed his wife and three young children before killing himself in their rented home in Middletown. Wood, 34, reportedly left six notes detailing his depression and his financial hardships. The family had taken out two mortgages on a home they owned in Florida, owing double the house's worth.

 

In January 2008, a top executive of a collapsed subprime mortgage firm based in Columbia killed his wife and then threw himself off the Delaware Memorial Bridge. Walter Buczynski was a vice president at Fieldstone Mortgage. He spared his two young children.

 

Most who commit suicide kill only themselves.

 

In February, Baltimore advertising executive Howard "Jack" Marks Jr., 63, took his own life, and his wife told police who responded to the couple's Glyndon home that financial woes had threatened to sink their firm, John Marks Associates. "They were in danger of losing the business," a Baltimore County police officer wrote in a report.

 

"I think he was so embarrassed by the situation that he didn't want certain people to know it," said Jon Levinson, vice president at Alex Cooper Auctioneers and a friend of Marks' for 20 years. "People could sense there were issues, but nobody knew how serious it was."

 

On Feb. 6, Marks and his wife, Virginia, awoke at 3 a.m. "due to the fact that they had been going through some financial issues with their business," the police report stated. Jack Marks, drinking and taking muscle relaxants, told his wife to "make sure you take credits on the television buy" - an apparent reference to their business.

 

About 8:15 a.m., an employee of the residence was washing a car when he saw Marks sitting on a tractor. Marks called the employee over and asked him to "take care" of his wife. Marks then drove to woods near the house and shot himself.

 

Coping with the strain

•Heed these warning signs that financial problems may be affecting one's emotional state: persistent sadness or crying; excessive anxiety, irritability or anger; lack of sleep or constant fatigue; increased drinking; illicit drug use, including misuse of medications; difficulty staying focused; apathy about things that usually matter; and inability to function well at work, school or home.

 

•Use these coping techniques to help manage stress: try to keep things in perspective, recognize what's good in life and stay hopeful; strengthen connections with family and friends who can provide emotional support; engage in activities such as exercise or hobbies; and develop new employment skills that can ease money woes.

 

•Seek help: Call the National Suicide Prevention Lifeline, 800-273-TALK (8255), or the National Domestic Violence Hotline: 800-799-SAFE (7233) go online for "Getting Through Tough Economic Times" at www.samhsa.gov/economy.

 

Sources: U.S. Substance Abuse & Mental Health Services Administration, National Domestic Violence Hotline

 

Copyright 2009 Baltimore Sun.

 

Disease samples likely destroyed, Army says

 

Associated Press

Baltimore Sun

Thursday, April 23, 2009

 

Army officials say an investigation of three disease samples discovered missing from a Fort Detrick lab last year found no evidence of criminality and the samples probably were destroyed. U.S. Army Medical Research Institute of Infectious Diseases at Fort Detrick spokeswoman Caree Vander Linden said Wednesday that the samples of Venezuelan equine encephalitis were discovered missing last year in an inventory of a group of samples left by a departing researcher. Vander Linden said the report that the vials were missing triggered the investigation, which found that the samples were likely among those destroyed when a freezer malfunctioned.

 

Copyright 2009 Baltimore Sun.

 

State fears census undercount could curtail federal funds

 

By Megan Miller

Capital News Service

Thursday, April 23, 2009

 

WASHINGTON - Maryland could get shortchanged on its share of $3 trillion in federal funding over the next decade if officials can't prevent undercounting of residents in the 2010 census.

 

The Census Bureau designated parts of Prince George's, Montgomery and Frederick counties, as well as Baltimore City, as extremely "hard-to-count" areas in the upcoming decennial census. Undercounting Marylanders could have long-term consequences for the state, since census results affect the distribution of federal funds for things like health care, education programs and public transit.

 

"For every individual that is not counted, you're talking about approximately $1,000 per year in federal funds that the state can garner for either goods or services," said Marco K. Merrick, director of communications and education for the Maryland Department of Planning. "If we miss an entire family of four, that's $4,000 in a year, which really equals $40,000 for the census' 10-year span."

