Office of Public Relations

[newsclippings/dhmh_header.htm]
Visitors to Date
Office of Public Relations
			Wednesday, July 1, 2009 News Clipping Archives *Maryland / Regional* Overdose deaths drop again (Baltimore Sun) Are military veterans adjusting to transition? (Cumberland Times-News) Swine flu sends campers home early (Baltimore Sun) Howard Co. child left in car 8 hours dies of heatstroke (Baltimore Sun) Financial help for women with breast cancer (Baltimore Sun) Holiday blood donors will get gift card (Cumberland Times-News) Causes, effects and treatment of erectile dysfunction (Baltimore Sun) Facility Cleaned After Officer Is Hospitalized for Strep (Washington Post) Pretty dangerous (Cumberland Times-News) *National / International* Panel Suggests Medical Priorities for U.S. (New York Times) Panel Urges Smaller Doses of Painkillers (AOL News) AMAG Pharma says FDA approves iron drug Feraheme (AOL News) Experiment seeks to head off Type 1 diabetes (Baltimore Sun) Dunkin' Donuts pulls drinks over salmonella concern (Baltimore Sun) New York may get graphic on smoking at retail sites (Baltimore Sun) 'Frequent Fliers' Add Billions to Hospital Bills (Washington Post) Wal-Mart Endorses Employer Mandate (Washington Post) Insured, but Bankrupted by Health Crises (New York Times) Argentina: Swine Flu’s Spread Leads to School Closings (New York Times) *Opinion* Baltimore city/county population decline (Baltimore Sun Editorial) An Advocate for Women (New York Times Editorial) Health Reform and Drugs (New York Times Letter to the Editor) *Maryland / Regional* Overdose deaths drop again Officials credit better outreach and treatment By Kelly Brewington Baltimore Sun Wednesday, July 1, 2009 Deaths from alcohol and drug overdoses declined for the second straight year in Baltimore and are at their lowest level since 1995, when the city began recording the data, according to a Health Department report released today. In 2008, 176 people died of a drug overdose in Baltimore, compared with 281 in 2007, a decrease of about one-third. Baltimore health officials called the figures significant and noted that they come at a time when overdose rates in other cities are climbing. They said increased treatment slots, better outreach to addicts and a five-year-old program that teaches drug abusers how to avoid overdosing themselves have contributed to the decline. "Short and sweet: Treatment works," said Gregory Warren, executive director of Baltimore Substance Abuse Systems, the quasi-governmental agency that oversees drug treatment in the city. "There are literally hundreds of people alive today because of what's happening." With the help of a $1.1 million grant from the state Alcohol and Drug Abuse Administration, the city has expanded treatment slots for heroin addicts treated with buprenorphine, which health officials contend is helping decrease overdoses. Mayor Sheila Dixon credited the increase in treatment and said partnerships between advocates and the health department are helping improve overdose statistics. "It's not often that we get a lot of good news when it comes to drugs," she said in an interview. "It's something we should be proud about and is due to a lot of hard work on behalf of our addiction counselors and recovery workers." While the report signals an important shift, Warren and other drug abuse experts said the city's decades-long drug problem is still severe and demand for residential treatment slots is so great that most facilities don't bother keeping waiting lists. "I think this is a human tragedy that has just been incredibly sad for Baltimore City," Warren said. "Families have been torn apart. Neighborhoods have seen residents dying on the streets, literally." Some 74,000 people needed substance abuse treatment last year, according to state estimates, but Warren's organization was only able to reach 16,000 of them, he said. "If you were able to offer substance abuse treatment to more people, we would be able to continue this positive trend," he said. "Of course, we'd like to get to treatment on demand. But that's a tall order." In the meantime, education and outreach programs can help, said Dr. Christopher Welsh, an addictions psychiatrist at the University of Maryland Medical Center. Chief among the city's efforts is a program called Staying Alive, which instructs drug users how to avoid overdose, even arming them with a prescription for Narcan, which can overcome the effects of heroin, oxycodone and other opiates. The program, launched in 2004, is based on a concept of harm reduction. Addicts may never halt their addiction, but the harm of their addiction can be minimized. When the program began, some critics said it would only help people continue to use, but there has been no evidence that it does, said Welsh. "A lot of these people get to a point where they do want help; but you can't get help when you're dead," he said. "That's really the idea behind this. I have seen people who have been revived and it really helped them come to a point where they realized they wanted to get help." At a training session yesterday at the offices of Baltimore Behavioral Health in West Baltimore, instructor Nathan Fields showed a mix of clients and staff how to spot the signs of overdose, when to inject Narcan, and how to perform "rescue breathing" on a mannequin named Brad. At the end of the session, participants received a prescription for Narcan, three syringes, alcohol wipes and a face shield for CPR. Fields started off by dispelling myths about overdose remedies, such as burning the fingers of a person experiencing overdose, injecting them with salt water and giving them a hard slap to the face. "Those street remedies are more damaging than the overdose themselves," he said. Frankie Wells, 46, of Baltimore, who is a client and a manager at Baltimore Behavioral Health, said the training helps people realize they are not powerless if they encounter someone suffering an overdose. "Just knowing about this can save a lot of lives," he said. Wells, who has been clean for 15 months after using heroin and cocaine for two decades, knows the impact of overdose intimately. His twin sister died of an overdose in 1999, just a week after leaving a treatment program. People are at higher risk for an overdose when the body has not used drugs for a while. "They found her in a tub of water," he said. "But God does some things so that someone else can see clearly. I think he wanted me to wake up." Copyright © 2009, The Baltimore Sun. Are military veterans adjusting to transition? By Kevin Spradlin Cumberland Times-News Wednesday, June 30, 2009 CUMBERLAND - Stakeholders met Tuesday to discuss the status of the transition of outpatient mental health services to the Martinsburg Veterans Affairs Medical Center and community-based outpatient clinics. Robert Border, director of the Cumberland clinic, said the meeting was closed to the media. Bob Manness, chief of customer service for the Martinsburg hospital, echoed Border’s comments. He said Director Ann Brown conducts regular meetings with stakeholders. The meetings, he said, include stakeholders who, since January, “have had a vested interest” in how - and where - veterans receive outpatient mental health services. Manness said it would be “inappropriate” to allow the media to attend via videoconference before discussing that possibility with stakeholders. He said Tuesday’s discussion was to include future, possible media involvement and that Brown might be made available later this week to address the issue. Robin Summerfield, field assistant to U.S. Sen. Ben Cardin, planned to attend the Martinsburg-based video conference in the Cumberland office on Glenn Street. Manness said a representative from U.S. Sen. Barbara Mikulski’s office was scheduled to attend as were staff on behalf of U.S. Rep. Roscoe Bartlett and U.S. Sen. Jay Rockefeller of West Virginia. Members of Maryland’s District 1 legislative delegation were invited to attend but Manness said he could not confirm whether they had indicated their intentions. Officials from the Patriot’s Path Foundation, a nonprofit organization that prepares veterans for and assists with reintegration into the community as VA-based services are phased out, also were invited. While in Frostburg last month, Brown said she believed the transition of the area’s 150 veterans that previously obtained mental health services at Re-Entry Associates in Cumberland was going well. All but 15 had integrated into the VA system, Brown said in mid-May. Frustrated veterans rallied for months against the transition. Many lauded the service they received at Re-Entry Associates and questioned the credentials of providers at the Cumberland clinic. Veterans also complained about the shorter hours available at the VA-operated facility. To address those needs, the VA hired additional licensed staff and increased operating hours two