Thursday, June 25, 2009

News Clipping Archives

 

Maryland / Regional

Hospitals Preparing Triage for Budgets (Washington Post)

Recognizing the signs of depression (Frederick News-Post)

Local union workers, families traveling to D.C. to join health care rally (Cumberland Times-News)

Virginia Abortion Restriction Is Upheld (Washington Post)

 

National / International

E. coli in Nestle cookie dough stumps FDA (USA Today)

Combination device reduces heart failure deaths (Baltimore Sun)

States Assert Place in Health-Care Debate (Washington Post)

HHS secretary to press lawmakers on health care (Annapolis Capital)

Groups Urge VA to Reform Disability Claim Procedures (Washington Post)

High-Profile Help Offered Against AIDS In the District (Washington Post)

Poison control at risk in California, other states (Washington Post)

Database Takes Patients for Billions, Study Finds (New York Times)

Health suffers in recession; preventive care often cut first (USA Today)

Panel: 1 less shot needed to treat rabies (USA Today)

 

Opinion

A milestone for youths (Baltimore Sun Editorial)

Lessons Learned (Washington Post Editorial)

On the rise (Cumberland Times-News Editorial)

Human Issues (Frederick News-Post Letter to the Editor)

 

 

Maryland / Regional

Hospitals Preparing Triage for Budgets

Centers Brace For Steep Cuts In State Funding

 

By V. Dion Haynes

Washington Post

Thursday, June 25, 2009

 

Washington-area hospitals, already battered by the recession, are bracing for what could be a budget crisis in coming months resulting from funding cutbacks by Virginia and Maryland.

 

Hospitals throughout the region are experiencing soaring demand from uninsured patients who cannot pay for their care and plummeting revenue from reductions in investment income, charitable giving and elective surgery.

 

So far, both nonprofit and for-profit hospitals have coped by freezing salaries and putting off construction projects and equipment purchases. But some experts predict that it could get much worse in the next fiscal year, with layoffs and reductions in services and programs, when Maryland and Virginia cut tens of millions of dollars from hospitals' funding.

 

The cutbacks are occurring as discussion grows about efforts by the Obama administration to extend health care to more uninsured Americans, a proposal that would be financed in part by reducing the government's reimbursement to hospitals for such patients by hundreds of billions of dollars.

 

If the economy doesn't improve, there could be "ugly scenarios that would require wrenching changes and scaling back of services," said Chris Bailey, senior vice president of the Virginia Hospital and Healthcare Association, adding that some facilities may have to make such tough choices as whether to continue operating the emergency department or obstetrics.

 

"There will be a lot of hospitals that won't survive," he said. "Already a number of them are operating on thin margins."

 

Across the country, the number of uninsured people has risen to 51 million from 47 million since the economy began sputtering in late 2007, and hospitals are reeling.

 

In April, the District significantly increased reimbursement for doctors with Medicare patients. For instance, rates for primary care visits more than doubled, from $46.46 to $101.56, city officials said. Still, investment losses and reduced federal reimbursement for elderly patients contributed to a $1 million deficit at National Rehabilitation Hospital, officials said. To plug the gap, about one-third of the full-time staff at the nonprofit hospital in Northwest Washington volunteered to relinquish up to three vacation days and the administration put off plans to buy therapy tables with lifts and other equipment for stroke victims.

 

At Reston Hospital Center, bad debt increased from $6.7 million in 2007 to $14.35 million in 2008, spokeswoman Joanna Fazio said. To cut costs, Fazio said, the for-profit hospital laid off a few workers, eliminated some more through attrition and delayed hiring of some non-clinical staff.

 

At the nonprofit Doctors Community Hospital in Lanham, decreasing values of its investments in part spurred fourth-quarter total profit to plunge 76.2 percent, or $31.5 million, from 2007 to 2008, according to the Maryland Hospital Association.

 

Funds for hospitals in Maryland and Virginia are expected to get much tighter in the next fiscal year, which begins in July.

 

Virginia's 100 hospitals are expected to lose up to $55 million after the legislature eliminated funds that reimburse hospitals for patients without insurance and froze reimbursement rates for Medicaid patients.

 

Maryland's Health Services Cost Review Commission determined that 47 hospitals can raise rates for various medical procedures by only 1.8 percent, down from the 4.7 percent increase this year. Maryland is the only state with a panel that annually sets the rates hospitals may charge for such services as surgeries, lab tests, radiology, in-patient care and emergency room care.

 

Robert B. Murray, the commission's executive director, said soaring health-care costs led to a range of economic problems, from the state's projected $500 million deficit in next year's budget to bankruptcies of major corporations.

 

"Every 1 percent increase [in hospital care spending] costs the state $20 million," Murray said.

 

Seeking to control health-care costs at the federal level, the Obama administration is proposing over 10 years to cut at least $200 billion in funding that hospitals receive to defray costs of patients who are uninsured and who are in the Medicaid and Medicare programs. The number of uninsured will be "reduced dramatically as we move to cover everybody," said Nancy-Ann DeParle, a counselor to Obama and director of the White House Office of Health Reform. There will be "less of a need for hospitals to get the payments."

 

But officials at the Maryland Hospital Association said they fear that the government would cut funding before the transition, leaving hospitals with less money for uninsured patients.

 

Association officials say year-to-year total profit for hospitals in the state plunged $488 million in the last quarter of 2008. The association says revenue loss after July may result in an acceleration of budget-cutting measures, including eliminating such money-losing programs as mobile mammography vans and in-school health programs.

 

"The president is proposing unprecedented cuts at a time when hospitals already are economically challenged," said Carmela Coyle, president and chief executive of the Maryland Hospital Association.

 

Some experts say they fear that the funding cuts could force Washington-area hospitals to make the same severe reductions in patient care as at other health-care facilities around the country.

 

Loyola University Health System in Maywood, Ill., which is trying to save more than $30 million, has cut about 200 positions, restricted overtime pay and postponed some construction projects. University Medical Center of Southern Nevada was forced to scale back outpatient cancer treatment and shutter its mammography center, while Kessler Memorial Hospital in Hammonton, N.J., closed its doors.

 

Edward A. Eckenhoff, founder, president and chief executive of National Rehabilitation Hospital, attributes the $1 million deficit to several factors: Investments are down about 25 percent, charitable giving is down 50 percent and the government's reimbursement rate for Medicare patients is down six percent.

 

Medicare represents "45 percent of our business. That's not fun," he said.

 

The recession couldn't have come at a worse time for Howard County General Hospital, which is in the midst of a $30 million fundraising campaign to pay for renovations and a new pavilion. The new wing, which will add 90 new patient rooms, opens this summer, and the hospital plans to hire 120 nurses and others to staff it.

