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			Saturday, March 14, 2009 News Clipping Archives *Maryland / Regional* Maryland business groups balk at dueling universal health plans (Baltimore Business Journal) Dixon statement about Sharfstein (Baltimore Sun) Restructuring team brought in to St. Joseph Medical Center amid federal Investigation (Baltimore Sun) Parents jailed for allowing drinking (Annapolis Capital) Dry weather may stave off mosquitoes (Cumberland Times-News) *National / International* Bargaining Down the Medical Bills (New York Times) Bills Would Ban BPA From Food and Drink Containers (Washington Post) Review Finds Modest Risk From Children's Toiletries (Washington Post) Guyana credits US campaign with slashing AIDS rate (Washington Post) *Opinion* Drugs v. Devices (New York Times) Health-care emergency grows (Washington Times) *Maryland / Regional* Maryland business groups balk at dueling universal health plans Employers fear cost of mandated benefits will be too expensive By Julekha Dash Staff Baltimore Business Journal Friday, March 13, 2009 While lawmakers debate two proposed universal health care plans in Maryland, business groups in the Free State say they are opposed to plans that would require more of small businesses during a recession. The debate highlights the obstacles that stand in the way of achieving universal health care even though it may be billed as a top legislative priority at the federal level. Facing more job losses, businesses are wary of anything that takes more money out of their pocket — especially health care mandates. And with less money coming from property and income taxes, the state is no position to fund broad health care expansion. CareFirst BlueCross BlueShield this month unveiled a $1.6 billion plan to create a health insurance pool that combines the state’s healthy and insured with those who lack health insurance or are ill. Meanwhile, Maryland Citizens’ Health Initiative’s universal health care plan also calls for a state health insurance pool for residents and small businesses to purchase coverage but includes further expansion of Medicaid. That $15 billion plan has drawn the ire of business groups because it would rely on increasing businesses’ payroll taxes by 2 percent. Both plans ask the state to subsidize health plans for those who cannot afford the premiums. “Our members are really struggling with difficult economic times,” said Ellen Valentino, executive director of the Maryland chapter of the National Federation of Independent Business. The group’s members fear Healthy Maryland’s mandate for businesses could result in more job losses, she said. Under CareFirst’s Healthy Maryland plan, employers must maintain their same level of health care expenditure as they did this year and provide insurance to full-time employees no later than Jan. 1, 2011. Employers who do not comply will pay a penalty equal to the average price employers pay for the state’s small-group insurance market. That is about $3,000 per employee. The plan would also penalize health insurers, individuals and businesses that do not participate. The plan, outlined in House Bill 860 and Senate Bill 515, has the backing of Del. Peter A. Hammen, chair of the House Health and Government Operations Committee, and Sen. Thomas “Mac” Middleton, chair of the Senate Finance Committee. But “it’s dangerous in a normal time and it’s unfavorable in the recession we’re in,” said Maryland Chamber of Commerce Lobbyist Ron Wineholt of the Healthy Maryland plan. The chamber would rather see the state offer more subsidies to small businesses so they can afford to purchase health insurance, Wineholt said. Facing a budget shortfall, the state cut its funding to subsidize small businesses’ health insurance by half, to $15 million, this fiscal year. The chamber is even more concerned about Maryland Citizens’ Health Initiative’s plan because it imposes a 2 percent payroll tax. The proposal contends businesses will see that money spent on the additional payroll tax offset by lower health insurance costs. Lawmakers who support universal health care say the goal is to spark debate on universal health care this year with the hope of adopting a plan in 2010. “There’s no way we can pass it this year,” said Middleton, a Charles County Democrat. “But it’s a good starting point.” Donald C. Fry, CEO of Greater Baltimore Committee, said the business group would like to see what happens at the national level before pushing for statewide reform. “Small businesses are watching and trying to conserve as much as they can,” Fry said. But Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, said any universal health coverage will require businesses and individuals to chip in their share. Some employers say they are ready to pay a price to support universal health care even if the state is not ready. “Everyone is going to have to make a sacrifice,” said Larry Walton, president of United Way of Central Maryland, which employs 85. “People are dreaming if they think they can have universal health insurance without there being a cost to it.” © American City Business Journals Inc. All rights reserved. Dixon statement about Sharfstein Baltimore