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			Friday, June 12, 2009 News Clipping Archives *Maryland / Regional* Swine flu appears in county (Cumberland Times-News) Poultry farmer in controversial food industry film (Salisbury Daily Times) Bon Secours mulls closing inpatient hospital to cut costs (Baltimore Business Journal) Va. to launch pilot health plan for state workers (Salisbury Daily Times) Howard University Hospital, Med Students Launch Free Clinic for Uninsured (Baltimore Afro-American) *National / International* Prevention Efforts Provide No Panacea on Health Costs (Wall Street Journal) To Flu Experts, ‘Pandemic’ Confirms the Obvious (New York Times) New Victims of Swine Flu Include 11-Year-Old (New York Times) Miami immigration center has 3 swine flu cases (Hagerstown Herald-Mail) Congress Sends FDA Tobacco Bill to Obama (Wall Street Journal) Business groups not standing in the way of health reform (Baltimore Business Journal) Senate Passes Bill to Let FDA Regulate Tobacco (Washington Post) *Opinion* Tobacco Regulation, at Last (New York Times Editorial) Got milk? You should (Baltimore Sun Letter to the Editor) *Maryland / Regional* Swine flu appears in county Michael A. Sawyers Cumberland Times-News Friday, June 12, 2009 CUMBERLAND - The number of confirmed cases of swine flu in Maryland increases daily and includes Allegany County’s first patient, according to local and state public health officials. Statewide, confirmed cases grew from 137 on Wednesday to 174 on Thursday, according to David Paulson, office of communications, Maryland Department of Health and Mental Hygiene. Paulson said the bulk of Maryland’s cases are in Prince George’s and Montgomery counties. No cases have been confirmed in Garrett County, he added. The person who contracted the flu in Allegany County is now home and recovering, according to Dr. Sue Raver, health officer for Allegany County. Raver would not provide the date the illness was confirmed or the duration of the hospital stay. A health department spokeswoman said Raver was concerned that any such information could possibly lead to the identification of the patient. “As Allegany County Health Department has monitored the increasing numbers of H1N1 flu nationwide and in Maryland, we anticipated that we would eventually see cases in our county,” Raver said in a news release. Raver said the flu is expected to stay in the county through the summer and autumn. Paulson said Thursday that as the number of cases grows in Maryland, health officials will spend less time counting them. “When we get a block of people in a particular area with symptoms and one or two test positive for H1N1, it is very probable that all of the sick people have it,” Paulson said. Paulson said the nature of this flu has been relatively mild and has resulted in few hospitalizations. “Recovery is probable. There have been no fatalities in Maryland,” Paulson said. “The state health officer has said that it is very likely that this flu is in every jurisdiction in the state.” Tracking of the illness by www.pandemicflu.gov shows that Wisconsin has the most confirmed cases with more than 2,200. In the states bordering Maryland, Virginia has 55 confirmed cases and the only fatality. Confirmed cases in other nearby states are: Pennsylvania, 299; and Delaware, 142. The Associated Press reported on Thursday the number of confirmed cases in West Virginia doubled to 59. Texas has the most fatalities with three. H1N1 influenza is a respiratory disease caused by a novel strain, the local health department reports. Because this is a new virus, most people do not have protective antibodies. It is believed that some people older than 60 may have limited protection against the disease because of swine flu outbreaks in the 1970s. The U.S. Centers for Disease Control and Prevention is working to develop a vaccine for H1N1. Preventative steps suggested by health officials include: • Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue in the trash. • Wash hands often with soap and water. • Avoid touching your eyes, nose or mouth. • Stay home seven days after the onset of symptoms. • Avoid crowds and pay attention to personal spacing. Information about the H1N1 influenza is available at: • www.alleganyhealthdept.com • www.cdc.gov/h1n1flu • www.dhmh.state.md.us/swineflu • www.pandemicflu.gov To inquire further, contact the health department at (301) 759-5093. Contact Michael A. Sawyers at msawyers@times-news.com. Copyright © 1999-2008 cnhi, inc. Poultry farmer in controversial food industry film By Laura D'Alessandro Salisbury Daily Times Friday, June 12, 2009 SALISBURY -- Carole Morison advocates sustainability and small farms, despite 23 years as a contracted poultry farmer in Pocomoke City. Morison details her problems with the industry in "Food Inc.," a feature-length documentary on agribusiness debuting in three major cities today. While Morison and other supporters of the film are pleased the new perspective on food is making mainstream waves, proponents of the Eastern Shore's deep-rooted poultry industry won't be likely to line up at theaters. "('Food Inc.') is a documentary about the American food system the way 'Raiders of the Lost Ark' was a documentary about archaeology," said Bill Satterfield, executive director of Delmarva Poultry Industries Inc., which is based in Georgetown. Satterfield describes the film as a "one-sided, negative and