days a week until 8:30 p.m. Copyright © 1999-2008 cnhi, inc. Swine flu sends campers home early By Stephanie Desmon Baltimore Sun Wednesday, July 1, 2009 Flu is not usually something summer camps have to worry about. Welcome to the Summer of '09. An outbreak of swine flu led the directors of Sandy Hill Camp in Cecil County this week to send roughly 200 campers home about halfway through a two-week session. (Flu is seasonal and usually hits in the winter.) The new virus swept quickly through the overnight camp. During the first few days, six campers came down with flu-like symptoms (later confirmed as swine flu in two kids) and were sent home. On Saturday, six more campers got sick. All campers and staff on the two-week session had their temperatures taken the next morning and four had fevers. Nine more campers developed symptoms by Sunday night. With 10 percent of the kids sick and who knows how many others exposed, the session was called off and everyone went home Monday. Not to worry, reads a letter sent to parents planning on sending their children to later sessions at Sandy Hill this summer. No one was seriously ill, the directors wrote. And the rest of the sessions this summer will go on. In fact, a one-week session that began Sunday is underway and so far no campers have gotten sick. Campers across the country have seen their summer plans dashed as swine flu has caused closures in other locations. The Muscular Dystrophy Association canceled all of its camps nationwide -- including two sessions at Camp Maria in Leonardtown -- for fear that a swine flu outbreak could be dangerous to the sick children it serves. On page two of the Sandy Hill letter, the camp directors try to look on the bright side: "Although not necessarily initially comforting, many experts believe that the influenza A virus will come back in additional waves in the fall/winter during the traditional flu season. It is believed that campers who work through the virus now will increase their immunity against future exposures." Copyright 2009 Baltimore Sun. Howard Co. child left in car 8 hours dies of heatstroke By Don Markus Baltimore Sun Wednesday, July 1, 2009 A 23-month-old Howard County girl died of heatstroke after one of her parents unintentionally left the child strapped in her car seat in front of the family's Ellicott City residence last week. Neither the identity of the child nor her parents was released. Police spokeswoman Sherry Llewellyn said Tuesday that no criminal charges will be filed. She said that emergency responders were called to the home about 5 p.m. June 25, eight to nine hours after the child had been placed in the car seat. Llewellyn said a "change of routine" caused the parent to forget that the child was in the car. Llewellyn said the Police Department, in conjunction with the county's Health Department, will be releasing a public service announcement about child safety. Copyright © 2009, The Baltimore Sun. Financial help for women with breast cancer Taneytown patient surprised by aid from Baltimore nonprofit Red Devils By Angela J. Bass Baltimore Sun Monday, June 29, 2009 After more than a year juggling the family finances to handle the expense of battling breast cancer, Ronda Badiang was surprised a few months back when she found she was unable to pay a $1,000 deductible for her treatment. She was even more surprised when the Red Devils stepped in to settle the bill, no questions asked. "Even with good insurance, I still needed them," said the 35-year-old Taneytown mother of one. "Initially, I cried. It was a blessing." The Red Devils - the name comes from a potent, scarlet-red chemotherapy drug - aim to help breast cancer patients and their families by funding child care, coordinating rides to the doctor and helping to pay bills, among other services. Created by friends of Jessica Cowling and Ginny Schardt, the idea behind the Baltimore-based nonprofit is to give newly diagnosed patients the same kind of support that the two Maryland women received before they succumbed to the disease in 2002. The organization assists about 650 women a year. But organization officials say tough economic times are making that work more challenging. "We're seeing a lot of people who need help with mortgages, gas and car payments," executive director Jan Wilson said. At the same time, "donations are down. We're seeing more gifts, but they're smaller in size. "The hospitals have a very difficult time deciding who to refer to our organization, because we can't help everybody." Treating a breast cancer patient can cost tens of thousands of dollars a year. The stormy economy has more women - including some, such as Badiang, who consider their insurance good and their support systems strong - seeking shelter under the Red Devils' umbrella. "When you have cancer, it's for 24 hours a day," said Elizabeth Weglein, chief executive officer of the Elizabeth Cooney Care Network, which provides services funded by the Red Devils. "[We] work to identify individuals who have fallen through the cracks." Recently, the Red Devils received a $150,000 grant from the nonprofit Susan G. Komen for the Cure. But the Red Devils' Heart and Sole Stroll this month in Columbia, its largest annual fundraiser, fell $25,000 short of its $130,000 goal. They are hoping to meet their target by securing more donations online. Badiang was diagnosed with breast cancer just six days shy of her 34th birthday, joining an estimated 3,660 Maryland women diagnosed with the disease every year, according to Susan G. Komen for the Cure Maryland. "It was Feb. 11, 2008," Badiang recalled of the Tuesday afternoon that her doctor phoned to break the news. Given her age and family history, she hadn't seen herself as a candidate for breast cancer. "I was told I had ductal carcinoma, which was like Latin to me, but I said, 'OK, where do I go from here?' " From there, she underwent two surgeries at Greater Baltimore Medical Center in Towson - one to remove the tumor from her left breast, another to remove lymph nodes, which tested negative for the spread of cancerous cells. Several rounds of energy-draining radiation and chemotherapy ensued. "My job as a home help aide involved lifting elderly people," said Badiang, "but some days I could barely lift my own head." Forced to quit her regular job, she immediately began a new full-time position fighting for her life and the lives of other breast cancer-afflicted women. Since being diagnosed, she has raised more than $5,000 for the Red Devils. Her husband, Jason Badiang, 32, an eighth-grade social studies teacher at Taneytown's Northwest Middle School, has taken a second job cleaning corporate offices at night to help pay off the mounting medical bills. "I call [breast cancer] my inconvenience," Badiang said. "You never know, you could be next." Copyright © 2009, The Baltimore Sun. Holiday blood donors will get gift card Cumberland Times-News Wednesday, July 1, 2009 CUMBERLAND — The Greater Alleghenies Blood Services Region of the American Red Cross will help area residents put the finishing touches on their Fourth of July weekend festivities in return for coming forward to help meet area blood needs. Blood and platelet donors at any area Red Cross blood drive Friday through Sunday will drive off with a $5 gift card, while supplies last. Platelet donor centers are located in Altoona, Beaver, Greensburg, Johnstown and State College, Pa. As of Tuesday morning, the 100-county region had a one-day or less supply of O negative and A negative blood types and just over a one-day supply of B negative. Upcoming area blood drives include: • Friday: Western Poto-mac Chapter House, 400 Cumberland St., 9 a.m. to 3 p.m.; Oakland Volunteer Fire Department, noon to 6 p.m. • Saturday: Cumberland Holiday Inn, 9 a.m. to 2 p.m.; Keyser Presbyterian Church, 9:30 a.m. to 2 p.m. • Sunday: Lake Rays-town Resort, 10 a.m. to 4 p.m. Anyone 17 or older who weighs at least 110 pounds and is in generally good health can donate blood. In Maryland, Pennsylvania, Virginia and West Virginia, 16-year-olds may donate blood with parental permission. For more information, call (800) 542-5663. Most donors are eligible to give blood every 56 days. To schedule a blood donation appointment, call (800) 448-3543. Copyright © 1999-2008 cnhi, inc. Causes, effects and treatment of erectile dysfunction Expert advice Baltimore Sun Monday, June 29, 2009 Erectile dysfunction, also known as ED, refers to the inability of the man to obtain and maintain erection of the penis sufficient to permit satisfactory sexual intercourse. About 18 million American men experience erectile dysfunction. Dr. Arthur L. Burnett II, medical director of the Johns Hopkins James Buchanan Brady Urological Institute's Male Consultation Clinic and professor of urology at the Johns Hopkins School of Medicine, discusses causes, effects and treatment of the condition. • Erectile dysfunction