 

Urban centers and high-poverty areas, immigrant and minority communities are most susceptible to miscounts, Merrick said. Minorities tend to be undercounted because some, especially immigrants, are mistrustful of and avoid sharing information with the government.

 

Maryland had the seventh-highest minority population in the country as of 2007, according to Census Bureau statistics. Blacks were the largest minority group, about 30 percent of the state's population, while Hispanics and Latinos were the second-largest group, about 6.3 percent.

 

Maryland's foreclosure crisis could also cause miscounting, because many people have been forced into temporary, hard-to-track housing arrangements. Prince George's County alone tallied 12,573 foreclosures in 2008. In the fourth quarter of 2008 the state's concentration of foreclosures-per-household ranked 18th in the nation, according to the Maryland Department of Housing and Community Development.

 

The Census Bureau has established measures to handle unusual housing situations, said Arnold Jackson, associate director for the national census.

 

"We are seeing a surge of tent cities and unusual living arrangements ... However, we have always counted places like RV parks, labor camps, and people in shelters. We have special enumeration procedures in place."

 

It's not just money on the line, but also government. The 2010 census could affect state political districts because of population changes, said Michael J.G. Cain, director of the Center for the Study of Democracy at St. Mary's College of Maryland.

 

In the past, Cain said, such changes contributed to political shifts in state elections. He pointed to demographic shifts recorded in the 1990 census that probably affected election outcomes in 1992 and 1994.

 

"Republicans doubled their number of state senators in 1994 to 15, and in the House almost doubled their number of delegates to about 40," Cain said. "Part of that had to do with the Republican revolution going on at the time, but it was also partly to do with redistricting."

 

To reach traditionally undercounted populations, the Census Bureau has invested more than $300 million in a major advertising campaign to begin in the fall, including $212 million in stimulus funds. Of that, more than $100 million is directed to media advertising, some nationally, but more than half at the local and regional levels.

 

Campaigns will target African Americans, Latinos, Asians, native Hawaiians, American Indians and Alaska natives, Jackson said. Preparations for the campaign included more than 70 focus group studies.

 

"We've done focus groups for Latino households who don't speak Spanish. We've done focus groups for Latino households from Central America," Jackson said. "We recognize that one size does not fit all, and this is an expensive proposition."

 

The Census Bureau also enlisted organizations already working in communities to help educate minorities on what the census means for them.

 

Martha Bazurto, director of the Latino Federation of Greater Washington, said 34 of its member agencies will help spread the word, both in everyday operations and at special events.

 

"In the Latino community, we've always said we want a bigger piece of the pie," Bazurto said, "and we can't get it if they don't count us right."

 

Copyright © 2009 University of Maryland Philip Merrill College of Journalism.

 

Group provides support for girls with emotional, behavioral problems

 

By Elahe Izadi

Prince George’s County Gazette

Thursday, April 23, 2009

 

A group of girls sold hundreds of cupcakes and brownies and poured countless cups of lemonade on April 16 outside of The Children's Guild School in Chillum to benefit childhood cancer research.

 

The money went to the Alex's Lemonade Stand Foundation, a Wynnewood, Pa.-based nonprofit created in 2000 by a young cancer patient who started a lemonade stand to help fund research.

 

Although it looked like a simple lemonade stand to passers-by, the service project was a big step for members of the group Greatly Inspired, Ready to Lead and Serve, or G.I.R.L.S., leaders said.

 

The G.I.R.L.S. group meets twice a month to help build self-esteem and confidence among the members.

 

The group provides a safe space for the girls to socialize, said group leader Tammy Williams. Most of the students in the Children's Guild school for children with autism or emotional disturbances are boys, with only 20 girls among its 140 students.

