No one has ever accused the Senate of doing anything quickly. And so it is with the Senate Finance Committee's consideration of Chairman Max Baucus's health overhaul measure.
Wednesday marked the sixth day of deliberations on the bill, which Baucus noted was the longest the panel has spent on a single measure in more than a decade and a half.
But as the amendments continue to pile up, it's becoming more and more clear that the measure is heading towards ultimate approval, if not by the end of this week, then next week for sure.
In just the past 24 hours, members managed to fend off changes to the bill equally sought by the left and the right -- all of which would upset the delicate balance Baucus has been trying to maintain to gain the elusive 60 votes needed to choke off that talk-a-thon in the Senate known as a filibuster.
When a pop star kills himself, or tries to, psychologists around the world hold their breath, waiting for the drop of the second shoe -- "copycat" suicides among depressed fans and others. But can the way the media covers these celebrity deaths really make a difference in then number of copycats?
The CDC and your mother have something in common: They both want you to eat more fruits and veggies. Americans, as it turns out, aren't quite fulfilling those food pyramid quotas.
Why aren't you eating these? (iStockphoto.com)
A report issued this week by the Centers for Disease Control and Prevention showed that only one-third of American adults are eating the recommended two or more servings of fruit per day, and only 27 percent are eating enough veggies -- three or more servings per day. The study also revealed that teens are doing even worse: less than 10 percent of them are getting enough fruits and vegetables.
This is far from the goal set by the CDC in 2000 to get 75 percent of Americans eating enough fruits and at least 50 percent to eat their recommended daily serving of vegetables.
Maybe President Obama should stick to photo ops with first dog Bo if he wants to get a health care bill passed. That's one of the messages from the public opinion poll out today by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health.
Public to Obama: more Bo and nurses, fewer men in suits. (Ron Edmonds/AP)
No, the poll didn't actually ask about Bo. But it did ask about the public's view of interest groups involved in the health overhaul debate. And the public had a decided preference for some groups over others.
Groups the public had the most confidence "to recommend the right thing for the country when it comes to health care" included those representing nurses, patients and doctors, in that order. Groups in which they had the least confidence included health insurance companies, major corporations and pharmaceutical companies.
So what does this have to do with President Obama and photo ops? A lot, says Harvard polling expert Robert Blendon.
So you think you're having a hard time understanding how the American health care system work? Well, so does your doctor.
A study of graduating medical students finds that less than half say they have a good sense of how to navigate health care systems or the economics of practicing medicine.
The new doctors say they feel their medical schools did not prepare them to understand the mind-numbing mess of American health care. Only 40 to 50 percent of medical students, polled between 2003 and 2007, said they felt confident they were leaving medical school with appropriate training in the practice of medicine.
The problem with this, of course, is that patients expect their doctors to guide them through the health care system.
"Patients look to their doctors for this kind of guidance," says study co-author Dr. Matthew Davis, an associate professor at the University of Michigan Medical School. "If we're graduating students from our medical schools in the U.S. who have coin-flip odds of being confident of knowing the U.S. health care system, then are we really preparing them to be the best source of information for their patients?"
President Obama (aka "our scientist-in-chief," according to National Institutes of Health director Francis Collins) stopped by the NIH today and took the opportunity to note that a previous presidential visitor had also been accused of trying to socialize medicine, nearly 70 years before.
Channeling FDR at NIH. (Gerald Herbert/AP)
Obama noted that when President Franklin D. Roosevelt spoke at the dedication of the NIH, he said, "Neither the American people nor their government intends to socialize medical practice any more than they plan to socialize industry."
"FDR was being accused of a government takeover of health care. But he thought NIH was a pretty good idea," said Obama.
Maybe it's time for Congress to get its ears checked.
A new poll released this morning by NPR, the Kaiser Family Foundation and the Harvard School of Public Health shows that 71 percent of the public thinks Congress is paying too little attention to what people like them are saying about changes in the health care system.
Congress is instead listening to the "lobbyists and people that'll get them re-elected," says Nancy Turtenwald, a petite, middle-aged woman from Milwaukee we stopped in the Capitol Visitor's Center yesterday.
