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			Friday, March 27, 2009 News Clipping Archives *Maryland / Regional* Hospitals Enrolling Uninsured Marylanders (EmaxHealth) Bill could stop Md. premiums from paying for D.C. program (Daily Record) Report: Maryland hospitals' profit eroded during final three months of 2008 (Baltimore Business Journal) After losing $466M, Maryland hospitals ask: What’s next? (Daily Record) Health expo offers screenings, info (Salisbury Daily Times) Abuse Bills Tug at Several Md. Lawmakers Personally (Washington Post) Universal health care debate in Md. is all talk these days (Baltimore Business Journal) Biotech leaders pressure lawmakers on tax credit (Gazette) Health care companies brace for cuts to Medicare plan (Baltimore Business Journal) *National / International* Study: Younger Blacks Have More Heart Failure (Baltimore Afro-American) A Vaccine Debate Once Focused on Sex Shifts as Boys Join the Target Market (Washington Post) Debate Over Drugs For ADHD Reignites (Washington Post) Salt: Americans Consume Too Much: CDC (U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES) More States Look to Legalize Medical Marijuana (Wall Street Journal) *Opinion* The defrauders win (Baltimore Sun) Protection for Smokers (Washington Post) *Maryland / Regional* Hospitals Enrolling Uninsured Marylanders By Ruzik Tuzik EmaxHealth Friday, March 27, 2009 This week, more than 20 Maryland hospitals are participating in the nationally-designated Cover the Uninsured Week by hosting events to spread the word that Maryland has affordable health coverage options. Events include free screening and counseling for Maryland residents who are without health insurance coverage; open enrollment exhibits at community venues; stations at the local food banks to help educate people on what programs they might qualify for; and exhibit booths at hospitals to provide free education and counseling for health assistance and financial assistance (see attachment for complete schedule). There are nearly 760,000 Marylanders living without health care coverage, of which 150,000 are children. Many of these uninsured residents are eligible for low-cost programs or health care coverage at no-cost through Medical Assistance. “At a time when many are losing their jobs, these open enrollment events are especially important,” said MHA President Carmela Coyle. “Hospitals are an essential safety net for the uninsured – providing care to all who walk through their doors regardless of their ability to pay—it is critical for Marylanders to know they don’t have to wait to get care.” Now in its seventh year, Cover the Uninsured Week is the largest mobilization in history to shine a national spotlight on the need to secure health coverage for all Americans. Sponsored by the Robert Wood Johnson Foundation, this year’s effort focuses on the pressing need for comprehensive, bipartisan health reform. For Maryland, this year’s Cover the Uninsured Week is an opportunity to celebrate the great strides the state has made to improve access to affordable health care. Through legislation such as Medicaid expansion and the Working Families and Small Business Act, more Marylanders have access to affordable health care than ever before. “This campaign provides hospitals and health care organizations the opportunity to work together and acknowledge that health coverage for all Marylanders is a widely shared community value,” said DHMH Secretary John M. Colmers. “Often the uninsured get their health care too late through expensive emergency room visits; costing everyone more in the long run. When we cover the uninsured, the whole community benefits.” Source: Maryland Department Of Health Copyright 2009 EmaxHealth. Bill could stop Md. premiums from paying for D.C. program By Andy Rosen Daily Record Friday, March 27, 2009 ANNAPOLIS — A bill before lawmakers could give state insurance regulators the ability to block Washington, D.C., from drawing on Maryland customers’ payments in a new health coverage program, which some worry will drain reserves or increase premiums paid by Marylanders. Officials say a new Washington law, which could require CareFirst Inc.’s local affiliate to offer an expanded open enrollment program that the company believes will be used by high-risk customers, could wind up costing CareFirst more than it would bring in from those customers. According to an estimate provided to lawmakers by CareFirst, the program could cost the company $22 million this year, and more than $160 million over five years, because it would have to provide coverage to 2,500 “difficult-to-insure” individuals. CareFirst spokesman Michael Sullivan said there is some concern that the district’s program will wind up costing Maryland residents, because the majority of the company’s customers live here. According to a legislative document, CareFirst’s affiliate in the Washington metropolitan area covers about 527,000 in the district. The losses from the Washington law could affect the company in two ways, he said, “by higher premiums or a diminishment of reserves, reserves that are largely built on the premium payments of Marylanders to fund a program that would only benefit district residents.” Passage of the bill would not automatically lead to the state blocking the Washington program. It would authorize the Maryland Insurance Administration to look into the program and gauge its effect, and then act if it found the bill would hurt state consumers. Insurance Commissioner Ralph S. Tyler said the law could turn out to be costly for Maryland customers. “We certainly don’t want it to be that the open enrollment program is paid for by premiums from Maryland customers,” he said. Neither Tyler nor Sullivan could say Thursday how customers would be affected by the Washington law. Tyler said his agency is now examining the reserve held by CareFirst, and how it relates to the company’s subsidiaries CareFirst BlueCross BlueShield and Group Hospitalization and Medical Services Inc. CareFirst BlueCross BlueShield covers a large part of Maryland, while GHMSI covers Prince George’s and Montgomery counties, Washington and parts of Virginia. According to the company, its reserve stood at about $1 billion at the end of 2008. The company holds a reserve to ensure that it always has enough money to pay its claims. Senate Finance Committee Chairman Thomas M. Middleton, D-Charles, introduced a version of the bill on Thursday (SB 1070), while the House had a hearing on its version of the bill (HB 1534) Wednesday. At the Wednesday hearing, MedChi, the Maryland state medical society, submitted testimony that raised concerns about the bill. The state should consider working collaboratively with other jurisdictions on regulation, according to the testimony. “Since CareFirst operates in three states … it is in the interest of all three jurisdictions to provide that the benefits given to CareFirst in its nonprofit role are returned to the jurisdiction and the communities which convey the benefits,” MedChi’s testimony reads. Tyler said he does not think the bill would preclude collaborative work with Washington and Virginia, because it only requires him to examine the effects of Washington’s program. Copyright 2009 Daily Record. Report: Maryland hospitals' profit eroded during final three months of 2008 By Julekha Dash Staff Baltimore Business Journal Thursday, March 26, 2009 The average revenue at 58 Maryland hospitals fell short of expenses by nearly 14 percent during the last three months of last year, compared with the previous year, according to the state’s hospital association. That is the worst profit margin hospitals have reported, according to the Maryland Hospital Association’s report released Thursday morning. Typically, a 3 percent margin is considered healthy for any of Maryland’s acute-care hospitals. The reported losses largely reflect a decrease in investment money and increased costs of borrowing due to the credit crunch, MHA President Carmela Coyle said. Hospitals in Maryland paid $48 million in interest on debt during the fourth quarter 2008, compared with $45 million during the same three-month period in 2007. Hospitals also spent $210 million on