 

Next year's budget will be under extreme pressure, hospital officials say, with profit margins expected to decrease to 2.7 percent from 4.6 percent. While it will receive about $6 million less in revenue because of the Maryland cost review commission's rate setting decision, said Chief Financial Officer Jim Young, the nonprofit hospital will face a $1 million increase in expenses related to a decline of assets in its defined-benefit pension plan.

 

"We'll be looking at the various services the hospital provides," Young said, "and possibly discontinuing those that don't satisfy the mission and margin test."

 

Copyright 2009 Washington Post.

 

Recognizing the signs of depression

 

By Ashley Andyshak Hayes

Frederick News-Post

Thursday, June 25, 2009

 

Family members and neighbors alike were shocked at the news Christopher Wood had killed his wife, Francie Billotti-Wood, and their three children before taking his own life in April.

 

Notes Wood left inside the family's Middletown home indicate he may have had some psychological issues, but it's unclear what those issues may have been or if he had been treated.

 

Suzi Borg, director of the Frederick County hot line for the Mental Health Association of Frederick County, wouldn't comment on what may have spurred the violence in the Wood home in April.

 

"It's such a tragedy. I don't think we'll ever know what was happening," she said.

 

Borg did discuss some behaviors and changes to watch for in a person who may be depressed or have thoughts of suicide.

 

Depression has a variety of warning signs, including changes in behavior, eating or sleeping patterns, or withdrawal from normal activities, Borg said.

 

"Or, you just know something's not right," she said.

 

The most important role a friend or family member can play is to ask if the person is depressed and listen for the answer, she said.

 

"Sometimes we want to fix the problem before we find out what it is," she said.

 

Concerned friends and family members should ask if a depressed person has considered suicide, Borg said, since many people won't disclose such information unless they are asked.

 

Though depression is a treatable condition, many people don't seek treatment for a variety of reasons, Borg said. Some people are afraid, while others just don't know where to go for help.

 

People suffering from depression have several starting points, Borg said. They can talk to a primary care physician or a licensed therapist, call the Mental Health Association's hot line or request help from the association's mobile crisis support team.

 

The 2-1-1 hot line is the best starting point for people who don't know where to turn, Borg said.

 

"They can talk about what's going on, and we can help them determine where to go next," she said.

 

All calls to the hot line are confidential unless the caller chooses to give a name and contact information.

 

Family members and friends can also call the hot line to get advice, though it may be a difficult decision, Borg said.

 

"We never want to think that someone we care about or love is considering hurting themselves or suicide," she said.

 

In past months, Borg said the hot line has seen an increase in the number of calls regarding financial issues and suicidal thoughts.

 

"When people become stressed, suicide becomes an option where it wouldn't have been before," she said.

 

Copyright 2009 Frederick News-Post.

 

Local union workers, families traveling to D.C. to join health care rally

 

By Kevin Spradlin

Cumberland Times-News

Thursday, June 25, 2009

 

CUMBERLAND - Two buses carrying nearly 100 local union workers and their family members left the Holiday Inn in downtown Cumberland this morning en route to Washington, D.C. to support President Barack Obama’s proposed health care plan.

 

Jim Bestpitch, of the Western Maryland Central Labor Council, said the group, which left at 8 a.m. and is to return tonight, will be part of 1,000 Marylanders and among 10,000 Americans to rally and lobby in support of quality, affordable health care for all in the U.S. He said past efforts have stalled and “it’s time to stop talking about it.”

 

Bestpitch said Obama’s plan in its current form might not be the end result but called it “a start.”

 

The group also will gather outside U.S. Representative Roscoe Bartlett’s office. Inside, 12 local union leaders will have 30 minutes to persuade him to support Obama’s plan.

 

“We’ll let him know (that) all of us vote,” said Chris Bird, 34, a cable splicer with Verizon and a member of the Communications Workers of America Local 2109.

 

Bird said at contract negotiations, the company attempts to take away health care benefits at the beginning of every three-year cycle.

“It’s the first thing the company tries to take away from us,” Bird said. “Premiums keep going up. What we pay out of pocket keeps going up.”

 

The group also is expected to be addressed by U.S. Sens. Barbara Mikulski and Ben Cardin.

 

Kevin Spradlin can be reached at kspradlin@times-news.com.

 

Copyright © 1999-2008 cnhi, inc.

 

Virginia Abortion Restriction Is Upheld

U.S. Appeals Court Votes 6-5 to Back 'Partial Birth' Ban

 

By Josh White

Washington Post

Thursday, June 25, 2009

 

A sharply divided federal appeals court ruled constitutional yesterday a Virginia law banning "partial birth" abortion that was overturned four years ago, bringing the state in line with a federal ban on the controversial procedure.

 

A three-judge panel of the U.S. Court of Appeals for the 4th Circuit overturned the Virginia law in 2005 by a 2 to 1 vote, finding that it did not allow for exceptions to safeguard a woman's health. The Supreme Court ordered the appeals judges to revisit the issue when it upheld the Partial Birth Abortion Ban Act two years ago, a law passed by Congress in 2003 that is similar to Virginia's ban.

 

Although the Virginia law permits women to choose various abortion procedures, it specifically makes it a crime for doctors to perform a rare midterm abortion that involves partially delivering the fetus before crushing its skull to ease removal.

 

William G. Fitzhugh, a Richmond doctor who challenged the law, argued that the procedure can be necessary to protect the life of a patient and that banning it could prevent doctors from performing legal procedures out of a fear of prosecution. Opponents of the procedure liken it to infanticide.

 

The appeals court split 6 to 5 in its ruling yesterday. Judge Paul V. Niemeyer, in the majority opinion, wrote that situations in which doctors would face criminal liability are so limited that it should not invalidate the law in every other circumstance. He wrote that Virginia law protects doctors who are taking prudent steps to save a patient's life and should prevent "a Morton's fork, where the doctor must choose between criminal liability or care that the doctor believes is not in the best interest of the patient."

 

In his dissenting opinion, Judge M. Blane Michael wrote that the Virginia law will have the effect of criminalizing the actions of doctors who seek to perform legal abortions but must resort to the banned procedure in rare instances. Michael wrote that such a law creates a "real fear of criminal liability" for doctors who perform standard abortions.

 

"This result places an undue burden on a woman's right to obtain a pre-viability second trimester abortion -- a constitutional right repeatedly reaffirmed by the Supreme Court," he wrote.

 

Virginia Attorney General William C. Mims said in a statement yesterday that he is pleased with the court's decision, as he and his four predecessors -- including Virginia gubernatorial candidate Robert F. McDonnell (R) -- have defended the statute over six years.

