Tuesday, February 24, 2009

News Clipping Archives

 

Maryland / Regional

State Watch | Federal Lawmakers Call for Justification of Tax-Exempt Status for Maryland Hospitals (kaisernetwork.org)

Urbana Middle mourns death of classmate (Frederick County Gazette)

Swallow peanuts, but choke on raw milk? (Hagerstown Herald-Mail)

Autopsy shows extensive trauma in murder, child abuse case (Baltimore Sun)

Low-Cost Health Care in Howard Not an Easy Sell (Washington Post)

Nursing home sale down to 2 bidders (Cumberland Times-News)

National / International

Report: Health care costs to exceed $8,000 per person (Baltimore Sun)

Report: Taxpayer-funded family planning averts need for 800,000 abortions per year  (Baltimore Sun)

Bill to restrict sale of 'alcopops' stirs heated debate (Baltimore Sun)

Pneumonia: Grant Will Allow Testing in Poor Countries to Determine Causes of a Common Killer (New York Times)

Insurer stocks tumble after Medicare announcement (Daily Record)

In Good Health — Eating Disorders Awareness Week (Frederick News-Post)

Ex-NC workers plead guilty in tainted syringe case (Hagerstown Herald-Mail

Opinion

Fighting infection (Baltimore Sun)

New options really no options (Cumberland Times-News)

 

Maryland / Regional

 

State Watch | Federal Lawmakers Call for Justification of Tax-Exempt Status for Maryland Hospitals

 

Kaiser Daiy Health Policy Report

kaisernetwork.org

Tuesday, February 24, 2009

 

Senate Finance Committee ranking member Chuck Grassley (R-Iowa) is considering legislation that would require Maryland hospitals to adhere to a federal standard in order to qualify for tax-exempt status as charity care hospitals, the Baltimore Sun reports. The state's unique system for setting hospital rates is designed to allow hospitals to recoup the cost of treating uninsured or low-income patients who might be unable to pay for services received (Drew, Baltimore Sun, 2/23).

 

A report by the Health Services Cost Review Commission, ordered by Gov. Martin O'Malley (D) in response to a Sun series examining how hospitals in the state collect debt from low-income patients, found that Maryland law should be changed to ensure state hospitals are meeting their obligation to offer no-cost care to low-income residents. The report recommended that hospitals be mandated to offer no-cost services to all state residents with incomes less than 200% of the federal poverty level; that written notice about the availability of financial assistance be provided to all patients; and that hospitals and their collection agencies be prohibited from adding interest and penalties to bills to uninsured patients before court judgments are entered against them (Kaiser Daily Health Policy Report, 2/17). O'Malley also has recommended that hospitals in the state implement minimum standards for who is eligible for no-cost care, rather than continuing to use voluntary guidelines created by the Maryland Hospital Association.

 

Grassley said that he and Sen. Jeff Bingaman (D-N.M.) plan to propose legislation that would enact these changes if the Internal Revenue Service does not set a standard for charity care. According to the Sun, one proposal Grassley and Bingaman are considering would require not-for-profit hospitals to devote at least 5% of annual revenue to charity care. Maryland hospitals, all but one of which are not-for-profit, spent 2% of patient revenue on charity care in 2008, according to state data.

 

Comments

John Colmers, secretary of Maryland's Department of Health and Mental Hygiene, said, "These reforms mean quality hospital care does not have to add a crushing hardship to uninsured patients or their families." Two members of the state's House of Delegates have proposed a bill requiring hospitals to provide no-cost care to all residents whose incomes are less than 150% of the poverty level, and state regulators have recommended a slightly higher maximum income level for eligibility.

 

The American Hospital Association has said that not-for-profit hospitals benefit low-income individuals more than any other sector of the health care industry and that IRS' account of charity care and community benefits provided is too low. MHA has held that its members justify their tax exemptions in annual IRS filings, and notes that state law requires them to file annual reports with regulators on how they benefit their communities. Carmela Coyle, president of MHA said, "Charity care and financial assistance is critical, but the benefit that our hospitals provide to communities is much broader than that" (Baltimore Sun, 2/23).

 

Copyright 2009 kaisernetwork.org.

 

Urbana Middle mourns death of classmate

Willis's ‘seat will not be filled'

 

By Chris Brown

Frederick County Gazette

Tuesday, Feb. 24, 2009

 

Urbana Middle School is mourning the loss of one of its own this week, one whose "seat will not be filled."

 

Ian Willis, a 13-year-old eighth-grader at Urbana, died on Feb. 19 at Children's Hospital in Washington, D.C.

 

Principal Frank Vetter said in a statement that Ian "had a tremendous smile and laugh, which all could hear after one of the many jokes he played."

 

Vetter said that the school community remembered Ian as a friendly and well-liked student who consistently achieved for himself - he was a consistent honor roll recipient - and also for others.

 

As a sixth-grader two years ago, Ian was the school's highest Relay for Life fundraiser. "Everyone was moved by his concern for others," Vetter said.

 

Vetter said in his statement that the Urbana Middle School community was saddened by Ian's death. "As one teacher said, ‘His seat will not be filled,'" Vetter said.

 

Ian was remembered in a memorial service at 11 a.m. on Monday at the Stauffer Funeral home in Frederick.

 

Ian's father, Robert Willis, was unable to return a phone call for comment Monday afternoon.

 

Angela Blair, a spokeswoman for the Frederick County Health Department, said in an e-mail that the department does not investigate individual causes of death. "If a source of illness is determined to affect the health of the public, the Health Department provides appropriate health education and information to the community," Blair said in her e-mail.

 

In response to community concern about the possibility of communicable diseases, Frederick County Public Schools has said that there is no outbreak of MRSA, an antibiotic-resistant strain of staphylococcus bacteria, at Urbana Middle School.

 

"There is no outbreak of MRSA in any of our schools," said Dian Nelson, a spokeswoman for Frederick County Public Schools.

 

Ian was born on May 21, 1995 and was the son of Michelle (Cardenas) and Robert L. Willis of Urbana. He enjoyed basketball, video games and recently took to the sport of fencing, according to his obituary.