 

Williams said the April 16 effort was "pretty significant" and represents about two months of work. Students voted on the service project, baked the goods and made posters together. They also practiced public speaking skills by talking to all the school's classes to advertise and explain their event.

 

Donika Hawkins, 13, of Washington, D.C., said the service project opened her eyes to the value of volunteering.

 

"I learned to help people when I get older because I would want someone to help me," she said.

 

The group's activities and regular meetings have taught many of its members lessons on how to work with others and express themselves. Members are 8 to 15 years old and have multiple emotional and behavioral disabilities. Williams said some of the girls live in foster homes and have experienced physical abuse or neglect.

 

Kara Perry, 13, of Hyattsville said she learned how to share her feelings in the group since "they don't judge."

 

"You get to talk about stuff you can't talk about with boys around," she said.

 

Group member Alexus White, 13, of Washington, D.C., said girls in the group can discuss how to handle bad days and how to bring grades up.

 

"I've changed. I've learned how to communicate more because I wasn't able to communicate before," she said. "I used to use my hands, and now I can communicate more and use my words to explain myself."

 

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

 

National / International

 

'Morning-after' pill available to minors

 

By Sean Lengell and Cheryl Wetzstein

Washington Times

Thursday, April 23, 2009

 

The Food and Drug Administration announced Wednesday that the "morning-after" birth-control pill now will be available to teenage girls as young as 17 without a prescription, saying it won't appeal a federal court order that overturned a Bush administration-era policy.

 

U.S. District Judge Edward Korman last month ruled in a New York lawsuit that Bush administration appointees had let politics, not science, drive their decision to allow over-the-counter access to the pills only for women 18 and older. Judge Korman ordered the agency to let 17-year-olds get the medication without a doctor's prescription, and to evaluate whether all age restrictions should be lifted.

 

FDA scientists and many in the overall medical community for years had called for age restrictions to be lifted for the drug, commonly called Part B. But top Bush-appointed managers refused to go along with the recommendations.

 

The FDA said it has sent a letter to the drug's manufacturer that it may, upon submission and approval of an application, begin marketing Plan B to girls and women 17 and older.

 

Plan B had been only available by prescription for girls 17 and younger.

 

Wendy Wright, president of Concerned Women for America, accused the Obama administration - not the Bush administration - of playing politics at the expense of the health and well-being of teenage girls.

 

"The FDA should have challenged the decision, especially its false premise," Ms. Wright said. "A judge's opinion can't change the fact that giving women a false impression about a drug's effectiveness forces the FDA to become snake-oil salesmen."

 

She added that because Plan B is a high-dose version of contraceptives that already are prescription-only and can cause blood clots, heart attacks and strokes, it is unsuitable for minors.

 

"Parents should be furious at the FDA's complete disregard for parental rights and the safety of minors," Ms. Wright said.

 

But supporters of the FDA decision praised it as leading to fewer - not more - abortions.

 

"It's a good indication that the agency will move expeditiously to ensure its policy on Plan B is based solely on science," said Nancy Northup, president of the Center for Reproductive Rights. "It's time the FDA restores confidence in its ability to safeguard the public health and put medical science first."

 

The Center for Reproductive Rights sued the FDA in 2005 for failing to grant over-the-counter status to Plan B against the advice of its scientific experts and in violation of its own procedures and regulations. The suit was filed on behalf of the Association of Reproductive Health Professionals, the National Latina Institute for Reproductive Health, the Morning-After Pill Conspiracy, and others.

 

If taken within 72 hours of unprotected sex, Plan B can reduce a woman's chances of pregnancy by as much as 89 percent. It contains a high dose of birth-control drugs and works by preventing ovulation, fertilization, or the implantation of a fertilized egg in the uterus. That last possibility, though it is very hard to determine that it occurred in a given case, is what has led some religious groups to denounce the treatment as abortifacient.

 

If the embryo already has implanted itself, Plan B has no effect.

 

Women must ask for Plan B at the pharmacy counter and show identification with their date of birth. The treatment consists of two pills and typically sells for between $35 and $60.