physician pay increases and on physician services last year in all of 2008, compared with $143 million throughout 2007. “Physicians are coming to hospitals to get financial help,” Coyle said. The association is hoping that Maryland hospitals can receive an increase in the price they can charge patients from the Health Services Cost Review Commission. Hospital revenue totaled $3.1 billion during the last three months of 2008 while total hospital revenue for 2008 totaled $12.4 billion. Hospitals lost a total of $422,717,692 last year. They made $65 million in profit in 2007. Though the health care industry is often viewed as recession proof, the industry is suffering the same setbacks as others. “With losses this big and this fast, a hospital has few choices as to where it can turn to reduce spending,” Coyle said. In its survey of Maryland hospitals, the association found that hospitals are slowing down their hiring pace and do not have the money to spend on new equipment or new technology. That also means that hospitals will not be spending money to buy radiology equipment, such as MRI or CAT scanner, Coyle said. Some will also freeze hiring and cut staff. A slowdown is expected to continue for many hospitals this year, as rising unemployment drives up the ranks of the uninsured and forces some patients to postpone elective surgeries. Erika Murray, a spokeswoman for MedStar Health, said operating margins are down at the health system’s eight hospitals this year compared to last fiscal year. Dean Kaster, senior vice president for corporate strategy at Upper Chesapeake Health System, said its two Harford County hospitals are considering where they can adjust expenses and looking at cutting costs tied to travel, continuing education and association memberships. The hospitals also are looking at restructuring contracts to get better deals on office and medical supplies. Richard Gundling, a vice president for the Healthcare Financial Management Association, said health care executives are trying to save money by negotiating better contracts by, say, whittling down the number of gauze pad suppliers from 30 to four. Copyright 2009 Baltimore Business Journal. After losing $466M, Maryland hospitals ask: What’s next? By Danielle Ulman Daily Record Friday, March 27, 2009 The strain of the economic crisis caused Maryland’s hospitals to lose $466 million in the fourth quarter of 2008, a dramatic decrease from the $41 million profit in the corresponding period in 2007. According to a financial analysis completed by the Maryland Hospital Association, 34 of the state’s 58 hospitals lost money in the quarter. The Washington County Health System got hit by the tanking stock market, said James Hamill, president and CEO of the hospital. “We’ve lost quite a bit of money,” he said. “It’s mostly driven by investment income; we’ve been conservative, but we’ve still lost money.” Losses statewide stemmed from increased interest rates on loans or lines of credit, smaller returns on investments and higher costs for upgrading or expanding programs and underwriting new technology. To help ease the burden of higher expenses, many hospitals have implemented hiring freezes, reduced administrative staff and curtailed spending on new technology upgrades, like moving medical records into electronic form, said Nancy Fiedler, senior vice president of communications for the hospital association. “There is a lot of belt tightening, and if these numbers continue, it will probably lead to cutting beds and patient care staff at the very time when we’re seeing our emergency room admissions grow,” she said. More doctors are seeking hospital employment or pay increases for services as insurance reimbursements decline. Hospital payments to physicians in Maryland last year reached $210 million, more than doubling the $103.9 million hospitals paid in 2003. Carmela Coyle, president and CEO of the hospital association, said two-thirds of hospital costs are for staff salaries and benefits. Most hospitals have already cut back on discretionary spending, she said, leaving little fat to trim. “I think the concern here is that as the economic crisis continues, what’s next? I think hospitals are on the precipice of making more difficult decisions,” Coyle said. “They have few choices other than personnel choices to fill those gaps.” Washington County’s Hamill said his hospital is in the process of putting together a budget for fiscal 2010, but it is waiting for the state’s Health Services Cost Review Commission to issue the new rates. Maryland is the only state in the country with government-controlled rates for hospital services. “I think the key is for us to get fair and adequate rate adjustments,” he said. The MHA said that anecdotally the financial picture for the state’s hospitals does not look better for the first quarter of 2009. That will make the commission’s rate decision “one of the most important in many, many years because it will make or break the financial liability of hospitals in this very difficult economic time,” Coyle said. The commission has only lowered fees once, according to Executive Director Robert Murray, and he said current draft plans do not show a reduction. While Murray said he sympathizes with the hospitals’ position, the commission will also take into account the 6.3 percent contraction in the economy in the fourth quarter. “Raising rates at the same pace as in years before would make health care that much less affordable,” he said. In the first half of fiscal 2009, Murray said hospitals have had operating profits “in excess of 5 percent” in the areas the commission regulates, like fees for day charges, emergency room service, lab services and radiology services, but not doctor’s fees, where hospitals are taking a big hit. “More and more doctors are looking to the hospitals to employ them, and that’s in part why they’re generating losses on the physician side because they are not charging as much as it costs them to secure those physicians’ services,” he said. Copyright 2009 Daily Record. Health expo offers screenings, info By Chris Kidd Salisbury Daily Times Friday, March 27, 2009 SALISBURY -- Day-to-day life can throw many obstacles in a person's way, causing health concerns to fester from a passing thought to an issue of concern. For others, health care can be too expensive to justify a regular check up. However, the Wicomico Convention and Visitor's Association and Peninsula Regional Medical Center are bringing the 2009 Health and Wellness Expo to the Wicomico Youth & Civic Center this weekend. Featuring more than 100 health-related vendors, the Health and Wellness Expo will be open and free to the public today from 5-8 p.m. and Saturday from 8 a.m.-4 p.m.. The Health and Wellness Expo will offer people the chance "to learn how to take control of their health," said Licia Spinelli, spokeswoman for the Wicomico Youth & Civic Center. "It's a great opportunity to get some free screenings, as well as learn about what businesses and organizations are in the community that can help people embrace a healthier lifestyle," she said. More than 30 free health screenings will be offered, ranging from vision tests to skin cancer tests. "All of the screenings are free and done in a private manner," Spinelli said. Peninsula Regional Medical Center will bring their da Vinci Surgical System Robot to give an interactive demonstration. Attendees will be able to get a hands-on experience with the robot to learn about the robot's surgical benefits. People interested in bringing their children will benefit from the "Kids Korner," which will include interactive games and other various means to entertain and teach kids. Visit www.wicomico festivals.org. Additional Facts If you go WHAT. Health and Wellness Expo WHERE. Wicomico Youth & Civic Center WHEN. 5 p.m.-8 p.m. today; 8 a.m.