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			Tuesday, February 3, 2009 News Clipping Archives *Maryland / Regional* In Good Health - Giving kids a smile (Frederick News-Post) Added protection (Baltimore Sun) Number of fatal fires decreases in Maryland (Carroll County Times) O'Malley proposes extending health benefits to gays (Baltimore Sun) More uninsured lean on low-cost care (Baltimore Sun) *National / International* The New Uninsured (Washington Post) No prison guinea pigs (Baltimore Sun) FTC Sues in 'Pay-for-Delay' Pact (Washington Post) *Opinion* Opening child care records (Carroll County Times) *Maryland / Regional* In Good Health - Giving kids a smile By Ashley Andyshak Frederick News-Post Tuesday, February 3, 2009 If you were to guess the most common chronic disease found in children, you'd most likely say asthma or diabetes. The answer will surprise you: it's tooth decay. Dental decay is five times more common than asthma and causes 51 million lost school hours nationwide every year, according to the Frederick County Health Department. There are several factors: diet, poor brushing techniques and lack of dental care top the list. According to the health department, the average teenage boy consumes more than 700 cans of soda per year. The problem starts early in life, as the average 2-year-old gets more sugar from soda than from all other sweet snacks combined. Race and economic status also appear to be factors. According to the Centers for Disease Control and Prevention, nearly a third of Mexican American children ages 6 to 11 have decay in their permanent teeth, compared with 19 percent of white children. Twelve percent of all children in this age group from families below the federal poverty line have untreated tooth decay, compared with 4 percent of children from families with higher incomes. Dr. Patrice McLeod, lead dentist at the health department, recommends choosing snacks such as fruits and veggies and drinking water instead of soda to ward off tooth decay. Getting kids into the dentist chair regularly is important, too. The health department provides dental exams and treatment for children who receive Medical Assistance and those who don't have dental insurance. Last year the department treated more than 2,400 patients, and as more families lose their jobs and their health insurance, this number is likely to rise. On Friday, other local dentists will offer free dental exams to uninsured kids as part of the annual Give Kids A Smile Day. To find a participating dentist, call the Maryland State Dental Association at 410-964-2880 or e-mail mddent@msda.com. The Frederick County Chamber of Commerce is offering a prescription drug discount card to all Maryland residents, regardless of chamber affiliation. The card provides an average 30 percent discount at more than 50,000 pharmacies. The card has no age limit or income requirements, and users need only provide a first and last name. To print your card, visit frederickchamber.org/community/drug_card.htm. Card must be presented to the pharmacist at time of purchase. Please send comments to webmaster or contact us at 301-662-1177. Copyright 1997-09 Randall Family, LLC. All rights reserved. Added protection Our view: Victims of domestic violence shouldn't have to worry about a trigger-happy spouse Baltimore Sun Tuesday, February 3, 2009 Mary Crawford is alive today because her estranged husband wasn't a very good shot. During an argument in their Carroll County home in 2001, he pulled out a shotgun and twice fired at her and missed. At the time, she had a restraining order against him. But the law did not require that her husband surrender his gun despite his history of threats and abuse. Now, Ms. Crawford is a compelling advocate to change Maryland law to keep guns out of the hands of spouses and others with a record of domestic violence. Gov. Martin O'Malley has proposed legislation that would strengthen protections for victims of domestic violence by allowing a judge to confiscate guns from a recipient of a temporary protective order. A second bill would require a judge to remove the guns from a person against whom a final protective order has been issued. The law would apply to both hand guns and rifles. The companion bills would give state judges the same authority that federal judges now have in these matters. Ms. Crawford's experience is not unique. Jessica M. Jacobsen of Timonium was shot and killed outside her home in September 2007 by her estranged husband, Jeffrey. He had been ordered by a judge to stay away from the couple's Baltimore County house, but was there that day to pick up his two sons. After shooting his wife, he turned the gun on himself and died. Previous legislative efforts to keep guns out of the hands of people with a demonstrated problem of family violence have languished in a House of Delegates committee. Gun rights advocates should realize that the O'Malley legislation gives judges who hear