is frequently associated with diabetes mellitus, cardiovascular disease, hypercholesterolemia, hypertension, pelvic trauma or surgery, and effects of various medications. • Erectile dysfunction can cause anxiety, depression, marital discord, and even violence among some sufferers and can have a significant negative impact on quality of life. • Erectile dysfunction is almost always detected by the patient suffering from the condition. Urologists evaluating the complaint of ED will look for the known risk factors. Physicians who are aware that their patients have any of these risk factors may initiate discussions with their patients to determine if ED is occurring. They will also want to know the impact of the ED on their patient's partner and may wish to discuss the issue with the partner. • Basic concepts in the management of erectile dysfunction primarily involve the preferences of the patient and partner. Therapeutic options include oral medications such as Viagra, Cialis and Levitra, local treatments such as vacuum erection devices, intraurethral suppositories, penile injections of vasoactive medications and penile prosthesis surgery. In general, the sequence of these therapies is offered from the least-invasive to the most-invasive alternatives. Recommendations are offered to preserve one's best physical fitness and overall health. •Work with your doctor to manage conditions that can lead to erectile dysfunction, such as diabetes and heart disease; limit alcohol use; avoid illegal drugs such as marijuana; stop smoking; reduce stress by exercising regularly and getting a good night's sleep; seek medical attention for anxiety or depression; and get regular checkups and medical screening tests. Copyright © 2009, The Baltimore Sun. Facility Cleaned After Officer Is Hospitalized for Strep By Dan Morse Washington Post Wednesday, July 1, 2009 Montgomery County officials scrubbed down portions of a police training facility Sunday after an officer contracted a strep infection that has him hospitalized in critical condition. County health officials stressed the cleaning was a precaution, and said it is unknown exactly how the officer developed the infection. Strep bacteria is typically passed through coughing or contact with skin wounds, a county health spokeswoman said. The officer, Thomas "T.J." Bomba, 28, is in critical condition at the University of Maryland Shock Trauma Center in Baltimore, a hospital spokeswoman said today. A public Web site created to update the officer's family and friends of his condition said he had developed a strep infection that turned into toxic shock syndrome. Streptococcus bacteria itself is very common, and millions of Americans every year develop relatively mild illnesses such as strep throat, according to the Centers for Disease Control and Prevention. In some cases, the infections become more serious, leading to conditions such as Streptococcal toxic shock syndrome. As many as 1,800 people die in the U.S. of such illnesses each year, according to the CDC. Attempts to reach Bomba's family through the hospital spokeswoman were not successful. A police spokesman declined to comment. Tributes to Bomba are pouring into the Web site: "You're the strongest person we know. If anyone can beat this it's you," a friend wrote last night. "TJ we are so stunned by what has happened to you and how such a big strong guy could be brought down by a little bacteria," a family member wrote a few hours earlier. According to the Web site, Bomba began feeling ill on June 23. He was experiencing muscle soreness under his right arm, and soon noticed discoloration and swelling. He went to Shady Grove Hospital and was eventually moved to the University of Maryland Medical Center in Baltimore. Workers thoroughly cleaned and disinfected parts of the training facility on Sunday, said Mary Anderson, a spokeswoman for the county's Department of Health and Human Services. The facility is part of a police and firefighting complex in Rockville. Bomba received the department's Award for Valor in 2007, after he and officer Michael Kane responded to a reported burglary and spotted a suspect walking along Old Columbia Pike near the Fairland Library, according to the police department. Bomba ordered him to stop and ended up chasing him across a snow-covered field. The suspect made his way to a parking lot, pulling out a gun and firing it. Bomba helped take him into custody, according to police. Copyright 2009 Washington Post. Pretty dangerous By Jeffrey Alderton Cumberland Times-News Tuesday, June 30, 2009 CUMBERLAND - If you think sparklers can’t cause injuries, talk to Tara Crawford, whose 4-year-old daughter was severely burned in a sparkler accident in March. The night of March 8, Sciona Smith was rushed to the Memorial campus of the Western Maryland Health System by private vehicle. The child was treated for second-degree burns to 11 percent of her body. The injuries covered her chest down to her navel. Crawford recalled that tragic night. “It was a beautiful day and we had a cookout. At night, we got out sparklers and the kids were playing with them. All of a sudden, Sciona's shirt flamed up,” said Crawford. “It was horrible. I never would have expected this to happen. I grew up playing with sparklers and my mom said she grew up playing with them.” Crawford watched her child suffer from her severe burns. “She would toss and turn all night for weeks. She didn’t eat well. It was very painful,” she said. Terri Dabbs, Crawford’s mother, helped with Sciona’s care and recovery. “We took care of her night and day. You had to change the bandages three times a day. It was so painful for her. She wouldn’t let anyone else change her but me. It was so bad. She wouldn't let any of the kids near her because she was afraid they would bump into her. “It was like she was in shock for the whole first week and she was heavily dosed with codeine for the pain. It was a nightmare,” said the Sheridan Place resident. Dabbs said she “never thought something like this could happen.” “The sparkler just touched her shirt and it caught fire. It’s a good thing a family friend was there. He rolled Sciona on the ground and got the fire out right away. If he had not been there at the time, she could have been killed,” said Dabbs. Deputy Fire Marshal Mike Mattingly of the Maryland State Fire Marshal’s Office investigated the incident. “It was purely accidental. It happened so quickly. The sparkler just touched her cotton shirt and it ignited. Sparklers are legal but they can be dangerous. When kids use them, it should be under the close supervision of an adult,” said Mattingly. Sciona is no longer under doctor’s care. “She’s doing good now and the scars are healing,” said Crawford, who offered a word of caution. “It was a freak accident and it caused a lot of pain. We were fortunate how it turned out. But there was a lot of pain and it can happen to other kids,” she said. “My kids will never play with sparklers again.” Of all injuries caused by fireworks, 16 percent can be attributed to sparklers, according to the National Council on Fireworks Safety. Most of the victims are young children who suffer burns to their hands and legs. Copyright © 1999-2008 cnhi, inc. *National / International* Panel Suggests Medical Priorities for U.S. By Barry Meier New York Times Wednesday, July 1, 2009 An influential scientific advisory panel has recommended that federal officials give top priority to comparing the effectiveness of competing medical strategies in areas that include treating prostate cancer, reducing hospital infections and lowering the rate of unwanted pregnancies. In a highly anticipated report, released Tuesday morning, a panel assembled by the Institute of Medicine released a list of 100 health topics that it said should get high priority as the Obama administration proceeded with a plan to spend $1.1 billion in comparing the effectiveness of competing drugs, medical devices, operations and other treatments for specific health conditions. The report is one of the first concrete steps in a broad effort by administration officials and health experts to shift the focus of medical practice toward scientific evidence — rather than a physician’s personal views or treatments promoted by medical product companies. Currently, though, in many areas of medicine there is scant data that compare competing strategies. And systems for gathering such data by mining hospital or insurance industry records are also very limited. “Health care decisions too often are a matter of guesswork, because we lack good evidence to inform them,” said Dr. Harold C. Sox, the editor of The Annals of Internal Medicine, a medical journal, who was co-chairman of the panel. Supporters of comparative effectiveness reviews include many medical researchers, consumer groups, unions and insurers. They say such studies are essential to curbing the