-4 p.m Saturday. INFO. www.wicomico festivals.org Copyright 2009 Salisbury Daily Times. Abuse Bills Tug at Several Md. Lawmakers Personally By Rosalind S. Helderman Washington Post Friday, March 27, 2009; B01 As a child, Prince George's Sen. C. Anthony Muse watched as his mother was beaten by his stepfather. So did Del. Michael D. Smigiel Sr., who comes from rural Cecil County. Several generations of women in Baltimore Sen. Verna L. Jones's family suffered abuse. And Del. Cheryl D. Glenn, also from Baltimore, was hit repeatedly by an ex-husband who later accidentally killed himself with a shotgun. As the Maryland General Assembly has spent several weeks debating difficult bills that deal with domestic abuse, a sad truth has emerged: Even lawmakers have not been immune from the scourge of violence in the home. And as a long-standing taboo on revealing painful experiences with the issue has been lifted, more and more have stepped forward to share their stories with colleagues. Yesterday, the state Senate advanced a bill, pushed by the governor, that would make it easier for judges to confiscate firearms from domestic violence suspects. They stripped the measure of an amendment that could have complicated its passage because it would have made it easier for domestic violence victims to get handgun permits. As they also did when the House of Delegates debated domestic violence measures in recent weeks, lawmakers announced from the Senate floor that their views on the proposal were shaped by personal history. For Muse, it was the image of his mother facing down a 200-pound abuser armed with an iron. The police were called, his stepfather was taken to jail and Muse was in foster care by age 13. Muse (D), a pastor at a Prince George's church, went on to tell senators that he has officiated at the funerals of eight congregants killed by abusive boyfriends or husbands. He ultimately took no position on the amendment, fearing it could bring down a bill he believes is important. But he said he hopes to start a discussion about whether victims should find it easier to get a gun to defend themselves when the law so often proves inadequate. "There are times a protective order is just a piece of paper, given to an irate man, already going to do whatever he's going to do," he said. Advocates for domestic violence victims had opposed the amendment, pleading with lawmakers not to encourage the injection of lethal weapons into highly charged disputes. Without the provision, they said, they were hopeful about the chances for the bill's passage when the Senate considers it soon for a final vote. The House has adopted a similar measure, which requires that judges confiscate firearms when issuing final protective orders. The bill, along with a separate measure giving judges the option to take guns when issuing a seven-day temporary order, has found a champion in Lt. Gov. Anthony G. Brown (D). He has been driven by the memory of his cousin, who was fatally shot last year by an estranged boyfriend. "What it shows is that domestic violence is pervasive. That it's found in many households, regardless of income, race, culture, ethnicity or religion," he said. "It's a positive thing that lawmakers stand up on this. What we want to see is more victims and families step forward and acknowledge when there's domestic violence occurring so victims can be connected to the help they need." Jones (D) told colleagues that she had been "intimately involved at a young age" with domestic violence. She later explained that growing up in an overcrowded and sometimes desperate community, she knew that her grandmother and aunts had been subjected to abuse. Glenn (D) said she had spoken about her experiences very little in public before revealing them to colleagues in the House. She suffered four years of abuse at the hands of her ex-husband. Victims' advocates said they have been surprised by the personal stories. They hope the message is that victims do not need to feel ashamed. "If all these people in our legislature have had these issues in their families, certainly I think it bodes well that they're open to discussion of it, so we can do better for all of Maryland's families," said Cynthia Lifson, legislative counsel for the Maryland Network Against Domestic Violence. Copyright 2009 Washington Post. Universal health care debate in Md. is all talk these days Budget woes, election year politics expected to halt major reform By Julekha Dash Baltimore Business Journal Friday, March 26, 2009 Universal health care may be the most talked about ongoing political issue. And lawmakers in Maryland will continue to talk, and talk and talk. Health care experts, lawmakers and political observers say Maryland residents should not expect the state to enact universal health care legislation this year or next. It is politically risky for lawmakers to support such expensive and extensive legislation when the state is strapped for cash and an election year looms. And as President Barack Obama promises national health care reform, there is less urgency in Annapolis to move ahead with at least two proposals for universal health coverage. “Everyone is waiting for Obama to drop the other shoe,” said Matt Crenson, a political science professor at Johns Hopkins University. The push for universal health coverage in Maryland is swimming against many strong streams. Unemployment in the state climbed to 6.2 percent in January, which means the state can expect to receive less money from income tax while shelling out more in unemployment insurance. That also means that businesses continue to struggle and consequently are wary of any proposals that will cost them more or mandate their participation. Meanwhile, the state anticipates health care costs to skyrocket as more people lose their jobs and crowd the emergency rooms. The state spends $970 million to treat uninsured patients. That concerns Del. Pete Hammen, chair of the House committee that oversees health care, who said that money should instead be used to expand health care access. Hammen, along with Sen. Thomas “Mac” Middleton Middleton, are backing a universal health care proposal called Healthy Maryland. Developed in conjunction with CareFirst BlueCross BlueShield, the $1.6 billion plan would create a health insurance pool that combines the state’s healthy and insured with those who lack health insurance or are ill. But Hammen does not know when the measures outlined in House Bill 860 and Senate Bill 515 will take hold. “I don’t want to define a time frame,” he said. Legislators up for re-election next year may find themselves in a bind if they support any legislation that requires additional taxes, Middleton said. Surveys of his constituents show that they want universal health care but they do not want higher taxes. Vincent DeMarco, president of the Maryland Citizens’ Health Initiative and author of another universal health care plan in Maryland, said he is more optimistic that health care expansion will pass in Maryland. But even he admits that with 2010 being an election year, it is more likely to happen in 2011 or beyond. DeMarco’s universal health care proposal includes a 2 percent payroll tax on businesses — a provision that several business groups including the Maryland Chamber of Commerce have come out against. Maryland’s financial future is “cloudy,” said Nicholaus R. Kipke, an Anne Arundel County Republican who sits on the Health and Government Operations Committee. With the state anticipating a $516 million budget shortfall in 2010, it’s unlikely any movement will be made on health insurance reform. “Because of the down economy, businesses just can’t afford to contribute to any more pet projects of the legislature,” Kipke said. Shaun Adamec, a spokesman for Gov. Martin O’Malley, said the governor is committed to expanding access to affordable health care to more Maryland residents. But during tough economic times, the governor has to consider whether the state has the resources available to support this expansion. Bryson F. Popham, a partner with law firm Popham & Andryszak P.A. and an Annapolis lobbyist, said the state’s budget crisis is so bad that health care reform may not happen this year or next. He did not when Maryland could see any real changes in health reform. “Until we climb out of this hole that we’re in, who knows?” Popham said. Dr. Rex Cowdry, executive director of the Maryland Health Care Commission, has not taken a position on the Maryland Citizens’ Health Initiative plan. But his agency has “soft opposition” to the CareFirst plan because it