initial requests for a restraining order the option of deciding whether to seek removal of someone's guns. Judges should at the very least have that right. Copyright 2009 Baltimore Sun. Number of fatal fires decreases in Maryland By Ryan Marshall Carroll County Times Tuesday, February 03, 2009 The state fire marshal’s office partially credited a new law mandating reduced ignition standards for cigarettes sold in the state for a decrease in fatal fires in 2008. Last year, 60 people died in 53 deadly fires in Maryland, down from 94 deaths in 2007, according to a release from the fire marshal’s office. The total is tied with 2006 for the lowest number of fire deaths recorded in Maryland since statistics started being kept in 1975, according to the release. Carroll County recorded one fire death in 2008, said Allen Gosnell, deputy chief state fire marshal for the Westminster office. Daniel Merchant, 46, died following a May 21 fire at his home in the 7500 block of Middleburg Road in Detour. According to the release, more than 88 percent of fatal fires in 2008 were in homes, and careless handling of smoking materials led to more fire deaths than any other cause. The new law, which went into effect in Maryland July 1, requires that all cigarettes sold in the state be designed to burn at a lower temperature and to go out if a smoker doesn’t pull on them, said Jane Edwards, a program manager in the fire marshal’s office. Only three deaths in the state occurred from careless handling of smoking materials after the law went into effect, compared to nine in the first half of the year, the release said. As of December 2007, 22 states had enacted laws concerning a statewide standard for Reduced Ignition Propensity cigarettes, according to the Web site for Phillip Morris USA. Reach staff writer Ryan Marshall at 410-857-7865 or ryan.marshall@carrollcountytimes.com. Copyright 2009 Carroll County Times. O'Malley proposes extending health benefits to gays Governor would include same-sex domestic partners of state employees By Laura Smitherman Baltimore Sun Tuesday, February 3, 2009 Gov. Martin O'Malley has proposed extending health care benefits to same-sex partners of state employees, fulfilling a campaign promise to gay-rights activists despite this year's strapped budget. The Democratic governor's proposal would allow state workers and retirees to add domestic partners and their dependents to health, dental and prescription drug plans, essentially putting gay couples on par with married spouses. As many as 300 employees in a state work force of more than 70,000 are expected to sign up, at a cost of $1 million to $3 million. More than 15 states and the District of Columbia provide domestic partner health insurance coverage, as do a majority of Fortune 500 companies, including Baltimore's Black & Decker and Constellation Energy Group. The gay-rights movement has made the availability of such benefits a priority, and leading advocates announced O'Malley's decision as they launched a mass lobbying effort in Annapolis. O'Malley extended benefits to same-sex partners of city employees when he was mayor of Baltimore, and he said he would do so statewide after he was elected governor in 2006. But that proposal - and other gay-rights goals - failed to gain traction during the first two years of his administration, to the chagrin of activists. O'Malley's aides said the benefits issue needed to be studied. "This move is consistent with the governor's goal to provide affordable, quality health care to more Marylanders rather than fewer," O'Malley spokesman Shaun Adamec said. "It's absolutely the right thing to do." The idea of extending benefits is likely to roil some lawmakers, in particular conservative Republicans, but leaders including House Speaker Michael E. Busch, an Anne Arundel County Democrat, said they support it. Senate Budget and Taxation Committee Chairman Ulysses Currie said he backs the idea but noted that it's early in the budget process. The state is facing a $2 billion shortfall next year, and O'Malley has proposed balancing the budget through 700 layoffs of state employees and other cost-cutting measures, and by tapping reserve accounts. His administration submitted regulations regarding domestic partner benefits Friday, and his budget submitted to the General Assembly includes funding. "We'll take a look at it along with other parts of the budget, and hopefully we'll be able to work with the governor," Currie said. Sen. Allan H. Kittleman, the minority leader, said he questions whether the benefits extension is "appropriate," given the state's financial difficulties. "My concern is about the cost," said the Republican, who represents Howard and Carroll counties. Kate Runyon, executive director of Equality Maryland, a leading gay-rights group, characterized the benefits as "a minimal state investment" because Maryland can expect a benefits enrollment increase of less than 1 percent. But, she