Thursday,
January 2, 2009
Second furlough day
for Maryland employees
(Annapolis Capital)
Medicare must control
wasteful spending
(Baltimore Sun)
'Concierge' model
offers a free-market solution
(Baltimore Sun)
Time to reorganize the
delivery of care
(Baltimore Sun)
Care center will
save open space, create jobs
(Baltimore Sun)
FDA Approved More Drugs in 2008
(Wall Street Journal)
Grocers Launch
Labels to Identify Healthy Foods
(Wall Street Journal)
New Laws in 5
States Call for Fire-Safe Cigarettes
(Wall Street Journal)
Second furlough day for
Maryland employees
Associated Press
Annapolis Capital
Friday, January 2, 2009
BALTIMORE (AP) — The day after New Year's Day is
another furlough day for more than 67,000 state workers.
Most state offices, including Motor Vehicle
Administration offices, are closed workers were given the day off without
pay. Last Friday, the day after Christmas, was the first furlough day.
Governor Martin O'Malley signed the order to
furlough the workers last month to help close a growing budget shortfall.
State employees earning $40,000 or more will be
required to take two to three additional days off without pay, between now
and June 30 — the end of the fiscal year.
A union representing many of the furloughed
workers says the furloughs are unfair and has posted protest videos on
YouTube.
Copyright 2008 Annapolis Capital.
Medicare must control
wasteful spending
Baltimore Sun Letter to the Editor
Friday, January 2, 2009
As a primary care physician who cares for elderly patients, I read the
editorial "Health care reform" (Dec. 26) with interest.
The editorial correctly pointed to the obscene discrepancy between the
salaries of primary care doctors and specialists as part of the problem in
providing cost-effective medical care. But the real question is why
specialists earn so much and use up such a disproportionate percentage of
our health care resources.
Medicare could easily fix the problem by altering its reimbursement policies
and limiting visits to specialists, and leaders of Medicare have been
talking about doing just that for 20 years. But they have done nothing. Why?
The answer is simple. The people of this country, prompted by the media and
politicians, erroneously believe that more testing is better than less, that
specialists provide better care than "general" doctors, that being in a
hospital leads to better care than being at home and that any restriction on
access to tests and doctors is akin to socialized medicine and leads to bad
outcomes.
Our very medical ethos has led us into this mess, and our politicians do not
have the political courage to curb spending on patients.
As someone who works within the Medicare system, I see patients and family
members demanding services that cost thousands of dollars because they can
do so without any restriction or cost to themselves. Some of these patients
are very old, demented and terminal. The tests and treatments are usually
excessive.
But in a Medicare system in which the patient can get nearly everything he
or she wants for practically no cost, and in a country that believes more is
better, this cycle of spending knows no end.
Unless we can change the nature of our medical culture and restrict our
excesses, not only is a universal health care system doomed but the systems
we have now will collapse under the weight of our insatiable appetites.
Dr. Andy Lazris
Columbia
Copyright © 2009, The Baltimore Sun.
'Concierge' model
offers a free-market solution
Baltimore Sun Letter to the Editor
Friday, January 2, 2009
The Maryland insurance commissioner's idea that the state might regulate
"concierge" medical practices threatens to cause a gross violation of
individual rights ("Md. ponders regulation of 'concierge' medicine," Dec.
20).
Patients and physicians have the absolute right to voluntarily contract for
medical services in a free market.
Under the concierge medicine model, physicians can spend more time with
their patients and practice according to their best medical conscience, for
reasonable reimbursement. Patients receive improved quality care for a fair
price. It is truly a "win-win" situation.
Instead of further government controls over medicine (such as "universal
health care") that harm physicians and patients alike, America needs more
such free-market reforms.
Otherwise, we'll all pay the price.
Dr. Paul HsiehSedalia
Colo.
The writer is co-founder of Freedom and Individual Rights in Medicine.
Copyright © 2009, The Baltimore Sun.
Time to reorganize the
delivery of care
Baltimore Sun Letter to the Editor
Friday, January 2, 2009
Dr. Thomas F. Lansdale III's comments on retainer-model medical practice
underscore the complete failure of the free market to deliver quality
medical care at a reasonable cost ("In defense of so-called concierge
medicine," Dec. 29).