Sun Saturday, March 14, 2009 "This is truly bitter sweet where we are equal parts saddened and excited for Dr. Sharfstein. As some may view this as a loss for Baltimore, I see this as a gain for the nation. We are proud that one of Baltimore's own has an opportunity to not only make Baltimore a healthier city but the United States a healthier nation as well. Dr. Sharfstein is a dedicated, intelligent and hard working administrator. I have considered him a superstar within my administration. Since becoming Mayor, he has served as an agent for change by helping to implement a number of important initiatives that made Baltimore a healthier city, such as passing a city-wide smoking ban, opening a 24-hour resource center for the homeless, performing a comprehensive study of the health of our neighborhoods and increasing education and outreach to prevent the contraction of HIV - just to name a few. President Obama chose an experienced advocate with a proven background in health policy. The people of the United States are fortunate to have Dr. Sharfstein looking out for their best interests. He will serve with passion and dedication for real change. I wish Josh and his family all the best in this new chapter of public service. I have asked Ms. Olivia Farrow, Esq. to serve as Interim Commissioner of the Health Department as we conduct a national search for a permanent replacement. She will serve on a team with Deputy Commissioner Jacquelyn Harvey-Duval, Assistant Commissioner Charlene Brown and Chief of Staff Michelle Spencer. This group of talented women will continue building upon the successes of Dr. Sharfstein's tenure as Commissioner." Copyright 2009 Baltimore Sun. Restructuring team brought in to St. Joseph Medical Center amid federal investigation Group to manage hospital and ensure federal health care laws not violated, according to internal memo acquired by The Baltimore Sun By Stephanie Desmon and Robert Little Baltimore Sun Saturday, March 14, 2009 St. Joseph Medical Center, where three top executives went on leave two weeks ago amid a federal investigation, has brought in an outside "restructuring team" to manage the hospital and ensure that it is not violating federal health care laws, according to a memo circulated among employees. Officials at the hospital, a 354-bed facility in Towson that is among the region's largest employers, did not elaborate yesterday on the restructuring team's role. But Beth O'Brien, who is leading the team, said in the memo that "the overarching goal is to create a compliance program at St. Joseph that parallels the same high standards as our clinical quality." According to documents from the U.S. Department of Health and Human Services, such programs are put in place primarily to avoid fraudulent payment claims to Medicare and Medicaid. Violating these laws can lead to substantial penalties, ranging from fines to exclusion from Medicare, which would effectively shut down a hospital by cutting off a major source of income. The internal memo, obtained by The Baltimore Sun, names John K. Tolmie, the hospital's longtime president and CEO; Sly C. Moore, chief operating officer; and Lucy Shamash, vice president of operations, as the three executives who took administrative leave. Hospital officials would not confirm the names, saying only that executives took leave to "avoid a conflict of interest during the investigation," but employees say the departures were announced in meetings Feb. 27. Three black, hard-bound journals labeled with the names of Tolmie, Moore and Shamash were left last week in the hospital's lobby, where employees were writing them notes of support. The scope of the federal investigation and internal restructuring at St. Joseph is unclear. But St. Joseph spokeswoman Vivienne Stearns-Elliott said in a statement: "Hospitals are highly regulated environments; investigations of this nature are becoming more commonplace." Hospital compliance experts said, however, that it is unusual for so many executives to step aside before an inquiry is complete. Minor compliance matters often result simply in settlement agreements and modest fines. Bret Bissey, a consultant who focuses on compliance programs and has experience with HHS investigations and their settlements, said: "I would say a significant minority require any kind of change of leadership." Bissey, who wrote The Compliance Officer's Handbook for the health care industry, said he does not have direct knowledge of the St. Joseph investigation. The federal investigation, according to hospital officials, dates to June 2008 and involves the hospital's relationship with a physician group that it did not name. The investigation is being conducted by the U.S. Department of Health and Human Services, whose Office of Inspector General typically investigates claims of Medicare fraud or other alleged violations of federal health care laws. A spokesman for the inspector general's office said he could not provide any information. The hospital's restructuring team is made up of five members, including two attorneys, an operations specialist and O'Brien, an executive at St. Joseph's parent company, Denver-based Catholic Health Initiatives. The