offers a single plan set by a government agency, with little choice for consumers. Jeff Valentine, a spokesman for CareFirst BlueCross BlueShield, said legislators are putting together a work group to address concerns about the plan. All contents of this site © American City Business Journals Inc. All rights reserved. Biotech leaders pressure lawmakers on tax credit Legislature may cut investment program By Kevin James Shay Gazette Friday, March 27, 2009 Maryland biotechnology leaders are focusing lobbying efforts on the Senate after the House gave preliminary approval to a budget this week that slashes $2 million annually from the biotech investment tax credit program. The House Appropriations Committee recommended trimming the popular $6 million program by one-third, and the full House went along with that on Wednesday. The House, which could revisit the budget today, also elected not to cut the state's $18 million stem cell research fund. The drive for more budget cuts is fueled by the state Board of Revenue Estimates' recent projection that revenue from income, sales and other taxes will come in $445.5 million less than expected this fiscal year and $716.5 million less in fiscal 2010, which begins July 1. The Senate is coming up with its own budget, and the chambers will likely then work out a compromise in a conference committee. The session ends April 13, but the legislature is required to pass a budget by April 6. That deadline can be moved back if an agreed budget is not approved. Advocates for the biotech tax credit continue to make a very strong case to retain full funding, Richard A. Zakour, executive director of MdBio, a division of the Tech Council of Maryland, said this week. He was among those who have testified in Annapolis. "We want to keep up our lobbying campaign," Zakour said. "The focus now is on members of the Senate Budget and Taxation Committee." If the Senate does retain the tax credit's full funding, it's possible the sides may meet in the middle and cut funding by $1 million, said Brian Levine, the tech council's senior director of government relations. Many biotech executives want to see the funding increase in the long term. The money invested in biotechs has helped those companies leverage millions more in private investment, they said. "This is a program that lays a path for future growth," Zakour said. "You might help solve a short-term funding problem by cutting it, but you will create a long-term problem for our economy." The first-come, first-served program, which formed in 2006, allows investors in Maryland biotechnology companies a 50 percent credit against state income taxes. The company must be headquartered in Maryland, have fewer than 50 employees and have been in business less than 12 years. Last July, the credits ran out on the first day applications were taken, with $8.5 million worth requested by local biotechs, officials said. Health insurance program faces changes The House committee also recommended that a program started last fall to help subsidize small businesses' health insurance costs be slashed by about $13 million. The legislature appropriated $15 million during the initial year. Not as many employers as expected have signed up for the program, largely due to the economy, said Nicole Stallings, chief of government relations and special projects for the Maryland Health Care Commission. Enrollment has reached 150 employers with more than 700 individuals participating, she said. That is up from 106 businesses in January and 48 in November. The plan is designed for small employers that have two to nine full-time employees; have not offered health insurance to employees during the previous year; and have an average annual employee salary below $50,000. The program offers a subsidy of up to 50 percent of the insurance premium, which is divided between the employer and the employee based on the contribution each makes toward the cost of coverage. Some business owners have said the requirements are too restrictive. Legislation that would expand eligibility, such as by allowing businesses with as many as 19 employees, unanimously passed the House and was scheduled to be considered by a Senate committee this week. If enacted, the measure would take effect June 1. Business groups including the Maryland Chamber of Commerce support the bill. In the interim, the health care commission will make some changes, such as increase the subsidy amounts available, Stallings said. "All of these actions should facilitate enrollment and continue to work toward the ultimate goal of covering the uninsured in our state," she said. "It is important to note that even with these efforts, the funds that are being cut from the appropriation are funds that, based on current projections, will not be spent. This proposed reduction will not impact enrollment into the partnership." Fewer funds Maryland House Appropriations Committee recommended cuts from current levels: · $13 million from the small-business health insurance program. · $3 million from the state arts council. · $2 million from the biotechnology tax credit program. · $1.7 million from industrial training programs. · $1.1 million from the tourism development board. · $1 million from the film production rebate program. Copyright 2009 Gazette. Health care companies brace for cuts to Medicare plan By Julekha Dash Baltimore Business Journal Friday, March 26, 2009 President Barack Obama’s proposal to cut federal spending on a Medicare supplement plan by nearly $180 billion over the next decade is forcing Baltimore’s Bravo Health to change its business plan. Next year, the private health insurer will likely participate in the Medicaid programs in Maryland, Pennsylvania, Texas, Delaware and Washington, D.C., for the first time, CEO Jeff Folick said. The move would diversify its business as it anticipates the federal cuts. Currently, 80 percent of Bravo Health’s $1 billion business is derived from Medicare Advantage, which supplements federal Medicare coverage for senior citizens with additional services, including coverage for preventative visits, eye glasses and health care services. There could be more money in Medicaid, the publicly funded insurance plan for low-income earners, Folick said. The $787 billion federal stimulus package passed last month includes $87 billion in matching federal funds for Medicaid. Of that, Maryland is expected to get $276 million. “We’re trying to influence outcomes so we can remain in the market we’re in,” Folick said. Cutting Medicare Advantage reimbursements to private insurers is one way Obama plans to fund expanded health care access. The other is through tax cuts on higher-income earners. Private health insurers are spending their days on Capitol Hill trying to fight this issue, though as one of Obama’s campaign pledges, the proposal does not come as a surprise. Health care officials say Obama’s proposal to trim Medicare Advantage could prompt health insurers, already facing overall Medicare reimbursement cuts of $14 billion over the next five years, to drop out of the program altogether, add new services or drop benefits to cut costs and boost revenue. Advocates of Obama’s proposal say Medicare Advantage costs the federal government too much. The government is expected to spend $1.5 trillion on Medicare Advantage over the next decade, according to the Congressional Budget Office. Obama’s proposal to cut costs would save 12 percent of that number. Baltimore’s XLHealth may adjust benefits and services to respond to the cuts, Executive Vice President Paul Serini said in a statement. The health insurer operates Care Improvement Plus, a Medicare Advantage plan for seniors with chronic diseases. The cuts were expected, Serini said. The proposed Medicare Advantage cuts will not impact Maryland’s largest health insurer, CareFirst BlueCross BlueShield, spokesman Jeff Valentine said. Medicare Advantage represents a small portion of its business for the 65-and-over population, he said. But the Owings Mills company is nonetheless watching the federal health reform closely for which programs could also face budget cuts. America’s Health Insurance Plans (AHIP), a group that represents 1,300 health