The market inefficiency of allocating physicians to high-income specialties
at the expense of more important primary care, the Kabuki dance between
insurers' attempts to reduce costs and physicians' attempts to maintain
income, and the increased caseloads necessary for doctors to cover their
ever-increasing costs have led to assembly-line medicine.
Those seeking medical care have become profit centers rather than patients,
just like customers in any other business.
Until the delivery of medical care is rethought and properly organized, not
just tweaked around the edges to avoid admitting the failure of the free
market, the situation will only get worse.
Thomas G. Pinter
Lutherville
Copyright © 2009, The Baltimore Sun.
Care center will
save open space, create jobs
Baltimore Sun Letter to the Editor
Friday, January 2, 2009
Thank you for the recent editorial regarding the Keswick Multi-Care Center's
proposed purchase and development of certain surplus land of the Baltimore
Country Club in Roland Park for a continuing-care retirement community
("Tie-breaker," editorial, Dec. 15).
Keswick sincerely believes that its proposal is a unique and compelling
opportunity, not only for the company but also for the Roland Park community
and the city of Baltimore.
The project will result in the following benefits:
• Keswick will continue its long-standing mission of providing quality
continuing care in Baltimore with a new and needed first-class
continuing-care facility.
• The Roland Park community will enjoy a substantial amount of preserved
green space, with significant safeguards regarding future development, while
adding to its community a first-class continuing-care facility. • Baltimore
will gain a $200 million capital investment by Keswick, one than involves no
subsidies or payments in lieu of taxes and will create 500 jobs during
construction and 150 permanent jobs once the center is completed.
Keswick will continue to consider modifications to its original concept that
can create additional green space while permitting a facility that will be
compatible with the Roland Park community.
The mayor has requested that the Roland Park Civic League and Keswick enter
into constructive discussions.
We support the mayor's request and look forward to engaging the Roland Park
Civic League in this process.
Libby Bowerman
Baltimore
The writer is the CEO of the Keswick Multi-Care Center.
Copyright © 2009, The Baltimore Sun.
FDA Approved More Drugs in 2008
By Jared A. Favole and Jennifer Corbett Dooren
Wall Street Journal
Friday, January 2, 2009
WASHINGTON -- Federal regulators approved more
new drugs in 2008 than in any of the prior three years, a consolation of
sorts to an industry struggling with greater scrutiny, thousands of layoffs
and thinning drug pipelines.
The Food and Drug Administration approved 24
first-of-a-kind drugs in 2008, compared with 18 in 2007, 22 in 2006 and 20
in 2005.
[fda approvals]
The new drugs included Pristiq, an antidepressant
from Wyeth; Treanda, a treatment for certain types of leukemia and lymphoma
from Cephalon Inc.; and Amgen Inc.'s Nplate and GlaxoSmithKline PLC's
Promacta to treat a blood condition that involves low platelet counts.
The agency also approved dozens of other
applications for new formulations or new uses of existing drugs. Among them
is an Allergan Inc. glaucoma drug that also was found to enhance eyelashes.
The FDA doesn't have a goal for the number of
drugs to approve each year, said spokesman Sandy Walsh. She said it is hard
to compare one year's approval figures with a previous year because drug
applications come in on a rolling basis.
"The primary factor driving new drug approval is
the quality of the application and the data that support the drug's safety
and efficacy," she said.
Although the pharmaceutical industry welcomes the
approvals, industry analysts say 2008 will be remembered more for delays in
the approval process. The FDA missed its original deadline to act on several
drugs, including Nplate and Promacta.
Few of the drugs approved in 2008 are likely to
be blockbusters, but Glaxo's Promacta has the potential to reach sales of
$1.1 billion for its currently approved uses, according to some analysts. It
could reach around $2 billion a year if it is later approved for other
ailments, such as hepatitis C or chemotherapy induced low-platelet counts,
Deutsche Bank analyst Brian Bourdot wrote in a recent research note. J&J's
pain medicine Tapentadol could bring in $750 million a year, according to
Citigroup analyst Matthew Dodds in a research note in November.
One high-profile drug still pending FDA action is
prasugrel, a blood-thinning agent developed by Eli Lilly & Co. and Daiichi
Sankyo Co. The FDA originally had a deadline to vet the product in June but
extended the review by three months. A panel of medical experts is set to
discuss the drug's fate at an FDA-sponsored meeting Feb. 3, according to the
agency.