misleading" account of United States food production, and one that portrays Delmarva's main multimillion-dollar business as one of the biggest enemies to public and environmental health. The poultry industry is a common target for environmentalists as a point source for water pollution and overall decline in environmental health. A Pulitzer Prize-winning former reporter and editor for The New York Times, Hedrick Smith recently released a documentary as part of his Frontline series for the Public Broadcasting System, titled "Poisoned Waters," chronicling case studies of polluted water bodies including the Chesapeake Bay. Smith also interviewed Morison and her previous employer, Perdue Farms. Morison said her decision to discontinue industrial farming with Perdue had little to do with "Food Inc." and was a decision that was a long time coming. "We refused to do demanded upgrades and that ended our relationship," Morison said. "Simply because there are other ways to do things and raise food." Perdue spokeswoman Julie DeYoung said Morison's contract ended in 2008 after she refused to meet Perdue's minimum poultry housing standards to provide optimal bird health and comfort despite cost-sharing offers made by the poultry company. Morison said she plans to continue farming sustainably, like "Food Inc." suggests, either by raising free-range or heritage breed chickens on a much smaller scale. She said her choice to discontinue with Perdue is of little importance to the movie and a personal choice, at that. "Everybody has their different opinions about that," she said. "I just really hope that people start to take notice about their food. I guess my choice really is a complete turnaround in comparison to my previous endeavor in food production, but this will be a way of food production that I like." Satterfield, like other members of the agribusiness community, said small-time farming will come at a high price that is impractical for the current economy and incapable of feeding the world's population with the efficiency of the current food system. He said while the model suggested in the film is viable as a niche in the existing market, it stands little chance in providing food for the world population. "No system is perfect, but American farmers, ranchers, producers of all kinds, processors, and manufacturers continue to meet the needs of consumers for safe, healthful and nutritious food that are convenient and affordable," he said. Copyright 2009 Salisbury Daily Times. Bon Secours mulls closing inpatient hospital to cut costs By Julekha Dash Baltimore Business Journal Friday, June 12, 2009 Bon Secours Hospital could close its inpatient hospital and expand its outpatient health services as state and hospital leaders determine how the financially struggling health care institution can stay afloat while still serving the surrounding West Baltimore community. That is one scenario that could be part of the hospital’s transformation, to be presented to state legislators as early as next month. The 125-bed hospital needs to outline how it can sustain its operations if it is to receive nearly $6 million the Maryland General Assembly approved to spend on Bon Secours during the 2009 session. The plan, which is being developed in conjunction with state health leaders, would need approval from the hospital board and the board members of parent Bon Secours Health System. Based in Marriottsville, the $2.6 billion Catholic health system owns or manages 18 acute care hospitals — most of them in other states. Many hospitals are struggling to contain costs and boost their profits in this economy. But Bon Secours is not a victim of the recession. Rather, it sits amid blighted West Baltimore neighborhoods that draw a high percentage of low-income patients who lack health insurance, resulting in operating losses at the hospital. Copyright 2009 Baltimore Business Journal. Va. to launch pilot health plan for state workers Associated Press Salisbury Daily Times Friday, June 12, 2009 RICHMOND, VA. (AP) — The Virginia commonwealth is partnering with Optima Health to help improve state workers' health and lower costs. Gov. Timothy M. Kaine announced details of the COVA Connect pilot program on Thursday. Beginning July 1, about 17,000 state employees and their family members will be eligible to meet with a health coach and enroll in Optima's healthier lifestyle programs for free. Those programs include making healthier food choices, quitting smoking and exercising more. The program is being offered initially to workers in Hampton, Norfolk, Suffolk, Portsmouth, Virginia Beach, Chesapeake and Poquoson, but may be expanded. Each participant will complete a confidential questionnaire that will help identify risk factors, such as smoking or obesity. Copyright 2009 The Associated Press. All rights reserved. Howard University Hospital, Med Students Launch Free Clinic for Uninsured Howard University News Service Baltimore Afro-American Wednesday, June 10, 2009 (June 10, 2009) - Howard University Hospital will be offering free medical treatment to low-income, uninsured patients on June 18 in a new clinic on the first floor of the hospital. The New Freedmen’s Clinic will be run, staffed and funded by medical students from the Howard University College of Medicine and will be open from 6 to 9 p.m. every Thursday. For one time only, the clinic will be open from 5 to 7 p.m., June 22, for general screenings. Initially, the