said, the move will have a "huge impact" on the families of qualifying state employees. "Symbolically, it says we are going to try to take down some of the barriers between families headed by opposite-sex couples and families headed by same-sex couples," said Sen. Richard Madaleno, a Montgomery County Democrat who is openly gay. The change also could help the state retain and recruit higher education employees, said University System of Maryland Chancellor William E. Kirwan, who endorsed the initiative. Equality Maryland held a rally outside the State House yesterday and dispatched dozens of volunteers to visit lawmakers to discuss their agenda. Among the attendees was V. Gene Robinson, Episcopal bishop of New Hampshire, who is gay. He also delivered the invocation at the start of last night's Senate session. The bishop, on his first trip to a state legislature outside his home state, praised O'Malley's administration for extending benefits for state employees but said that's only one step. "Any step forward is a step in the right direction," Robinson said. "On the other hand, we can't see these small steps as a way of buying us off so that we don't pursue the fight for full equality." While gay-rights activists in Maryland concede it's unlikely they will get the votes this year to approve same-sex marriage, a top priority, they are still working to add lawmakers as sponsors of the bill. O'Malley has said that he would support civil unions, but he didn't take a lead in pushing for legislation last year. Activists also hope to win over enough lawmakers for passage of a state law to protect transgendered people from discrimination. As mayor, O'Malley signed into law a city measure addressing that issue. Copyright 2009 Baltimore Sun. More uninsured lean on low-cost care Md. medical nonprofits take on greater role as more people lose jobs, fall into near-poverty By Joe Burris Baltimore Sun Tuesday, February 3, 2009 When Carroll County resident Donna Hanson went to see a doctor about chronic gastrointestinal pain in October, she discovered that her misery had been triggered by a life-threatening heart condition. Doctors unclogged a right artery that was more than 90 percent blocked and inserted a stent. Then they sent Hanson, who had no medical insurance, away with a new lease on life - and no bill. Instead of going to a doctor or emergency room, the Westminster resident visited Access Carroll - a medical nonprofit organization that offers free health care to county residents with low incomes and no health insurance. Hanson joined a growing number of people with no insurance - particularly those who have been laid off during the recession - who have turned to medical nonprofit organizations instead of traditional institutions that often leave them with crushing debt. "I worked in the medical profession for 30 years," said Hanson, 52, a former medical receptionist who now earns a meager living providing day care for her grandchildren. "I know enough medically not to ignore symptoms, but when you're uninsured and you don't have the money, what can you do? I had been ignoring [the stomach pains] for quite some time." That is, until she read about Access Carroll in a local newspaper. Founded three years ago, Access Carroll provides primary medical care with volunteer physicians and nurses and provides such services as laboratory and radiology testing, referrals to specialists and medications. The organization is funded by grants and donations from individuals and local businesses. Also, several area medical specialists treat Access Carroll patients in their offices. The number of patients treated by Access Carroll more than doubled between 2006 and last year, when more than 2,300 patients were seen in 5,700 visits. "The last several months, people have been coming to us literally saying, 'I can't afford my health insurance anymore because I just lost my job, and I'm a diabetic,'" said Tammy Black, executive director of Access Carroll. And with the economy projected to continue its downward spiral this year, organizations such as Access Carroll will be in greater demand, Black said. "Seventy-five percent of our patients are chronically ill, meaning they've been on medication for more than six months for diabetes or heart disease or lung disease or asthma or depression," she said. To receive care from Access Carroll, county residents must have a household income that is less than 200 percent of federal poverty guidelines. For example, a family of four must have annual income of no more than $42,400 to be eligible. Access Carroll is one of several nonprofit organizations in the area that offer free or low-cost health care to the uninsured. Another is the Baltimore-based Shepherd's Clinic, where patients pay an hour's wage for an office visit. Those who are unemployed pay $9 at the time of the visit. The Community Free Clinic in Hagerstown offers free services such as gynecologic, pediatric, podiatry, teen pregnancy, family planning and mental health care. And the Fairfield, Pa.