Despite the big bats of Sen. Jay Rockefeller (D-W.Va.) and Sen. Charles Schumer (D-NY), each of whom took a crack at tacking on the so-called public option, they both struck out today as the committee entered its second week of debate on a health overhaul bill.
The count: 15-8 in Rockefeller's case, 13-10 in Schumer's slightly watered-down version.
As August heated up, opposition to a health-care overhaul hit the boiling point. But a September poll taking the public's temperature on the administration's plan to remake the health system show tempers may be cooling and that support for action is on the rise.
How do you feel about health overhaul? (iStockphoto.com)
The Kaiser Family Foundation, a nonpartisan health research group, has surveyed a nationally representative random sampling of Americans six times since February on healthcare issues. The latest results, from polling during the week ended Sept. 18, show President Obama's luck may be turning.
One feeling that has eased for Republicans is the belief that their families would be "worse off if the president and Congress passed health care reform," Kaiser said. The September poll shows about half of Republicans feel this way, that's down from 61 percent in August. Overall, only 23 percent of respondents believe they would be worse off --down from 31 percent in August.
Early this year the biotech firm Sequenom made waves by saying it could test a sample of a mother's blood to detect Down syndrome as early as eight weeks into pregnancy with nearly 100% accuracy.
The chromosomes of a male, with three copies of chromosome 21, or Down syndrome. (Wikimedia Commons)
The results of clinical studies conducted by the company fanned hopes for a noninvasive and highly accurate alternative to amniocentesis, which carries risks for mother and baby.
But in April, Sequenom disclosed that the launch of the new Down syndrome test, expected in June, would be delayed "due to the discovery of mishandling of research and development test data and results."
That bombshell slammed the company's stock and triggered an independent investigation by outside lawyers, shareholder lawsuits and an inquiry by the Securities and Exchange Commission. Now, five months later, Sequenom said the independent report is in and it has fired company president and CEO Harry Stylli and R&D chief Elizabeth Dragon. Several other employees were let go or resigned.
Get ready to roll up your sleeve for another shot. The Centers for Disease Control and Prevention, already on guard against the flu, is expected to urge millions of Americans to get vaccinated against yet another dangerous lung infection.
Streptococcus pneumoniae heightens health risks for people who catch swine flu. (Janice Carr/CDC)
A new CDC analysis shows that many people who died this spring of swine flu also had bacterial pneumonia, most often caused by Strep pneumoniae, or pneumococcus.
Such dual infections were often seen in 20th-century flu pandemics. But they hadn't been documented in the early swine flu cases until now. "They are clearly occurring," says Dr. Matthew Moore of the CDC, who briefed doctors on the new danger Monday morning.
Many drugmakers turned their backs on the most common vaccines, such as flu shots, after years of low profits and worries about lawsuits. Wyeth gave up making flu vaccine in 2002, after losing money in four of the preceding five years on the business.
The fear of breast cancer is so strong for some women at risk for the disease that they choose to have their breasts removed to protect themselves.
But how often? A new study based on data from New York finds the surgical removal of both breasts in the absence of a cancer diagnosis is rare. But more women are having mastectomies of the noncancerous breast after surgery to remove the cancerous one, despite questions about the benefits of the approach.
Drawing on 11 years of data in New York, researchers from Roswell Park Cancer Institute and the state health department identified 6,275 women who had prophylactic mastectomies. Some 81 percent of them had a cancer diagnosis in one breast, while the rest had no personal history of breast cancer.
If you take your kid to the doctor, there's about a 70 percent chance you'll walk out with the child having got a shot or instructions to take some sort of medicine.
Be watchful for kids' reactions to medicines. (iStockphoto.com)
Afterward, there's a possibility of a bad reaction. Nearly 600,000 times a year, kids head to the ER, clinic or doctor's office because of problems with medicines they took, say researchers who crunched more than a decade's worth of federal data. The findings were just published online by the journal Pediatrics.