sole physician on the panel, Dr. Richard Vernick, is a cardiologist who "specializes in performance improvements and physician relationships with hospitals," according to a biography circulated to hospital employees. O'Brien's memo to employees said little about the projected course of the hospital's restructuring plan, but it said that crafting a new compliance program is its "overarching goal." "Establishing an excellent compliance program propels the Medical Center forward, which is very important to our long-term success," she wrote. Federal compliance programs for hospitals cover everything from ethical business practices to patient safety to billing rules and regulations. The inspector general's guidance for hospitals states: "Compliance programs help hospitals fulfill their legal duty to refrain from submitting false or inaccurate claims or cost information to the Federal health care programs or engaging in other illegal practices." Copyright 2009 Baitimore Sun. Parents jailed for allowing drinking By Scott Daugherty Annapolis Capital Saturday, March 14, 2009 A Cape St. Claire couple was sentenced yesterday to 10 days in jail for allowing their teenage son and his friends to drink and party in their house. New Homes Laura Davis, 44, of 967 Dogwood Tree Drive, will start her sentence Monday morning at the Jennifer Road Detention Center. Her husband, Timothy, also 44, will serve his sentence over five weekends starting Friday. "The message needs to go out to the community this is not appropriate," District Court Judge John E. Nunn III said yesterday from the bench at the courthouse in Glen Burnie. Police charged the Davises with maintaining a disorderly house last summer after learning one of their guests committed suicide July 7 on Highpoint Drive. Numerous Broadneck High School students told detectives investigating the suicide of 16-year-old Taylor Goetzke that the Davises knew they were drinking in their house. One boy told police the Davises allowed their son, who is now 17, to host at least 10 parties, prosecutors said. "The Davises were undermining the choices of other parents as well as endangering the public," said Assistant State's Attorney Mark Tyler, stressing the case was about the Davises' "poor parenting choices" - not Taylor's subsequent suicide, which was never mentioned in the courtroom. "This is a serious problem, not just in the Broadneck community, but in Anne Arundel County," he said. Matthew Goetzke, Taylor's father and brother of Circuit Court Judge Paul G. Goetzke, agreed. He noted that many of the teens who were drinking at the Davises are still posting pictures of themselves drinking on their Facebook and MySpace pages. "These kids are still drinking," he said. "And they are out in the woods, they are in people's houses." Defense Attorney Edward W. Brady, who unsuccessfullyargued for the judge to grant his clients probation before judgments, stressed the Davises were not throwing parties. "They didn't encourage anyone to drink. Quite frankly, I think 'allow' is too harsh of a word," he said. Timothy Davis, a professional chef and amateur soccer coach, said he and his wife now realize they should have done more to deter the teens from drinking in their home. "It's quite embarrassing to be here," he said. The Davises declined to speak to The Capital after the hearing. About a dozen family members who attended the hearing left the courthouse in silence, specifically ignoring questions from a reporter. The Davises were convicted only of providing the teens a place to drink. Police could not prove who purchased the beer for them. The Davises pleaded not guilty to the charges, but did not dispute the state's version of events. Nunn convicted them and sentenced each spouse to 10 days in jail, the statutory minimum for maintaining a disorderly house. He allowed them to pick when they wanted to serve their respective sentences. Nunn also ordered each to pay $357.50 in fines and fees, and said he hoped they would voluntarily work with school officials and speak to students and parents about the dangers of underage drinking. However, he did not order them to do so. Police charged the Davises' son in juvenile court with charges similar to his parents', according to court documents. The outcome of that case is unavailable. According to prosecutors, court documents and Matthew Goetzke, Taylor and several other teens went to the Davises' house late July 6 and started drinking beer. Guests told police Taylor brought several beers to the party. They said he was acting weird and "trying to fight everybody." After one dispute, they escorted Taylor outside and he walked away. Taylor did not go home, though. In the early morning hours of July 7, he hanged himself from a tree on Highpoint Drive. It is unclear what exactly motivated Taylor to commit suicide, Goetzke said. He said his son had a blood alcohol content of 0.11 - about one and a half times the legal limit to drive. Goetzke said he did not know his son, who would be a junior at Broadneck High School this year, would be drinking at the Davises' home that night and would not have let his son go there if he had known. At least 31 states, including