 

"This is a law that passed both houses of the General Assembly with bipartisan support," Mims said in the statement. "While we anticipate that the U.S. Supreme Court may be asked to review the decision, I am confident that the Supreme Court ultimately will uphold the law."

 

Gov. Timothy M. Kaine (D), who has a faith-based opposition to abortion, supports a partial-birth abortion ban and a reduction in abortions but does not support prosecuting doctors, spokeswoman Lynda Tran said.

 

Opponents of the law said the ruling is a setback for women's rights and could deter doctors from performing legal abortions, thus limiting options for women.

 

Stephanie Toti, a staff attorney at the Center for Reproductive Rights who argued the case before the appellate court, said yesterday that she is still digesting what the impact of the law will be and whether to challenge it further. She said her clients are clearly disappointed.

 

"This decision is yet another assault on women's constitutional rights and the protections long afforded to women's health," Toti said. "It really sets us back."

 

Toti said the Virginia law differs from federal law because it is broader, punishing doctors who accidentally violate the law while pursuing legal abortion procedures.

 

"It puts doctors in a really untenable position because it forces doctors to choose between taking all the steps necessary to protect their patients and committing a felony," Toti said.

 

Copyright 2009 Washington Post.

 

National / International

E. coli in Nestle cookie dough stumps FDA

 

By Elizabeth Weise

USA Today

Thursday, June 25, 2009

 

Federal officials plan to stay in a Virginia food plant associated with a national food-borne outbreak "as long as it takes" to solve this mystery: How did E. coli O157:H7, most commonly associated with raw hamburger, get in refrigerated cookie dough?

 

"That's the $64,000 question," says David Acheson, the Food and Drug Administration's assistant commissioner for food safety.

 

The outbreak appears to be linked to consuming uncooked Nestlé refrigerated and frozen Toll House cookie dough products.

 

It has sickened 70 people nationwide, 30 of whom have been hospitalized, according to the Centers for Disease Control and Prevention. No one has died.

 

Nestlé has recalled all product produced at the plant and suspended operations there. But cookies made from refrigerated dough are safe to eat, Nestlé says. The company notes that the instructions "clearly state that the raw dough must be baked before consumption."

 

Theories on how E. coli got into the dough include cross-contamination or a sick worker, Acheson says. "For this particular bug, it doesn't take many (bacteria) to make you sick; 10 to 100 is enough."

 

Copyright 2009 USA Today.

 

Combination device reduces heart failure deaths

A defibrillator and cardiac resynchronization apparatus cuts fatalities by 29% in patients with mild heart failure, study shows. It is already approved for implant in those with severe heart disease.

 

By Thomas H. Maugh II

Baltimore Sun

Thursday, June 25, 2009

 

A combination defibrillator and cardiac resynchronization device reduced deaths by nearly one-third in patients with mild heart failure in a study that was terminated early on Monday because of its success, the device's manufacturer said Tuesday.

 

The combination device, called a CRT-D, had previously been shown effective in patients with severe heart failure, but this is the first study to investigate its use in those with milder forms of disease, who account for about 70% of the 5.5 million U.S. heart failure patients.

 

"This is a breakthrough finding," said Dr. Albert Waldo, a cardiologist at University Hospitals Case Medical Center in Cleveland who was not involved in the study. "It shows for the first time that in a group of patients that have [mild] heart failure . . . you can decrease the death rate by 29%. . . . The data from the trial are very clear."

 

Heart failure occurs when the muscles of the heart weaken and the ventricles fail to coordinate properly, or synchronize, reducing the ability of the organ to move blood through the body. In the most severe cases, patients can become so weak that they are bedridden, or suffer a variety of symptoms, such as shortness of breath, buildup of fluids in the lungs and other organs, confusion and fatigue. Patients with mild heart failure typically have few or no symptoms, but both groups have an equally high risk of atrial fibrillation (erratic heartbeats) or death.

 

Cardiac resynchronization therapy uses a cellphone-size device implanted in the chest to deliver a regular, small electric signal to the heart to trigger beating, increasing the ejection fraction. The device has leads going to both ventricles to make sure they are synchronized. (A conventional pacemaker has only one lead going to the right ventricle.)

 

The CRT-D device also contains a defibrillator to shock the heart back into normal rhythm if it begins to beat erratically.

 

In the study terminated Monday, Dr. Arthur J. Moss of the University of Rochester Medical Center and his colleagues studied more than 1,800 patients at 110 centers in the United States, Canada and Europe for as long as 4 1/2 years. Half received a defibrillator and half received the combination CRT-D device. The trial was sponsored by Boston Scientific Corp. of Natick, Mass., which manufactures the CRT-D and which released the preliminary results.

 

The trial was halted Monday when the executive committee overseeing it concluded that the study had achieved its primary goal, a significant reduction in deaths or surgical interventions with the CRT-D device. Similar devices are also made by St. Jude Medical Inc. of St. Paul, Minn., and Medtronic Inc. of Minneapolis.

 

The most important drawback of the devices is cost: about $25,000 to $30,000 for the device itself -- compared with $20,000 or less for a defibrillator alone -- and an additional $10,000 to $15,000 for the surgeon and the hospital.

 

Another complicating factor is that among patients with severe heart failure, for which the device has already been approved, "there are an awful lot of people who don't get better" after the device is implanted, said Dr. Steven M. Schiff, chief of cardiology at Orange Coast Memorial Medical Center in Fountain Valley. The same is likely to be true for those with milder disease, he said. "There has been reams and reams of literature looking at other criteria to predict which people within the group will get better," but so far, no one has found how to do this.

 

Copyright © 2009, The Los Angeles Times

 

Copyright 2009 Baltimore Sun.

 

States Assert Place in Health-Care Debate

Governors Fear Shifting of Costs

 

By Michael A. Fletcher

Washington Post

Thursday, June 25, 2009

 

A bipartisan group of governors told President Obama yesterday that they share his urgent desire to restructure the nation's health-care system but warned that any changes should not place more burdens on strained state budgets or eliminate innovative programs they already have in place.

 

With many state budgets burdened by ballooning Medicare and Medicaid costs, the five governors who met with Obama at the White House agreed that changes are needed to expand health-care coverage and contain its costs. But some of the governors voiced concern about how to achieve reform.

 

"There's no perfect unanimity across the table in terms of every single aspect of reform. I think everybody here wants to make sure that governors have flexibility, that they have input into how legislation is being shaped on the Hill," Obama said.