Last week, Takeda Pharmaceutical Co. said the FDA
set a June 26, 2009, deadline for its diabetes drug alogliptin after failing
to meet an Oct. 27, 2008, date. The company said the FDA couldn't complete
the review "due to internal resource constraints."
A standard drug-review time is 10 months, while a
priority-review period is six months and is given to drugs the agency deems
an advance over existing treatments. The FDA has a goal of making a decision
on 90% of applications within the six- or 10-month time frame. Since 1993,
the FDA has been partly funded by fees from drug companies, which were put
in place to speed drug-review times.
John Jenkins, director of the FDA's office of new
drugs, told an industry conference this month that the agency has "been
struggling to meet [drug approval] goals for the past several years" and
earlier in 2008 made a "management decision" that it simply couldn't meet
all of its deadlines for the year given the workload and a staff shortage.
According to the FDA, the agency missed its
deadlines on 32 out of 159 drug applications through Oct. 31, or 20% of the
time.
Ira Loss, senior health-care analyst at
Washington Analysis, a research firm, predicts that by mid-2009 the FDA's
approval process will be more rapid since the agency recently hired hundreds
of people to review drug proposals.
Legislation passed last year gave the FDA more
money to hire additional drug reviewers along with other kinds of employees,
but it also imposed new requirements on the agency that are now being
implemented and are temporarily contributing to the slowdown in
drug-approval times.
Mr. Jenkins said the agency hired more than 800
employees in the FDA's drug division in 2008, but he said training has taken
time. He said the agency hopes to be closer to the goal of reviewing 90% of
drug applications on time in 2009.
Another issue contributing to missed deadlines is
a requirement that all new drugs be reviewed by agency advisory committees
that are made up of outside medical experts. Indeed, Novo Nordisk A/S had a
March 23, 2009, deadline for the FDA to act on the diabetes drug
liraglutide, but the agency recently told the company it wouldn't be able to
hold an advisory-panel meeting on the product until early April.
Shirley S. Wang contributed to this article.
Write to Jennifer Corbett Dooren at
jennifer.corbett-dooren@dowjones.com
Copyright 2008 Dow Jones & Company, Inc. All
Rights Reserved.
Grocers Launch
Labels to Identify Healthy Foods
By Timothy W. Martin
Wall Street Journal
Friday, January 2, 2008
Northeast grocery chains Stop & Shop and Giant
Food are unveiling a product-labeling system designed to help customers find
their stores' healthiest foods.
The "Healthy Ideas" system will distinguish more
than 3,000 of the stores' products and fresh produce with a bright
green-and-blue symbol signifying they meet U.S. Department of Agriculture
and other federal guidelines defining what makes a food healthy. That
represents about 10% of the store's total inventory and includes items
ranging from dairy products to pancake mix to frozen Brussels sprouts.
As the nation's obesity and diabetes problems
have become more serious, supermarkets hope that health-conscious consumers
will increasingly look toward supermarkets to help them balance their diet.
"Customers are looking for help," says Andrea Astrachan, Stop & Shop's vice
president of consumer affairs.
Seeking to Simplify
Healthy Ideas is one of several new food-labeling
programs that attempt to simplify the identification of nutritious foods.
The more-detailed nutritional labels required by the Food and Drug
Administration have confused some consumers who might not be able to parse
the differences between the benefits and drawbacks of reduced fat versus
reduced sodium. And not everyone agrees on what makes a food healthy,
leading to criticism of the programs over which items get included.
Labels at Stop & Shop and Giant Food will
indicate items that meet federal guidelines defining healthy foods.
The new programs try to distinguish which
products in a given category -- cookies, for instance -- are healthier than
others in that category. "Not all cookies are created equal," says David L.
Katz, director of the Yale University Prevention Research Center.
One new program, NuVal, developed by a team of
nutrition and public health experts, led by Dr. Katz, was launched in two
grocery chains, Price Chopper, based in Rotterdam, N.Y., and Hy-Vee, based
in Des Moines, Iowa, this fall. The system rates more than 45,000 products
on a 1-to-100 scale, with 100 being healthiest.
Food manufacturers, including Kraft Foods Inc.,
PepsiCo Inc. and Unilever PLC, are working with nutritionists on another
program to add a "Smart Choices" label to certain products in a program
scheduled to launch this summer.