widespread use of ineffective treatments and to helping control health care costs, which totaled $2.2 trillion in 2007, or 16 percent of the nation’s gross domestic product. But the effort has come under attack by critics, including some conservative commentators and medical products companies, who warn that the process could lead to inadequate treatment for some patients and even the rationing of health care. There also may be sharp Congressional debate in the weeks ahead on issues like whether a new federal entity should be created to oversee government-financed comparative research and what role private industry might play in the effort. Dr. Sox said that medical products makers had a “muted” response to the panel’s efforts, including its call for public comments and recommendations on what should receive financing for comparativeness reviews. Of the approximately 2,000 recommendations the panel received, only 28 came from makers of medical devices, drugs or biologic products, he said. While medical products manufacturers pay for clinical trials of their own products, such studies often compare a drug or device’s effectiveness in treating an illness against a placebo or no treatment, rather than against a competing product or treatment. In addition, people selected for clinical trials often do not represent the many different types of patients who will receive a drug or device after it is approved by federal regulators for sale. In many areas of medicine, there is frequently more than one treatment with no clear winner. To treat prostate cancer, for example, a patient is faced with strategies ranging from watchful waiting to surgery to the use of radioactive implants. A similar conundrum faces patients diagnosed with abnormal heart rhythm known as atrial fibrillation. In such cases, a doctor may recommend drugs or a surgical procedure known as ablation, with little evidence as to which strategy works better or has fewer side effects. The Institute of Medicine panel said studying both those conditions should be among the top priorities. The panel, composed of doctors, health care experts and consumers, was convened at the request of Congress. Its recommendations are expected to have an impact on how some of $1.1 billion initially allotted by lawmakers for comparative effectiveness research is spent. Along with recommending 100 health areas for comparative effectiveness reviews, the panel’s report focused heavily on setting up systems for collecting the data to undertake such studies and ensuring that such information is clearly communicated to patients. The panel also urged that the government subsidize the training of a new generation of researchers skilled in doing comparative effectiveness reviews. While most of health areas cited by the panel involved medical treatments, others included topics like the best way to reduce hospital-based infections or to compare the effectiveness of differing medical imaging technologies. Some of the panel’s recommendations also involved social or preventative issues that could generate controversy among industry or interest groups. For example, the panel urged that researchers look at the effectiveness of school programs to reduce childhood obesity through means like bans on vending machines. It also recommended research to determine the programs most effective in reducing unwanted pregnancies, including the free distribution of contraceptives. Speaking to reporters Tuesday, Dr. Sox, the medical journal editor, said that based on public comments, the panel had decided it was important to look at such public health issues. Copyright 2009 News York Times. Panel Urges Smaller Doses of Painkillers Experts Also Call for Elimination of Vicodin, Percocet Associated Press By Matthew Perrone AOL News Tuesday, June 30, 2009 ADELPHI, Md. (June 30) — Government experts called for sweeping safety restrictions Tuesday on the most widely used painkiller, including reducing the maximum dose of Tylenol and eliminating prescription drugs such as Vicodin and Percocet. The Food and Drug Administration assembled 37 experts to recommend ways to reduce deadly overdoses with acetaminophen, which is the leading cause of liver failure in the U.S. and sends 56,000 people to the emergency room annually. About 200 die each year. Acetaminophen is the key ingredient in Tylenol, Excedrin and other over-the-counter painkillers. But overdoses cause 56,000 cases of liver failure a year, the FDA says. Skip over this content "We're here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact," said Dr. Judith Kramer of Duke University Medical Center. But over-the-counter cold medicines — such as Nyquil and Theraflu — that combine other drugs with acetaminophen can stay on the market, the panel said, rejecting a proposal to take them off store shelves. The FDA is not required to follow the advice of its panels, though it usually does. The agency gave no indication when it would act on the recommendations. In a series of votes Tuesday, the panel recommended 21-16 to lower the current maximum daily dose of over-the-counter acetaminophen from 4 grams, or eight pills of a medication such as Extra Strength Tylenol. They did not specify how much it should be lowered. The panel also endorsed limiting the maximum single dose of the drug to 650 milligrams. That would be down from the 1,000-milligram dose, or two tablets of Extra Strength Tylenol. A majority of panelists also said the 1,000-milligram dose should only be available by prescription. The industry group that represents Johnson & Johnson, Wyeth and other companies defended the current dosing that appears on over-the-counter products. "I think it's a very useful dose and one that is needed for treating chronic pain, such as people with chronic osteoarthritis," said Linda Suydam, president of the Consumer Healthcare Products Association. The experts narrowly ruled that prescription drugs that combine acetaminophen with other painkilling ingredients should be eliminated. They cited FDA data indicating that 60 percent of acetaminophen-related deaths are related to prescription products. But some on the panel opposed a sweeping withdraw of products that are widely used to control severe, chronic pain. Prescription acetaminophen combination drugs were prescribed 200 million times last year, according to the FDA. "To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake," said Dr. Robert Kerns of Yale University. If the drugs stay on the market, they should carry a black box warning, the most serious safety label available, the panel decided. "If we don't eliminate the combination products we should at least lower the levels of acetaminophen contained in those medicines," said Sandra Kewder, FDA's deputy director for new drugs, summarizing the panel's vote. Percocet and similar treatments combine acetaminophen with more powerful pain relieving narcotics, such as oxycodone. If the combination products are eliminated, the acetaminophen and the other ingredients could be prescribed separately. In effect, patients would take two pills instead of one, and be more aware of the acetaminophen they are consuming. Vicodin is marketed by Abbott Laboratories, while Percocet is marketed by Endo Pharmaceuticals. Both painkillers also are available in cheaper generic versions. "The panel recommending banning Vicodin and Percocet seems a little draconian," said Les Funtleyder, an analyst for Miller Tabak & Co. Drug companies avoided the most damaging potential outcome with the defeat of proposal to pull NyQuil and other over-the-counter cold and cough medicines that combine acetaminophen with other drugs. These drugs can be dangerous when taken with Tylenol or other drugs containing acetaminophen, according to the FDA, but cause only 10 percent of acetaminophen-related deaths. "I don't think we should be advocating a solution to a problem that really is not there," said Dr. Osemwota Omoigui, of the Los Angeles pain clinic. A recall of combination cold medicines would have cost manufacturers hundreds of millions of dollars in revenue. Total sales of all acetaminophen drugs reached $2.6 billion last year, with 80 percent of the market comprised of over-the-counter products, according to IMS Health, a health care analysis firm. "The acetaminophen people dodged a bullet," said Erik Gordon, a University of Michigan business professor who studies the biomedical industry. Even with the lower daily dosage recommendation, consumers will likely keep taking as many pills as they think they need to ease their pain, Gordon said. Analyst Steve Brozak of WBB Securities said the panel votes were a "shot across the bow" of the pharmaceutical industry. "This basically puts more government oversight into something that heretofore has been less than present," Brozak said. AP Business writers Stephen Manning and Donna Borak contributed to this report. Copyright 2009 The