-based Mission of Mercy offers a free mobile medical clinic (services include cardiovascular, respiratory, gastrointestinal and genitourinary care). It visits Reisterstown, Frederick, Mount Airy and Westminster. The number of patients treated at Mission of Mercy's seven Maryland sites has increased over the past few years, said Linda Ryan, the organization's executive director. Many people also turn to federally qualified health centers, which charge for services on a sliding scale. Others who are unemployed use such facilities as Access Carroll while awaiting eligibility for federal programs. "It's a huge problem facing our nation," Black said about the gaps in health care. More than 45 million Americans were uninsured in 2007, according to the most recent Census Bureau figures. That number was down slightly from the year before, but the number and percentage of people without medical insurance has increased over the past two decades. In Maryland, 761,000 were uninsured, according to the most recent numbers. Because of the increase in patients, Access Carroll's operating expenses for the past quarter were about $80,000, an increase of about $15,000 from the previous six months. Still, the nonprofit remains committed to serving 2,400 patients with services from 70 specialists and 200 clinical and clerical volunteers. "It makes me feel good to be able to do it," said Dr. Charles Cummings, a cardiologist who has been volunteering his services at Access Carroll for nine months. "It's not a miracle of medicine but a miracle of the system - a lot of people in the business community donate money to this thing, and it helps to save lives." It did for Hanson, a single mother who for years had experienced chronic gastrointestinal pain. In October, the pain became too severe to withstand any longer. Although electrocardiogram testing revealed no abnormalities, doctors at Access Carroll still weren't satisfied that Hanson's pains were gastrointestinal in nature - in part because for women some heart abnormalities manifest themselves as stomach and back pain. Moreover, Hanson, a smoker, has a history of heart disease in her family. Both her mother and grandmother died from heart attacks. She was administered a heart stress test and about four minutes into the test, she said, her heart began beating abnormally. "It felt like an elephant was standing on my chest, and I couldn't breathe," Hanson said. The attending physician called 911 and had Hanson rushed to a hospital, where a catheterization revealed a blocked artery. Cummings performed an angioplasty and inserted a heart stent. "She quickly got a diagnosis that saved her life," Cummings said. Hanson, who still has some gastrointestinal problems, now has some insurance to cover procedures for that ailment for up to a year. Yet she shudders to think where she would be had she not turned to Access Carroll when she was uninsured. "I probably would have put it off even more, that's the scary part," she said. "There are so many families in my position who work hard and are barely able to meet the bills. Unless you're with a company that offers insurance, it can be very difficult. "If I had insurance, I never would have ignored the symptoms. I would have gone to the doctor immediately. But what happened was a strong lesson for me. I won't be ignoring symptoms anymore." Copyright 2009 Baltimore Sun. *National / International* The New Uninsured Neither Rich Nor Poor, Many People Who Have Lost Their Jobs In the Deepening Recession Find Getting Health Care Is Something of a Lottery Kaiser Health News By John Fairhall and Kate Steadman Washington Post Tuesday, February 3, 2009; HE01 People young and old crowd the hallway outside the locked door of the Arlington Free Clinic. They grip small pieces of paper that will determine whether they get in -- or give up and go home. It's lottery day, and 45 county residents who lack health insurance and money to pay for medical care are competing for 30 openings on a cold afternoon in January. Mary Gleason, a clinic volunteer, draws letters from a plastic box. Those holding matching letters will be ushered through the door for interviews. If they meet the clinic's criteria, they'll return in a couple of weeks to see doctors or other staff. One by one, winners are separated from losers. Gleason plucks a Z, and a man holding a Z strides into the clinic. His broken arm had been set in a hospital emergency room, and he needs to see a specialist for follow-up care. Another man, who has Parkinson's disease and urgently needs drugs to treat it, leaves disheartened. He will have to return in two weeks and try again in the next lottery. The lottery is just one example of the fate of the newly uninsured -- the growing numbers who once had jobs and insurance and now seek treatment with neither. Although most of the clinic's clients have low incomes, the