 

Besides his parents, Ian is survived by his sister, Emily, of Urbana; his maternal grandparents, John and Sine Marschall of Santa Fe, Texas; his paternal grandparents, Sue and Alfred Willis of Hitchcock, Texas; his paternal uncle and aunts, Andrew Willis and wife, Kimberly, of Friendswood, Texas, and Carrie Campbell of Santa Fe, Texas; his maternal uncle and aunts, Hugo Cardenas, Jr., and wife, Julie, of Nashville, Tenn., and Pam Wyly of Marietta, Ga.; several cousins; great aunts and great uncles; and his godparents, Scott and Kristina Hensel of Jacksonville, Fla.

 

Ian was preceded in death by his maternal grandfather, Hugo Cardenas Sr. in 1973.

 

The family requests that memorials in Ian's name be offered to the Best Friends Animal Society, 5001 Angel Canyon Road, Kanab, Utah 84741-5000.

 

E-mail Chris Brown at chbrown@gazette.net.

 

Copyright 2009 Gazette.com.

 

Swallow peanuts, but choke on raw milk?

 

By Tim Rowland

Hagerstown  Herald-Mail

Sunday, February 22, 2009

 

It's rich to hear state health departments and the federal Food and Drug Administration shake a warning finger at the Maryland General Assembly over the dangers of raw milk.

 

It is equally quaint to hear the farm bureaus raise the same complaints, considering that many of their dairy-farmer members grew up drinking the stuff.

 

The message is that any milk that hasn't been cooked beyond recognition under the watchful eye of government regulators is unfit for human consumption - and as regulators guard the front door with shotguns to prevent a dairy breaking and entering, tons of bacterially poisoned peanut butter are slipping in through the back, which should be proof enough that it's the producer, not the product, that makes the difference.

 

Fans of raw milk in Maryland have to purchase it on the black market or drive to Pennsylvania, where it's legal, according to a story by Meredith Cohn in The (Baltimore) Sun. They believe it to be more nutritious, a claim that the government disputes. Common sense, however, would suggest that cooking anything diminishes its food value.

 

But this is about a lot more than nutrition; this is about knowing where your food comes from and knowing who produced it.

 

Every day we put blind trust in the products we pull from the supermarket shelves. Likely as not, they've been shipped hundreds or thousands of miles (burning carbon fuel in the process) and we have no idea how many - as was the case with the peanut butter - rats were in the ventilation ducts.

 

The government says trust us, we're on top of it. But peanuts, tomatoes, spinach and downed cattle fork-lifted into the grinders would indicate it is not.

 

And none of this takes into account the chemicals, hormones and artificial processing ingredients that are all nice and legal. Everything the government does, in fact, is designed to protect the big, faceless producer. This is no accident, since it is these corporations that write campaign checks to the people in Congress and the legislatures who write the laws.

 

But here's the thing to remember about raw milk, or any product that comes from a small, local farm: The producers are putting the same stuff on their tables as they are selling to you.

 

During congressional hearings, Rep. Greg Walden, R-Oregon, brandished a jar of peanut butter before Peanut Corp. of America CEO Stewart Parnell and asked whether he would be "willing to take the lid off and eat any of these products now ..." Good question.

 

People who visit a local farm to pick up a gallon of raw milk have an advantage - they can inspect the operation and decide for themselves on the matters of the operation's care and cleanliness. Small producers are almost always happy to give you a tour. In fact, such is their enthusiasm that the greater problem is getting away in a reasonable amount of time.

 

It's also rather amazing the amount of energy the state will spend trying to put the clamps on people who have a couple of cows or a small herd of dairy goats. It's legal to drink milk from your own cow, so farmers began to sell shares of a cow to people who could then pick up "their" milk from "their" cow. But the state swooped in and put a stop to it.

 

If the government put this kind of effort into mass-produced peanuts, five people might still be alive.

 

Similar creative efforts have been necessary for the sale of wholesome, grass-fed beef - a product whose health benefits have been proved in university studies. The government doesn't want you buying this if it hasn't been processed under the eye of an inspector. It would prefer you bought grain-gorged, hormone-soaked beef, whose ration includes proteins from other ground up animals.

 

Again, beef farmers tried to sell the cow to the consumer before processing. But in Virginia some years ago, that didn't work, because the state reasoned thusly: If you are selling meat by the pound, you must be selling the meat and not the whole animal. So at least one farmer sold his steers for $1 - and then charged $2.95 a pound for shipping and handling.

 

Such marketing gymnastics should not be necessary. It should be the job of the state to encourage, not discourage, locally grown and carefully produced food. Raw milk sells for $6 a gallon. That's a real incentive for small farmers who otherwise cannot match the economies of scale of the big boys.

 

And the benefits of making small farms cost-effective are multitude. Less fuel is consumed getting the products to market. More rural land is preserved. Small farmers often raise heritage breeds that would not be susceptible to widespread outbreaks of disease, should one break out among standard varieties. Grass is generally the primary foodstuff, as opposed to the horribly inefficient use of grain. And finally, after tasting, say, a range-raised chicken, it's awfully hard to go back to the bland, soggy birds from the store.

 

 

Many laws, many regulations need to be changed before small producers can truly thrive. But legalizing the sale of raw milk would be a positive start. And the producers of raw milk, I am sure, would be more than happy to consume their own product in front of a legislative panel.

 

Tim Rowland is a Herald-Mail columnist.

 

Copyright 2009 Hagerstown Herald-Mail.

 

Autopsy shows extensive trauma in murder, child abuse case

Pathologist details findings in court, saying starvation ultimately killed toddler

 

By Nick Madigan

Baltimore Sun

Tuesday, February 24, 2009

 

As the pathologist checked the list of injuries in his autopsy report of a Rodgers Forge toddler, he kept repeating the same phrase: blunt-force trauma.

 

He must have said it 15 times.

 

Zabiullah Ali, who performed the autopsy of Andrew Griffin on Dec. 27, 2007, the day after the child was pronounced dead in a Towson hospital, testified in Baltimore County Circuit Court yesterday that Andrew showed signs of trauma throughout his body - bruises, lacerations and abrasions, some months old and "too many to count."

 

John and Susan Griffin, both 39, are accused of first-degree murder and child abuse in the death of Andrew, who was two months shy of his third birthday when he died and was one of the couple's five children at the time. A sixth child was born after Susan Griffin was incarcerated pending trial. Her husband, a computer systems engineer, is free on bail.