The youngest kids--newborns to 4-year-olds--accounted for 43 percent of the visits, making them the most likely to run into trouble. Antibiotics were the most common culprit, especially for the youngest kids. Those first doses of antibiotic, often penicillin or related medicines, are the ones that can reveal an allergy. For young children there's a higher risk of errors in medication dosing, and youngsters are more sensitive to those kinds of mistakes, too.
To find the fault lines in America's health-care map, just follow the money.
Where do the health-cost increases end? (iStockphoto.com)
For starters, the insurance status quo isn't exactly static. Costs keep climbing. Premiums and out-of-pocket expenses for workers who get insurance on the job will rise 10 percent next year, the Chicago Tribunereports. All told, the average insured Joe is looking at direct health costs of $4,023 in 2010, according to data from HR consultants Hewitt Associates.
So if the country agrees to change things, who pays? An op-ed in the Wall Street Journal co-authored by ex-Health and Human Services chief Michael Leavitt and two economists says young people will foot a bigger part of the bill than they may have realized.
The discussion about how to remake health care often gets boiled down to a debate over expanding coverage to the tens of millions of people who don't have any.
But what about the 25 million Americans who have insurance that's just not very good? These are the underinsured, people who pay more than 10 percent of their income on out-of-pocket expenses or 5 percent on deductibles.
NPR's Richard Knox takes us inside the Maine home of the Martins, who spent 45 percent of their household income last year on insurance and uncovered medical care. "That's just crazy," says mother Martha, 52, who works three part-time jobs and is facing another year of big medical expenses. "I don't pay that much in taxes."
The first batches of swine flu vaccine -- between six million and seven million doses -- should start trickling into U.S. clinics within a couple of weeks federal health officials said Friday. More vaccine will soon follow, said Dr. Thomas Friedman, head of the Centers for Disease Control and Prevention.
But Friedman cautions that getting the stuff distributed to the right people is, at least initially, "going to be a little bumpy."
The first swine flu doses shipped will be the nasal version, not injections. (istockphoto.com)
Recent tests suggest the vaccine is a good match to the pandemic strain of flu that's already circulating in all 50 states.
And though children under ten are still likely to need a double dose, there's good evidence that a single dose of vaccine should be "quite protective for everybody age 10 and above," Frieden said.
That's the good news.
But actually getting the 250 million doses of the vaccine that the U.S. has purchased from five different manufacturers into the arms and noses of everybody who needs protection still presents "enormous logistical challenges," Frieden said.
We just got back from the office flu vaccination, with a smiley-face sticker on our shirt, a bandage on our left arm and just a hint of soreness. As soon as the vaccine for swine flu is ready, we plan to be in line for those shots (or spray) too--for us and the kids.
How many parents will have their children vaccinated against H1N1? (iStockphoto.com)
But we may be in the minority, according to results of a national survey just out from the University of Michigan. Only 40 percent of parents surveyed in August said they intend to have their children immunized against H1N1. Thirty-one percent weren't sure and 29 percent said they weren't going to do it.
The findings fly in the face of recommendations from the Centers for Disease Control and Prevention that all children older than six months be a top priority for vaccination.
In a study of American kids, Straus and a colleague asked parents of about 1,500 young children participating in an IQ research project how often they spanked their children.
The findings? The 2- to 4-year-old kids who weren't spanked at all, according to their parents, had IQs that were, on average, about five points higher after four years than the kids who were spanked. The same trend held for 5- to 9-year-olds, though the differences were less pronounced.
The pharmaceutical industry's controversial deal with the administration on health overhaul held up in its first public test yesterday.
( iStockphoto.com )
The Senate Finance Committee defeated an amendment to Sen. Max Baucus's bill that would have sought more than $100 billion in rebates from drugmakers over 10 years. Previously, the industry pledged $80 billion in cuts to President Obama in return for companies' support of an overhaul.
The Republicans voted as a bloc against an amendment, proposed by Democratic Senator Bill Nelson of Florida, that would have tapped Big Pharma for more money to close the doughnut hole of the Medicare drug benefit.
The Food and Drug Administration doesn't often admit mistakes, but the agency today acknowledged all kinds of irregularities in its controversial approval last year of a device to repair damaged knees.