nonprofit, privately funded operation and others like it in the region are seeing more people who used to be solidly middle-class. Victims of the deepening recession, they're now wondering where to turn for help. Neither rich nor poor, this group doesn't readily qualify for public programs such as Medicaid but often can't afford to buy insurance or pay hospital, doctor and drug bills. The Democrats' economic stimulus package would significantly enhance options for the unemployed and their families through insurance subsidies and a possible expansion of Medicaid, a package that some experts say would ease the financial dilemma. "How many of us can lose our jobs and pay for our health insurance? Not many," says Gail Shearer, director of health policy analysis for Consumers Union, publisher of Consumer Reports magazine. Where one lives matters, Shearer says. Some states make it easier than others for people with chronic conditions to obtain private insurance. Medicaid serves the poor, especially children, but eligibility criteria vary. Virginia has the most stringent guidelines for adults in the region: Working parents with a child can earn no more than $5,352 annually to qualify for coverage. Uninsured kids and some parents who don't qualify for Medicaid may be eligible for the soon-to-be-extended State Children's Health Insurance Program (SCHIP). Arlington resident Jean Perry, 57, tried her luck in a clinic lottery because she couldn't afford insurance after losing her $40,000-a-year job as a coffee shop manager last summer. Under federal law, she could have kept her employer-provided policy, but at full cost: $400 a month. "Of course I couldn't afford that," said Perry, not even with unemployment benefits, which in Virginia top out at $1,452 a month. Buying a cheaper policy also was beyond her means. She put her dwindling funds into prescriptions for treatment of chronic problems, an upper respiratory blockage and high blood pressure. They cost from $29 to $159 a month each. Monthly doctor's visits added $72 more. Needing help, Perry showed up for the clinic lottery on Dec. 2. "I was quite overwhelmed, to say the least, never having been in that situation before," she said. "Just watching the many people who were there and observing the people who didn't get it." She won a slot at the clinic with the letter S. Now she pays nothing to see doctors, and her prescriptions cost $5 each, the result of the clinic's obtaining free drugs from pharmaceutical companies. This recession is much harder on the uninsured than on some others, not just because it's deep and long. Health-care and insurance costs have been rising faster than workers' incomes. As Perry discovered, buying a policy or paying for care out-of-pocket is prohibitively expensive. "Because of increasing per-capita spending on health care," said Brookings Institution economist Henry Aaron, "the costs of losing insurance are greater than they were 15 years ago." Since the recession began in December 2007, the number of unemployed Americans has increased by 3.6 million. Economists predict more job losses. The number of uninsured is approaching 48 million, according to data from the Kaiser Commission on Medicaid and the Uninsured, and would increase by roughly 1 million if the unemployment rate -- now 7.2 percent -- hits 8 percent. (Both the commission and Kaiser Health News are part of the Kaiser Family Foundation.) Proposals by President Obama and Democratic congressional leaders to overhaul the health-care system vary, but the most ambitious ultimately would require all Americans to be covered by private or public plans. Republicans are developing their plans, while debating the Democrats over stimulus legislation proposals to make many laid-off workers temporarily eligible for Medicaid and help others retain their employer health insurance. Republican critics say even temporary expansion of insurance programs will likely lead to expensive new government involvement in paying for health care. Under a federal law known as COBRA, most laid-off workers have the right to retain employer health insurance for 18 months by paying the full premiums, which average nearly $13,000 a year for comprehensive family coverage and $4,700 for individuals. The stimulus bill approved by the House would have the government temporarily subsidize 65 percent of the cost of premiums, which many now find unaffordable. It also would enable people 55 or older, or those who have worked for a company for 10 years to keep COBRA coverage until they're eligible for Medicare or get another job. "COBRA is ridiculous," said Hamilton Shoop III, who until October made a good living helping businesses negotiate favorable terms with contractors. "You go from making so much money every two weeks on your paycheck, and they send you a COBRA notice for $800 a month." Alternatively, many people investigate buying policies on the individual market. But such coverage often has