 

Using dozens of gruesome, close-up photographs of Andrew - his eyes and mouth open, his face bloody with wounds - Ali methodically described each of the injuries, some of them brown, others yellow and blue, depending on their age. Some abrasions and cuts were round, some crescent-shaped, he testified, suggesting that an object might have been used to strike the child. Andrew was devoid of fat, and his muscles had atrophied, the pathologist said, and he would have been incapable of walking. His starvation was so advanced that his brain had begun to shrink.

 

The pictures of the autopsy, conducted by Ali for the Maryland Office of the Chief Medical Examiner, became increasingly graphic, showing wounds and bruises on the boy's face, head, legs, feet, hands and arms. There were also signs that Andrew had been beaten on the soles of his feet, a pattern that Ali said he recognized because such beatings are conducted as a punishment in some Muslim nations. Andrew also had bed sores behind his ears, something that one would normally expect to find on a person's buttocks, Ali said.

 

An examination of the boy's head, he went on, showed "a minimum of three blows" to the right side. At that point, Andrew's father, who has shown almost no emotion during the trial since it began last week, became more and more upset. His face turned red and his head sank into his hands, his shoulders heaving.

 

His wife mostly averted her gaze from images of the dead boy, as she has done throughout, but could be seen at one point crying into a tissue.

 

Ali said Andrew also had pneumonia, a blood infection, and was dehydrated and "severely emaciated." Despite the extent of the injuries, the cause of death was starvation, Ali concluded, and the death was a homicide.

 

"At this phase of starvation, all the healing process was shut down," Ali said to explain why many of the boy's injuries, while apparently weeks or months old, were still visible.

 

Under questioning by prosecutor Robin S. Coffin, Ali said Andrew weighed 13 pounds at his death, what a normal 3-month-old baby weighs, and was almost as tiny. His heart weighed 34 grams; the heart of a normal boy his age would weight about twice that, Ali said.

 

During cross-examination, defense attorney Joseph Murtha, who represents the child's father, suggested to the pathologist that the pneumonia might have been a cause of Andrew's drastic loss of weight. Ali countered that the pneumonia and blood infection were indeed contributory factors in his death, but they were a result of the starvation, he said, which is what killed him.

 

After Ali's testimony, the prosecution rested its case.

 

Copyright 2009 Baltimore Sun.

 

Low-Cost Health Care in Howard Not an Easy Sell

 

By Lori Aratani

Washington Post

Tuesday, February 24, 2009; B01

 

What if you build it and they don't come?

 

Officials in Howard County thought their low-cost health-care program would be an easy sell in a community where an estimated 15,000 adults are without coverage. But nearly four months later, they are struggling to get people to enroll.

 

Turns out, Howard is not unique. In Arkansas, a statewide program offering coverage through small businesses has enrolled 5,000 people, even though it can accommodate 10 times as many. And in Massachusetts, where health coverage is required by law, more than 167,000 individuals are losing tax benefits because they haven't signed up for insurance.

 

As the Obama administration and the Democratic-led Congress work to fulfill President Obama's campaign pledge to extend health coverage to more Americans, the experiences of those jurisdictions demonstrate a frustrating paradox: Even when low-cost health coverage is offered, many people fail to take advantage of it. People don't think they need coverage, don't know programs exist or don't have the money to afford even comparatively inexpensive, subsidized programs.

 

As a result, the programs have stepped up their marketing efforts. Howard officials plan to increase outreach efforts to local college students and small businesses. They are even resorting to cold cash -- offering some nonprofit community groups $20 for each person they help recruit for the program.

 

But the numbers alone show how daunting the job is.

 

In 2006, about 12 million non-elderly uninsured Americans -- about one in four -- were eligible for existing state or federal health programs but weren't enrolled, according to a recent study by the National Institute for Health Care Management, a D.C.-based nonprofit group underwritten partly by insurers. In all, 45 million people are without health coverage, a number expected to grow as the economy sheds jobs.

 

Still, even if more programs are offered, experts said, there is no guarantee that uninsured individuals will take advantage of them.

 

John Gruber, a Massachusetts Institute of Technology economics professor who studies health-care issues, said there is a long history of voluntary coverage programs that have failed because too few people enroll. The reasons run the gamut: People don't think they need coverage, don't know programs exist or don't have the money.

 

Julia Flynn, who lives in Howard and runs a marketing business with her sister, fits two of those three categories. She does everything she can to stay healthy -- everything, that is, but buy health insurance. She said she can't afford the premiums.

 

"It's always on my mind,'' said Flynn, who uses holistic treatments to keep healthy. She hasn't had any serious medical problems, but "when something does come up and I have to see the doctor, it's very upsetting."

 

There's a chance she could be eligible for coverage under Healthy Howard, which offers care for as little as $50 a month, but she wasn't aware of the program, the first of its kind in the Washington region and one of two of its type in the country.

 

Policymakers "can't take it for granted that people will come to them," said Linda Blumberg, an economist and senior fellow at the Urban Institute's health policy center who has studied enrollment trends in federal programs. States and counties that want to offer such programs must realize that they have to devote sizable resources to recruitment, especially now that the faltering economy will mean a growing number of people who have not dealt with the public system could be looking for help, she said.

 

In Arkansas, the need for coverage was obvious. The response was puzzling.

 

"We knew there was a lot of need," said Julie Munsell, communications director for the Arkansas Department of Human Services, which launched ARHealthNetworks in December 2007. But "one of the things a lot of us underestimated was the interest and desire [for health coverage]. A number of folks said, 'I'm not sick, and I don't need it.' "

 

The lack of enrollment should not be taken as a sign that such programs are not needed, experts said.

 

"It really comes down more to the financial issue -- pay rent or pay health insurance," said Barbara Lyons, vice president of the Kaiser Family Foundation. "It comes back to not being used to having coverage or not knowing where to get it."

 

Shayla-Rene Little, a 24-year-old Howard County Community College student, went without health coverage for about three years because she couldn't afford it.

 

"I would just pray, 'Please, don't let me get sick,' " she said. Then, she did. A serious ear infection landed her in the emergency room. One of her instructors told her about the county's program. She decided to bite the bullet and come up with the monthly fee to enroll.

 

In Massachusetts, those who aren't covered tend to be "young, healthy people who sometimes think they don't need health insurance because they're not going to use it,'' said JudyAnn Bigby, the state's secretary of health and human services.