A report on an internal investigation of the agency's handling of the application by ReGen Biologics for an implant to replace torn cartilage in knees raised "troubling questions" about the process that warrant a "reevaluation" of the decision.
In a conference call with reporters, Joshua Sharfstein, FDA's principal deputy director, said the investigation found "definite threats" to the integrity of the agency's process for looking at medical devices, the Wall Street Journalreported.
Even as health overhaul lurches along in the Senate, there's action in the House to spare millions of Medicare beneficiaries from having to pay more for coverage of outpatient care and doctor visits.
A House bill would halt an increase in Medicare Part B premiums in 2010. (iStockphoto.com)
The House just voted 406-18 in favor of a bill that would prevent an increase of about $7 a month on premiums next year for Medicare Part B. This year the standard premium is $96.40.
What's the big deal? Social Security beneficiaries aren't getting a cost-of-living increase next year because inflation is so low. Although most Medicare recipients would be exempt from a hike in Part B premiums because of a clause in their plans that kicks in under those circumstances, millions would be still be left on the hook without additional money to pay the extra amount.
If swine flu takes a turn toward the truly terrible, hospitals will be swamped and there won't be enough ventilators to help the very sick breathe.
Short supplies of ventilators could force tough decisions, if swine flu gets ugly. (Michael Krinke/iStockphoto.com)
Right now, a doomsday scenario doesn't seem likely. The second wave of H1N1 looks a lot like the usual seasonal flu and not a reprise of the Spanish Flu, the 1918 pandemic that killed 50 million or more.
Still, public health officials are preparing for the worst and that means coming up with plans for who would get a ventilator and who wouldn't. Rationing of ventilators could pit the families of people with serious non-flu illnesses against those of acutely ill flu patients.
ProPublica's Sheri Fink writes about controversial guidelines in the works that could, for instance, allow hospitals to withhold ventilators from people with chronic, irreversible illnesses, such as cancer, so that flu patients would get breathing help instead.
The ultimate weapon against AIDS would be a vaccine to prevent infection with the HIV virus. Until now, though, every test of experimental vaccines has failed.
Thai Public Health Minister Witthaya Kaewparadai (R) talks with US Ambassador to Thailand Eric John (L) about promising HIV vaccine test results. (Pornchai Kittiwongsakul/Getty Images)
But results from the largest-ever vaccine trial gave new hope to scientists that, in principle, a vaccine could work someday.
When it takes two health professionals 30 minutes and a bunch of algebra to puzzle out the proper dose of the flu drug Tamiflu to give their sick six-year-old, how's the average parent supposed to make sense of medication labels?
Kara Jacobson, a health literacy researcher at Emory University in Atlanta -- and mom of the sick kid in question -- would sure like to know.
Don't use a kitchen spoon to measure medicine. (iStockphoto.com)
Jacobson says she was "sick as a dog and flat on my back," with swine flu two weeks ago when her two daughters came down with flu symptoms. Their pediatrician prescribed liquid Tamiflu for the six-year-old.
In most states, kids aren't supposed to be able to be visit the local tanning salon without a parent's permission.
Tanning salons could do a better job on rules limiting teenagers' use of tanning beds. (iStockphoto.com)
And a creative study that used college students who sounded like 15-year-old girls to call salons for appointments found most of them--87 percent--wouldn't go ahead without a parental OK.
But, the sting, which targeted tanning salons in all 50 states, found they didn't do as good a job in following Food and Drug Administration recommendations that newcomers shouldn't go for tanning sessions more than three times in their first week. Only 11 percent of salons met that standard.
Add Dr. Sanjay Gupta to the growing list of celebs like Marilyn Manson, Harry Potter's movie sidekick, and a couple of worldleaders who have reportedly fallen ill from the new H1N1 flu.
Dr. Gupta, pre-H1N1 days (Diane Bondareff/AP Photo)
As an added bonus, Gupta gives a nice summation on his blog of the symptoms and attempts to reassure us that generally, it feels just like the "regular" flu.