 

The governors were adamant that the restructuring of the health-care system not push new costs on states. "If we're going to add more population onto the Medicaid rolls, there has to be a way to pay for that," said Gov. Jennifer M. Granholm (D-Mich.), adding that it is a position Obama supported.

 

Last night, the president fielded questions at a town hall meeting broadcast by ABC News from the East Room of the White House. The president used the event to continue his effort to drum up public support for his health-care proposals. He said he is open to a range of ideas for funding the expansion of care to cover 46 million uninsured Americans, saying he did not want "to prejudge" the work being done in Congress.

 

Early in the program, the president was confronted with a personal question about his plan.

 

Orrin Devinsky, a neurologist, asked the president whether, if he had a family member who was ill, he would accept restrictions in access to specialists that some think would be part of any plan to drive down future health-care cost increases.

 

If "it's my family member, if it's my wife, if it's my children, if it's my grandmother, I always want them to get the very best care," Obama said.

 

Earlier at the White House, the president met with Republican governors Jim Douglas of Vermont and Mike Rounds of South Dakota, and with Democrats Granholm, Jim Doyle of Wisconsin and Chris Gregoire of Washington. All five had hosted regional health-care forums this year in which they heard concerns about the current system.

 

White House officials said Obama opened the meeting with his pitch for reform, calling the status quo unsustainable because of runaway costs that threaten the budgets of families, businesses, and state and federal governments. He also repeated his pledge to restructure health care without adding to the federal budget deficit, while creating new incentives to control costs.

 

As the governors met with Obama, talks over a health-care measure continued on Capitol Hill, where Senate Finance Committee Chairman Max Baucus (D-Mont.) said he was making progress toward a plan that could win bipartisan support.

 

With cost estimates for health reform soaring beyond $1 trillion over the next decade, Democrats are struggling to come up with a funding proposal. In the Senate, lawmakers are talking about trimming billions of dollars from Medicare and Medicaid spending, taxing the health benefits millions of people get through their employers and imposing a "free-rider" penalty of as much as $300 billion over the next 10 years on companies that fail to provide quality, affordable health insurance to their workers, said Sen. Kent Conrad (D-N.D.).

 

But they are scrambling to find another $200 billion in savings or new revenue to cover the full cost of a plan estimated at $1.2 trillion.

 

House Democrats, meanwhile, are headed in a different direction. While their plan also includes about $500 billion in Medicare and Medicaid cuts, many Democrats in the House oppose taxing health benefits, a proposal that has the potential to break Obama's pledge not to impose new taxes on families who earn less than $250,000 a year.

 

Instead, they are looking at a 2 percent surtax on the nation's wealthiest families, in addition to an array of other options.

 

Staff writer Lori Montgomery contributed to this report.

 

Copyright 2009 Washington Post.

 

HHS secretary to press lawmakers on health care

 

Associated Press Writer

By David Espo

Annapolis Capital

Thursday, June 25, 2009

 

WASHINGTON (AP) — Health and Human Services Secretary Kathleen Sebelius told lawmakers Wednesday that President Barack Obama is willing to listen to suggestions on how to pay for a health care overhaul, as long as they don't increase the deficit.

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"The president is open to good ideas about how we finance health reform," she said in testimony prepared for delivery to a House committee. "But we are not open to deficit spending."

 

Sebelius' appearance before the House Energy and Commerce Committee comes as congressional Democrats struggle with the $1 trillion-plus price tag for extending health coverage to 50 million uninsured Americans over 10 years.

 

Although lawmakers are considering an option Obama has opposed — taxing employer-provided benefits — Sebelius' testimony indicates that the administration is ready to be flexible if Congress can deliver a bill.

 

That has seemed uncertain, as cost concerns and partisan disputes have stalled progress. Sebelius used her testimony to encourage Democratic efforts — and to make clear that Obama expects lawmakers to deliver.

 

"Health reform constitutes our most important domestic priority," she said.

 

A new Washington Post-ABC poll found that most Americans are "very concerned" that a health care overhaul would lead to higher costs, lower quality, fewer choices, a bigger deficit, diminished insurance coverage and more government bureaucracy. About six in 10 are at least somewhat worried about all of these factors, the poll found.

 

More than eight in 10 said they were satisfied with the quality of care they now receive and were relatively content with their own current expenses.

 

Addressing that issue, Obama on Tuesday dismissed as "not logical" the insurance lobby's assertion that a new government health plan he backs would dismantle the employer-sponsored coverage most Americans now have. Yet, despite the harsh words from the president, senators attending a Tuesday evening meeting in the Capitol with White House Chief of Staff Rahm Emanuel said the administration was not ready to abandon the search for compromise.

 

That puts the spotlight on a small group of senators who are trying to find common ground on the issue of giving the middle class the option of joining a government health plan. Republicans are almost unanimously opposed, while Democrats insist it must be part of any final deal.

 

Dubbed "the coalition of the willing," the Senate group is focusing on nonprofit co-ops as an alternative both to private insurance and full-blown government intervention.

 

"The co-op proposal is alive and well, and negotiations are ongoing," said Sen. Kent Conrad, D-N.D., who proposed the idea, adding that it's the only version of a public plan that stands a chance of getting Republican support.

 

Democratic liberals in Congress are leery of the co-op idea, even if the White House is open to it. Part of the debate centers on whether the co-ops would be part of a national organization, or isolated outposts.

 

The health care industry went on the attack, meanwhile, warning in a letter to senators released Tuesday that a government plan would take over the U.S. health care system.

 

America's Health Insurance Plans and the Blue Cross Blue Shield Association also said they didn't believe it was possible to design a government plan that could compete fairly with private companies in a revamped health care market.

 

"We do not believe that it is possible to create a government plan that could operate on a level playing field," said the insurers' letter, signed by AHIP head Karen Ignagni and Scott Serota, the Blue Cross CEO. " Regardless of how it is initially structured, a government plan would use its built-in advantages to take over the health insurance market."

 

The public plan that most Democrats envision would be offered alongside private plans through a new kind of insurance purchasing pool called an exchange. Individuals and small businesses would be able to buy coverage through exchanges, but eventually businesses of any size might be able to join.

 

Officials disclosed Tuesday that key Senate Democrats had whittled more than $400 billion off the cost of a health care plan that carried a $1.6 trillion price tag last week. The new cost is below $1.2 trillion, but still above the informal target lawmakers have set. The officials spoke on condition of anonymity, saying they were not authorized to disclose details of the closed-door talks.

 

Conrad told reporters the reductions were achieved by lowering subsidies designed to make insurance affordable for those who lack it, as well as other changes.

___

Associated Press writer Erica Werner contributed to this report.

 

Copyright 2009 Annapolis Capital.