insurers, is lobbying hard in Washington. The group is trying to convince lawmakers that seniors on Medicare Advantage should not shoulder the financial responsibility of paying for one-third of the reserve fund Obama is proposing to pay for improved health care access, spokesman Robert Zirkelbach said. “We have some concerns on what impact this would have on seniors,” Zirkelbach said. Medicare Advantage cuts could impact rural areas where there is only one provider and less incentive to contract with health plans that control the market, he said. If it takes effect, Obama’s budget proposal will reduce the number of plans interested in participating in Medicare Advantage, said Dr. Rex Cowdry, executive director of the Maryland Health Care Commission. That is not the case for Bravo. But the insurer is in the process of amending its contracts with hospitals and physicians to participate in Medicaid coverage, Folick said. It is also adding pediatricians and obstetricians who would accept Medicaid patients. Folick did not know how many the company will add. Currently, it does not have those physicians as they would not likely serve seniors. Bravo serves 12,000 Medicare Advantage customers in Maryland and 66,000 in total. Nationally, 11 million seniors are enrolled in Medicare Advantage plans. In Maryland, there are 64,000 Medicare Advantage beneficiaries. Some health officials applaud Obama’s plan to curb Medicare Advantage spending. “It doesn’t appear to be a more efficient means of financing health care for the elderly,” said Dr. Ronald Sroka, a family practice physician in Crofton. Sroka is president of MedChi, but said his views are his own and not that of MedChi, which has yet to develop a position on Obama’s Medicare Advantage proposal. Medicare Payment Advisory Commission, a congressional Medicare advisory commission, said in Congressional testimony that each dollar spent on enhanced benefits in these plans costs Medicare $3. “The government is looking to save money wherever [it] can,” said Guy D’Andrea, president of Discern LLC, a health care policy consulting firm in Baltimore. Health plans that offer Medicare Advantage will need to contain their costs, he said. For instance, they might help patients better manage their diseases or measure physicians’ performance. All contents of this site © American City Business Journals Inc. All rights reserved. *National / International* Study: Younger Blacks Have More Heart Failure By Mike Stobbe Baltimore Afro-American Wednesday, March 25, 2009 (March 25, 2009) - ATLANTA (AP) -- One in 100 black men and women develop heart failure before age 50, according to one of the first long-term studies to look at the life-threatening condition in younger adults. The research suggests blacks in that age group suffer the condition at a rate 20 times higher than whites do -- an astounding difference more pronounced than earlier studies had indicated. However, those findings are based on a very small number of heart failure cases, the authors said, so more study is needed. The takeaway message is that doctors should be more aggressive about treating young blacks who may be at risk, some experts said. “Usually this is a disease of the elderly,” said Dr. Kirsten Bibbins-Domingo, one of the study's authors. “When this disease happens in 30 and 40 year olds, it's quite dramatic.” The research appears in the New England Journal of Medicine. Heart failure occurs when the heart loses its ability to pump sufficient blood through the body. It's often fatal, but not always -- some suffer disabling shortness of breath, fatigue and retention of fluids in their legs or lungs. Earlier studies of heart failure, focused mainly on older people, showed heart failure rates were two to three times higher in blacks than whites. In the new study, the researchers looked at data from more than 5,100 blacks and whites in Chicago; Minneapolis; Birmingham, Ala.; and Oakland, Calif. The participants were ages 18 to 30 at the time they joined the study more than 20 years ago. Over the years, 27 people developed heart failure by age 50 and all but one was black. Five people died, all of those black. At the outset, blood pressure levels and weights were similar, no matter which race, said Bibbins-Domingo, an epidemiologist at the University of California at San Francisco. But the researchers found that a disproportionate number of blacks developed high blood pressure in their young adulthood and went on to suffer heart failure. Blacks also were more likely to develop diabetes and chronic kidney disease, and to suffer impairment in the heart muscle's ability to contract. It's not clear why more blacks develop those problems so early, Bibbins-Domingo said. Possible explanations range from income and social environment to genetics, she added. Another mystery: Researchers told those who were diagnosed with high blood pressure to see their doctors about it. But 10 years into the study, the condition was untreated or poorly controlled in three out of four black patients diagnosed. That's likely a failure by both doctors and patients, said Dr. Eric Peterson, a Duke University professor of medicine who wrote an editorial accompanying the study. Treatments need to be effective and affordable, and doctors also must follow up with patients to make sure they're taking their medicines and, if they aren't, find out why and address the obstacles, he added. “We as physicians are so quick to say it's the patients' fault. But I would argue the system has failed,” Peterson said. Copyright 2009 Baltimore Afro-American. A Vaccine Debate Once Focused on Sex Shifts as Boys Join the Target Market By Rob Stein Washington Post Thursday, March 26, 2009; A01 When a vaccine designed to protect girls against a sexually transmitted virus arrived three years ago, the debate centered on one question: Would the shots make young girls more likely to have sex? Now the vaccine's maker is trying to get approval to sell the vaccine for boys, and the debate is focusing on something else entirely: Is it worth the money, and is it safe and effective enough? "We are still more worried about the promiscuity of girls than the promiscuity of boys," said Susan M. Reverby, a professor of women's studies and medical history at Wellesley College. "There's still that double standard." The shift in the discussion about Gardasil illustrates the complex interplay of political, economic, scientific, regulatory and social factors that increasingly influence decisions about new types of medical care. For the vaccine, the new dynamic reflects a strategic tack by Gardasil's critics, growing concern about health-care costs, fears about whether medical treatments are being vetted adequately and stubborn biases about gender, experts say. "There is the cost, the safety, the boys versus girls," said Susan F. Wood, a professor of public health at George Washington University. "These are some of the complexities that are going to have to be addressed one way or the other with this vaccine." Gardasil protects against the human papillomavirus, the most common sexually transmitted infection. HPV causes genital warts and, in women, can lead to cervical cancer -- a disease that strikes about 10,000 American women a year and kills about 3,700. For males, the vaccine is aimed at protecting against genital warts and less common malignancies that HPV can cause, such as penile and anal cancer, as well as cancer of the mouth and throat. The virus causes at least 250,000 new cases of genital warts and an estimated 7,500 cancers in males each year, causing perhaps about 1,000 deaths. Vaccinating boys and men would also help prevent the spread of the virus to their sexual partners. "By vaccinating men as well as women, you reduce the amount of virus that is out there that can be transmitted back and forth," said Richard M. Haupt, who leads the HPV vaccine program at Merck & Co., which makes Gardasil. "Hopefully there will be a benefit not only to men themselves, but to their partners and future partners." After the Food and Drug Administration approved the vaccine in 2006 for girls as young as 9, medical authorities recommended that they receive it at age 11 or 12 to protect