 

Copyright 2009 Washington Times.

 

Plan B shift OK'd

FDA lifting prescription rule for 17-year-olds

 

Tribune Washington Bureau

By Noam N. Levey

Washington Times

Thursday, April 23, 2009

 

The Food and Drug Administration, announcing Wednesday that it would allow 17-year-olds to buy the emergency contraceptive pill Plan B without a prescription, signaled a major shift in the agency's approach to a long-simmering family planning issue.

 

The decision follows a ruling last month from a federal judge who rejected a Bush administration policy that allowed nonprescription sales of the pill only to people 18 or older, requiring younger girls to consult a doctor before they could get it.

 

The FDA's announcement was another example of the new priorities of the Obama administration, which in the past three months has moved to reverse several Bush-era restrictions on family planning services.

 

Obama overturned a ban on U.S. support to international aid groups that provide abortion services and threw out a rule allowing health care workers to deny services that violated their moral beliefs.

 

Both changes were top priorities of family planning advocates and women's groups. They had accused the FDA of letting politics dictate scientific policy, including the restriction on the Plan B pill.

 

On Wednesday, Nancy Northrup, president of the Center for Reproductive Rights, praised the agency's apparent change of heart.

 

"We commend the FDA for taking swift action to ensure that its decisions on Plan B are based solely on the drug's safety and efficacy," said Northup, whose group had brought the lawsuit against the FDA. "It is a key step for the agency as it seeks to restore confidence in its ability to safeguard public health and leave politics at the lab door."

 

Popularly known as the "morning-after pill," Plan B works largely by preventing ovulation. The pill may also make it harder for sperm to fertilize any egg by thickening mucus secretions, and it might inhibit implantation by affecting the uterine lining.

 

Studies show that as many as 89 percent of pregnancies can be averted if Plan B is taken within three days of intercourse.

 

Copyright 2009 Washington Times.

 

Facts about the morning-after pill

 

Associated Press
Washington Post
Thursday, April 23, 2009

 

A summary of the morning-after pill:

 

NAME: Plan B.

 

MANUFACTURER: A subsidiary of Teva Pharmaceuticals Inc.

 

USE: If taken within 72 hours of unprotected sex, it can lower the risk of pregnancy by up to 89 percent.

 

WHAT IT IS: A high dose of a drug found in many regular birth-control pills.

 

WHAT IT ISN'T: It's not the same as the abortion pill RU-486. Plan B prevents ovulation or fertilization of an egg; it also may prevent the egg from implanting into the uterus, though recent research suggests that's unlikely. It has no effect on women who already are pregnant.

 

WHAT ELSE IT ISN'T: Everyday contraception. It's not intended for routine use.

 

WHO CAN BUY IT: Starting soon, women 17 and older can buy it without a prescription. Currently, they must be 18 for nonprescription sale. Anyone younger still requires a prescription.

 

SIDE EFFECTS: Some nausea, dizziness, breast tenderness, temporary menstrual changes.

 

© 2009 The Associated Press.

 

Pharmacy Error May Have Killed Polo Ponies

 

Associated Press

New York Times

Thursday, April 23, 2009

 

WEST PALM BEACH, Fla. — An official at a Florida pharmacy said Thursday the business incorrectly prepared a supplement given to 21 polo horses that died last weekend while preparing to play in a championship match.

 

Jennifer Beckett, chief operating officer of Franck’s Pharmacy in Ocala, Fla., told The Associated Press in a statement that the business conducted an internal investigation that found “the strength of an ingredient in the medication was incorrect.” The statement did not identify the ingredient.

 

Beckett said the pharmacy is cooperating with an investigation by state authorities and the Food and Drug Administration. The pharmacy may have illegally created a compound imitating the supplement Biodyl, which is not approved for use in the United States.