 

Groups Urge VA to Reform Disability Claim Procedures

 

By Steve Vogel

Washington Post

Thursday, June 25, 2009

 

Citing a fast-growing backlog of unresolved disability claims, veterans groups and members of Congress are calling for an overhaul of Department of Veterans Affairs procedures for handling cases.

 

The number of unprocessed disability claims has grown by nearly 100,000 since the beginning of the year and totaled 916,625 as of Saturday, a rise driven in part by increasing numbers of veterans from the Iraq and Afghanistan wars.

 

Rep. John Hall (D-N.Y.), who last week chaired a House Veterans' Affairs subcommittee meeting titled "Can VA Manage One Million Claims?," said the department needs "a cultural and management sea change."

 

Veterans "are waiting to have their claims and appeals processed," Hall said at the hearing last Thursday. "They are waiting for compensation. They are waiting for medical assistance and rehabilitation."

 

The American Legion, the nation's largest veterans service organization, says immediate reform is needed. "As the backlog of claims approaches 1 million, and the needs of deserving veterans go unmet, VA can wait no longer to institute new and workable policies and procedures," said David K. Rehbein, the national commander.

 

But the VA contends that the 1 million figure is misleading and that, in any event, it is incorrect to refer to it as backlog.

 

About 234,000 of the unresolved cases involve claims that are awaiting adjustment. An additional 195,000 are on appeal, and about 79,000 are considered miscellaneous. The remaining 410,000 cases are original or reopened claims for disability compensation and represent the "core" of the VA claims inventory, said Michael Walcoff, deputy undersecretary for benefits.

 

"While we currently have approximately 400,000 claims in our inventory, the majority of these claims are not 'backlogged,' " Walcoff told the subcommittee in prepared testimony. "The inventory is dynamic rather than static. It includes all claims received, whether pending for just a few hours or as long as six months."

 

Critics accuse the VA of resorting to semantics. "It seems like they're looking at ways to minimize the significance of it," said Steve Smithson, deputy director of veterans affairs and rehabilitation at the American Legion.

 

"At the end of the day, these are still individual veterans waiting for benefits they were promised," said Meaghan Smith, a spokeswoman for Hall. "If you asked the veteran waiting, he or she would call it a backlog."

 

For Army veteran David Bohan, who fought with the 1st Infantry Division during the Persian Gulf War, the bottom line is that it takes veterans too long to navigate the system. "This is very frustrating and very time-consuming," Bohan told the subcommittee. "I understand why so many people just give up."

 

But the VA said veterans have shorter waits, despite the 13.5 percent increase in the number of claims since last year. The average amount of time to resolve disability claims is 162 days, compared with 179 the previous year, according to the VA. About 20 percent of the cases have been pending for more than half a year.

 

"They have made some progress, but it's still unacceptable," Smithson said. "They need to move forward and not try to explain it away."

 

The National Veterans Foundation said in a news release that it receives hundreds of calls each month from veterans stuck in the VA claims process.

 

"This isn't a problem that was created overnight," said Shad Meshad, president of the group. "It's been building for decades. It's bad enough that these young veterans are being held up, but the men and women who served in Vietnam are still getting the short end of the stick, 40 years later."

 

Some of the delay results from congressionally mandated reforms that force the VA to be less arbitrary about how it reaches decisions, according to testimony at the hearing.

 

The VA has hired nearly 4,200 additional employees since January 2007, but it takes at least two years to fully train them to process claims, Walcoff said. "We're only now beginning to see the full impact of those employees hired at the outset of this initiative," he said.

 

Subcommittee members expressed frustration at the rate of progress. "VA seems to be overwhelmed, and it is well past time for frank assessment of what is going on," said Rep. Doug Lamborn (R-Colo.), the ranking member.

 

Walcoff said VA officials are "not satisfied with current performance and strive for new methods of improvement."

 

Copyright 2009 Washington Post.

 

High-Profile Help Offered Against AIDS In the District

 

By Darryl Fears

Washington Post

Thursday, June 25, 2009

 

A coalition of major corporations announced yesterday that the District is one of three cities in which it will help fight the spread of HIV and AIDS with better marketing, appearances by professional basketball players and financial donations to city health departments.

 

In an announcement on Capitol Hill at its annual conference, the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria -- comprising Pfizer, the National Basketball Association, Facebook, Nike, Nokia and many others -- said that the District, New York and Oakland, Calif., will be allowed to tap the marketing expertise of its members while shaping campaigns promoting AIDS prevention and treatment.

 

"I think the ability of our corporate partners to help develop really effective messages, help provide resources to get the message out, contribute talent, air time and media space" is crucial, said John Newsome, a coalition spokesman. "Companies have a reach that far exceeds that of a city administration. Lots of people in the public health community are trying to figure out how to take advantage of text messaging, for example. Well, Facebook and Nokia can certainly help."

 

The three cities were selected because they are among the 20 with the highest rates of HIV and AIDS in the United States and because the corporate coalition has a relationship with city officials. The coalition plans to expand the effort to other cities eventually.

 

Shannon Hader, director of the D.C. HIV/AIDS Administration, said the effort can help the District through a "sea change" in its cash-strapped prevention and awareness campaigns.

 

"I think a lot can be achieved," she said in an interview. "They're investing in a new model of public-private partnership. It's not about money coming into a project. It's about pairing. It's about bringing a technical expertise that adds value to whatever we're doing."

 

Hader's agency has been criticized by AIDS prevention groups such as the D.C. Appleseed Center for Law and Justice for a lack of awareness campaigns.

 

Some advocates said they are skeptical that the initiative can do much to push back the wave of U.S. infections.

 

"I think it depends on what exactly the coalition is going to do. Anyone launching major initiatives must tie it to goals and objectives, a statement on how they're going to deliver," said Phill Wilson, director of the Black AIDS Institute, which advocates for prevention and awareness in African American communities. "It's not completely clear to me how we'll evaluate whether they're successful in three years."

 

Oakland Mayor Ronald Dellums said he is not worried.

 

"We're all facing budget deficits," Dellums said. "We have to reach out to private partners because we lack the resources to do this alone. In my opinion, HIV is one of the great threats to the human family."

 

The coalition has been active internationally in countries such as Kenya and Botswana, which have the world's worst AIDS epidemic. Hader, who has worked in Zimbabwe for the U.S. Centers for Disease Control and Prevention, said the coalition has helped promote awareness in Africa.

 

The group turned its attention to the United States this year, reaching out to Hader and other urban health directors in January. Two months later, Hader released a report that said the District's HIV-AIDS prevalence rate of 3 percent is the country's worst. She compared the city's rate to some parts of sub-Saharan Africa.