Maryland, Virginia, Delaware and Pennsylvania, allow parents to give their own children alcohol in a private residence, according to the Alcohol Policy Information System, a federal Web site that tracks alcohol laws. No state allows adults to give alcohol to other people's children, but only seven states have laws specifically restricting the hosting of underage drinking parties. Maryland is not one of them. Prosecutors used an obscure law usually reserved for brothels, gambling dens and drug pits against the Davises. They were able to do so because police discovered they let teenagers drink in their home on multiple occasions. Like Nunn, Matthew Goetzke hopes that parents get the message and stop letting kids drink in their homes. He said it's not cool - it's dangerous. "All of these kids are not going to stay at the house. They are going to leave," he said. "What happens when one gets in a car with three of his friends and wraps it around a tree?" Copyright 2009 Annapolis Capital. Dry weather may stave off mosquitoes CNHI News Service Cumberland Times-News Sunday, March 15, 2009 WASHINGTON — Warmer weather and sunny skies are just around the bend, which, sadly means the mosquitoes are not too far behind. But it may not be time to stock up on the bug repellant and cortisone cream. There are “multiple factors” that determine the strength of the mosquito population’s emergence, said Kim Mitchell, chief of Rabies and Vector-Born Diseases, Maryland Department of Health and Mental Hygiene. She listed climate and the specific species’ resiliency to environmental change as factors. This year, Maryland’s lack of precipitation and low groundwater levels might curb or at least delay the pest’s seasonal debut. Thus far, Maryland is behind in precipitation, with deficits of more than three-quarters of an inch for the month of March and more than 4 inches for the year to date, according to National Weather Service data taken at BWI-Marshall Airport. The region has had a string of cold days and may have a few really hot days this summer, but these temperature fluctuations have temporary effects on mosquito populations, said Mike Cantwell, Maryland Department of Agriculture mosquito control program manager. “Rainfall and high tides affect the numbers (of mosquitoes).” Mosquitoes and wet conditions make not only for more swatting and scratching itchy red bumps, but potentially life-threatening diseases such as malaria and West Nile virus. “In recent years we’ve seen a general decline in West Nile virus cases,” said Mitchell, who said the disease seemed to have moved west to unexposed areas. In 2003, Maryland’s West Nile cases peaked with 73 infected humans and 204 infected horses resulting in eight human fatalities. Last year, there were 14 human cases and no deaths. Neither rain nor snow has been sufficient in the region (except for the storm that blanketed the East Coast with nearly a foot of snow earlier this month). And these warm weather pests need water to breed and multiply. Rain and snow replenish groundwater supplies and saturate the soil, said Cantwell. “(Ground)water levels are getting kinda low,” said Dan Soeder, hydrologist for U.S. Geological Survey in Baltimore. “And we’re heading into a drought,” if dry conditions persist. Up near the Mason-Dixon Line, the levels are more or less normal, said Soeder. But in southern Maryland, where they never recovered from the 2002 drought, levels are very low. Low groundwater levels easily translate into low stream levels and dry soil, which can impede gardening and farming. “It kind of snuck up on us,” Soeder said. “It got dry over the winter and we didn’t notice it.” However, Cantwell expects Maryland to see just as many mosquitoes as last year. Some species have evolved and developed strategies to overcome harsh changes in the environment. “Eggs are still out there and (some species) can survive years in the egg stage waiting for rain,” Cantwell said. “And when the rain comes the mosquitoes will come.” As a survival mechanism, “mosquitoes can exploit every type of stagnant, still or contained water” no matter how little water is available, Cantwell said. But too much water from floods, hurricanes, or just several inches of rain “can flush these mosquito breeding sites out,” Cantwell said. Copyright © 1999-2008 cnhi, inc. *National / International* Bargaining Down the Medical Bills Patient Money By Lesley Alderman New York Times Saturday, March 14, 2009 WHEN money is tight, everything is negotiable - including your health care bills. As the economy sheds jobs and more people lose their health insurance or are forced to switch to less generous plans, doctors and hospitals are becoming accustomed to patients who are struggling financially. According to the American Hospital Association, half of their members reported an increase in the number of patients needing help with their bills. And that was in November, before the national unemployment rate hit 8.1 percent. “It’s rough out there,” said Dr. Jacques Moritz, the director of gynecology at St. Luke’s-Roosevelt Hospital Center in New York, who also has a private practice in Manhattan. (Full disclosure: He delivered my son five years ago, but my insurance at the time covered me in full.) Lately, Dr. Moritz said, “The first thing I say to my long-term patients is, ‘Do you still have a job?’ ” If patients say no, or otherwise indicate that paying will not be easy, Dr. Moritz says he assures them that bills are negotiable. And keep in mind that doctors, hospitals and medical labs are accustomed to negotiating. After all, they do it all the time with insurers. A hospital may have a dozen or more rates for one procedure, depending on whether Medicare, Medicaid or a private insurer is paying the bill, said Ruth Levin, corporate senior vice president for managed care of Continuum Health Partners, a nonprofit hospital system in New York. Your request for a special arrangement will hardly confound their accounting department. And it is usually in everyone’s interest to avoid dealing with a bill collector. If you recently lost your insurance or have a plan with minimal benefits, here is what you need to know if you want to seek a price break from the doctor, hospital or lab. Dealing With Doctors DON’T BE SHY “Patients are often intimidated by their doctors - it’s the white coat,” said Dr. Davis Liu, a family doctor in California and author of “Stay Healthy, Live Longer, Spend Wisely” (Stetho Publishing, 2008). “But if you need help, speak up. Most are likely to help out.” Talk directly to your doctor about your financial situation. If that makes you uncomfortable, then go to the billing manager. The office may be able to offer you a discount of 10 to 30 percent depending on the practice (specialists may offer a bigger break), or propose a plan in which you pay your balance in a few installments or on a monthly basis - typically at no interest. OFFER TO PAY CASH UPFRONT Doctors can lose thousands of dollars every year on unpaid bills and spend countless hours haggling with insurers over reimbursements. If you can make their life simpler by offering to pay right away, you’re likely to get a small discount - even if you don’t have financial hardship. BE RESPECTFUL You’re negotiating for your health, not haggling over a used car. So Dr. Moritz cautions you not to call your physician and say: “Dr. So-and-So will do the procedure for $300 less. Can you match that?” “When someone does that,” Dr. Moritz says, “that’s the end of the relationship.” Talking to Hospitals STRIKE A DEAL, THEN CHECK IN If you need shoulder surgery, for instance, but don’t have insurance - or are facing a high hospital co-payment - call the hospital’s billing department and explain that you would like to discuss getting a discount and why. Dr. Moritz suggests saying, “I’d like to pay the lowest rate you give an insurance company.” MAKE A COUNTEROFFER Like doctors, hospitals would rather be paid something than nothing. They lost $34 billion in 2007 on uncompensated care, up 55 percent from 2002. “Hospitals would rather set up a payment plan than turn it over to a collections agency and then expect to write it off,” Dr. Liu said. If you end up with a bill you can’t pay - or at least can’t pay right away - don’t panic. Find out what Medicare would pay for your condition or surgery, since that program tends to pay less than private insurers. You can learn that at the federal Department of Health and Human Services database, www.hospitalcompare.hhs.gov, by clicking on the gray button “find and compare hospitals.” I learned on the Web site, for example, that if I were admitted to my local hospital for chest pain, the average Medicare payment would be $5,732. Use the Medicare numbers as the starting point for your negotiation. The truth is, said Ms. Levin of Continuum Health Partners, “only a very small portion of consumers or insurers pay 100 percent of our hospital charges.” If your situation is truly dire or your bill very large, you may qualify for charity care. But you’ll have to show the hospital proof of your income and your hardship. Bargaining With Labs Charges for lab work can be exorbitant. But, as with hospital bills, the numbers you see on your statement may not reflect what most insurers actually pay, according to Dr. Woodson C. Merrell, chairman of the department of integrative medicine at Beth Israel Medical Center in New York. Negotiate just as you would with your doctor or hospital. Quest Diagnostics, the largest clinical laboratory in the country, for instance, offers a six-month interest-free payment plan, as well as financial assistance for those with real hardship. “But we evaluate each case individually,” says Jerry Diffley, corporate director of patient advocacy and billing compliance. Copyright 2009 New York Times. Bills Would Ban BPA From Food and Drink Containers Milwaukee Journal Sentinel Washington Post Saturday, March 14, 2009; A04 Leaders from the House and Senate introduced legislation yesterday that would establish a federal ban on bisphenol A in all food and beverage containers. The bills, introduced by Rep. Edward J. Markey (D-Mass.) and Sens. Dianne Feinstein (D-Calif.) and Charles E. Schumer (D-N.Y.), would greatly expand efforts to limit the chemical from products for young children. The move came a day after Sunoco, the gas and chemical company, sent word to investors that it