clinic will be for adults only. Each Thursday, four medical students, overseen by two Howard University Hospital physicians, will treat patients by appointment and those referred to them by the hospital’s emergency department. The clinic is largely the culmination of the dream of one student, Raolat Abdulai, a third-year medical student who began the effort more than a year ago and will serve as the clinic’s director. Abdulai, 27, of Silver Spring, Md., got the idea for a free clinic in an e-mail from an instructor, Dr. Christopher DeGannes. The professor told her of a course being offered in Portland, Ore., on organizing student-run clinics. She attended the course and found overwhelming support for a free clinic when she returned to Howard. “When we had a meeting to see who might be interested, more than 100 students showed up, and there were some faculty members as well,” Abdulai said. She was later selected from more than 3,000 women who applied to a joint project between, O, The Oprah Magazine and The White House Project, a national nonprofit organization working to advance women’s leadership. The initiative, entitled Women Rule!, provided training for a select group of women leaders to bring their dreams to fruition. Abdulai and 79 other women were selected to attend the three-day leadership-training workshop in New York City. The women learned to write a business plan, negotiate, build teams and organize themselves and others. She and other students later visited and observed the workings of a student-run free clinic at Bread for the City, a non profit agency that provides food, clothing, medical care, legal and social services for low-income Washington residents. “That’s when I really learned how much effort has to go into a project like this,” Abdulai said. “We needed attending physicians. We needed a space. We needed to learn lab skills and perfect our clinical skills in order to serve the patients. And I really learned it’s a hectic pace at these kinds of clinics.” Undeterred by those obstacles, she and fellow students applied to the Association of American Medical Colleges for funding and received a $30,000 grant. “After we got the grant, we finally realized that our dream would come true,” she said. “I’m so excited. I’m ecstatic. I can’t wait until opening day.” Dr. Charles Mouton, chair of Department of Community and Family Medicine at the College of Medicine and advisor to the clinic, said the students’ efforts reflect the medical school’s mission. “Howard University College of Medicine’s mission is to serve the underserved populations and reduce health care disparities,” Mouton said. “Our students are driven by that mission. That’s why they came here, because they want to serve people.” Copyright 2009 Baltimore Afro-American. *National / International* Prevention Efforts Provide No Panacea on Health Costs By Janet Adamy Wall Street Journal Friday, June 12, 2009 WASHINGTON -- There is one idea for fixing the health-care system that lawmakers in both parties agree on: a bigger government role in disease prevention. Yet many previous government prevention efforts aimed at costly chronic diseases have had little success in reducing illness or costs. "It is not going to cut costs," said Louise Russell, a research professor in the Institute for Health at Rutgers University who has studied the issue. "We already do a lot more prevention than other countries. We are not healthier." The findings don't question the benefits of a healthy lifestyle, and many preventive measures are effective. The problem is that when testing becomes too widespread, or heavy investments are made in monitoring people with chronic diseases, the rewards often fail to match the costs. The results are striking because of the broad consensus in Washington that it is cheaper to invest in keeping people healthy than it is to treat them once they are sick. "The health-care system is tilted toward a disease system rather than a wellness system," said Health and Human Services Secretary Kathleen Sebelius in an interview. Many prevention strategies show proven cost savings, she said, including antismoking programs and those that promote weight loss to reduce conditions like diabetes. However, she said there is a shortage of proof surrounding prevention, "because there haven't been enough consistent strategies in place." The Congressional Budget Office, in a December report, concluded that greater use of preventive care would at best generate modest reductions in costs over 10 years, and might even result in increases. One reason cost savings are hard to achieve, according to Prof. Russell, is that much of the money spent on disease prevention goes for people who aren't going to get sick anyway. Also, people have trouble making difficult lifestyle changes, such as taking up regular exercise or eating healthier food. A report published in the New England Journal of Medicine last year examined 279 spending ratios in published studies of health-oriented prevention measures, and another 1,221 on treatments for people who were already sick. Some measures clearly saved money, like screening men in their early 60s for colorectal cancer. But the report concluded that most preventive measures reviewed didn't save money. For instance, screening all 65-year-olds for diabetes would cost $590,000 for every healthy year of life it adds over just screening people that age with high