 

Recently, Massachusetts officials have emphasized that there are financial penalties for not having coverage, which is having some effect. The number of uninsured adults has dropped by nearly half, and Bigby said that more are expected to sign up for coverage, because financial penalties increased this year. Those penalties are designed to not exceed half of what a person would have to pay for the cheapest coverage.

 

Now that more people are covered, the amount the state spends on uncompensated care has dropped dramatically.

 

In Howard, the early response to the Healthy Howard program was so promising that officials worried that they might have so many applicants they would be forced to hold a lottery for the 2,200 spots. Howard officials spread the word about the program through the news media, community groups and medical providers serving the uninsured population.

 

But as officials sorted through applicants, they discovered that many were eligible for other state or federal programs and directed them there instead. By the end of January, although more than 1,500 of the estimated 15,000 uninsured people in the county had coverage, only about 109 were receiving it through Healthy Howard.

 

Still, Peter Beilenson, the county's health officer, said the process has been successful because more people now have health care. He said officials will expand their outreach to community college students and small businesses. The county also recently changed the program requirements to allow the newly unemployed to enroll sooner than previously permitted. Beilenson said he expects enrollment to grow, given the state of the economy.

 

"There are now more than a thousand people getting care who didn't have it before,'' Beilenson said. "We've cut by 10 percent the number of uninsured people with very little added cost, so from that perspective, it's been a tremendous success."

 

Copyright 2009 Washington Post.

 

Nursing home sale down to 2 bidders

 

By Kevin Spradlin

Cumberland Times-News

Tuesday, February 24, 2009

 

CUMBERLAND - The search for a new owner of the Allegany County nursing home is in the final stretch, according to sources familiar with the negotiations.

 

North Bay Health Associates LLC, based in Miami, Fla., had appeared, until recently, to have the edge over Cumberland-based Allegany HealthCare Group LLC from an original list of 13 interested parties.

 

The county commissioners have a meeting planned with each group in the next several days, according to County Attorney Bill Rudd, one of three people on the commissioner-appointed evaluation committee.

 

The commissioners have emphasized a concern for the Allegany County Nursing Home and Rehabilitation Center’s work force and its residents. Many of the employees are union members. The negotiations with the union have delayed the potential sale, which first was expected to be finalized by July 1, 2008, the beginning of the current fiscal year.

 

“Everything we worked on was through the Florida group and its dynamics,” said union representative Jim Bestpitch, who is negotiating on behalf of nearly 160 workers. “There’s still some items that still have to be hashed out. Most of (the issues) have been talked about. When it comes to the other group, we have to negotiate with them, and that might be a different set of dynamics.”

 

Bestpitch said the negotiation process with North Bay was not a done deal, but having Allegany HealthCare Group approach the bargaining table at this point could be confusing.

 

“I’m not sure how that would work,” Bestpitch said. “Everything we have done has been geared towards North Bay. The other group ... hasn’t reached out to me (until) this week. I haven’t even heard from any of the other groups.”

 

The commissioners were expected to announce North Bay as the successful bidder as early as last week.

 

Former Speaker of the House Cas Taylor might have been the root of the delay. Each of the six finalists was interviewed at least once. But Taylor asked the commissioners for at least one extra session with Allegany HealthCare Group, of which there are five members - Cumberland attorney Paul Kelly, local orthopedic surgeons Gregg Wolff and Roy Carls, along with Bill Frease and Mid-Atlantic Health Care LLC, owned by Scott Rifkin.

 

Reached Monday, Kelly said Frease and the two orthopedic surgeons would be “integral” in designing a course of rehabilitation treatment for nursing home residents.

 

Kelly said everyone signed a confidentiality agreement and declined to answer any more questions.

 

Rudd has served on the committee evaluating each bid with Jason Bennett, of the county finance department, and acting County Administrator David Eberly. Rudd declined comment when asked about Taylor’s role in the process, if any, or what part he played in facilitating the meetings between Allegany HealthCare Group and the county.

 

“I don’t think anybody’s expressed that concern” about Taylor’s dual role with assisting Kelly’s group and being a paid lobbyist for Allegany County government, Rudd said. “He’s a lobbyist. That’s his job. He doesn’t have any more influence than anybody else. He’s a facilitator.”

 

Rudd said Taylor was hired in November by the county - after being hired by Kelly’s group. While Taylor’s contract, and that of his firm, Alexander & Cleaver, allows him to work in areas of interest to Allegany County outside the Maryland General Assembly, Taylor “has been called upon to do nothing related to the nursing home,” Rudd said. “There really isn’t a conflict related to that project.”

 

Taylor said he was unable to comment on the situation and that Kelly is the spokesman for the group. Commission President Jim Stakem said he talks with Taylor “every week about a lot of different things. He has asked me, ‘Where are you with the nursing home?’ My answer was always, ‘We are where the committee is.’ ”

 

Overall, Stakem said he thought the sale of the nursing home has been “fair.”

 

The negotiations have centered around a long-term contract for the employees. It’s possible part of the proceeds of the sale - figured to be slightly more than $7 million - could go toward paying existing employees past-due wages for unpaid comp time.

 

North Bay’s proposal was the high bid - at least at the beginning. Neither Bestpitch, Rudd nor Kelly would confirm a report that Allegany HealthCare’s first bid was nearly $2 million lower and has since come close to North Bay’s original offer. A decision is expected before the commissioners adopt the county budget in late May.

 

“On July 1, someone (else) is going to be running that nursing home,” Stakem said. “As a county, we can’t do it and probably shouldn’t do it.”

 

Bestpitch said the process has “taken longer” than perhaps most had expected, but for good reason.

 

“It’s a major transition going from a government entity into the private industry,” Bestpitch said. “I don’t really think the powers that be would have thought it would take as long as it has taken. I knew it was going to be a long process. It’s two different worlds.”

 

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

 

Copyright © 1999-2008 cnhi, inc.

 

National / International

 

Report: Health care costs to exceed $8,000 per person

Obama expected to call for overhaul of health care in speech to Congress

 

Associated Press

By Ricardo Alonso-Zaldivar

Baltimore Sun

Tuesday, February 24, 2009

 

WASHINGTON - A new government report on medical costs paints a stark picture for President Barack Obama, who is expected to call for a health care overhaul in a speech tonight to a joint session of Congress.