high deductibles, offers fewer benefits than employer policies and may not cover long-standing medical problems. Shoop, 56, a Jessup resident, ran into this problem when he shopped around after losing his job. His wife, who'd been covered under his insurance plan, has high cholesterol, and he has diabetes and high blood pressure. For now, he's paying out-of-pocket for whatever he can afford. Which isn't much. He still doesn't have insurance or a job, and in the meantime is hoping to turn his passion for playing music into income. Shoop is postponing the blood test he needs every three months. "I don't have money to pay for doctor's visits," he said. Children fare better under government programs. After architect Marisol Hernandez was laid off in November, she and her husband obtained coverage for their 4-year-old girl and year-old boy through Famis, the Virginia version of the children's insurance program. Health insurance was her first concern after losing her job. "I care a lot about my income," said Hernandez, who lives in Reston. "But my insurance, when I have kids, is something that has to be working all the time." Baltimore HealthCare Access, a nonprofit affiliated with the city health department, assists people trying to navigate the system. "People don't always know -- even providers don't always know -- which application they should fill out, which program they should apply for," said Kathleen Westcoat, president of the organization. Her staff is working with Clarence Hooper, a building contractor who was let go by his company in September. He has applied to the state Primary Adult Care Program, which serves people 19 and older who don't qualify for Medicaid. Although it doesn't offer hospital and specialty care coverage, it would be a godsend for Hooper. He has glaucoma, and his wife has carpal tunnel syndrome and needs surgery. But they can't afford it. "So she's suffering," said Hooper, 54. "It's a big toll on you when you can't do anything." Some nonprofits and public officials in the Washington area have tried to close the gap for people who don't qualify for Medicaid but can't afford private coverage. Howard County's "Healthy Howard" initiative offers a broad spectrum of care for people with a wide range of incomes, up to $63,600 for a family of four. Participants pay a flat monthly fee. Christian Akuffo and his wife, Doris, have applied to the program. A hotel housekeeping manager in Laurel, he lost his insurance last spring when another company bought the hotel. Since then, Doris Akuffo has gone to a hospital emergency room repeatedly for care but found it difficult to get follow-up treatment with doctors. "You call and try to work out something," her husband said, "but without insurance it's rough." Community clinics, some private and others federally subsidized, offer help to those who can't get any elsewhere. Robin Roberson, director of the Community Free Clinic in Hagerstown, says that since August she has seen a 30 to 40 percent increase in demand for services, reflecting rising unemployment. Western Maryland is losing hundreds of well-paying jobs as manufacturers of automobile equipment, boats and furniture cut back or close. "We have people who just walk through our doors every day," she said. ' "I lost my job, I don't have any benefits, what do I do?' " She strongly recommends that people who can't afford or qualify for COBRA buy individual insurance. "Coverage isn't as good," she said, "but may be enough to get you through a crisis -- an accident or life-threatening illness. For those with chronic illness, just the cost of medicine may be greater than the mortgage payment." Lois Wadace participated in Arlington Free Clinic's recent lottery because it "felt like my only option." She worked as a full-time registered nurse until she had a stroke last May. She had started a new job, and her health benefits hadn't kicked in. She wasn't eligible for COBRA, Wadace said, and couldn't purchase insurance on the individual market because of her stroke. Wadace, a 61-year-old grandmother, "got very worried as all the people showed up" for the lottery. But her letter was drawn. If she meets the criteria (there are residency and income requirements), she'll have access to health care. Like many others who have lost their jobs and insurance, she's stunned. "I never imagined I'd be in this position." This story was produced through a collaboration between The Post and Kaiser Health News. KHN is a new service of the Kaiser Family Foundation, a nonpartisan health-care policy research organization unaffiliated with Kaiser Permanente. Copyright 2009 Washington Post. No prison guinea pigs President Obama should act now to ensure incarcerated Americans aren't used for medical research By Allen M. Hornblum and Jeffrey Ian Ross Baltimore Sun Tuesday, February 3, 2009 We keep hearing that President Barack Obama is intent on correcting the excesses of the previous administration, whether