blood pressure. Medicare has conducted seven pilot programs in the past decade testing the theory on some of the most costly chronic diseases. Each showed little if any cost savings or measurable improvement in patients' health. The largest experiment, the Medicare Health Support program, started in 2005 and eventually included about 200,000 patients. Groups were assigned to companies that specialize in helping people with chronic health conditions lower their medical costs and keep from getting sicker. Most of the patients had diabetes or congestive heart failure. Nurses contacted the patients to make sure they were following doctors' instructions to take medication and reduce sodium intake. They also mailed patients packets about their diseases and directed them toward community health classes. Overall, the program didn't reduce the group's rate of acute-care hospitalizations, hospital readmissions, emergency-room visits or death, according to a summary of the pilot program's first phase. It didn't meet its goal of lowering patients' Medicare payments in an amount equal to the cost of the prevention services, which ranged from $67 to $118 a month. The company that achieved the highest cost savings recouped only 26% of the fees spent on the program through lower Medicare spending. "Changing behavior takes time," said Christobel Selecky, chief executive of LifeMasters Supported SelfCare Inc., an Irvine, Calif., company that withdrew early from the test. While such efforts can be successful, she said, "I would hope that nobody thinks that this is a silver bullet." Nonetheless, private health insurers are placing bets that prevention can lower their costs. Based on its own disease-management programs, UnitedHealth Group Inc. estimates that Medicare could save $24.8 billion over a decade on patients with congestive heart failure if it identified high-risk patients and counseled them to stay healthier. And some experts point out that focusing on savings is the wrong way to think about prevention. Health care "is a good, and we don't purchase goods to save money," said Steven Woolf, professor of family medicine at Virginia Commonwealth University. "When a new imaging device comes out, or a new antibiotic, we don't say, 'Does it save money?'" Printed in The Wall Street Journal, page A11 Copyright 2009 Dow Jones & Company, Inc. All Rights Reserved. To Flu Experts, ‘Pandemic’ Confirms the Obvious News Analysis By Donald G. McNeil Jr. and Denise Grady New York Times Friday, June 12, 2009 It came as no surprise on Thursday when the World Health Organization declared that the swine flu outbreak had become a pandemic. The disease has reached 74 countries, and probably met the technical definition of a pandemic — or global spread — weeks ago. Nearly 30,000 cases have been reported, but disease experts think hundreds of thousands or millions of people have actually been infected. So the agency made official what had become obvious: that the H1N1 virus is spreading quickly in different parts of the world, and its chief, Dr. Margaret Chan, said, “Further spread is considered inevitable.” The announcement does not mean that the illness, which has been mild in most people, has become any worse. The term pandemic reflects only the geographic spread of a new disease, not its severity. Pandemics typically infect about a third of the world in a year or two, and sometimes strike in successive waves. “Globally, we have good reason to believe that this pandemic, at least in its early days, will be of moderate severity,” said Dr. Chan, director general of the health agency. So far, 144 people have died from H1N1. The decision to raise the pandemic alert from Phase 5 to Phase 6, its highest level, is meant to signal to countries to step up their efforts to deal with the disease. It also means that the health organization is asking drug makers to start making vaccine as quickly as possible, with the hope of having some batches ready by September. Efforts to make a vaccine are under way, and stockpiles of antiviral drugs have been opened. But the agency does not recommend closing borders or restricting travel. “This is not a surprise,” said Dr. Thomas R. Frieden, the new director of the Centers for Disease Control and Prevention. “For all intents and purposes, the United States government has been in Phase 6 of the pandemic for some time now.” Even though the disease has been relatively mild in most people so far, governments must not relax, Dr. Chan said. For one thing, she explained, the virus could change at any time and become more severe. In addition, the illness may take a greater toll when it reaches poor countries with higher rates of malnutrition, AIDS and other diseases that can lower people’s resistance to infection. Dr. Chan said rich countries should help poor ones less able to protect themselves. Even in developed countries, the virus can cause severe and sometimes fatal illness in pregnant women, babies and people with underlying problems like asthma, heart disease, diabetes, obesity and autoimmune diseases. Dr. Frieden said people in those risk groups should seek treatment if they have a fever of at least 100.4, and a cough or a sore throat. A third to half of the severe and fatal cases have occurred in young and middle-aged people who were previously healthy. In contrast, seasonal flu tends to kill the frail elderly. The severity of the new virus does not even approach