 

Even before lawmakers start debating how care is delivered to the American people, the report shows the economy is making the job of reform harder.

 

Health care costs will top $8,000 per person this year, consuming an ever-bigger slice of a shrinking economic pie, says the report by the Department of Health and Human Services, due out today.

 

As the recession cuts into tax receipts, Medicare's giant hospital trust fund is running out of cash more rapidly, and could become insolvent as early as 2016, the report said. That's three years sooner than previously forecast.

 

At the same time, the government's already large share of the nation's health care bill will keep growing.

 

Programs such as Medicaid are expanding to take up some of the slack as more people lose job-based coverage. And baby boomers will soon start reaching 65 and signing up for Medicare. Those trends together mean that taxpayers will be responsible for more than half of the nation's health care bill by 2016 -- just seven years from now.

 

"The outlook for health spending during these difficult economic times is laden with formidable challenges," said the report by statisticians at HHS. It appears in the journal Health Affairs.

 

The health care cost forecast did not take into account recent legislation that expanded medical coverage for children of low income working parents, and added to the government's obligations.

 

The report "accelerates the day of reckoning," said economist John Palmer of the Maxwell School at Syracuse University.

 

"It is bringing home more immediately the problematic dimensions of what we face," added Palmer, who has served as a trustee overseeing Social Security and Medicare finances. "The picture was bad enough ten years from now, but the fact that everything is accelerating gives greater impetus to be concerned about health reform."

 

The report found health care costs will average $8,160 this year for every man, woman and child, an increase of $356 per person from last year.

 

Meanwhile, the number of uninsured has risen to about 48 million, according to a new estimate by the Kaiser Family Foundation.

 

The government statisticians estimated that health costs will reach $13,100 per person in 2018, accounting for $1 out of every $5 spent in the economy.

 

Policy makers would like to slow the rate of increase in spending, but that has proven difficult, because American-style medicine care relies on intensive use of costly high-tech tests and procedures.

 

In a separate report, also due out today, private researchers looked at spending on medical conditions and found that the most costly were mental disorders -- including Alzheimer's -- and heart problems.

 

The White House says Obama believes that out-of-control costs are the main obstacle to securing coverage for all.

 

"Health care costs are crushing middle class families and the small businesses that fuel job growth in this country," said White House spokesman Reid Cherlin. "President Obama believes that if we're going to get our economy back on track, we have to act quickly to address this pressing issue."

 

Copyright 2009 Baltimore Sun.

 

Report: Taxpayer-funded family planning averts need for 800,000 abortions per year

 

By David Crary

Baltimore Sun

Tuesday, February 24, 2009

 

NEW YORK (AP) — Publicly funded family planning prevents nearly 2 million unintended pregnancies and more than 800,000 abortions in the United States each year, saving billions of dollars, according to new research intended to counter conservative objections to expanding the program.

 

The data is in a report being released Tuesday by the Guttmacher Institute, a reproductive-health think tank whose research is generally respected even by experts and activists who don't share its advocacy of abortion rights.

 

Report co-author Rachel Benson Gold called the family planning program "smart government at its best," asserting that every dollar spent on it saves taxpayers $4 in costs associated with unintended births to mothers eligible for Medicaid-funded natal care.

 

Despite such arguments, federal funding for family planning is a divisive issue.

 

Last month, under withering Republican criticism, House Democrats abandoned an attempt to include an expansion of family planning services for the poor in the economic stimulus bill. One anti-abortion activist, Troy Newman of Operation Rescue, called the short-lived proposal a "shameful population control program that targeted low-income families."

 

However, Democrats in Congress are not abandoning their overall goal. They plan to push soon for a major funding increase for Title X, the main federal family planning program, as part of broader legislation endorsed by President Barack Obama to reduce the number of unintended pregnancies.

 

The Guttmacher report provides ammunition for those who will advocate the funding increase.

 

Surveying data from the 2006 fiscal year, the report says the national family planning program prevented 1.94 million unintended pregnancies, including almost 400,000 teen pregnancies. Based on statistical analysis and projections, these pregnancies would have resulted in 860,000 unintended births, 810,000 abortions and 270,000 miscarriages, according to the report.

 

Without publicly funded family planning, it said, the U.S. abortion rate would be nearly two-thirds higher, and nearly twice as high among poor women.

 

Other findings:

 

—More than 9 million women — including nearly 2 million under 20 — received publicly funded contraceptive services in 2006.

 

—Six in 10 women who use a family planning center consider it their basic source of health care. The services they receive often include pelvic and breast exams, tests for HIV, screenings for reproductive cancers, high blood pressure and diabetes, and referrals to other health providers.

 

—Public expenditures for family planning in 2006 totaled $1.85 billion, with 71 percent of the funds coming from the joint federal-state Medicaid program. Twenty-seven states have expanded eligibility for family planning for low-income women who otherwise wouldn't qualify for Medicaid.

 

"States as varied as Texas, New York, South Carolina and Missouri have decided to undergo the cumbersome and time-consuming process to seek federal permission, known as a waiver, to expand family planning services," said Gold. "It's a popular policy because it helps women while saving public dollars. It more than pays for itself."

 

The report recommends that Congress eliminate the waiver requirement and allow states to use the same income criteria to determine eligibility for family planning under Medicaid that they use to determine eligibility for pregnancy-related care. It also recommends lifting a ban on family planning coverage for legal immigrants in their first five years in the United States.

 

The report also endorses pending congressional legislation that would increase funding for Title X family planning. Some advocacy groups hope to more than double the current funding to $700 million a year.

 

Some conservatives, however, dislike Title X because one of its big recipients is the Planned Parenthood Federation of America, a major provider of abortions as well as family planning services. Title X funds cannot be used for abortions, but critics contend the federal money frees up other Planned Parenthood funds for its abortion services.

 

"It's another Planned Parenthood bailout," said Tony Perkins, president of the conservative Family Research Council. "It covers their overhead."

 

He also expressed concern about the concept of public funding of contraception for unmarried people.

 

"The issue is whether taxpayers should fund, and thereby encourage, behavior that's risky and morally questionable," he said.

 

One of the Democrats leading the push for more family planning money, Rep. Diana DeGette of Colorado, bristles at such criticism.