them before they start having sex. Critics worried that vaccinating children would send a subtle signal that their parents assumed they would become sexually active and that it would give youngsters a false sense of security. Merck also began an ambitious marketing campaign and lobbying push to persuade states to add the vaccine to the list of those required for children to attend school. But the company eventually abandoned the strategy in the face of an intense backlash from critics who argued that the decision should be left to parents. Although many states considered such mandates, so far only Virginia and the District have imposed one, and Haupt said the company has no plans to pursue that strategy again. But in December, Merck asked the FDA to approve the vaccine for males ages 9 to 26, and in February it presented the results of a large study that tested the vaccine in men to the federal Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, in the hopes of winning the panel's endorsement. The committee's recommendations influence which vaccines schools require and whether private insurance companies and state programs will pay. "There would be a tremendous public health benefit to vaccine 11- and 12-year-olds, both boys and girls," Haupt said. The Merck study, involving more than 4,000 boys and men ages 16 to 23, showed that the vaccine is about 90 percent effective in preventing infection with four HPV types, as well as genital warts and precancerous lesions, Haupt said. In preparation for a vote as soon as October, the CDC committee will meet again in June to consider cost-benefit analyses underway at the CDC and elsewhere. The relatively pricey vaccine costs about $500 for three shots and the associated office visits. "The cost-effectiveness data will be looked at very carefully," said Lauri Markowitz, who leads the HPV vaccine work group for the CDC. "There is increased interest in taking cost-effectiveness into consideration when considering prevention efforts." The American Academy of Pediatrics will also consider cost-effectiveness in deciding whether to endorse Gardasil for boys. Some question that focus. "The cost-effectiveness studies are really important, but I don't think they should be the sole driver of public health policy," said Gregory D. Zimet, a professor of pediatrics and psychology at Indiana University. "This is a vaccine that principally benefits women's health. I wonder if it was the reverse, and there was a vaccine for women that helped prevent prostate cancer in men, this would be as much of an issue." Groups that initially were critical when Gardasil was introduced for girls say they now want to make sure the decision is left up to parents. "We do not oppose the development or distribution of the vaccine," said Peter S. Sprigg of the Family Research Council. "The only concern we have is about proposals to make vaccination mandatory for school attendance. It's a parental rights issue." Little research has been done on parents' attitudes about vaccinating their sons, but several experts said it would probably be a harder sell. "For girls, you can go right to protection against cervical cancer. That's a powerful argument," said Zimet, who is studying the issue as part of his own research and in studies sponsored by Merck. "For boys, you have to make several arguments. Part of it is an altruistic argument. I think it's persuasive, but it's more complex." Debbie Stein of Bethesda, whose 15-year-old daughter, Sara, was vaccinated, thinks she would agree to have her 11-year-old son, Ben, get the shots if his pediatrician recommended them. "My feeling is it's a serious virus that causes cancer, and there's no reason not to vaccinate him," Stein said. "I think it will protect him and protect his wife in the future. I don't want to see him when he's 35 or 40 have a wife die of cancer." But Agustin Zamora, who lives in the District, worries that Gardasil has not been studied enough to know that it is safe and effective for his 9-year-old son, Marco, and his twin 2-year-olds, Antonio and Joaquin. "It's sort of like doing an experiment on people," Zamora said. "This is something you're giving to a lot of children. You need many years of study." Federal health officials, Merck and others say they are confident that the vaccine is safe. But some experts said they are concerned that there is insufficient evidence about how long Gardasil's protection will last, whether serious side effects will emerge and whether the relatively modest benefits for boys are worth even the small risks associated with any vaccine. "There are lots of things about this vaccine we do not know yet," said Karen K. Smith-McCune of the University of California at San Francisco. "I just want to be the voice in the room saying, 'What's the rush to vaccinate in the absence of the best available data?' " Some also question whether the reduction in infections will mean fewer cancers in the future. "There's probably enough data to say it probably is effective for the prevention of genital warts. They're not fun, but they're not at the same level as cancer or lethal infectious diseases," said Diane M. Harper, a professor of medicine at the University of Missouri at Kansas City who helped study the vaccine in women for Merck. "This may not be the best use of our resources at this time." Copyright 2009 Washington Post. Debate Over Drugs For ADHD Reignites Long-Term Benefit For Children at Issue By Shankar Vedantam Washington Post Friday, March 27, 2009; A01 New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months. The study also indicated that long-term use of the drugs can stunt children's growth. The latest data paint a very different picture than the study's positive initial results, reported in 1999. One principal scientist in the study, psychologist William Pelham, said that the most obvious interpretation of the data is that the medications are useful in the short term but ineffective over longer periods but added that his colleagues had repeatedly sought to explain away evidence that challenged the long-term usefulness of medication. When their explanations failed to hold up, they reached for new ones, Pelham said. "The stance the group took in the first paper was so strong that the people are embarrassed to say they were wrong and we led the whole field astray," said Pelham, of the State University of New York at Buffalo. Pelham said the drugs, including Adderall and Concerta, are among the medications most frequently prescribed for American children, adding: "If 5 percent of families in the country are giving a medication to their children, and they don't realize it does not have long-term benefits but might have long-term risks, why should they not be told?" The disagreement has produced a range of views among the researchers about how to accurately present the results to the public. One e-mail noted that an academic review of the group's work, called the Multimodal Treatment Study of Children With ADHD (MTA), asked why the researchers were "bending over backward" to play down negative implications for drug therapy. Peter Jensen, one of Pelham's fellow researchers, responded that Pelham was biased against the use of drugs and was substituting his personal opinion for science. Jensen said Pelham was the only member of the team of researchers who took away "the silly message" that the study raised questions about the long-term utility of drugs, but interviews and e-mails show that Pelham was not alone. The MTA was designed to test whether children diagnosed with attention-deficit hyperactivity disorder, or ADHD, do better when treated with drugs, with drugs plus talk therapy, with talk therapy alone or with routine medical care alone. Children with the disorder have trouble paying attention, are restless and hyperactive, and are sometimes disruptive in school. The initial 14-month analysis published in 1999 randomly assigned children to one of four treatment options and showed clearly that those treated with medication did much better than those who got only talk therapy or routine care. The drugs' manufacturers distributed thousands of reprints of the article to physicians at a time when diagnoses of