that of the 1918 one, which killed 40 million to 50 million people worldwide. But even the milder flu pandemics took serious death tolls. The one in 1957 killed two million people, and the 1968 pandemic killed about one million. Seasonal flu, by comparison, kills 250,000 to 500,000 people a year. Countries that have not yet had cases must anticipate them and prepare their health systems to treat patients, Dr. Chan said. Countries in the early stages of outbreaks should try to contain the disease, she said. Those further along, like Mexico, should not let their guard down even if the disease seems to be waning, she added. “The virus can come back in a second wave,” Dr. Chan said. “When you’re over the first wave, start preparing for the future.” The W.H.O. has been questioned sharply for weeks as to why it would not go to Phase 6 even though the spread of cases, first in Britain and Spain, then in Japan, Australia and Chile, seemed to meet its pandemic definition: the sustained community spread of a novel virus in two different W.H.O. regions. Dr. Chan has indicated recently that she thought a pandemic was under way, especially as cases in Australia quadrupled in a week, but she wanted to consult with countries that had large outbreaks and then with a panel of experts on Thursday. From early reports in Mexico and the United States, scientists have said that H1N1 appears to have roughly the same 0.6 percent death level as the 1957 Asian flu. The 1918 flu killed about 2.5 percent of those infected. But in 1918, antibiotics did not exist, and many people died of secondary bacterial infections. In 1957, antiviral drugs did not exist, and mechanical ventilators were less common. Dr. Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said this year’s flu is not acting like the 1957 one, which quickly faded into a seasonal pattern. There would normally be no flu cases in the United States in June, but flu hospitalizations are increasing in Minnesota, he said. Flu levels continue to be high in New York and New England, and especially in Massachusetts, the C.D.C. said. Denise Grady contributed reporting. Copyright 2009 The New York Times Company. New Victims of Swine Flu Include 11-Year-Old By Javier C. Hernandez New York Times Friday, June 12, 2009 An 11-year-old girl who attended a Brooklyn school has died after becoming infected with the swine flu virus, classmates and school officials said on Thursday. The death, which occurred this week, was the first of a public school student in New York City and one of three new flu deaths that city health officials announced on Thursday. The girl, whose name was not released, was in the sixth grade at the Urban Assembly School for Criminal Justice, which shares a building with Intermediate School 223 in Borough Park. Students were seen carrying letters home announcing the death and advising parents to keep their children in class. An evening play at the school was canceled. “I’m scared,” said Brenda Barranco, 12, who was leaving school early because she felt sick and was coughing. But attendance has been relatively normal at both the Urban Assembly School and I.S. 223 in recent days, according to the Department of Education. Two 13-year-old girls who knew the student who died said that she enjoyed giving hugs and was “very joyful and playful.” They said that when they last saw her about a week ago she was coughing and complaining of stomach pain. She was overweight, the girls said — a factor that can make people vulnerable to the virus, health experts have said. The other two new deaths were of a child younger than 2, the second death of a child that young, and a person older than 30, the health department said. City health officials continued to face questions over their handling of the spread of swine flu, which has killed at least 15 people in the city. At a City Council hearing on the issue on Thursday, council members said that the city had been slow to provide information about the illness and that its decisions to close schools seemed arbitrary. Councilman Peter F. Vallone Jr. of Queens said the public should be told if those who die after contracting the virus have pre-existing illnesses. Health officials have said that virtually all of those who have died had a condition that made them more susceptible to the flu. But the officials have not specified those conditions, and the list of high-risk factors is so long — including heart disease, obesity and being older than 65 — that as many as one in three New Yorkers may have at least one. “Why is the information about the people who have succumbed to this flu being kept secret?” Mr. Vallone asked. The new health commissioner, Dr. Thomas A. Farley, defended the city’s reluctance to divulge details about people who have come down with the virus. “We have to separate what’s important for people to know and plan versus privacy,” Dr. Farley said. “Specific medical information about individual patients will not change how an individual or an organization responds.” Council members also expressed concern about the increase in visits to emergency rooms last month. Health officials said the number of visits appeared to be declining, but the department would continue to monitor the data. Dr. Farley said increased federal funding would be crucial as the city prepared for the next flu season and the possibility that a more severe strain of the virus would develop. Flu seasons