 

"Right-wing Republicans continually use sex as a weapon when they don't have an effective argument to stand on," she wrote earlier this month. "They attack commonsense policies that not only save taxpayers money, but also promote public health."

 

Adam Sonfield, a Guttmacher policy expert who co-authored the new report, said the institute is concerned by statistics showing low-income and minority women with higher rates of unintended pregnancies and abortions than U.S. women as a whole.

 

He expressed hope that proposals for improving family planning for low-income women would be part of the overall conversation as policymakers tackle health care reform.

 

"Family planning should be noncontroversial," Sonfield said. "In this economic climate, it's so important in terms of ability to get an education, to stay in the work force."

 

On the Net:

http://www.guttmacher.org/

 

Copyrigh t2009 Baltimore Sun.

 

Bill to restrict sale of 'alcopops' stirs heated debate

Lobbyist tells House panel activists' claims that beverages are marketed to youth are false

 

By Gadi Dechter

Baltimore Sun

Tuesday, February 24, 2009

 

Public health advocates are urging state lawmakers to restrict the sale of flavored malt beverages sometimes called "alcopops," which studies have linked with underage drinking and alcoholism.

 

But the state's powerful liquor lobby, defending its industry from a slew of reform bills, said it left an anti-alcopops bill "bloodied" and "beaten" after a contentious hearing Monday in a House of Delegates committee.

 

Last year, the General Assembly and Gov. Martin O'Malley upheld the beer-equivalent status of sugary drinks such as Smirnoff Ice and Mike's Hard Lemonade, much to the chagrin of activists who believe the beverages are marketed to teenagers. Under a bill sponsored this year by Del. William Bronrott, a Montgomery County Democrat, the beverages would be restricted to establishments licensed to sell distilled spirits -- effectively banning them from the shelves of about 1,400 beer-and-wine retailers across the state.

 

The governor supports the measure, a policy shift that comes after taking "a closer look at this in the off-session," said spokesman Rick Abbruzzese in an interview.

 

"This is precisely the kind of reasonable measure that will help prevent youth drinking," said Marlene Trestman, of the attorney general's office, which is also supporting the measure.

 

Also referred to as "enhanced beer," the beverages are the drink-of-choice of young imbibers, said David H. Jernigan, a Johns Hopkins University Bloomberg School of Public Health professor who has advised the World Health Organization on alcohol policies. Jernigan cited a 2007 federal survey reporting that 77 percent of alcohol-using 8th graders had a flavored malt beverage in the past month. The drinks' popularity waned with age, the survey found.

 

Marta Harding, a lobbyist for the spirit company Diageo, told the House committee that the bill's proponents had "absolutely no credible evidence" to suggest alcopops are favored by youths and that claims of marketing to children are "absolutely false." Harding said the typical flavored malt beverage drinker is a 35-year-old woman.

 

Several members of the House Economic Matters Committee asked questions that were skeptical of the plan, and committee vice-chairman Del. David D. Rudolph, a Cecil County Democrat, pronounced Harding's presentation "excellent."

 

Bruce Bereano, a lobbyist for the Licensed Beverage Distributors of Maryland, did not dispute that assessment. "This bill is bloodied," he said, before taking his turn at the witness table, where he declared it "beaten up pretty badly."

 

Among other alcohol bills considered Monday was a perennial attempt by wineries to loosen the state's alcohol-distribution system and ship wine directly to consumers; and a new initiative that would create a special liquor license category allowing wineries some of the privileges of retailers.

 

Committee Chairman Dereck E. Davis, a Prince George's County Democrat, said before the hearing that he thought his committee would this year again reject the direct-to-consumers wine bill, largely out of concern that it would make it easier for minors to access alcohol.

 

Bronrott, who has gone up against the liquor lobby and lost before, said he remained optimistic. "Hope is big this year," he said before the hearing. "Everything I do is an uphill battle. I'm willing to take on a tough fight against the most powerful special interest in Annapolis."

 

Asked after the hearing whether he felt bloodied and beaten, Bronrott shrugged and said, "I feel pretty good, actually. I'll sleep well tonight."

 

Copyright 2009 Baltimore Sun.

 

Pneumonia: Grant Will Allow Testing in Poor Countries to Determine Causes of a Common Killer

 

By Donald G. McNeil Jr.

New York Times

Tuesday, February 24, 2009

 

Pneumonia is the biggest killer of the world’s children — two million a year, more than AIDS, malaria and measles combined.

 

But pneumonia, which just means fluid in the lungs, has many causes: bacterial, viral, fungal and parasitical. In poor countries, it is often treated without testing for the cause; a health worker will see a child panting for breath and give antibiotics.

 

There are vaccines against two of the common bacterial causes, Hib and Streptococcus pneumoniae. They have prevented many deaths in the United States and, thanks to donor money, are now reaching Africa and Asia.

 

Last week, the Bill and Melinda Gates Foundation gave $40 million to the Johns Hopkins Bloomberg School of Public Health to figure out which killers will take their place. “Once you squash Hib and pneumo, other things will become prevalent,” said Orin S. Levine, the leader of the group getting the grant.

 

The money will pay for laboratories in five poor countries — not yet chosen — to screen children with pneumonia to see what caused it. The labs will employ techniques not yet in use in poor countries: inflating children’s lungs with mist to get deep sputum samples, and using a technology called MassTag PCR that screens for pathogens.

 

“Most existing information was generated 10 to 20 years ago with lab techniques that hadn’t changed vastly since Louis Pasteur’s time,” Dr. Levine said.

 

The foundation also gave Johns Hopkins smaller grants to calculate how many pneumonia cases there are in adults and adolescents.

 

Copyright 2009 New York Times.

 

Insurer stocks tumble after Medicare announcement

 

Associated Press

Daily Record

Tuesday, February 24, 2009

 

Several managed care stocks sank sharply Monday, one trading day after the government surprised analysts with a lower-than-expected increase in Medicare Advantage reimbursements for 2010.

 

The Centers for Medicare and Medicaid Services released preliminary 2010 Medicare Advantage payment rates after the markets closed on Friday. Those rates showed a reimbursement increase of less than 1 percent.

 

Goldman Sachs analyst Matthew Borsch said in a research note he expected an increase of between 3 percent and 5 percent. He predicted that Medicare Advantage plans will need to cut benefits to maintain their profit margins, a tricky task when dealing with increased competition.