 

Pfizer has committed $1 million over three years to the national effort, which will slightly defray some advertising costs. But mostly the coalition wants to help broaden the message to those who need it: to those at risk of heterosexual transmission, the fastest-rising mode in the city, and to places such as wards 6, 7 and 8, where the infection rate is highest.

 

How the effort unfolds in the District depends on Hader, said Jack Watters, vice president for medical affairs at Pfizer.

 

"One of the things we're good at is getting information out there," he said. "What happens when I'm tested? What happens if I'm negative? If positive, how do I get . . . help? There's no reason to ramp up awareness if you can't handle it."

 

Copyright 2009 Washington Post.

 

Poison control at risk in California, other states

 

Associated Press

By Jared Grigsby

Washington Post

Thursday, June 25, 2009

 

SAN FRANCISCO -- Each day, skeleton crews of doctors, nurses and pharmacists field almost 900 calls a day around California from people such as a mother whose child swallowed flea repellant and an elderly man who accidentally doubled up on his medication.

 

But the poison control centers that have been a lifeline for millions of residents could go dark this summer under the governor's plan for closing the state's $24.3 billion deficit. That would make the nation's most populous state the only one without poison control assistance.

 

The demise of the California program could have a domino effect throughout the country, officials say. Washington and Michigan centers already have been forced to downsize, and officials in Tennessee and Oregon also have proposed significant cutbacks. But here, the entire program sits on the chopping block, with some lawmakers hoping to reach a compromise to keep some of the money available.

 

Many states strapped for cash would like to see how California, which handles 10 percent of the nation's poison calls, fares without a state-funded system, said Jim Hirt, executive director of the American Association of Poison Control Centers.

 

"This could jeopardize the nation's entire poison control centers," Hirt said.

 

With cuts, the growing alternatives would be hospitals and emergency rooms. In California, the deficit situation is so dire that Gov. Arnold Schwarzenegger's office says they have to make tough choices, even if it means targeting important programs like poison control.

 

"While there were many incredible programs that we were able to fund in the past, like this one, we simply don't have the revenue to sustain them today," said Lisa Page, a spokeswoman for Schwarzenegger.

 

Poison control programs also provide data for health research.

 

Their reports, which are regularly fed to state health departments and the Centers for Disease Control and Prevention, alerted health officials to recent salmonella outbreaks in tomatoes and in peanut butter. Earlier this year, the CDC used the data to track a contaminated nutritional supplement distributed in about a dozen Southeast states.

 

The poison control database allows officials and researchers to better understand trends and the magnitude of an event, said Colleen Martin, a CDC epidemiologist in Atlanta.

 

"If certain states drop off the map, that's going to affect our ability to provide national surveillance," Martin said.

 

Closing California's call centers - in Sacramento, San Francisco, Fresno and San Diego - would save about $5.9 million annually, but program officials say the state could end up paying much more than that in emergency room and other doctor visits. In the worst cases, they say, not having access to a poison control hot line could lead to deaths.

 

"Without assistance, people may do inappropriate or deadly actions," Thomas Kearney, director of the San Francisco center, said noting that some common medications around the house can kill a child with only one pill.

 

Officials with the California Poison Control System, currently slated to close in September, estimate that eliminating the program would translate into $80 million in additional health care costs each year, as well as greater pressure on 911 call centers.

 

Page declined to comment on potential health care costs associated with a poison control shutdown.

 

In Washington state, lawmakers have pulled 35 percent of the poison control program's budget, forcing the layoff of its medical director. Without that position filled, the program risks losing its accreditation, which is needed to qualify for federal money.

 

For now, outgoing director William Hurley plans to volunteer to help keep it afloat while officials scramble for funding and consider filling the position on a part-time basis.

 

"We're hoping this is a temporary problem," Hurley said. "These cuts don't leave us in a long-term sustainable position."

 

Since California's statewide poison control system was established in 1997, it has faced several funding cuts, including a 15 percent budget reduction last year.

 

Before 1997, poison control services were provided through a combination of state, local and private funding. State finance director Michael Genest has suggested returning to a similar model.

 

"We did not have poison control centers some time back," Genest said during a May 29 budget conference call. "There is certainly a chance that the poison control center information will remain available to people privately, or get picked up by others."

 

But hard times have hit governments at all levels, meaning counties and cities are unlikely to be able to keep poison control afloat this time, program officials said.

 

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Associated Press writer Shannon Dininny in Yakima, Wash., also contributed to this report.

 

© 2009 The Associated Press.

 

Database Takes Patients for Billions, Study Finds

 

By The Associated Press

New York Times

Thursday, June 25, 2009

 

WASHINGTON (AP) — Congressional investigators said Wednesday that two-thirds of the nation’s health insurance industry used a faulty database that overcharged patients for seeing doctors outside their insurance network, costing them billions of dollars in inflated bills.

 

The flawed database was operated by Ingenix, a subsidiary of the health insurer UnitedHealth Group, which agreed in January to pay $350 million to settle allegations that it deliberately kept rates low to underpay doctors, driving up expenses for patients.

 

UnitedHealth has admitted no wrongdoing in its handling of Ingenix, though it agreed to close the database and help pay for a new one operated by a nonprofit group.

 

An investigation by Senator John D. Rockefeller IV, Democrat of West Virginia, shows that nearly 20 regional and national insurers also used Ingenix data.

 

A continuing investigation by the New York attorney general, Andrew M. Cuomo, previously focused on the use of Ingenix data by only a handful of top insurers, including Aetna, Wellpoint and Cigna. About a dozen insurers, including UnitedHealth, have reached settlements with Mr. Cuomo.

 

More than 100 million Americans have plans that allow them to see doctors who are not part of their insurance network. For more than a decade, insurers submitted data to Ingenix to determine the typical cost for care received in such visits.

 

But Congressional investigators say companies would deliberately skew data to underestimate the costs of medical services, leaving patients to pay more in out-of-pocket expenses.

 

“The result of this practice is that American consumers have paid billions of dollars for health care services that their insurance companies should have paid,” according to the report of the Senate Commerce Committee’s investigative staff.

 

Copyright 2009 New York Times.

 

Health suffers in recession; preventive care often cut first

 

By Rita Rubin

USA Today

Thursday, June 25, 2009

 

After her husband died in 2004, Gayla Moeckel decided to give up teaching and take over the family farm near Plevna, Kan. The land had been in her and her husband's families for more than a century.

 

But when she gave up teaching, she also gave up the health insurance plan that went with it.