it's waterboarding or dirty air or international relations. But how about this: There exists the possibility that prisoners in American jails could be used for "voluntary" experiments - clinical trials for drugs, new surgical procedures and the like. It's a troubling piece of Bush-era business that the president could correct with the stroke of a pen. For more than two years, we, as members of a liaison panel advising the Institute of Medicine, have been waiting for an answer from the secretary of health and human services concerning the troubling potential for inmates in American prisons to be used for experiments. In 2006, the formal IOM committee recommended that convicts be made available for human subject research - a possible return to the mindset that gave us horrors such as the Tuskegee Syphilis Study. Fortunately, the Bush administration did not act on the recommendation, but the lack of a decision has not given us any comfort. This country's leaders should firmly reject the proposal. Our panel, focused on former prisoners and prisoner advocates, tried to convince the IOM committee that loosening restrictions on the already weakened protections for incarcerated Americans would take us back to a time when vulnerable populations were grist for the research mill and ethical abuses were tolerated. Prisoners were used as the guinea pigs of choice for researchers and pharmaceutical companies well into postwar America, and prisons have been a convenient storehouse of cheap and available research subjects. Physicians with pet medical theories and budding careers, or drug companies in the financial straits of product development, aggressively sought access to walled institutions as perfect places for testing. Incorporated in everything from testicular transplant and irradiation experiments to studies subjecting them to radioactive isotopes, dioxin and chemical warfare agents, prisoners were a key pillar of American medical and pharmaceutical research. This, from the same country that led the prosecution of Nazi doctors for their barbaric medical experiments on concentration camp prisoners. And this, from the country that served as a principal author of the Nuremberg Code, which ardently proclaimed that people "unable to exercise free power of choice" or subject to "constraint or coercion" should not be included as subjects in medical experimentation. Regrettably, the research community back at home continued to mine our mental institutions, orphanages and prisons for research subjects. Only during the great ethical enlightenment of the 1970s and the aftermath of the Tuskegee "studies" did American researchers condemn this practice. The IOM's 2006 report, "Ethical Considerations for Research Involving Prisoners," called prisoners "an especially vulnerable class ... who historically have been exploited by physicians and researchers." This turned out to be lip service, though: The group decided that the use of prisoners for experiments could be rationalized because this population is also vulnerable to diseases such as AIDS, hepatitis C and tuberculosis, and therefore could benefit from new treatments, even if they are experimental in nature. Develop an "ethical framework" for research, the committee urged, and the potential for abuse would be eliminated. We're skeptical, given the lack of choice that convicts have in their daily lives. Couple that with the notoriously poor health care available in American cellblocks, and you have a potential disaster. President Obama and his nominee for secretary of health and human services, Tom Daschle, have an opportunity to clarify our nation's stance toward those whom we have declared unfit to live free among us. They can demonstrate, by rejecting the IOM's recommendation, that the prison abuses condoned or ignored by previous administrations will stop. While steps are being taken to close the notorious prison at Guantanamo, let's do what we can closer to home to ensure civil treatment for the incarcerated. Allen M. Hornblum, author of "Acres of Skin" and "Sentenced to Science," frequently lectures on medical ethics. Jeffrey Ian Ross, a University of Baltimore professor and a fellow in UB's Center for International and Comparative Law, is author of "Special Problems in Corrections" and co-editor of "Convict Criminology." Copyright 2009 Baltimore Sun. FTC Sues in 'Pay-for-Delay' Pact Drugmaker Paid Rivals to Withhold Generic, Agency Says By Lyndsey Layton Washington Post Tuesday, February 3, 2009; A04 The Federal Trade Commission has filed suit in federal court in an attempt to block a deal in which a manufacturer of a brand-name testosterone-replacement drug paid three competitors to delay rolling out cheaper generic versions. The FTC said the "pay-for-delay" agreement violates antitrust laws, robs consumers of less-expensive alternatives and allows the brand-name drugmaker an unfair monopoly. The state of California joined the federal agency in its