 

But he also noted that the final rate could be adjusted before it is announced April 6.

 

Medicare Advantage plans are government plans in which patients receive their benefits through a private health insurer and are not traditional Medicare benefits. The plans also include prescription drug coverage.

 

BMO Capital Markets analyst Dave Shove said in a phone interview that rates for them have increased more than 4 percent this year and last.

 

Shove downgraded Humana Inc., HealthSpring and Universal American to "Underperform" in a Monday research note. He noted that all three insurers have greater exposure to Medicare Advantage as a percentage of total earnings.

 

In contrast, Shove kept an "Outperform" rating on Aetna Inc. and Cigna Corp., which have relatively low levels of exposure to Medicare Advantage and the Part D drug benefit.

 

"Medicare is Humana's growth engine, and we believe it is about to stall out," he wrote. "We feel that while Humana's commercial business is running well, it does not guarantee enough earnings power to support current growth expectations."

 

Humana shares sank more than 22 percent, or $9.14, to $31.40 in Monday afternoon trading.

 

The Louisville, Ky.-based insurer reaffirmed its 2009 profit outlook Monday, but it said the preliminary 2010 payment rates could hurt premiums and benefits for Medicare Advantage beneficiaries next year.

 

The preliminary rates account for a 20 percent Medicare reimbursement cut for doctors. Stifel Nicolaus analyst Thomas Carroll said in an interview that cut likely will be softened, but not before Medicare Advantage rates are set, potentially leaving insurers stuck with the difference.

 

"I guess I would characterize it as a back door cut to Medicare Advantage plans," he said.

 

HealthSpring Inc. shares fell 32 percent, or $4.77, to $10.04; Universal American shares dropped more than 15 percent, or $1.58, to $8.56; UnitedHealth shares sank 14 percent, or $4, to $23.98; and Coventry Health Care Inc. shares dropped more than 10 percent, or $1.68, to $14.05.

 

Shares of Aetna Inc. fell 6 percent, or $1.84, to $27.98, while the shares of both WellPoint Inc. and Cigna Corp. dropped less than 5 percent.

 

Copyright 2009 Daily Record.

 

In Good Health — Eating Disorders Awareness Week

 

By Ashley Andyshak

Frederick News-Post Camp Directory

Tuesday, February 24, 2009

 

This week is Eating Disorders Awareness Week. Up to 10 million people in the U.S. have some type of eating disorder, according to the National Eating Disorders Association, and the costs are high in both dollars and human life.

 

Anorexia nervosa, which includes self-starvation and excessive weight loss, has the highest premature mortality rate of any psychiatric disorder, according to NEDA. The annual cost to treat eating disorder patients in the U.S. is between $5 billion and $6 billion.

 

While eating disorders can start as preoccupations with food and weight, they often have a more complicated cause, according to NEDA. Behavioral, emotional, and social factors often contribute to the development of eating disorders as the affected person attempts to control food as a way to deal with overwhelming issues.

 

Low self-esteem, troubled relationships, and social pressure to be thin are just a few of the factors that can drive people to develop an eating disorder. Scientists are researching possible biochemical causes, and eating disorders also often run in families, according to NEDA.

 

The field of eating disorders include the main three: anorexia nervosa, bulimia nervosa (also known as bingeing and purging), and binge eating disorder (or compulsive overeating), as well as others that include symptoms of these three. While not everyone with disordered eating habits has a clinically diagnosable illness, all such behaviors can be physically and emotionally harmful and should be treated professionally, according to NEDA.

 

Screening for Mental Health has developed an online tool to help users determine if they are at risk for an eating disorder and if they should consider seeking professional help. Take the quiz at mentalhealthscreening.org/screening/welcome.asp (enter s4mh to log in). For more information on eating disorders, visit nationaleatingdisorders.org.

 

Copyright 2009 Frederick News-Post.

 

Ex-NC workers plead guilty in tainted syringe case

 

Hagerstown Herald-Mail

Tuesday, February 24, 2009

 

Two former workers at a North Carolina plant pleaded guilty for their roles in shipping bacteria-tainted syringes that prosecutors blamed for five deaths and hundreds of infections, and authorities are searching for the company's chief executive.

 

Prosecutors said the company shipped heparin- and saline-filled syringes contaminated with bacteria to hospitals and clinics in Colorado, Florida, Illinois and Texas. Heparin, a blood thinner, and saline are used to flush intravenous lines during cancer treatments, kidney dialysis and other procedures.

 

Plant manager Aniruddha Patel, 43, of Carpentersville, Ill., and quality control director Ravindra Kumar Sharma, 54, of Richmond, Va., each were sentenced Monday in federal court more than four years in prison for fraud and allowing tainted drugs into the marketplace.

 

The company's chief executive, Dushyant Patel, was indicted last week on 10 charges including fraud and selling adulterated medical devices. An arrest warrant for Patel, who may be in his native India, has been issued.

 

U.S. Attorney George Holding did not have a name for Patel's attorney.

 

Patel said about a year ago when federal officials were investigating the outbreak that company voluntarily recalled the implicated syringes and there was "nothing out there anymore."

 

The company sold nearly $7 million worth of heparin and saline syringes between 2006 and 2007, court documents said.

 

"Citizens in this country trust that producers of medical devices aren't lying when they say that have adequately tested a given product," said Holding. "As we've seen in this case, such lies can literally mean the difference between life and death."

 

Prosecutors said the plant operators at the Angier facility skirted checking sterility so the company could ship syringes faster. The drugs weren't produced at the plant but were loaded into syringes there and shipped.

 

Manufacturing dates also were falsified to make it appear that safeguards were followed, according to court documents.

 

Angier is about 20 miles south of Raleigh.

 

Copyright 2009 Hagerstown Herald-Mail.

 

Opinion

 

Fighting infection

Combat superbugs, other threats with multifaceted, regional approach

 

By Ramanan Laxminarayan and Eli Perencevich

Baltimore Sun Commentary

Tuesday, February 24, 2009

 

Most people come to a hospital expecting to get better. But many don't realize that on average, one in 20 patients admitted to a hospital in the United States will contract an infection during his or her stay. These infections cause a staggering 99,000 deaths per year. And a growing proportion of these infections no longer respond to a wide range of antibiotics. Doctors must turn to more costly antibiotics or ones with more side effects - if they can cure the infection at all.