 

She pays the $157 cost of her annual mammograms out of pocket. Given her family history, she's religious about getting them. Her sister died of breast cancer at 37. Her paternal grandmother died of it at age 52. Her mother has survived it.

 

When Moeckel turned 50 in February 1999, her primary-care doctor advised her to get a screening colonoscopy. Her maternal grandfather died of colon cancer 45 years ago. She knew it was important to get screened.

 

But nearly eight years passed before she could afford to comply.

 

As the recession continues and unemployment climbs, surveys suggest many Americans are cutting costs by delaying or forgoing preventive health care.

 

Emphasis on prevention

 

Although the details of President Obama's health care plan are not yet known, much of the discussion has centered on preventive care. "We can all agree that if we want to bring down skyrocketing costs, we'll need to modernize our system and invest in prevention," Obama said March 5.

 

Moeckel, 59, pays $490 a month for catastrophic health insurance, which would cover up to $1 million worth of her care if she were hospitalized for colon cancer. It won't pay for a colonoscopy.

 

So Moeckel saved up and paid for it herself. The colonoscopy itself cost $1,450. Removing and biopsying three polyps cost extra. "There were plenty of other things that needed to be paid," such as bills for diesel fuel and fertilizer, Moeckel says.

 

But she's relieved that the polyps were benign, and now she's saving up for her next screening colonoscopy in 3½ years. To help, she works occasionally as a substitute teacher at a school 22 miles from her home. Her take-home pay: $64 a day.

 

If she lived in Connecticut, Moeckel might have been able to take advantage of a state-funded pilot project that provides free screening colonoscopies to people who lack coverage for them.

 

"Here at the University of Connecticut, you will see a lot of people come to you because they didn't get screened in time for cancer," says gastroenterologist Joseph Anderson, clinical director of the UConn Health Center's Colon Cancer Prevention Program.

 

The program pays gastroenterologists and pathologists half their usual fees.

 

"I think that everybody understands that the bottom line is we all need to sort of pull together to try to fix the holes in the current system," Anderson says.

 

One morning last week, Anderson screened seven people through the project, including Veronica Francis, 56. "At present, I'm not working, and I don't really have insurance," says Francis, a Jamaica native who moved to Hartford, Conn., last September from New York.

 

Anderson told her that her colon looked fine and that she doesn't need another screening colonoscopy for 10 years, Francis says. "You don't know how relieved I am."

 

More health problems

 

A survey of family doctors released last month by the American Academy of Family Physicians suggests not everyone who puts off preventive care is as fortunate as Francis or Moeckel. Six out of 10 respondents said they were seeing more health problems as a result of skipped preventive care, such as screenings, or unfilled prescriptions.

 

"What's become clear with this economic recession is that America is sicker than it was prior to the recession," says Ted Epperly, a Boise doctor who serves as president of the family physician's group.

 

One survey respondent wrote about a 46-year-old patient who cut back on his pills for type 2 diabetes, Epperly says. The man's blood sugar got out of control, and he ended up having a fatal heart attack.

 

Another respondent wrote of a patient with bipolar disorder who tried to save money by not filling his prescription for an antipsychotic medication. "Within a week to 10 days, he spun out of control," Epperly says, and he lost his job, his family and his house.

 

Deb Clements, an associate professor of family medicine at the University of Kansas, says her practice has seen fewer patients coming in for preventive care.

 

Recently, an older patient was hospitalized with high blood pressure. A combination of five medications lowered it, and she was released. A week later, she was back in the hospital.

 

"To tell you the truth, I didn't take the medicine," Clements says the woman told her. "I couldn't afford it."

 

Copyright 2009 USA Today.

 

Panel: 1 less shot needed to treat rabies

 

Associated Press

USA Today

Thursday, June 25, 2009

 

ATLANTA (AP) — People exposed to rabies need only four vaccinations, not the five currently recommended, a vaccine advisory committee said Wednesday. In the past, rabies shots were dreaded almost as much as the disease itself. Until the 1970s, an encounter with a rabid animal led to at least 14 shots in the abdomen. But vaccines have improved, and five shots in the arm or thigh have been the U.S. standard for more than 20 years.

 

The Advisory Committee on Immunization Practices voted unanimously that four shots — all given within the first 14 days after exposure to rabies — are sufficient.

 

The panel advises the U.S. Centers for Disease Control and Prevention, which issues official guidance to doctors

 

Committee members made the decision after hearing that out of 20,000 to 40,000 Americans exposed to rabies each year, an estimated 1,000 get only three or four shots and none of them have developed rabies.

 

The shots cost between $100 and $200 apiece. Two companies make rabies vaccine for the U.S. market, Novartis and Sanofi Pasteur.

 

The committee's recommendations usually harmonize with what drug companies' package insert information about how their product should be used, but not in this case. A Novartis official, Clement Lewin, said he disagreed with the panel setting a precedent by making an off-label recommendation. He said it might confuse doctors who read company information about the vaccine that calls for five doses over 28 days, but see government guidance that says four shots are enough.

 

Rabies is a viral disease transmitted through the bite of a rabid animal. Most rabies cases occur in wild animals like raccoons, skunks, bats, and foxes.

 

The virus can infect the nervous system and can cause symptoms like insomnia, anxiety, confusion, paralysis, salivating, hallucinations, difficulty swallowing and fear of water. Death usually occurs within days of the onset of symptoms.

 

It's a recurring menace in the developing world, but the number of U.S deaths have declined to an average of two or three each year.

 

Copyright 2009 The Associated Press. All rights reserved.

 

Opinion

A milestone for youths

Our view: Maryland now has a unique opportunity to fix its long-broken child welfare system; for the sake of future generations, it can't let that chance go to waste

 

Baltimore Sun Editorial

Thursday, June 25, 2009

 

The stories were horrifying and heart-wrenching: a boy beaten bloody while in foster care; a 15-year-old girl tortured and starved to death by a mentally ill guardian; a 5-year-old fatally scalded by his mother after state officials removed him from a safe foster home.

 

It's no wonder such egregious cases of abuse and neglect have helped drive a 25-year-old lawsuit over how the Maryland Department of Human Resources and the Baltimore Department of Social Services care for the state's most vulnerable children and adolescents.

 

That's why the settlement announced this week between advocates for Baltimore's children and the city's foster care system represents a potentially tremendous step forward for the health and well-being of children in Maryland.

 

The agreement would allow the state to free itself from federal court supervision for the first time since 1988 if it meets dozens of specific goals and maintains that performance for an 18-month period. It sets clear targets for child health and dental care, education, caseworker training, family preservation and finding permanent homes for thousands of at-risk youngsters currently languishing in foster care.