is now refusing to sell bisphenol A, known as BPA, to companies for use in food and water containers for children younger than 3. The company told investors that it cannot be certain of the chemical compound's safety. Last week, six baby-bottle manufacturers, including Playtex and Gerber, announced that they will stop using BPA in bottles. Tests have found toxic levels of the chemical in products, including those marked as "microwave safe." The amounts detected were at levels that have caused neurological and developmental damage in laboratory animals. The problems include genital defects, behavioral changes and abnormal development of mammary glands. The changes to the mammary glands were identical to those observed in women at higher risk for breast cancer. Studies have shown that the chemical can cause breast cancer, testicular cancer, diabetes, hyperactivity, obesity, low sperm count, miscarriage and a host of other reproductive problems in laboratory animals. More recent studies using human data have linked BPA to heart disease and diabetes. It has been found to interfere with the effects of chemotherapy in breast cancer patients. Copyright 2009 Washington Post. Review Finds Modest Risk From Children's Toiletries By David Brown Washington Post Saturday, March 14, 2009; A04 Extensive studies of two toxic chemicals found in children's bath and personal care products suggest that if they pose a health hazard, it is likely to be extremely small and probably incalculable, a review of scientific research shows. The two chemical compounds -- 1,4-dioxane and formaldehyde -- were found in trace quantities in children's shampoos, bath gels, lotions and wipes in a study conducted by the consumer group Campaign for Safe Cosmetics. The results, released this week, showed that of the 48 products studied, two-thirds contained 1,4-dioxane. A subgroup of 28 products was tested for formaldehyde, and about 80 percent contained that compound. Numerous compounds contained both. Neither of the compounds is listed as an ingredient in the products. Formaldehyde is a breakdown product of preservatives in the liquids, and 1,4-dioxane is a trace contaminant left from the manufacturing process. But federal experts yesterday urged caution in assessing the results of the study. The Environmental Protection Agency, which evaluates the toxicity of chemical compounds, released a statement yesterday saying that it "is currently doing new human health risk assessments on both dioxane and formaldehyde." It noted that previous studies had shown dioxane may cause cancer when inhaled, and formaldehyde may cause cancer when ingested, but that the agency has "not yet reached a determination pertaining to skin exposure." Because the products are washed off, the ability of the body to absorb them is limited. The low-dose, short-lived and intermittent nature of exposure is one of the reasons the Food and Drug Administration does not require that the chemicals be removed. "FDA has not concluded, based on risk assessment, that the products containing these substances are injurious under intended conditions of use," said Linda M. Katz, director of FDA's office of cosmetics and colors. The human health effects of formaldehyde have been studied extensively; those of 1,4-dioxane, less so. (The second compound is not the same as dioxin, a much-studied industrial contaminant.) In virtually all cases, however, researchers have examined the experience of people exposed frequently and for long periods (often decades) to much higher doses of the chemicals than a bathing child would get. Dioxane, which evaporates quickly, carries a label as a "probable human carcinogen" based on animal studies. Rats and mice fed relatively large amounts of it in drinking water for most of their lives were at higher risk for cancer of the nasal cavity and liver than animals not exposed to the chemical. Three epidemiological studies of workers exposed to 1,4-dioxane on the job, however, found no increase in cancer deaths, according to an EPA assessment. At the Society of Toxicology's annual meeting, which will be held in Baltimore next week, a CDC scientist is scheduled to present a study in which blood levels of 1,4-dioxane were measured in about 2,000 Americans 12 and older. No detectable amounts were found. That suggests actual -- as opposed to theoretical -- exposure to the compound is virtually nil. Formaldehyde can cause two kinds of skin problems: allergic reactions in people sensitive to it; and garden-variety irritation in people chronically exposed, such as embalmers. Studies suggest that 1 to 4 percent of the population is allergic to formaldehyde. However, allergic reactions are rare when the concentration is less than .025 percent, which is the equivalent of 250 parts per million. Thirteen out of the 23 products found to contain formaldehyde in the Campaign for Safe Cosmetics survey had levels over 250 parts per million (with the highest being 610). There are no studies of mortality from skin exposure to formaldehyde. However, mice exposed repeatedly to 10 percent concentrations of the chemical did not have shorter lives than other mice. Formaldehyde is also a "probable human carcinogen" in the EPA's eyes. Lab animals chronically inhaling the compound have higher rates of cancer of the nasal passages. More than 40 human studies of occupational exposure -- in pathologists, funeral directors, garment workers, resin-makers -- overall demonstrate a slight increase in cancer of the lungs and the nose and throat. Copyright 2009 Washington Post. Guyana credits US campaign with slashing AIDS rate Associated Press Washington Post Saturday, March 14, 2009 GEORGETOWN, Guyana -- Guyana says a U.S.