typically begin in the fall and peak in the winter. As of Thursday, city officials estimated that swine flu had spread rapidly, affecting more than half a million people. But since the beginning of the outbreak, only 567 New Yorkers have been hospitalized with swine flu. City officials suggested that the low rate of hospitalization indicated how mild the strain of virus had been. Ann Farmer, Anemona Hartocollis and Karen Zraick contributed reporting. Copyright 2009 The New York Times Company. Miami immigration center has 3 swine flu cases Associated Press By Curt Anderson Hagerstown Herald-Mail Friday, June 12, 2009 MIAMI (AP) -- Authorities have confirmed three cases of swine flu at Miami's Krome immigration detention center. U.S. Immigration and Customs Enforcement officials say steps are being taken to prevent the spread of the disease. Krome currently houses 542 detainees who are either being deported or seeking asylum. New detainees are being sent elsewhere and social visits have been suspended through June 14. Detainees can still meet with their attorneys. ICE officials say the three who tested positive for the H1N1 virus are among 16 detainees who currently have flu-like symptoms. Health officials reported Thursday a total of 111 swine flu cases in Miami-Dade County. Swine flu has affected about 29,000 people in 74 countries during the current outbreak. © 2009 The Associated Press. All rights reserved. Congress Sends FDA Tobacco Bill to Obama By Fawn Johnson Wall Street Journal Friday, June 12, 2009 WASHINGTON -- A bill allowing the Food and Drug Administration to regulate tobacco is on the way to the White House for President Barack Obama's signature. A day after the Senate overwhelmingly approved the measure, the House passed it Friday on a 307-97 vote. (See related article.) Mr. Obama said the legislation gives the government much greater power to regulate tobacco "truly defines change in Washington." The president spoke in the Rose Garden Friday and promised to sign the bill. Health and Human Services Secretary Kathleen Sebelius said Thursday that her agency looked forward to implementing it. The FDA now will take on an unprecedented role overseeing the production and marketing of cigarettes. Health advocates are happy about the prospect, saying at long last regulators can determine exactly the types of toxins involved in making and smoking cigarettes. Some FDA watchers and people in the tobacco industry say the new responsibilities will be too heavy a lift for the agency and will harm small tobacco farms. "Allowing the FDA to regulate tobacco in any capacity would inevitably lead to the FDA regulating the family farm," said Rep. Howard Coble (R., N.C.), during the House debate. "This could create uncertainty for family farmers as they are already struggling." Many North Carolina elected officials have protested the legislation, arguing that it would hurt jobs in their state. Reynolds American Inc. and Lorillard Inc., the second- and third-largest tobacco companies in the U.S., are based in North Carolina. But the No. 1 U.S. tobacco producer, Altria Group, Inc., the parent company of Philip Morris USA, has given its stamp of approval to the measure. Critics, including Lorillard, say Altria supports FDA regulation because new rules could solidify the company's dominance in the market. Altria spokesman William Phelps said previous regulations on cigarettes haven't stifled the tobacco market. Health advocates aren't concerned about the solvency of tobacco companies. "As long as players in the industry are fighting over market share, all that we care about is that they're fighting over a shrinking market," said Gregg Haifley, senior associate for federal relations at the American Cancer Society Cancer Action Network. After the bill becomes law, tobacco-product manufacturers must register with the FDA and provide a detailed product list. They also must pay user fees to cover the cost of the new regulation. The FDA can evaluate health claims made by cigarette makers and require companies to change their tobacco products. Packets of cigarettes will have larger and more strongly worded warning labels. There will be strict controls on advertising, stopping use of the terms "mild" and "low tar." Copyright 2009 Wall Street Journal. Business groups not standing in the way of health reform By Kent Hoover Washington Bureau Chief Baltimore Business Journal Friday, June 12, 2009 This will be a critical month for health care reform as two U.S. Senate committees begin writing legislation that aims to extend insurance coverage to every American. President Barack Obama has mobilized the grass-roots supporters that helped elect him to lobby for his vision of health care reform, which includes offering Americans a government-run health plan as an alternative to private insurance. A coalition of labor unions and progressive organizations plans to spend $82 million on organizing efforts, advertising, research and lobbying to support the Obama plan. Business groups, meanwhile, mostly are working behind the scenes to shape the legislation. While they have serious concerns about some of the proposals — including the public plan option and a mandate for employers to provide insurance — few are trying to block health care reform at this point. The cost of health insurance has become so burdensome that something needs to be done, they agree. “Nobody supports the status quo,” said