Associated Press. AMAG Pharma says FDA approves iron drug Feraheme Associated Press AOL News Wednesday, July 1, 2009 LEXINGTON, Mass. -The Food and Drug Administration approved AMAG Pharmaceuticals Inc.'s Feraheme, an iron replacement therapy for patients with chronic kidney disease, the company said. AMAG said late Tuesday the FDA had approved the product. It expects to make Feraheme available in late July. The drug is delivered intravenously, and AMAG said the recommended dose is 510 mg, followed by a second 510 dose three to eight days later. The approval ends years of delays for AMAG, which initially sought FDA approval in December 2007, and received requests for more information twice in 2008. Copyright 2009 The Associated Press. All rights reserved. Experiment seeks to head off Type 1 diabetes Associated Press By Lauran Neergaard Baltimore Sun Wednesday, July 1, 2009 PITTSBURGH - The doctor had barely pulled away the needle when a blister appeared on Tracey Berg-Fulton's abdomen: An experimental shot was revving up the 24-year-old's immune system -- part of a bold quest to create a vaccine-like therapy for diabetes. "If we're right, that is what's going to stop Type 1 diabetes," said Dr. David Finegold as he watched the blisters appear -- one to match each of four shots -- with intense satisfaction. It's a big "if." The research is in its infancy, a first-step experiment to be sure the vaccine approach is safe before researchers at Children's Hospital of Pittsburgh test their real target -- kids newly diagnosed with this deadliest form of diabetes. It's also part of a big shift: Scientists increasingly hope to control Type 1 diabetes by curbing the rogue immune cells that cause it, before patients become completely dependent on daily insulin injections to survive. "Treating at onset in children is the best chance we have," said Pittsburgh immunologist Dr. Massimo Trucco, whose novel vaccine -- made from patients' own blood -- is among a handful of possible immune therapies being tested around the country. About 3 million Americans have Type 1 diabetes, where the body mistakenly attacks and destroys cells in the pancreas that produce insulin, the hormone crucial to converting blood sugar to energy. It's different from the far more common Type 2 diabetes that is usually linked to obesity, where the body produces insulin but gradually loses the ability to use it properly. Type 2 patients have more treatment options, including diet and exercise. To stay alive, Type 1 patients must rigorously inject insulin, or wear a pump that infuses it. "It bothers me all the people who say, 'Can't you just exercise and get rid of it?'" said Berg-Fulton of Millvale, Pa., who was diagnosed just before her 10th birthday. "Type 2 gets all the attention. This is Type 1 -- we die from this." Hence the new push for immune therapy. Preserve enough precious insulin-producing cells before irreversible damage is done and maybe patients would need far less insulin, perhaps only occasional injections like when they splurge on ice cream. But how? A "therapeutic vaccine" must shut down T cells that are the immune system's attack dogs, racing out to tackle infections or other invaders -- but only the faulty ones that erroneously attack a Type 1 diabetic's own pancreas. Body-wide immune suppression would leave patients vulnerable to other illnesses. Drug companies are biologically engineering antibodies to disarm those T cells. Two competing teams -- MacroGenics Inc. and Eli Lilly, and Tolerx Inc. and GlaxoSmithKline -- have advanced tests under way. Also, an experimental drug made from a kind of bone marrow stem cell might tamp down overly aggressive T cells. Rather than a drug, Trucco's government-funded strategy: He blocks the 911 call that different white blood cells send to direct T cells to the pancreas. They're called dendritic cells, and altering three communication molecules on their surface basically confuses and paralyzes the T cells. In mice and monkeys, the reprogrammed cells ended the vicious cycle of a pancreas attack that in turn attracts more T cells to attack again. Now to try it in people. "It's a neat concept," said Dr. Jay Skyler of the University of Miami, who heads a consortium of diabetes specialists that is closely watching Trucco's experiment. "It has a whole lot of potential." Exploring all the different immune-altering methods is important because combinations may be needed, said Dr. Richard Insel of the Juvenile Diabetes Research Foundation. Maybe a quick hit on T cells like antibodies might offer, followed by some gentler cell-based vaccines to keep them in check. But "these are early days," he cautioned. "I'm getting poked for science," joked Berg-Fulton as Finegold, an endocrinologist and geneticist at Children's, readied her shots last week. Back in April, Berg-Fulton donated her own blood so researchers could filter out immature dendritic cells and reprogram them. Reinject them just inside the skin over the pancreas -- no deeper than a pinprick -- and Trucco's animal experiments show the cells somehow find their way back to that organ to start working. That might be too much poking for children; Trucco also is developing a more drug-like way to alter dendritic cells without removing them first. For now, Berg-Fulton is part of a safety test, one of 15 adult diabetics being injected to make sure there are no unexpected side effects before researchers test if reprogrammed cells might really protect children's pancreas cells. Even if the vaccine ultimately works, she's had diabetes too long to benefit, Finegold carefully explained when she volunteered. "I'd be lying to say I'm not a little disappointed" at that, Berg-Fulton told him. Think long-term, Finegold responded. If doctors one day learn to restore insulin production, they'll need to keep the faulty immune system from just destroying it again. EDITOR'S NOTE -- Lauran Neergaard covers health and medical issues for The Associated Press in Washington. Copyright 2009 Associated Press. All rights reserved. Dunkin' Donuts pulls drinks over salmonella concern Associated Press Baltimore Sun Wednesday, July 1, 2009 CANTON, Mass. - Dunkin' Donuts has temporarily stopped selling hot chocolate and Dunkaccino brand beverages after learning equipment used at a supplier's facility might have been contaminated with salmonella. The Canton, Mass.-based company said Tuesday none of its products was contaminated and the withdrawal of the beverages from its stores was a precaution to ensure customer safety. It has about 6,400 franchised restaurants in the United States and says it serves 3 million customers a day. Plainview, Minn., supplier Plainview Milk Products Cooperative announced it had voluntarily recalled its instant nonfat dried milk and whey protein because of potential salmonella bacteria contamination. It says there were no reported illnesses. Dunkin' Donuts says it expects to resume hot chocolate and Dunkaccino sales shortly. The chain sells 52 types of doughnuts and more than a dozen coffee drinks. Copyright © 2009, The Baltimore Sun. New York may get graphic on smoking at retail sites Newsday Baltimore Sun Monday, June 29, 2009 The New York Health Department is proposing city tobacco retailers post signs with graphic images such as cancer-ravaged throats and black lungs in an effort to discourage smoking, officials say. The signs, which would be the first of their kind in the country, would include health risk warnings and information on how to quit, said Sarah Perl, assistant commissioner of the city's Bureau of Tobacco Control. The city Board of Health will hold hearings and vote in September on the proposal. Officials expect opposition from many of the city's 12,000 tobacco retailers and the cigarette industry. Copyright © 2009, The Baltimore Sun. 