 

Some of the requirements seem obvious: The state must make sure children in its care have case plans and that they actually receive the health care, educational support and other services identified in those plans. Others are a sad testament to how badly the system has failed over the years, notably the requirement that children not spend the night in state office buildings while social workers try to find a place to put them.

 

The goals have been translated into measurable outcomes - for example, that each caseworker will be responsible for no more than 15 children, and a single supervisor will be responsible for no more than six caseworkers. The system has agreed to hire an outside expert with broad credibility in the field to monitor its progress and make periodic reports.

 

One of the attorneys who has represented the children for more than two decades said this week's commitment by the state left him optimistic for the first time that conditions for children in state-sponsored care actually will improve. State Secretary of Human Resources Brenda Donald, who has fought hard to improve the state's child welfare services, concurred in calling it a milestone, saying, "These are the things we are supposed to be doing anyway."

 

But now comes the hard part - actually making the improvements that both sides agree are necessary. Unfortunately, that task could be made harder by the current state budget crunch. Although Ms. Donald says she doesn't anticipate her department will need additional infusions of state dollars to achieve the goals set out in the agreement, it will need to maintain current levels of funding.

 

That will be a challenge, given the need to trim hundreds of millions more from the state budget to deal with the fiscal crisis created by the economic downturn.

 

Ironically, the very reforms Ms. Donald has been so successful in bringing about could make her agency a more tempting target. Under her watch and that of Baltimore Department of Social Services Director Molly McGrath, the number of children in foster homes in the city has dropped nearly 20 percent, and the number in group homes has dropped significantly as well. Placing kids in permanent homes saves the state money, which up to this point the department has been able to invest in other services. But in a budget crunch, those signs of progress could become justification for reduced funding.

 

Gov. Martin O'Malley should strive to hold Ms. Donald's department as harmless as possible in the budget cutting that is sure to come. The state has a unique opportunity now to capitalize on the momentum its social service providers have created in recent years to finally put an end to decades of dysfunction in its child welfare system. It must not let that chance go to waste.

 

Copyright © 2009, The Baltimore Sun.

 

Lessons Learned

The death of a 13-year-old girl is spurring Prince William officials to make needed reforms.

 

Washington Post Editorial

Thursday, June 25, 2009

 

AUTHORITIES in Prince William County did not, tragically, heed calls to help Alexis "Lexie" Agyepong-Glover. But thankfully, they seem committed to not repeating the mistakes that contributed to the death of this troubled 13-year-old girl. Not only have they taken action against those who didn't do their jobs, they are also strengthening the way the county's agencies can work together to protect children.

 

A social services worker was dismissed and two others were disciplined as state and local officials continue to review how they handled the girl's case. Alexis was found dead, of drowning and exposure, in a creek on Jan. 9. Her adoptive mother was charged with killing and abusing her; after Alexis's death, it was revealed that several people had reported concerns about the girl's well-being but that they were never taken seriously by social workers and police. The girl repeatedly ran away and told people she was being mistreated -- but again and again she was returned home. The medical examiner's office found evidence of old injuries.

 

"I would say that we made some errors, no doubt about it," county social services director John P. Ledden Jr. told The Post's Jonathan Mummolo with refreshing candor. In addition to the actions against employees, Mr. Ledden announced needed systemic changes, for example, improvements in how multiple complaints should be handled. Equally significant is the recognition of poor coordination by the different agencies dealing with Alexis.

 

At the behest of Police Chief Charlie T. Deane, experts from the National Center for Missing and Exploited Children conducted an all-day workshop this month for the county's top leaders on how to improve the system. The presence of such officials as the commonwealth's attorney, the school superintendent and the chief judge for juvenile affairs speaks well of their desire for reform. Mr. Deane made clear to us that the county's work is just beginning. There is probably a need, for instance, for legislation to relax strict confidentiality rules so that information can be better shared. Another area being studied is how the county deals with runaways; that the girl fled her home should have been seen as a sign of trouble. Alexis's death was inexcusable, but we hope the lessons learned can help to prevent future tragedies.

 

Copyright 2009 Washington Post.

 

On the rise

 

Cumberland Times-News Editorial

Thursday, June 25, 2009

 

Health officials in West Virginia have to be disheartened about the latest tobacco sales statistics in the Mountain State.

 

The Synar Report submitted to the U.S. Department of Health and Human Services shows that about 17.9 percent of 458 retailers subject to random inspections sold tobacco products to minors. That is up from 14.2 percent the previous year.

 

The Synar report, named for an Oklahoma congressman, is part of the method the federal government uses for dispensing grant money.

 

Not only is the increased use of tobacco by teen-agers a health concern, it is a monetary issue as well. If the percentage of retailers selling tobacco to minors goes over 20 percent, West Virginia could lose about $3.4 million in substance abuse grants.

 

“No tobacco is supposed to be sold to kids,” said Bruce Adkins, director of West Virginia’s Division of tobacco Prevention.

 

Obviously, adults are aiding children in obtaining cigarettes and smokeless tobacco — either by buying it or selling it.

 

Compared to other states, West Virginia’s tabacco use rate is abysmal. While the West Virginia rate is just under 18 percent, the weighted average rate of all states is 10.5 percent.

 

The West Virgina Alcohol Beverage Control Administration is the enforcement agency for underage tobacco sales. And while it receives $200,000 in federal funding each year to try to curb illegal tobacco sales, more obviously needs to be done. More undercover investigations and more education programs are needed — especially when it comes to convincing retailers about the importance of keeping tobacco away from minors.

 

The more state officials, parents, educators, students and the community at large talk about the tobacco problem, the more likely West Virginia’s high rate of illegal use will drop.

 

It’s a problem that did not occur overnight. And one that will not go away in just a year or two.

 

Copyright © 1999-2008 cnhi, inc.

 

Human Issues

 

Frederick News-Post Letter to the Editor

Thursday, June 25, 2009

 

Health care is everyone's issue.

 

Health care reform is not just a Democratic issue, or a Republican issue — it is a human issue. Sixty percent of the bankruptcies every year are health care-related and the majority of these people have insurance. Most are small-business owners, like the many shopkeepers who live in Frederick .

 

Health care reform is not just about cost. It is about affordable access to the 50 million people (and increasing every month) who have no insurance. This by definition means through a public plan that runs parallel to private plans — much like Medicare runs alongside private plans now.

 

Health care reform is everyone's concern, whether they are motivated by concern for people, the desire for economic recovery, or the need to reform an inefficient system that currently treats the uninsured in hospitals, which inherently provide the most expensive care.

 

JACKIE BALDICK

Middletown

 

Copyright 2009 Frederick News-Post.

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