 

The horses from the Venezuelan-owned Lechuza polo team began collapsing shortly before Sunday’s U.S. Open match was scheduled to begin, shocking a crowd of well-heeled spectators at the International Polo Club Palm Beach in Wellington.

 

“On an order from a veterinarian, Franck’s Pharmacy prepared medication that was used to treat the 21 horses on the Lechuza Polo team,” Beckett said. “As soon as we learned of the tragic incident, we conducted an internal investigation.”

 

She said the report has been given to state authorities.

 

Lechuza also issued a statement acknowledging that a Florida veterinarian wrote the prescription for the pharmacy to create a compound similar to Biodyl, a French-made supplement that includes vitamins and minerals and is not approved for use in the United States.

 

“Only horses treated with the compound became sick and died within 3 hours of treatment,” Lechuza said in the statement. “Other horses that were not treated remain healthy and normal.”

 

Lechuza also said it was cooperating with authorities that include the State Department of Agriculture and Consumer Services and the Palm Beach County Sheriff’s Office.

 

Biodyl contains a combination of vitamin B12, a form of selenium called sodium selenite and other minerals. It is made in France by the Georgia-based animal pharmaceutical firm Merial Ltd. and is widely used to treat horses for exhaustion, but it is not approved for use in the United. States.

 

Compound pharmacies can add flavor, make substances into a powder or liquid or remove a certain compound that may have an adverse reaction in different animal species. F.D.A. spokeswoman Siobhan DeLancey said compounding pharmacies cannot legally recreate existing drugs or supplements under patent. In most cases, they are also not allowed to recreate a medication that is not approved for use in the United States.

 

On its Web site, the F.D.A. says it generally defers to “state authorities regarding the day-to-day regulation of compounding by veterinarians and pharmacists.”

 

However, the agency says it would “seriously consider enforcement action” if a pharmacy breaks federal law in compounding medications. It isn’t yet clear Franck’s broke the law.

 

Copyright 2009 The New York Times Company.

 

Attorney: Mice, leaky roof found at Ga. nut plant

 

Associated Press

By Greg Bluestein

Frederick News-Post

Thursday, April 23, 2009

 

A south Georgia factory linked to a deadly nationwide salmonella outbreak was infested with vermin and had a leaky roof, gaping holes and other problems, attorneys said Thursday after touring the plant.

 

Bill Marler, an attorney who has filed nine lawsuits on behalf of salmonella victims, said he and a team of experts discovered structural problems and numerous mice during the tour of the Peanut Corp. of America's plant in Blakely, Ga.

 

There were clear problems with the roof and "it was pretty easy for raw products to get near potentially contaminated products," the Seattle-based attorney said in a telephone interview. "You add mice, vermin and water and it's pretty clear how this outbreak happened."

 

Marler toured Peanut Corp.'s plant in Plainview, Texas, the day before, where he found similar problems including rodent and bird excrement and dead roaches.

 

Ron Simon, a Houston-based attorney who led a separate team through the plant, said he discovered gaps on the roof where grates appeared to have rusted off.

 

"Imagine a tennis racket — and you drove your hand through it. Except the hole was huge. Big enough for a grown man to crawl through — they were several feet wide."

 

He said he found more than 150 rat traps littered throughout the plant. To fix a leak in one of the building's skylights, he said workers had covered it with a plastic tarp kept in place by cinderblocks.

 

"It's a pathetic attempt to solve a serious problem," said Simon. "When you get water and peanuts together, you're getting a petri dish for salmonella."

 

The accounts provide a rare glimpse of the Georgia plant at the heart of the salmonella outbreak that sickened hundreds and was linked to the deaths of at least nine people.

 

The plant has been off-limits during the investigation, but Marler, Simon and several other attorneys who have filed lawsuits against Peanut Corp. have been granted access.

 

Both Marler and Simon said it appeared as if the Blakely plant had been recently cleaned. Peanut Corp. of America attorney Andrew S. Goldstein did not immediately return phone calls seeking comment.