-funded AIDS prevention program has helped slash the HIV infection rate in the South American country from nearly 3 percent to about 1 percent. Health Minister Leslie Ramsammy says the program led by the U.S. Agency for International Development "is a huge success story." The $20 million public awareness and prevention program was launched five years ago. Some of the grant aid went to non-governmental organizations that staged skits around the former British territory of 750,000 people to warn of the dangers of promiscuous behavior and the effects of the virus. Ramsammy said Saturday the government has tracked the decline of the virus by testing nearly half the population over the past three years. © 2009 The Associated Press. *Opinion* Drugs v. Devices New York Times Editorial Sunday, March 15, 2009 Now that the Supreme Court has ruled that patients can sue drug companies in state courts for harm caused by medicines approved by the Food and Drug Administration, Congress ought to give patients the same right to sue makers of medical devices. The Supreme Court ruled last year that device makers could not be sued for damages in state courts if the device was approved by the F.D.A. The justices concluded that the wording of a 1976 law that gave the F.D.A. authority to regulate devices pre-empted state suits. By contrast, in a ruling early this month, the court found no such pre-emptive language in the statutes governing drug regulation. It upheld state court rulings in Vermont that awarded damages to a woman who developed gangrene and had part of her arm amputated after she was treated with an anti-nausea drug. Now Democratic leaders in Congress want to make it clear that nothing in the medical device laws should be construed to prevent damage suits in state courts or to protect manufacturers from liability under state laws. Identical bills introduced in the House and the Senate would accomplish that worthy purpose. Opponents argue that the F.D.A. should be the sole authority because it has the expertise to balance risks and benefits. State juries, they warn, often make inconsistent decisions or may be influenced more by emotion than science. State trials have played an invaluable role in backstopping an all-too-fallible F.D.A.: ferreting out corporate documents, compensating injured patients, and giving manufacturers an incentive to exercise extreme care in production and labeling. Suits in state courts reinforce federal regulations. Patients who have been hurt by faulty medical devices should have the right to seek redress there. Copyright 2009 New York Times. Health-care emergency grows Washington Times Letter to the Editor Friday, March 13, 2009 Contrary to what former Democratic National Committee Chairman Howard Dean says ("Dean warns GOP on Obama health plan," Page 1, Tuesday), President Obama's plan for health care reform will not be "perfect" unless it addresses the needs of the million Americans who seek emergency care each year. The president's plan does not even address America's struggling emergency departments. We cannot have a complete conversation about health care reform without focusing on the need to shore up emergency departments across this country. They are vastly overcrowded and have provided too few mandates and too few resources. The problem is only getting worse as this economic crisis deepens. The number of emergency visits had increased by 32 percent (from 90.3 million up to 119.2 million) between 1996 and 2006, while the number of emergency departments had decreased by 5 percent, leaving fewer emergency departments left to serve a larger volume of patients. This lack of resources contributes to overcrowding and threatens access to life-saving emergency care for everyone - insured and uninsured. Emergency departments are the safety net of the nation's health care system. That is even more evident now during this struggling economy. When people lose their jobs and their health insurance, they rely on the emergency department because they know they won't be turned away, which happens today at other health-care facilities. We urge Mr. Obama and Congress not to turn their backs on emergency patients. We also urge Congress to hold hearings on the state of emergency medicine. Unless the government takes action, more emergency departments will close, and with America's growing elderly population, many patients may not be able to get the care they need and deserve - and that very easily could be you or your own family. Dr. Nick Jouriles President American College Of Emergency Physicians Chagrin Falls, Ohio Copyright 2009 Washington Times. BACK TO TOP


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