Gupta, CNN's chief medical correspondent and one-time presidential pick for Surgeon General, has been reporting from Afghanistan, where he apparently caught the virus. He writes this morning that "it started as a cough. It wasn't the kind of cough where something is temporarily stuck in your throat."
You can't expect a generation of med students that's practically grown up online to refrain entirely from using Facebook, Twitter and Flickr. But a little decorum from the nation's future doctors would go a long way.
NSFMS: Not safe for med school. (iStockphoto.com)
Results of a survey of med school administrators found a fair amount of unseemly online conduct by their students. Among the 78 med schools that responded to the survey, 60 percent reported incidents of students posting unprofessional content on the Web.
What were the common problems? The usual Facebook fare: profanity, depictions of intoxication and sexually suggestive material. Some of the more troubling examples went further, though, including violations of patient confidentiality--reported by 13 percent of responding schools--and "frankly discriminatory language" reported by 4 percent. The findings appear in the current issue of JAMA.
We watched the Senate Finance Committee's jawboning on the Baucus health bill yesterday, but have to admit that our usual media multitasking meant we mostly heard five-minute snippets here and there.
Sen. Max Baucus, flanked by senators from both parties, leads the discussion of his health overhaul proposal. (Chip Somodevilla/Getty Images)
NPR's David Welna has a longer attention span and filed a report for All Things Considered late Tuesday that helped us catch up on what we missed. First, the Republicans didn't surprise anyone by rushing to get on board.
Despite months of courting by Chairman Max Baucus and a reduction in the bill's expense, Republican Sen. Chuck Grassley of Iowa blasted the legislation as too costly, "There's no plausible rationale for imposing all these new taxes and big spending on top of an economy that's doing its best right now to recover."
For a fight over something that's being called a "gag order," there's sure a lot of jawing going on.
The fight went public Monday, when Medicare officials revealed they had warned Humana that a missive sent to some members of its Medicare Advantage health plans could be "misleading and confusing." The government agency ordered Humana -- and other private companies that serve Medicare -- not to offer "misleading and/or confusing opinion and conjecture by the plan about the effect of health care reform legislation."
Republicans (read our earlier post) immediately jumped in to defend the rights of insurance companies to warn Medicare members, in essence, that Congressional Democrats were considering cuts to the insurance companies' bottom lines, and possibly those members' additional Medicare benefits.
When Humana, one of the biggest private insurers offering plusher Medicare plans to seniors, warned some customers a health overhaul could eliminate benefits they like, the feds told the company to knock it off.
At issue is a mailing sent by Humana to some patients enrolled in its Medicare Advantage plans. Those are the private options that replace standard Medicare for about one in five beneficiaries who chose the option. (The Huffington Post got a copy of a Humana mailing you can read here.)
Medicare Advantage costs the government more and is a prime target for cuts by Democrats as part of a health overhaul. Analysts say the plans, on average, get paid about 14 percent more than it costs to provide benefits to patients.
We'll admit it. We tried clove cigarettes. Once. In college.
There better not be any cloves in there. (iStockphoto.com)
It was a terrible experience, and sitting near somebody smoking them was even worse than the half-dozen numbing puffs we took ourselves.
So we imagine most kids, other than a few wannabe bohemians, are celebrating the federal ban of clove cigarettes, along with all other flavored cigarettes--except menthol
John Clarke, the rapping medical director for the Long Island Rail Road, is the winner in the government's contest to find a catchy public service announcement about swine flu prevention.
The guy has got the moves and the rhymes, and we're with New York magazine, which called him a "genius" for rhyming "hand sanitizer" and "I advise ya."
Check out his handiwork, the "H1N1 Rap":
Clarke, a fellow of the American Academy of Family Physicians, said he's been writing and producing medical rap since 1997. He dubs the genre "health hop."
The Wall Street Journal's Melinda Beck writes about an often overlooked wonder drug: time. Washington rheumatologist Raymond Scalettar lets her in on his little secret, "You can do more for yourself than I can do for you."