ADHD were spiraling upward. Because children given drugs alone appeared to do about as well as those treated with both drugs and talk therapy, the study skewed treatment in the direction of medication. In a second phase of the study, the researchers followed the children and compared how they fared, but researchers no longer randomly assigned them to the various treatment options, making this phase less scientifically rigorous. In August 2007, the MTA researchers reported the first follow-up data, which by then no longer showed differences in behavior between children who were medicated and those who were not. But the data did show that children who took the drugs for 36 months were about an inch shorter and six pounds lighter than those who did not. A news release issued by the National Institute of Mental Health (NIMH) at the time, however, presented the results in a more favorable light. The release, dated July 20, 2007, was titled "Improvement Following ADHD Treatment Sustained in Most Children." The release noted that the initial advantages of drug treatment were no longer evident, but it quoted Jensen as saying this did not mean that long-term drug therapy was ineffective. Jensen said, "We were struck by the remarkable improvement in symptoms and functioning across all treatment groups." And rather than saying the growth of children on medication was stunted, the release said children who were not on medication "grew somewhat larger." As the MTA study continued to find smaller and smaller behavioral differences between children who were medicated and those who were not, use of the drugs soared. Pelham said most parents and doctors took away the message that the study had found drug therapy effective over the long run. In 2004, physicians wrote 28.3 million prescriptions for ADHD drugs; last year, they wrote 39.5 million, according to data provided by IMS Health. With the MTA having followed the children for eight years, the latest data have confirmed that there are no long-term differences between children who were continuously medicated and those who were never medicated. Some of the data were published online yesterday in the Journal of the American Academy of Child and Adolescent Psychiatry. In a telephone interview, Jensen denied that the researchers had misled the public, pointing out that some children getting the drugs did do better over the long term. Looking at overall results was not as useful as studying how particular groups of children fared, he said. Jensen and another co-author, L. Eugene Arnold at Ohio State University, who are both psychiatrists, emphasized the importance of individualizing treatment -- and warned parents against abruptly terminating drug therapy. The subgroup analysis found that children in homes that were socially and economically stable did the same in the long term with or without medication. Children from troubled or deprived backgrounds slid backward as soon as the intensive therapy stopped and they went back to their communities. About one-third -- those with the least impairment to begin with -- continued to improve over the long term. Jensen and co-author Benedetto Vitiello at the NIMH said drugs may not have shown an overall long-term benefit because the quality of routine care that children received may have been inferior to the care they got during the initial part of the study. Jensen said the take-home message is that community care needs improvement. Brooke Molina, also a co-author and a University of Pittsburgh associate professor of psychology and psychiatry, argued in an e-mail that if the researchers wanted to draw attention to subgroups that might be helped by medication over the long run, they also should acknowledge that "long-term treatment with medication may not be efficacious" for others. In an interview, Molina said the data do not "support that children who stay on medication longer than two years have better outcomes than children who don't." In an e-mail she shared with Pelham, she noted that academic "reviewers thought we were bending over backward (inappropriately) to dismiss the failure to find medication effects at 8 years." James Swanson, another MTA co-author and a psychologist at the University of California at Irvine, said he believes that the researchers have been open about the diminishing benefits of medication therapy. He cited a variety of scientific publications in which he and others reported data showing that medications lost effectiveness over time and stunted growth. "If you want something for tomorrow, medication is the best, but if you want something three years from now, it does not matter," he said. "If you take medication long-term beyond three years, I don't think there is any evidence that medication is better than no medication." Pelham, who has conducted many drug therapy studies, said the drugs have a valuable role: They buy parents and clinicians time to teach youngsters behavioral strategies to combat inattention and hyperactivity. Over the long term, he said, parents need to rely on those skills. A yet-to-be-published study, Pelham added, found that 95 percent of parents who were told by clinicians to first try behavioral interventions for ADHD did so. When parents were given a prescription for a drug and then told to enroll their children in behavioral intervention programs, 75 percent did not seek out the behavioral approaches. Copyright 2009 Washington Post. Salt: Americans Consume Too Much: CDC U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Thursday, March 26, 2009 Lower sodium recommendation applies to almost 70 percent of American adults Most Americans consume more than double the amount of their daily recommended level of sodium. A new study by the Centers for Disease Control and Prevention shows that more than 2 out of 3 adults are in population groups that should consume no more than 1,500 milligrams (mg) per day of sodium. During 2005-2006 the estimated average intake of sodium for persons in the United States age 2 years and older was 3,436 mg per day. A diet high in sodium increases the risk of having higher blood pressure, a major cause for heart disease and stroke. These diseases are the first and third leading causes of death in the United States. “It’s important for people to eat less salt. People who adopt a heart healthy eating pattern that includes a diet low in sodium and rich in potassium and calcium can improve their blood pressure,” said Darwin R. Labarthe, M.D., Ph.D., director of the CDC’s Division for Heart Disease and Stroke Prevention. “Reducing sodium intake can prevent or delay increases in blood pressure for everyone.’’ “People need to know their recommended daily sodium limit and take action to reduce sodium intake,” Labarthe said. Most of the sodium we eat comes from packaged, processed and restaurant foods. CDC along with other HHS agencies, including the Food and Drug Administration, will be working with major food manufacturers and chain restaurants to reduce sodium levels in the food supply. The study in CDC’s Morbidity and Mortality Weekly Report used data from the National Health and Nutrition Examination Survey, a survey designed to assess the health and nutritional status of adults and children in the United States. This study is the first to use national data to show that 69.2 percent of the adult population belongs to a specific group that should aim to consume no more than 1,500 mg of sodium per day. This group includes persons with high blood pressure, blacks, or middle-aged and older adults (more than 40 years old). The 2005 Dietary Guidelines for Americans recommend that adults in general should consume less than 2,300 mg (approximately one teaspoon of salt) of sodium per day. The dietary guidelines, by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture, provide advice for people 2 years and older about how good dietary habits can promote health and reduce risk for major chronic diseases. For more information on the guidelines, see http://www.health.gov/DietaryGuidelines/. Nationwide, 16 million men and women have heart disease and 5.8 million are estimated to have had a stroke. People who reduce their sodium consumption benefit from