 

A 2005 report showed that hospitals could charge the cost of health care-associated infections to third-party payers such as Medicare and Medicaid. Medicare has changed its rules in response to these concerns and will no longer reimburse hospitals for the excess costs associated with the care of patients who contract a hospital-associated infection. But now hospitals have no incentive to accurately report their infection levels. If Medicare were to provide hospitals with more resources for infection control, rather than just penalize them for caring for very sick patients who contract a hospital-associated infection, hospitals might perform better.

 

Baltimore hospitals are on the front lines in the fight against these infections, many of which are caused by "superbugs" - infections resistant to most common antibiotics. The Baltimore Health Department reported last month that the rate of infections caused by the superbug methicillin-resistant Staphylococcus aureus (known as MRSA) runs twice as high in Baltimore hospitals as in neighboring regions. Often, the disease can be detected with only expensive screening programs.

 

Last month, the U.S. Department of Health and Human Services released a plan urging hospitals and other health care facilities to adopt increased use of sterile techniques and follow strict protocols to prevent such infections. These include guidelines on the proper insertion of catheters and disinfection of ventilators, as well as practices that minimize risk of infection before, during and after surgery.

 

The University of Maryland Medical Center screens all patients at high risk for MRSA when they are admitted. Screening includes patients in intensive care units and those who have been in another health care facility during the past year. The tests are repeated during the hospital stay. Isolation precautions are instituted for those who test positive for MRSA. During the past year, the hospital has performed more than 33,000 MRSA screening tests. This aggressive action has slashed the hospital's rate of MRSA infection by more than 30 percent and has saved lives.

 

Unfortunately, many hospitals are struggling financially, and most have little incentive to take these steps. For one thing, unlike most medical problems, there is no direct reimbursement to hospitals for providing these expensive and lifesaving preventive measures.

 

A further challenge is that patients with health care-associated infections move among hospitals, other health care facilities and nursing homes, and can spread the infections regionally. That means that a specific hospital does not necessarily receive all of the benefits from its infection control activities.

 

What's the solution? Infection control efforts should be regionally targeted, and HHS and the Centers for Medicare and Medicaid Services should provide hospitals with tools and incentives to work together so that they can coordinate infection-control measures. If regional coordination existed, infections wouldn't just be transferred from one place to the next.

 

Health care-associated drug-resistant infections are a complex problem. The overselling and overuse of antibiotics, as well as the lack of new antibiotics in the research pipeline, are driving the high rates of resistant infections. Timely prescribing of antibiotics can help reduce infections in hospitals, but we have to work to reduce overprescribing as well. Our government leaders need to deploy a strategy that addresses all factors driving this epidemic.

 

Ramanan Laxminarayan is a senior researcher at Resources for the Future, a think tank whose Extending the Cure initiative aims to extend antibiotic effectiveness. His e-mail is ramanan@rff.org. Eli Perencevich is medical director for infection control at the University of Maryland Medical Center, and associate professor at the UM Medical School. His e-mail is eperence@

 

epi.umaryland.edu.

 

Copyright 2009 Baltimore Sun.

 

New options really no options

 

Cumberland Times-News Letter to the Editor

Tuesday, February 24, 2009

 

To the Editor:

 

My four children and I have been enrolled in the Mental Health Center in Oakland.

 

On Jan. 28, Mark Lannon, the executive director of the program, signed a letter to be sent to us with notice that the office would be closing on March 27 at 5 p.m. (“Oakland mental health center ending services, Feb. 16 Times-News, Page 1A)

 

In the letter, Mr. Lannon recommended the following places as an option for our continued treatment:

 

1. The Mental Health Center in Frostburg, Dr. John Yarbrough

2. The Garrett County Health Department

3. Casselman Counseling Consortium

4. Graig Abrahamson

5. Burlington United Methodist Family Services

6. Stewart Callis

7. Dove Center

8. Garrett County Lighthouse

9. Nancy Elizabeth Nimmich

10. Sherry O’shell

11. Skyeia Holistic Services

 

In my search to seek out help for my family and me, under the recommendations of Mr. Lannon, this is what I found:

 

Pretty much other than the Garrett County Health Department, all of the agencies recommended to us by Mr. Lannon are out of traveling range for Garrett County residents.

 

Most of the ones recommended are private therapists, which Mr. Lannon knows does not accept Maryland Medicaid, with which the majority of the clients of the Mental Health Center are insured.

 

The others are just doctors who provide medication but not counseling. Burlington United Methodist Family services works only with families, not individuals, and does not provide counseling. I see no reason at all why the Dove Center was recommended to us.

 

I would like to know why other methods of budgeting were not tried. It is my understanding that the northern side of the county will be transported to Frostburg for services.

 

Why couldn’t the center try to find a smaller building on the northern end of the county, and the southern part of the county be transported there? A place where just outpatient mental health services could be provided by Dr. Yarbrough, the therapist who currently works at the center.

 

A few other options could have been explored to reduce cost, such as less cost on corporate overhead and personal usage of accounts. Maybe more family participation and fewer funds on those who think of Life Skills as a babysitting service.

 

The Mental Health Center in Oakland Maryland could have handled things a lot differently than how the closing of the center was handled.

 

After the decision was made, Mr. Lannon and Ms. Shanan Spencer should have met with consumers at the Mental Health Center out of respect, compassion, and professionalism.

 

The professional counselor skills of Shanan Spencer could have been used to help us understand better about the closing rather than the cold, confusing letter that was sent to us.

 

The lack of respect, compassion, and professionalism they displayed was cold, harsh, and with no human compassion of any kind being shown to us, the consumers.

 

It is also my personal opinion that he Maryland Medicaid paid to the Mental Health Center for psychiatric rehabilitation was only used to victimize us in ways.

 

A wise lady once told me: A small voice can be heard through a whisper. I pray that a small voice in me is heard, and this does not happen to any other person or family that does not have many options in life.

 

Options should include evening and weekend counseling and therapists that can see clients once or twice a week instead of just once a month, and that is close to Oakland due to transportation being an issue for a lot of us.

 

I have no fancy office, or degrees hanging on my walls, but I do have human compassion.

 

Renee Kitzmiller

Oakland

 

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