James Gelfand, the U.S. Chamber of Commerce’s senior manager of health policy. “We absolutely have to have reform.” Copyright 2009 Baltimore Business Journal. Senate Passes Bill to Let FDA Regulate Tobacco By Lyndsey Layton Washington Post Friday, June 12, 2009 Landmark legislation approved by the Senate yesterday will give the federal government sweeping new powers to oversee tobacco products, allowing regulators to control factors including the amount of addictive nicotine in a cigarette and how that cigarette is packaged and marketed. For the 20 percent of Americans who smoke, the law will mean confronting more graphic warnings of the risks of their habit every time they pick up a pack. The law also bans most cigarette flavorings. For the $89 billion tobacco industry, it will mean new requirements to disclose the ingredients in cigarettes and other tobacco products, and severe limitations on how they are advertised and promoted. The government could also issue new rules on nicotine content, flavorings and other product features. Many of the new restrictions are aimed at preventing children from starting to smoke. Cherry and other fruit flavorings that appeal to children will be banned, along with marketing aimed at younger smokers, such as the use of Joe Camel and other cartoon characters. The 79 to 17 vote virtually ensured that the bill will become law. The measure now goes to the House, which passed a nearly identical version in April and could take a final vote today. President Obama, himself a smoker who has struggled to quit, has said he will sign it. Congress has been battling for more than a decade over regulating tobacco, coming close several times but faltering in the face of opposition from the tobacco lobby or the White House or procedural hang-ups. But over the years, changing social attitudes toward smoking have helped transform the idea of regulation from controversial to common sense. "There's been a fundamental sea change in attitudes about tobacco in both the Congress and the public," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, which led a coalition of more than 1,000 public health and faith organizations that supported the legislation. "A bill this broad, comprehensive, this strong would have been unimaginable even five years ago." The legislation, which comes 50 years after the surgeon general first warned about the health effects of tobacco, gives broad new authority to the Food and Drug Administration to regulate the manufacturing and marketing of tobacco products. "Miracles still happen," the bill's sponsor, Sen. Edward M. Kennedy (D-Mass.), said in a statement. Kennedy, who had worked for years to push the bill forward, is battling brain cancer and missed yesterday's vote. "The United States Senate has finally said 'no' to Big Tobacco." On the Senate floor, lawmakers took turns detailing their personal struggles with tobacco. "There's not a smoker in the country that's an adult who wishes their children would begin smoking," said Sen. Christopher J. Dodd (D-Conn.), himself a former smoker. "And there are many adult smokers today who wish they never started. . . . This has been a very long battle." Sen. Richard Burr (R-N.C.), whose state is home to the R.J. Reynolds and Lorillard tobacco companies, tried to kill the measure, arguing that the FDA cannot handle additional duties. But in the end, he could not gather enough support for a filibuster. His colleague from North Carolina, Sen. Kay Hagan, was the only Democrat to vote against the bill. Philip Morris, the country's largest manufacturer of tobacco products, supported the legislation, saying it hopes to develop new reduced-risk offerings. The rest of the industry opposed the measure, saying it would freeze market share and give Philip Morris an unfair advantage. The idea of tobacco regulation strikes some as nonsensical -- taking a product that, if used as directed, will kill a third of those who use it and placing it under the control of an agency charged with protecting public health. But health advocates argue that FDA oversight is the best hope for reducing the 400,000 deaths each year from tobacco use. Under the bill, the industry will have to disclose the ingredients in its products for the first time, and the FDA could ban the most harmful of the estimated 6,000 chemicals used in cigarettes, cigars and other tobacco products. It could also reduce the amount of nicotine, perhaps to a point where tobacco is no longer addictive and smokers who want to quit can break free more easily. The legislation requires tobacco companies to expand the size of warning labels so that they cover 50 percent of a pack, and to include graphic images of the health effects of tobacco, such as images of diseased lungs. Congress required warning labels on cigarette packs in 1965 and updated them in 1984. Advertising and promotion will also be restricted. Tobacco manufacturers will be unable to use the terms "light," "mild" and "low" unless they can scientifically prove that the product so labeled is less harmful than standard tobacco. The legislation creates a new tobacco center within the FDA that will be funded by fees from the industry. Those fees are estimated to reach more than $500 million annually by 2013, according to the Congressional Budget Office. The FDA first tried to regulate tobacco in the 1990s under then-Commissioner David A. Kessler, but the industry battled it to