 

Marler said gaps in the roof could have allowed birds and vermin that carry salmonella into the building. Water from a leaky roof can make it easier for the bacteria to spread, he said.

 

The plant's problems have been well documented. A state inspector who searched the Georgia plant in October found only minor problems, but less than three months later federal agents scoured the building and found roaches, mold, a leaking roof and other problems.

 

The Blakely plant was shut down in the aftermath of the outbreak.

 

The company voluntarily closed its Plainview plant on Feb. 9 after private test results indicated salmonella contamination. Texas officials soon found dead rodents, rodent excrement and bird feathers in a crawl space above a production area there.

 

Officials from Peanut Corp., which is based in Lynchburg, Va., have repeatedly declined to comment on the investigation. The company filed for bankruptcy in February and has been targeted with at least a dozen lawsuits. It was also fined $14.6 million this month by Texas regulators.

 

Press Association

 

Copyright © 2009 Associated Press.

 

Swine flu cases up to 7, probe expanding

 

By Mike Stobbe

Frederick News-Post

Thursday, April 23, 2009

 

Health officials say a unique type of swine flu has now been diagnosed in seven people in California and Texas, up from the two reported earlier this week. The five new cases in the two states have all recovered, and testing indicates some mainstream antiviral medications work against the virus.

 

But it's a growing medical mystery: Only a few of the seven people were in contact with each other, and none were in contact with pigs.

 

U.S. Centers for Disease Control and Prevention officials said Thursday they are expanding their investigation.

 

Copyright 2009 Frederick News-Post.

 

Opinion

 

Tragedy in Towson

Our view: A rash of murder-suicides involving families here and elsewhere suggests such killings are becoming a public health problem that must be addressed

 

Baltimore Sun Editorial

Thursday, April 23, 2009

 

No one can fail to be shocked, saddened and mystified by the tragedy that befell the Parente family, whose bodies were discovered this week in a Towson hotel room, the victims of a murder-suicide that took the lives of 59-year-old William Parente, his wife, Betty, 58, and their daughters, Stephanie, 19, and Catherine, 11. The couple had driven to Baltimore with their youngest daughter from their home in Garden City, N.Y., to visit Stephanie, a sophomore at Loyola College. But what might have been a joyful family gathering at college instead turned deadly on the last day of their visit. Over a period of several hours on Sunday, police say, Mr. Parente beat and asphyxiated his wife and youngest child, then killed his elder daughter when she arrived at the hotel that afternoon. The next day, police say, he took his own life by cutting himself.

 

Confronted with such heartbreaking loss, people invariably ask, why? Neighbors described the elder Parentes as lovely people, outgoing and active members of their church who loved traveling with their daughters. The father apparently was a successful tax and estate attorney; his wife devoted herself to several charities. The girls were smart and beautiful. What could have gone so wrong?

 

It's a question communities across the country have been asking themselves in recent weeks, as a rash of murder-suicides involving families have dominated the headlines. In Maryland, police in Middleton found a family of five dead in their home last week, and similar crimes were reported this spring in California and North Carolina. Last year, a distraught father, caught up in a custody fight, drowned his three children in the bathtub of a Baltimore hotel.

 

Health officials say such familicide increasingly is being viewed as a public health issue that threatens the well-being not only of victims but of the extended families and the communities where they live. And although economic conditions may play a role, the greatest risk factors are mental health disorders such as depression and stress. William Parente may have acted as much out of grief and anguish over his mother's recent death as from the financial difficulty he reportedly was experiencing. Studies show most murder-suicides involving close relatives are committed by men who find they cannot face the shame of financial failure and its devastating effect on their families.

 

Crafting policies to combat familicide isn't easy because the most effective strategies depend on recognizing the symptoms of the problem and taking action before it's too late - something that's hard even for family and friends. Health officials can design campaigns that raise public awareness of the danger signs, but then family, friends and neighbors must encourage people in difficulty to get help. That can be tough, especially when the response is likely to be, "Mind your own business." Yet we owe it to ourselves, our loved ones and our communities to make the effort. All of us feel the loss from such terrible tragedies, and we all have a stake in working to prevent them.