'Frequent Fliers' Add Billions to Hospital Bills Kaiser Health News By Joanne Kenen Washington Post Tuesday, June 30, 2009 Doctors call them frequent fliers. They are the patients who leave the hospital, only to boomerang back days or weeks later. They have become a front-burner challenge not only for hospitals and doctors but also for those trying to rein in rising costs. Typically elderly and suffering from the chronic diseases that account for 75 percent of health-care spending, their experiences of being readmitted time and again reflect many of the deficiencies in a fragmented, poorly coordinated health system geared toward acute care. Take Margaret White. With better management of her congestive heart failure, she might have avoided being rehospitalized this spring for five days. She's back home again now, doing well, with help from a new monitoring program at Inova Mount Vernon Hospital in Alexandria. There are many reasons for readmissions, including high rates of medical errors and hospital-acquired infections; lack of communication between doctors who care for patients in the hospital and their regular physicians; trouble getting a prompt doctor's appointment after discharge; missed referrals for home health care; and poor coordination and medication management during transitions from hospital to home or nursing home. "Transitions are just so dangerous. Every time you move a patient from one setting or facility to another, you have to ask, 'Is something going to go wrong?' " said Joan Teno, a geriatrician at Brown University Medical School, who has often treated her patients in nursing homes for conditions that otherwise would propel them back to the hospital. Teno said the ways nursing homes are paid mean it's often easier for them to let the hospitals take care of sick patients. Experts don't agree on how many readmissions are avoidable. Dozens of promising initiatives designed to cut down on them are underway. But many experts say sweeping changes are needed in how health care is delivered and how hospitals and doctors are paid -- sensitive issues that confront Congress and the medical industry in the debate on overhauling the health system. President Obama and health reformers in Congress are looking at many ways to reward quality and emphasize prevention and coordination. Right now, hospitals -- such as Inova Mount Vernon -- that do a better job of preventing readmissions sometimes end up losing money because the health-care system doesn't pay for the extra work they do. Some health reform proposals would change the way hospitals are paid, so that stopping readmissions becomes good business. One idea is to bundle the payments to hospitals, doctors and perhaps nursing homes or rehabilitation centers, to cover both the hospitalization and those first critical weeks after discharge. Another proposal is to have Medicare penalize hospitals with high readmission rates for eight common chronic diseases. Members of both parties have been looking at ways of paying primary care doctors more to help patients manage their chronic diseases and avoid trips to the hospital every few weeks or months. Both doctors groups and the American Hospital Association have agreed that it's time to address readmissions. The association, however, prefers to start with pilot programs to test new payment systems rather than implementing an across-the-board new approach. The AHA also says hospitals should not be held responsible for problems that patients encounter when they're outside the hospitals' control. Readmission costs are staggering. One of five Medicare hospital patients returns to the hospital within 30 days -- at a cost to Medicare of $12 billion to $15 billion a year -- and by 90 days the rate rises to one of three, according to an analysis of 2007 data by Stephen Jencks. Within a year, two out of three are back in the hospital -- or dead. Jencks consults on this issue for the independent Massachusetts-based Institute for Healthcare Improvement. For the population as a whole, including patients too young for Medicare, the readmission rate is 14 to 19 percent for the first 30 days, said Jencks. One tactic used by Inova Mount Vernon is to change the way it deals with some discharged patients. For example, the hospital began its HeartLink program in November, after Honora Fowler, a nurse, and Lynne Weir, a physical therapist who specializes in cardiac rehabilitation, brainstormed about how to help their congestive heart failure patients take better care of themselves. Patients monitor themselves daily and call a toll-free telephone line to answer some simple questions about weight gain, swelling and breathing difficulties. Fowler reviews the answers to see whom she needs to call, whom she needs to keep an eye on for a day or two, who needs their medications adjusted and who better get in to see a doctor right away. Occasionally, with a patient with advanced disease, she calls a case worker or doctor to suggest it's time to have a gentle conversation about palliative care or hospice. White's first hospitalization for her heart disease was last September, before HeartLink was up and running. When she returned this spring, her cardiologist talked to her about HeartLink. "I hadn't been paying attention to the fluids. In fact, when I gained the weight, I didn't realize it was all fluid, I thought it was good, that I was regaining the weight I had lost" during treatment a year earlier for breast cancer, said White, 59. Now she weighs herself daily, checks her feet for swelling, pays attention to changes in her breathing, and calls it all in to HeartLink, which Inova offers at no charge. After months of barely getting out of bed, White has started a small summer vegetable garden on her balcony in Alexandria. "We catch problems faster," Fowler said. Because the patients and their families trust her, she can find out what went wrong and how to stop it. Sometimes it's as simple as persuading a heart failure patient that it's not okay to splurge occasionally on a bacon double-cheeseburger. Some doctors are skeptical of this new stress on avoidable hospitalizations. At an American Medical Association meeting in Washington this year, some questioned whether they could do much to reduce hospitalizations. Cases can be very complicated, they said; patients don't always follow directions. HeartLink is new and small, and the results are anecdotal and preliminary. But other hospitals and doctors say they're proving that innovative approaches can cut readmissions while providing higher-quality care at lower cost. At Saint Luke's Hospital in Cedar Rapids, Iowa, nurse Peggy Bradke and her team use a simple "Teach Back" system to make sure that patients or a family member truly understand all the medications and treatments needed at home. Instead of going home with a sheaf of incomprehensible discharge instructions, patients leave St. Luke's with simple information, a refrigerator magnet with danger signs, a phone number they can call day or night and an appointment with their doctor, preferably within three to five days. Making that appointment is essential. Jencks's research has shown that half the patients who are readmitted within a month hadn't seen a doctor after leaving the hospital. Then, even though it's not paid for by Medicare or other insurance, St. Luke's sends a nurse to the patient's home at no charge 24 to 48 hours after discharge, and follows up later with a phone call. "We've had some great catches," said Bradke. "We find a shoebox full of meds that is completely different from what we thought they were taking in the hospital. Or we find that one of the hospital prescriptions wasn't filled or [was] not delivered." Bradke's team intervened when Frederick Peterson, 72, a "frequent flier" who has lost track of how many times he has been admitted, returned to the hospital yet again in January. Among his many health problems, Peterson has had congestive heart failure for a decade, which he has not always controlled well. Sometimes he has gone back into the hospital just days after being discharged. "A nurse came home and went over all my medications. She even went over the labels in our canned food," Peterson said. "I knew salt was bad, but I still used it. But this nurse explained it more thoroughly and now we don't use salt." St. Luke's three-year-old program has cut the hospital's 30-day readmission rate for congestive heart failure patients in half, from 12 to 6 percent. The goal is to bring it to 4 percent. Even when patients do return to the hospital, they tend to have shorter stays and less severe illness. Pat Rutherford, a vice president at the Institute for Healthcare Improvement, has been working with hospitals across the country that want to see less of their frequent fliers. "There are a lot of innovations out there, and we have growing evidence that we can improve this for the patient, to make their experience better and make sure they have a better handoff to a home or community setting," she said. "How many hospitals are ready to step up to the plate? That's to be determined," she added. "But more and more are becoming aware that in terms of quality and cost, this could be a huge home run if we do it right." This story was produced through a collaboration between The Post and Kaiser Health News. KHN is a service of the Kaiser Family Foundation, a nonpartisan health-care-policy research organization unaffiliated with Kaiser Permanente. Comments: health@washpost.com. Copyright 2009 Washington Post. Wal-Mart Endorses Employer Mandate By Ceci Connolly Washington Post Wednesday, July 1, 2009 After years of strenuous opposition, Wal-Mart, the nation's largest private employer, announced yesterday that it supports a controversial proposal requiring businesses to contribute to the cost of employee health insurance. The retailing giant's endorsement comes as the push and pull on health reform intensifies, and it could have broad economic and political consequences. Many