improved blood pressure and reduce their risk for developing other serious health problems. Choosing foods like fresh fruits and vegetables, when eating out, asking that foods be prepared without added salt, and reading the nutrition label of foods before purchasing can improve health for all adults. CDC has commissioned an Institute of Medicine study that will outline strategies to reduce sodium consumption to levels recommended by the Dietary Guidelines for Americans. Learn more about the CDC report on salt. For more information about heart disease and stroke, visit CDC’s Web site at http://www.cdc.gov/dhdsp. #### U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. More States Look to Legalize Medical Marijuana Wall Street Journal Friday, March 27, 2009 With the Obama administration pledging to take a hands-off approach to state medical marijuana laws, more states may make it legal for patients to use the drug, which doctors sometimes recommend to treat symptoms such as pain and nausea. New Hampshire’s state House passed a medical marijuana bill on Wednesday, USA Today reports. A similar bill failed a few years back. A New Jersey bill passed the state senate last month, a Minnesota bill passed a state House panel earlier this week and both houses of Illinois’s legislature are considering a bill, USAT says. Under the Bush administration, the DEA regularly raided medical marijuana dispensaries, on the grounds that they were violating federal law, even if they were operating in compliance with laws in more than a dozen states that already allow medical marijuana use. With the Obama administration’s move away from those policies, “we may be seeing the end of an era,” a UC Berkeley law professor told the WSJ earlier this month. Photo: Associated Press. Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved. *Opinion* The defrauders win Our view: Senate rejection of anti-fraud law means those who bilk Medicaid need not worry about paying big fines as long as they can hide behind jobs Baltimore Sun Editorial Friday, March 27, 2009 Your Honor, I was saving jobs." Malefactors of every stripe ought to memorize that explanation. Next time they're in court facing a stiff penalty for wrongdoing, that's clearly what they ought to tell the judge. It's an argument that apparently persuaded the state Senate to shield those who commit fraud against the government from having to pay for it. What nonsense. And what bad news for Maryland taxpayers. The Senate rejection this week of Gov. Martin O'Malley's proposal to crack down on Medicaid fraud is going to open up a gaping $11 million hole in next year's budget - that's how much additional revenue the governor's budget assumed would be generated by the new law. The measure lost in a razor-thin 24-23 vote that likely would have gone the other way had any of four senators simply voted as he or she did on a similar measure last year. Baltimore's Nathaniel J. McFadden and Catherine E. Pugh and Prince George's County's C. Anthony Muse and Nathaniel Exum reversed themselves in the wake of intensive lobbying by a coalition of drug companies, hospitals and other health care providers who claimed that jobs would be lost if the bill passed. Lost jobs? Isn't that a bit like saying Bernard L. Madoff shouldn't pay punitive damages to the people he swindled because it might force him to reduce his staff? Of course the scale of the crime involved isn't comparable - Medicaid fraud is far worse. Maryland alone spends about $5 billion on Medicaid each year. With so much money changing hands, eliminating fraud - estimated to consume as much as 10 percent of the health care program's budget - should be of paramount concern to lawmakers. What sort of fraud are we talking about? Generally, it involves an unscrupulous provider submitting claims he knows to be false. Not accidents, not occasional slip-ups, but deliberate behavior. This wasn't a matter of the governor seeking some unusual authority, either. The federal government (and 22 other states) can seek the same triple-damage penalty at issue here. The difference is that the feds have a 10-year backlog of investigations that states like Maryland can address a lot faster. That's why federal law gives extra benefits to states that adopt these tougher penalties. Senate President Thomas V. Mike Miller told reporters after the vote that he hoped the measure could be resurrected before the legislature adjourns next month, but that now seems unlikely. Instead, his chamber will stay on record as favoring perpetrators of fraud over the public interest, and no bogus excuses about mythical lost jobs change that. Copyright 2009 Baltimore Sun. Protection for Smokers Why is the deadliest product sold legally in the United States free from federal oversight? Washington Post Editorial Friday, March 27, 2009; A16 THERE HAS BEEN a flurry of outrage at the lax regulation that allowed contaminated peanuts to kill nine people and sicken close to 700. Yet it almost goes unnoticed that cigarettes, the deadliest products sold legally in the United States, are free from oversight. That's right: The Food and Drug Administration regulates almost everything Americans ingest, including nicotine gum, but not the product that makes that gum necessary. That allows cigarette makers to peddle a noxious mix of chemicals with impunity. Long-stalled legislation that would give the FDA authority to regulate tobacco products would change that. The House shouldn't hesitate to pass the measure, which could come up for a vote as early as Monday. Some 400,000 people die in this country each year from smoking-related causes. Yet cigarette makers don't even have to disclose what is in their products. The legislation would make such disclosure mandatory by creating a new agency within the FDA tasked with regulating tobacco products. Full disclosure would help health officials more accurately assess the dangers of smoking. The FDA would then be able to order tobacco companies to remove harmful additives and to make other changes that could make cigarettes less lethal. Increased oversight of Big Tobacco would be reason enough to support the measure. But the bill also imposes restrictions on marketing that could help prevent young smokers from picking up the habit. There would be a ban on cigarette billboards and other outdoor advertising of tobacco products near schools. Cigarette makers wouldn't be able to sponsor sports and entertainment events, and health warning labels would have to cover at least 30 percent of the front and back of a cigarette pack. In addition, tobacco companies would no longer be able to promote their products with misleading labels as "light" or "low tar." These sensible restrictions are why more than 1,000 organizations -- even tobacco giant Altria, the parent company of Richmond-based Philip Morris -- support the legislation. As the bill nears a vote, opponents, including some Philip Morris competitors and tobacco-state lawmakers, are ratcheting up the vitriol. Lorillard, the company that manufactures the menthol cigarette Newport, ran an advertisement in the Wall Street Journal charging that "Congress is forcing this regulation on an agency that seems to be struggling to attend to its most fundamental responsibilities to keep our food and drug supply safe." This missive ignores the bill's provision for a user fee to be imposed on cigarette makers to create a tobacco oversight agency; that would allow the FDA to shoulder a new responsibility without impairing its ability to carry out its other missions. North Carolina Sens. Richard Burr (R) and Kay Hagan (D) are also scrambling to protect their state's tobacco growers. They've proposed an alternative bill that would create an agency separate from the FDA to regulate tobacco. The separate agency would get only a fraction of the funding that its FDA counterpart would receive, and it would effectively shield Big Tobacco from meaningful oversight. Lawmakers shouldn't let these diversions distract them from the task at hand. The bill before them would save lives, and they should move with haste to approve it. Copyright 2009 Washington Post. BACK TO TOP


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