 

Copyright 2009 Baltimore Sun.

 

Not Yesterday's Health Fight

 

By E. J. Dionne Jr.

Washington Post Commentary
Thursday, April 23, 2009

 

Over time, certain ideas become irresistible. They start out as problematic. Later, no one can remember why.

 

Consider Tuesday's bipartisan ceremony at which President Obama signed the Edward M. Kennedy Serve America Act. Thirteen years ago, Republicans in Congress tried to kill Bill Clinton's AmeriCorps program. This year, Republicans and Democrats joined together to pass the largest expansion of service opportunities in decades. Tomorrow isn't always defined by yesterday.

 

Bear that in mind as you hear reports about this or that snag, controversy or disagreement over the effort to pass comprehensive health-care reform. Because of its defeat in 1994, there will be a temptation to treat every dispute -- notably the recent reports of contention over the inclusion of a government-run option in a final bill -- as the first step toward the collapse of the process.

 

The "public plan" idea is a good one, and the issue is important: If the government makes it possible for everyone to buy health coverage, one option among many should be a government-run health insurance plan akin to Medicare.

 

The genius here involves both politics and policy. Many liberals believe our entire health-care system should be scrapped in favor a government-run single-payer plan along Canadian or British lines. The problem is that single-payer is not only politically impossible; it would also cause significant disruptions in the existing system. The public-option idea is a clever halfway house. It would allow the United States to move gradually toward a government-run system if -- and only if -- a substantial number of consumers freely chose to join such a plan. The market would test the idea's strength.

 

Private insurers hate the idea because they think the public plan would undercut them in the marketplace. This argument is, in some ways, self-refuting. If the private insurers are right that the government would actually provide health coverage more cheaply than the private companies, why shouldn't that option be available? Since the government would be ponying up to help people buy insurance, wouldn't this save taxpayers money in the long run?

 

But negotiations over health care will involve give-and-take. What if including a robust public plan has the effect of dooming a bill that gets affordable health insurance to everyone? Should public-plan advocates block any bill that doesn't contain their idea, as originally conceived? Of course not.

 

As a negotiating tactic, they should hold firm to get as close to a decent public plan as they can. Obama himself at last month's health-care summit that the public option "gives consumers more choices" and helps "keep the private sector honest, because there's some competition out there."

 

Yet Obama also acknowledged concerns that "private insurance plans might end up feeling overwhelmed" and said these worries were "serious" and "real." This suggested that a compromise is in the cards. One public-plan advocate who recently met administration officials on the issue told me he also sensed movement in this direction.

 

And in a little-noted session last week sponsored by the Kaiser Family Foundation, Nancy-Ann DeParle, the White House health reform director, suggested that payment rates to both doctors and hospitals could be set at similar rates in both public and private plans to make sure that private insurers weren't driven out of business.

 

Another possible compromise would be a bill that did not include a public plan as such, but instead provided a "trigger" that would bring such a plan into being if insurance costs went too high or if coverage rates were too low. And an unlikely alliance of the pharmaceutical industry and the liberal group Families USA has suggested that expanding Medicaid (which, after all, is a public plan) might be a way around a deadlock.

 

The biggest difference between now and the last time around is the emphasis on creative compromise in place of creative obstruction. Public-plan advocates should stay at the table to keep things moving.

 

They should also remember the lessons of Tuesday's Serve America event, which, by the way, received scant media attention. That was sad, except for the fact that the media's indifference was a sign of how a once controversial idea has now won such wide acceptance. That acceptance, in turn, allowed for the big improvements in the program that Obama signed into law.

 

Someday, that will happen with universal health coverage. If a bill passes this year, enhancements in the program down the road will not be seen as controversial but as inevitable.

 

Copyright 2009 Washington Post.

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