But we Americans are an impatient bunch and want whatever is ailing us to go away--now. We happily spend billions of dollars each year on ultimately unnecessary doctor visits, tests and remedies. A third to a half of the $2.2 trillion spent annually on health care may be wasted, Beck writes.
The health-care sausage-making goes public today as the Senate Finance Committee meets to mark up the overhaul bill put together by Chairman Max Baucus, the Montana Democrat.
Sen. Max Baucus will lead Finance Committee in mark up of his health bill starting today. (Mark Wilson/Getty Images)
Republicans Grassley, Enzi and Snow will be there. They and the rest of the 23 members of the committee are expected to make the most of the national speechifying moment with individual opening statements that could take hours.
Expect more theater than policy, the New York Times's Prescriptions blog says, suggesting a few senators to pay some attention to. Topping the list: Arizona's Jon Kyl, the Republican's "muscle man" an West Virginia's John D. Rockefeller IV, the "Democrats' liberal conscience."
The Mayo Clinic keeps popping up as a model for how Americans should get their care. There's hardly a better brand-name around, but could the Mayo approach, melding lower-than-average cost and better-than-average quality, really work everywhere?
The Mayo Brothers, founders of the eponymous clinic, insisted on salaries for doctors. (Mayo Clinic)
NPR's Linda Wertheimer asks Mayo Clinic President and CEO Denis Cortese on Tuesday's Morning Edition. Yes, he says, the Mayo model "is transportable--with difficulty." The key ingredient is instilling a culture among physicians that puts the needs of patients first, he says.
We thought the Hippocratic Oath was supposed to cover that, but evidently even the modernized version used in many med schools isn't up to the task.
As is the modern fashion, the FDA wants your help in figuring out what to do about advertising and promotion of regulated products on the Internet. You can find the info on how to submit comments or attend the meeting, scheduled for Nov. 12 and 13, in the Federal Registerhere.
The announcement includes a helpful primer on such obscure terms as podcast, blog, and social network, where people with common interests can "create profiles and then invite people to join as 'friends.' " Oh, really?
You'll learn about people in nine different situations, ranging from the uninsured to folks with top-shelf coverage. Even the insurance haves, like federal worker Rhonda Dorsey profiled by NPR's Joe Shapiro on Monday's Morning Edition, face limits.
If you saw one appearance by President Obama over the weekend, you might as well have seen them all. He put on his salesman-in-chief hat again and flogged a well-honed set of talking points, as the debate over plans for a health overhaul intensifies.
NPR's All Things Considered weekend host Guy Raz boiled down the president's interviews on five Sunday yak shows to about 2 1/2 minutes, if you want a recap.
If you're really lazy, allow us to summarize the summary for you: Eighty percent of what Obama wants in a health overhaul is in the bills already kicking around Capitol Hill; health premiums went up 5 1/2 percent last year, so we better do something--and fast; and, fear of change--not race--is fueling resistance to the plan.
How much is health insurance worth? Not enough for one 53-year-old freelance writer to pay for it out of his own pocket.
Freelance writer Duncan Moore is an unlikely insurance daredevil. (Duncan Moore)
Duncan Moore, a reporter who has covered the ups and downs of health care for years, explains his surprising decision in the Los Angeles Times. "I'm the last person I would have imagined living without a safety net between me and the medical risks of early middle age," he writes.
But after Moore left his last full-time job and no longer qualified to continue his coverage by paying $447.12 a month, he figured he was better off taking his chances.
The Centers for Disease Control and Prevention says the first doses of swine flu vaccine should get into Americans in a couple of weeks -- but through their noses, not their arms.
The first batches of swine flu vaccine won't hurt a bit. (iStockphoto.com)
Around 3.4 million doses of a swine flu version of the spray vaccine known as FluMist will be shipped the first week of October. Each state will get a share according to its population size.
The nasal spray vaccine won the race because it contains a live, though chemically crippled, form of the pandemic H1N1 virus. Producing the live-virus vaccine was faster than killed-virus preparation used in shots.
That's because you're not Momen Wahidi, a lung specialist at Duke, who was as surprised as anyone by the big piece of a plastic utensil he fished out of the lung of John Manley, a 50-year-old plagued by a bad cough and shortness of breath.