business groups, displeased with the shape of the legislation that has emerged so far, have begun to mobilize against President Obama's top domestic priority. Obama is countering with a series of public events -- including today's town hall meeting in Annandale -- and private negotiations with industry players such as Wal-Mart. Yesterday's announcement, which came after a White House meeting, brought together Wal-Mart, the liberal think tank Center for American Progress and the Service Employees International Union, which has often sparred with the retailer over the benefits it provides its 1.4 million workers. "We are entering a critical time during which all of us who will be asked to pay for health care reform will have to make a choice on whether to support the legislation," leaders of the three groups wrote in a letter to Obama. "This choice will require employers to consider the trade off of agreeing to a coverage mandate and additional taxes versus the promise of reduced health care cost increases." Three years ago, Wal-Mart battled initiatives in several states, including Maryland, that would have required large employers to provide health insurance or contribute money toward coverage for workers. Yesterday, company executives said they decided to back a federal "employer mandate" if certain conditions are met: It must be part of a broad health-care reform bill, it should exempt some small firms, and it must be pegged to a moderately priced benefits package similar to the coverage Wal-Mart offers most of its workers. "In order to reduce the increase in health-care costs, you've got to cover as many people as possible," Leslie Dach, executive vice president of corporate affairs at Wal-Mart, said yesterday after meeting with White House Chief of Staff Rahm Emanuel. Wal-Mart declined to discuss the size and shape of a mandate it was willing to support. About 158 million Americans receive health insurance through the workplace, though the percentage has dwindled as costs have risen and the economy has soured. Wal-Mart, once criticized for its stingy health benefits, has moved to provide basic coverage to many more workers. Today, 95 percent of its employees have some form of health insurance, through the company, a family member or the government. Opinion in the corporate world over an employer mandate is split. "This would be bad for businesses, employees and consumers everywhere, even Wal-Mart shoppers," said E. Neil Trautwein, a vice president at the National Retail Federation. The federation is pressing for an individual mandate and significant insurance market reforms. But some large employers support an employer mandate as a way to "level the playing field," said Helen Darling, president of the National Business Group on Health, which represents primarily Fortune 500 companies. "A lot of big companies in the retail business already provide it, and they feel that creates a competitive disadvantage for them," she said. Wal-Mart is a major political player, spending millions of dollars on lobbying and campaign contributions in recent years. Its political action committee gave $3 million to federal campaigns during the 2008 cycle, primarily to Republicans, according to data from the Center for Responsive Politics. The donations included $12,000 to Sen. Max Baucus (D-Mont.), who is leading health-care reform efforts as head of the Senate Finance Committee. The company also spent more than $8 million on lobbying from January 2008 through March of this year, including a strong focus on health-care reform, according to Senate disclosure documents. Wal-Mart's interest in health policy extends beyond employer mandates, including policies that might affect its pharmacy business. Staff writer Dan Eggen contributed to this report. Copyright 2009 Washington Post. Insured, but Bankrupted by Health Crises By Reed Abelson New York Times Wednesday, July 1, 2009 Health insurance is supposed to offer protection — both medically and financially. But as it turns out, an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured. And so, even as Washington tries to cover the tens of millions of Americans without medical insurance, many health policy experts say simply giving everyone an insurance card will not be enough to fix what is wrong with the system. Too many other people already have coverage so meager that a medical crisis means financial calamity. One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital. He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000. In the House and Senate, lawmakers are grappling with the details of legislation that would set minimum standards for insurance coverage and place caps on out-of-pocket expenses. And fear of the high price tag could prompt lawmakers to settle for less than comprehensive coverage for some Americans. But patient advocates argue it is crucial for the final legislation to guarantee a base level of coverage, if people like Mr. Yurdin are to be protected from financial ruin. They also call for a new layer of federal rules to correct the current state-by-state regulatory patchwork that allows some insurance companies to sell relatively worthless policies. “Underinsurance is the great hidden risk of the American health care system,” said Elizabeth Warren, a Harvard law professor who has analyzed medical bankruptcies. “People do not realize they are one diagnosis away from financial collapse.” Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers and dump the sick.” “The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance,” Wendell Potter, the former Cigna executive, testified. Mr. Yurdin learned the hard way. At St. David’s Medical Center in Austin, where he went for two separate heart procedures last year, the hospital’s admitting office looked at Mr. Yurdin’s coverage and talked to Aetna. St. David’s estimated that his share of the payments would be only a few thousand dollars per procedure. He and the hospital say they were surprised to eventually learn that the $150,000 hospital coverage in the Aetna policy was mainly for room and board. Coverage was capped at $10,000 for “other hospital services,” which turned out to include nearly all routine hospital care — the expenses incurred in the operating room, for example, and the cost of any medication he received. In other words, Aetna would have paid for Mr. Yurdin to stay in the hospital for more than five months — as long as he did not need an operation or any lab tests or drugs while he was there. Aetna contends that it repeatedly informed Mr. Yurdin and the hospital of the restrictions in policy, which is known in the industry as a limited-benefit plan. The company says such policies offer value by covering some hospital expenses, like surgeons’ fees or a stay in the intensive care unit. Aetna also says all of its policyholders receive significant discounts on the overall cost of hospital care. But Aetna also acknowledges that a limited-benefit plan was inappropriate in Mr. Yurdin’s case because his age and condition — an irregular heartbeat — made him likely to require more comprehensive coverage. “Limited benefits aren’t right for everyone, and it clearly wasn’t right for Mr. Yurdin,” said Cynthia B. Michener, an Aetna spokeswoman. Charles E. Grassley, the ranking Republican on the Senate Finance Committee, which is taking a lead on health legislation, says Congress needs to make “meaningful” insurance coverage more affordable and accessible. But “until that happens,” he said, “any presentation of limited-benefit plans ought to be completely straightforward, and not misleading in any way.” Insurers like Aetna generally defend limited-benefit policies as a byproduct of the nation’s flawed health care system, which they say makes it too expensive to adequately insure someone like Mr. Yurdin. If everyone in the country were required to have insurance, the industry says — a mandate that Congress is contemplating — the costs and risks of insurance would be spread over a large enough pool of people to let insurers provide full, affordable coverage even to people with pre-existing medical conditions. Mr. Yurdin worked at TEKsystems, which employs people for short periods as contractors for other companies. TEKsystems says it does not pay for the contract workers’ health benefits, but it does enable them to purchase individual policies with limited benefits so they have at least some coverage. “There’s no way we make this sound like regular coverage,” said Neil Mann, an executive vice president at Allegis Group, which owns TEKsystems. Although Mr. Mann acknowledged that the plan Mr. Yurdin purchased excluded routine hospital care, he said he thought it still provided value to employees who wanted “peace of mind.” True peace of mind, however, comes with a much higher price tag. When Mr. Yurdin no longer qualified for the Aetna coverage after he left TEKsystems and his