complaint, which was filed last week in U.S. District Court in the Central District of California. FTC officials are hoping the case will ultimately reach the U.S. Supreme Court. "We want to stop these unconscionable pay-for-delay deals that force consumers to overpay for much-needed drugs," said Jon Leibowitz, an FTC commissioner. Androgel is a synthetic testosterone gel prescribed to men who have low levels of the hormone due to aging, cancer, or HIV/AIDS, among other conditions. Solvay Pharmaceuticals was granted a 17-year patent for Androgel in 2003, and it has become the drug company's second-highest grossing drug, earning about $400 million in annual sales. Several other drugmakers -- Watson Pharmaceuticals, Par Pharmaceuticals and Paddock Laboratories -- applied to manufacture a generic version of Androgel and challenged Solvay's patent, saying they could produce a version of the drug that did not impinge on the patent. When the U.S. Food and Drug Administration granted approval, Solvay made a deal with the would-be competitors: They would get a share of Solvay's profits in return for not marketing a generic version until 2010, the FTC complaint said. Known as "reverse payments," the deals have become increasingly common. The FTC found that nearly half of all settlements between generic drugmakers and brand-name manufacturers in fiscal 2006 and 2007 resulted in some kind of payment to the generic maker in exchange for a pledge to stay out of the marketplace. Generic manufacturers pose a significant threat to brand-name drugmakers because they can price their versions of drugs as much as 80 to 90 percent lower than the brand-name price. The FTC says that such payments, also called "exclusion payment settlements," stymie the intent of the Hatch-Waxman Act of 1984, which was meant to speed generic drugs to market. The FTC has tried unsuccessfully to persuade the Supreme Court to hear two cases challenging such agreements in recent years, but each time, the Department of Justice argued that the high court should not take the case. Leibowitz said he believes the Justice Department under President Obama will be more supportive of the FTC's position. "There seems to be a growing recognition, especially by this administration, that these deals need to be stopped," he said. Sen. Herb Kohl (D-Wis.) and others, including then-Sen. Barack Obama, filed legislation last year that would prohibit reverse payments. The bill, which faces strong opposition from the pharmaceutical industry, is expected to be filed again this week. Copyright 2009 Baltimore Sun. *Opinion* Opening child care records Carroll County Times Editorial Monday, February 2, 2009 A new online database provides a good resource for parents exploring child care options. The Maryland State Department of Education’s Office of Child Care created the database. Parents can search by provider, type of care or location. For Carroll, the database contains 406 entries. Each inspection report contains a listing of almost 100 criteria, along with yes or no answers to the question “was the child care center found out of compliance with this regulation.” The database is a big step toward openness in an area that is of critical importance to parents. It is also a departure from the philosophy of secrecy adopted by the state Department of Human Resources concerning the same records. In 2003, after the state shut down a Carroll County child care center amid allegations it had hired a convicted sex offender, the Times embarked on a months-long battle with the DHR in an attempt to get inspection reports from the facility. An Administrative Law Judge ruled with the DHR in determining that it was not in the public’s interest to know about allegations of sexual abuse at a day care center. What made the ruling even more incredulous was the fact that these records are - or are supposed to be - readily available to parents who have children in the day care, or who are considering placing their children at the facility. Despite the ruling, the Times was able to work through the state Attorney General’s office, which helped pry the records from DHR. The new database, which interestingly is run by the Maryland State Department of Education’s Office of Child Care, is similar to databases found in almost half the states in the nation. Putting inspection reports and reports of complaints online for easy access is good way to ensure openness, and can lead to earlier detection when a facility begins experiencing a pattern of failures. Perhaps if the records had been online, potential problems might have been identified earlier. Parents also now have an easier way to check child care centers they may be considering and can rest a little easier knowing that information about potential problems can’t be swept under a rug. On the Web: http://msdecompliancereports.org Copyright 2009 Carroll County Times BACK TO TOP


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