Just take a look at the picture Wahidi snapped inside the main airway leading to Manley's left lung recently. Tilt your head to the left and squint, and you might be able to read the upside-down letters A, M and maybe even the B.
A fragment of a Wendy's utensil lodged in John Manley's lung. (Duke Medicine)
"We saw this white body, and we didn't know what it was made of," Wahidi told us. "It appeared flat, we cleaned it with saline and we're seeing letters." An assistant watching along yelled out "hamburger" as the letters appeared on a video screen, solving one part of the mystery and raising another: How did a Wendy's utensil get stuck in Manley's bronchial tube?
The administration's proposal to move ahead on experiments in malpractice reform was supposed to draw support for President Obama's health overhaul plans.
(iStockphoto.com)
But the reaction to a few more details announced Thursday, including a $25 million budget for grants to be made available next year, didn't show much progress in winning hearts or minds.
Republicans, long advocates for changes in medical malpractice, said the administration is being too timid. Senate Minority Leader Mitch McConnell (R-Ky) said the health legislation moving through the Senate doesn't do "enough to get rid of junk lawsuits on doctors and hospitals," the Chicago Tribune reported.
There's been a setback on the swine flu front. The crash program to make vaccine against the pandemic strain will produce "substantially less" than the 4.9 billion doses that had been expected by the World Health Organization.
Swine flu vaccine supply will be tighter than expected. (Thierry Zoccolan/Getty Images)
Even after results from recent clinical tests showed one dose of vaccine should be enough to protect most people, the supply of vaccine will be "inadequate" to shield the world's population from swine flu, a WHO spokesman said today.
The bottom line: weekly production of swine flu will be less than 94 million doses, Reuters reports.
When we need answers about what's going on with the health overhaul, we run over to the cube of NPR's Julie Rovner and grab her before she runs off to the studio or up to Capitol Hill.
On Thursday's All Things Considered, you get your chance, as Rovner tackles questions from listeners. We got a preview and share a few highlights.
A listener in Ohio wants to know how the government would enforce a mandate that everyone in the country have health coverage? Some people would be exempt, mainly on grounds of economic hardship, but the rest of us who could afford health coverage and don't get it would be dunned through the tax system.
Twenty-five million dollars sounds doesn't sound like much, but it's the administration's start down the road to potential medical malpractice reform.
The money will go toward experiments that try to reduce preventable injuries, improve communication between patients and doctors, assure "fair and timely" compensation to injured patients while cutting down on "frivolous lawsuits," and lower malpractice insurance premiums for doctors, as Health and Human Service Secretary Kathleen Sebelius explained it today.
President Obama keeps saying under his plan for health overhaul, you can keep your insurance if you like it. But what if you don't care for the coverage you get on the job? Can you easily get something better?
Sen. Wyden says give choice a chance. (Rick Bowmer/Associated Press)
Probably not. And the options for most people wouldn't change much under the leading overhaul proposals on Capitol Hill. Sure, new state marketplaces, or exchanges, would offer a range of insurance choices. But, as it looks now, only the uninsured and people working for small companies would be able shop there.
An absence of insurance choice is a mistake, Sen. Ron Wyden (D-Ore.) argues in today's New York Times. And he offers up an idea to expand options while taking care not to undermine employer-based health coverage.
It's going to take a while for people to make their way through the details of the Baucus health bill. We've only scratched the surface ourselves. But the most important review--the price tag calculated by the Congressional Budget Office--is already in.
Sen. Max Baucus briefs the press Wednesday on his health bill. (Mark Wilson/Getty Images)
Yesterday afternoon the CBO bean counters tallied up the numbers in the Baucus proposal and worked a little arithmetical magic to put the cost at $774 billion over 10 years, 9.6 percent less than the Montana senator's own estimate of $856 billion.
Who's right? "CBO is the official scorekeeper for Congress, so what it says pretty much goes," NPR's health-policy guru Julie Rovner notes. Still, the Finance Committee fired off a memo late yesterday, saying both numbers are right, with an explanation of the differences here.