eligibility eventually ended, his only option was a special state plan in Texas for people who are at high risk for expensive medical care. He has been paying more than $1,000 a month for comprehensive coverage, compared with the roughly $250 a month he was paying for the Aetna plan. But as of Wednesday, his future insurance problems are largely solved: he qualifies for Medicare because he turns 65. Many insurers, as part of the Congressional overhaul of their business, say they expect the demand for limited-benefit policies to fall. “Until the nation achieves the universal coverage that we strongly support, some individuals will want to be able to choose limited indemnity products, but with comprehensive health reform we think that need should diminish,” said Simon Stevens, an executive at UnitedHealth. UnitedHealth drew criticism last year for selling policies with sharply limited coverage through AARP, the advocacy group for older people. One of the plans capped reimbursement for an operation at $5,000, for example, although many procedures cost at least several times that amount. After Senator Grassley began investigating its sales practices, UnitedHealth agreed to stop offering the limited AARP plans. Mr. Yurdin and his wife say it was not clear that he was liable for tens of thousands of dollars in hospital bills until after he had the first two of what would eventually be four operations. St. David’s says it tried to persuade them to apply for charity care, under which the hospital would absorb much, or all, of the unpaid bills. But the couple says a lawyer advised them to turn to bankruptcy as the way to be certain they would not be left with too much debt. “I knew we were getting way, way over our heads,” Mrs. Yurdin said. While Aetna disputes the Yurdins’ and the hospital’s version of events, it also says it has tried to clarify the language it uses to describe the coverage. In its most recent brochure, the fine print describing the limits to “other” hospital services now defines what they are in a footnote on the same page and warns that the excluded expenses could be “significant.” Senator John D. Rockefeller IV, Democrat of West Virginia, who is also on the Finance Committee, has introduced legislation that would require insurers to be more clear about what they do — and do not — cover. He says he advocates such a change, even if Congress cannot agree to a more sweeping overhaul of the health insurance industry. But advocates for broad changes to the health care system say Congress can succeed only by making sure health reform goes beyond giving every American a buyer-beware insurance card. One such person is Len Nichols, a health economist for the New America Foundation. “Conceptually,” he said, “insurance means normal people should not go bankrupt from serious medical conditions.” Copyright 2009 The New York Times Company. Argentina: Swine Flu’s Spread Leads to School Closings By Charles Newbery New York Times Wednesday, July 1, 2009 Authorities in Buenos Aires and the surrounding province announced Tuesday that they were canceling classes for hundreds of thousands of schoolchildren to try to contain a fast-spreading outbreak of swine flu that has killed at least 35 people locally. The two governments announced that they would start the school winter break on Monday, two weeks early, and that it would last four weeks. “I am asking kids to stay home and to not go to places with a large concentration of people to avoid the infection,” the mayor of Buenos Aires, Mauricio Macri, said during a televised news conference after meeting with a crisis committee of doctors, health officials and experts. The authorities did not, however, close bars, restaurants, theaters or shopping malls. Copyright 2009 The New York Times Company. *Opinion* Baltimore city/county population decline Baltimore Sun Editorial Wednesday, July 1, 2009 It hardly comes as news that the Census Bureau estimated this week that Baltimore City lost more than 3,000 people from July 1, 2007, to July 1, 2008. There have only been three years in the last 20 in which the city has gained population, part of a decades-long decline from Baltimore's million-plus peak long ago. What's more surprising is that Baltimore County lost population in the same period. Not much -- just 212 people out of a population of more than 785,000. But it does reflect a change in the trends in the region's population. When the county first surpassed the city in population in 1994, the city was losing 10,000 or more people a year, and the county was gaining 5,000-7,000 a year. The numbers don't prove that the city's losses were the county's gain, but it's a pretty good bet. Now both of those trends appear to be cooling off. The county isn't gaining as many people as it once was, and the city, even including this year's dip, isn't losing nearly so many. The city has been grappling with the issues of population decline for a very long time. But the end of steady population growth would be a big change for the county. A government that has been focused on managing development and holding the line on the property tax rate could, in the years ahead, find itself dealing with a very different set of problems. Unless the county abandons its long-standing (and wise) policies of limiting rural development, it will quickly reach the point at which it stops growing altogether. Is the county's leadership prepared for that day? Copyright 2009 Baltimore Sun. An Advocate for Women New York Times Editorial Wednesday, July 1, 2009 Domestic violence is a serious law enforcement and public health problem affecting as many as one in four women in this country. Yet Washington has devoted too little attention to reducing domestic violence and sexual assaults generally. We welcome President Obama’s decision to create a new post, White House adviser on violence against women, and his appointment of a seasoned advocate for victims to fill it. Lynn Rosenthal is a former executive director of the National Network to End Domestic Violence. She will report to Mr. Obama and Vice President Joe Biden, whose keen interest in the issue dates from his days in the Senate and his key role in enacting the 1994 Violence Against Women Act. Ms. Rosenthal’s challenge, and the administration’s, will be to improve the carrying out of existing laws intended to protect women, starting with better coordination of the activities of all the government bureaucracies involved, including the Justice Department, the Department of Health and Human Services and the Department of Housing and Urban Development. A national survey of domestic violence shelters released in May showed a significant increase in the number of women seeking assistance since last fall, a rise largely attributable to the stresses of the economic crisis and rising unemployment. States need to set up more emergency shelters and find more transitional housing for people fleeing violent situations. And they must do more to help these victims rebuild their lives. Ms. Rosenthal will need to tackle bureaucratic and legal hurdles and find more money to help states, localities and charitable groups address those needs. She must also help end the scandal of the thousands of rape kits sitting untested in crime labs and police storage facilities across the country, allowing countless criminals to escape punishment. All of this will require strong and creative leadership from Ms. Rosenthal and Mr. Biden and from the president. Copyright 2009 The New York Times Company. Health Reform and Drugs New York Times Letter to the Editor Wednesday, July 1, 2009 To the Editor: Re “The Drug Industry’s Offer” (editorial, June 25): Saving money as part of comprehensive health care reform is critically important. But so is saving lives. Leaders in our nation’s research hubs understand the fragile balance: United States jobs — and America’s role as global innovation leader — are jeopardized if Congress does not strike the right balance on health reform. Our significant $80 billion commitment toward reform comes straight from our companies’ balance sheets — which forces our chief executives to make difficult business decisions moving forward. But they demonstrated an iron-willed leadership that we hope other industries follow. Our commitment to innovation is a big reason that American patients with cancer live longer today, heart attack rates have dropped and deaths from H.I.V. have plummeted. The president has declared medical innovation a national priority as part of his goal of devoting more than 3 percent of gross domestic product to research and development. We will be there to do our part. Now it is time for other stakeholders to join us. Billy Tauzin President and Chief Executive Pharmaceutical Research and Manufacturers of America Washington, June 26, 2009 Copyright 2009 The New York Times Company. BACK TO TOP


[newsclippings/dhmh_footer.htm]