the Supreme Court, which ruled 5 to 4 in 2000 that the agency had exceeded its statutory authority. It called on Congress to amend the law. "All along, we thought it never made sense that the most dangerous preventable cause of death was not regulated," Kessler said yesterday from Boston, as he watched the Senate vote via C-SPAN. By the time the Supreme Court rendered its decision, a curious thing had happened: Philip Morris, the maker of Marlboro, said it would accept some oversight. At the time, Philip Morris executives were charting a strategy to improve the company's image and regain the social acceptance it had lost in the 1990s as evidence emerged that the industry had lied to the public about the addictive nature of nicotine. The company changed its name in 2001 to Altria Group; executives said they wanted to craft a new image untainted by cigarettes. Exactly what the new legislation will mean for smokers will depend on how aggressively the FDA exercises its new power. Copyright 2009 Washington Post. *Opinion* Tobacco Regulation, at Last New York Times Editorial Friday, June 12, 2009 After more than a decade of struggle — and countless smoking-related deaths — the Senate overwhelmingly approved a bill on Thursday that gives the Food and Drug Administration the power to regulate tobacco products. The House approved a similar bill in April, also by an overwhelming margin. The days when this rogue industry could inflict its harmful products on Americans with impunity are drawing to a close. This is an enormous victory for public health. For that, we owe thanks to tireless advocacy by the Campaign for Tobacco-Free Kids, a nonprofit organization, and strong endorsements from medical groups. It still might not have passed without the decision by Philip Morris, the industry leader, to accept regulation. The company apparently believes it can thrive better under regulation than its competitors, who complain that it will now be much harder for them to introduce new products to challenge Philip Morris’s dominance. The bill is not perfect. It will not allow the F.D.A. to ban cigarettes or nicotine — a concession made years ago to avoid drawing intense opposition from smokers and free-market advocates. But the agency will still have far-reaching powers. It could order a reduction in nicotine levels and the elimination of other harmful ingredients. Companies will also have to submit lists of all their product ingredients and disclose research about their health effects. And all new tobacco products will have to get marketing approval from the F.D.A. Most flavorings used to lure first-time smokers would be outlawed. To the extent allowed by the First Amendment, the regulators could restrict advertising and promotions to children — industry needs to addict them to keep replenishing the population of smokers — and could shape advertisements aimed at adults as well. The agency could prohibit unsubstantiated health claims about supposedly “reduced risk” products and require larger, more effective health warnings on packages and advertisements. Funds to support tobacco regulation would come entirely from new fees imposed upon the manufacturers, a reasonable step to prevent siphoning money from other vital regulatory activities at the hard-pressed F.D.A. The Congressional Budget Office estimates that the legislation will reduce youth smoking by 11 percent over the next decade and adult smoking by 2 percent. That’s a good start, but clearly the regulators will still need help from strong anti-smoking campaigns. The House is expected to move quickly to approve the Senate version of the bill. There are few substantial differences. And that is the fastest and surest way to get it to President Obama, who is eager to sign it into law. It has now been proved beyond a shadow of a doubt that cigarette makers have spent decades making false statements, suppressing evidence of harm, and manipulating the design of cigarettes to increase their addictiveness. Federal regulators should be able to stop many of these abuses — and we hope help prevent more Americans from losing their lives to smoking. Copyright 2009 The New York Times Company. Got milk? You should Baltimore Sun Letter to the Editor Friday, June 12, 2009 Laura Vozzella's June 7 story on milk may have actually confused more than clarified how to navigate milk choices ("Today, multiple answers to the familiar question: Got Milk?"). True, there are more choices in the dairy case, but milk is good and consumers need to know that and feel good about drinking milk. Milk is the most tested food in our food supply. All milk products are wholesome and safe, whether they come from organic or conventionally managed dairies. I'm a pediatric nutritionist and registered dietitian. I have enough difficulty getting people to eat well, and we need articles that give clarity, not confusion. Consumers need to know that the health benefits of drinking milk have been well documented by decades of nutrition research and are backed up by the nutrition and science community, including the surgeon general ( www.surgeongeneral.gov/library/bonehealth/content.html) and National Institutes of Health ( www.nichd.nih.gov/milk/). Keith-Thomas Ayoob, New York, N.Y. The writer is an associate professor of pediatrics at the Albert Einstein College of Medicine Copyright 2009 Baltimore Sun. BACK TO TOP


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