"The majority of consumers feel there is
information overload," said Burt P. Flickinger, managing director of the
Strategic Resource Group, a consulting firm in New York. Mr. Flickinger said
a minority of shoppers, mostly women with children, are seeking more
nutritional information, and the labeling may appeal to them.
One of the first such labeling programs, called
Guiding Stars, was launched by Hannaford Bros. Co., based in Scarborough,
Maine, and a subsidiary of the Belgian Delhaize Group, in September 2006. It
ranks more than 25,000 products in a three-star system of good, better and
best, while other products weren't ranked at all. Hannaford said products
that received stars saw an increase in sales.
But the program came under criticism because some
unranked products were seen as healthy by others. V8 vegetable juice, for
example, is endorsed by the American Heart Association, but Hannaford didn't
rank it because it had too much sodium.
The new program at Stop & Shop and Giant Food,
sister chains owned by Netherlands-based Royal Ahold NV, came about because
consumers said they wanted something to be a sole source for determining
whether one food item is healthier than another, Ms. Astrachan said.
Good Nutrient Source
Products in the chains' 561 stores that carry the
Healthy Ideas symbol have less fat or cholesterol than other products in
their category and include at least one good nutrient source such as fiber,
protein or calcium, Stop & Shop says. The company says Healthy Ideas wasn't
created to help consumers lose weight or elevate one product over another,
but rather to highlight the items that meet or exceed federal guidelines for
healthy food.
Still, consumers shouldn't fall into the trap of
buying any item with a label on it and assuming it is healthy, says Jeff
Stier, associate director at the American Council on Science and Health, a
consumer group based in New York. Portion control and reading the
nutritional label, he says, are still the most important things to determine
a food's health.
"Even if you see a big bag of chips with a label
on it, that doesn't mean you can go crazy," Mr. Stier says.
Write to Timothy W. Martin at
timothy.martin@wsj.com
Copyright 2008 Dow Jones & Company, Inc. All
Rights Reserved.
New Laws in 5
States Call for Fire-Safe Cigarettes
Associated Press
Wall Street Journal
Friday, January 2, 2008
FORT WORTH, Texas -- Laws mandating stores only
sell cigarettes that are slow-burning and fire-safe went into effect in five
states on New Year's Day.
Delaware, Iowa, Oklahoma, Pennsylvania and Texas
Thursday joined 17 other states in mandating the fire-safe cigarettes.
Fifteen other states have laws that will take effect this year or next,
according to the Coalition for Fire-Safe Cigarettes.
The paper on these "fire safe" cigarettes is
thicker in two separate spots so they will go out if not puffed when they
burn to these areas. The idea is to prevent fires caused when cigarettes are
left unattended. Critics say that the fire-safe brands taste different and
can extinguish a cigarette before a smoker is done smoking it.
About 800 Americans die each year in fires caused
by careless smoking and the coalition estimates that number will be reduced
if at least half the states pass the law.
"There has been a rash of smoking materials
deaths," Oklahoma Fire Marshal Robert Doke said Monday. "A cigarette will
fall into overstuffed furniture or mattresses when people fall asleep, or it
rolls off an ashtray and on to the carpet, then the possibility for ignition
happens.
"This cigarette is supposed to snuff out before
it can cause enough heat to start a flame."
Julie Alexander, manager of a Tobacco Outlet Plus
store in Des Moines, Iowa, said 95% of her store's stock is "fire safe"
cigarettes. Many brands have only been available in the new design for some
time, she said.
But Ms. Alexander said customers' response hasn't
been positive.
"Our customers say they are harder to smoke and
the taste isn't the same," Ms. Alexander said.
According to the coalition, states that already
had implemented fire-safe cigarette laws are New York, Vermont, California,
Oregon, New Hampshire, Illinois, Maine, Massachusetts, Kentucky, Montana,
New Jersey, Connecticut, Maryland, Utah, Alaska, Rhode Island and Minnesota,
as well as the District of Columbia.
Idaho, Indiana, Kansas, Colorado, Arizona,
Washington, Louisiana, Hawaii and Wisconsin have laws that take effect this
year, according to the coalition's Web site. Florida, Georgia, North
Carolina, Tennessee, Virginia and South Carolina have laws that will take
effect in 2010.
Some states such as Texas are giving retailers a
grace period to sell off their old inventory.
Copyright © 2009 Associated Press
Copyright 2008 Dow Jones & Company, Inc. All
Rights Reserved.