If you make it to the end of the Baucus overhaul bill, starting around page 213 you'll find a bunch of new taxes, er, fees that will be levied on various sectors of the health-care economy to fund expansion of coverage.
Probably tax-free under Baucus plan. (iStockphoto.com)
Though the figures had been telegraphed before the release of the bill, it's still something to see the annual amounts in black and white: $750 million from clinical labs, $2.3 billion from Big Pharma, and $6 billion for health insurers.
Then there's the medical device industry, which gets socked with $4 billion in annual taxes, though its domestic sales are a fraction of the drug industry's. The trade group AdvaMed called the bill's tax on devices "unfair and counterproductive."
Let's take a break for one moment from the breathless coverage of the health care overhaul on Capitol Hill to consider something else listeners are concerned about, especially the pregnant ones: Whether to get vaccinated against the swine flu.
What to consider when pregnant. (istochphoto.com)
FDA recently approved four new swine flu vaccines, and a fifth is in the works.
But there has been some confusion about what the estimated 3 to 4 million women who are pregnant should do.
Health Correspondent Richard Knox, who has been closely following developments on the new H1N1 virus and vaccine development, weighs in on this issue:
What's included and what's out of Senator Max Baucus's bill?
Senator Max Baucus. (Getty Images)
Well, you won't find any public option. President Obama may be disappointed but probably won't be surprised. In the public option's stead as a choice in state insurance exchanges are the health co-ops we've been hearing were a favorite in the Senate.
The bill would make available $6 billion in loans and grants to get co-ops rolling. They're more concept than reality in most parts of the country as it stands now.
Just to be crystal clear these co-ops wouldn't be a stealthy government-run alternative, the language stipulates the non-profit co-ops can't be "sponsored by a state, county, or local government, or any government instrumentality." [Our emphasis added.]
Please join us in perusing the proposal. Even though it's long, it's a so-called chairman's mark, meaning it's written in something approaching regular English instead of hardcore legislativese.
Baucus, chairman of the Senate Finance Committee, is supposed to brief reporters in a couple of hours on the plan.
He's been the focus of plenty of attention from the administration, the media and, of course, interest groups that have a lot at stake in how a health overhaul shakes out.
So would you be surprised to learn that Baucus has received $3.9 million in contributions from the health industry over the last two decades? The Associated Press reports that figure and says Baucus has gotten more money from health interests than any other elected federal official except President Obama and three other senators.
Who needs health insurance? Not me. (iStockphoto.com)
Health coverage under the overhaul plan would be mandatory, with a few exemptions, and those who don't get coverage through their jobs or a government plan like Medicaid would face a penalty if they don't buy insurance themselves.
That's where subsidies are supposed to make a difference, but healthy young people who've long gambled they can get by without coverage and working folks who are just eking out a living may balk anyway. Subsidies may not help them much, if at all, so an insurance mandate could cost these people a pretty penny.
Swine flu is serious stuff. But Johns Hopkins University figures a little humor might make it easier for students and staff to take to heart messages about prevention and proper care.
Barnyard denizen or college kid with the flu? ( USDA)
So some folks in the public affairs office of the Baltimore-based university compiled a tongue-in-cheek lexicon to help educate people on campus about H1N1.
For starters, students sick with swine flu shall now be known as "pigs," making freshmen "piglets" and those who comply with orders to stay in the dorm "pigs in blankets."
Alcohol-based sanitizer is "hog tide," and henceforth "Boar War" will designate a college's all-out push against swine flu.
The Food and Drug Administration just approved the vaccine against the H1N1 virus that causes swine flu.
Vaccine against the H1N1 virus is a step closer. (CDC)
FDA just put out the details on the approval (see the full text after the jump), which applies to vaccine from four different manufacturers.
The FDA affirms, as expected, that a single dose for adults should be sufficient to raise a strong immune response in eight to 10 days. A recommendation on the dose for children, whose immune systems may need more priming, should be ready in the "near future," the FDA said, after some clinical test results come in.
Health and Human Services Secretary Kathleen Sebelius told Congress the approval news in testimony a little while ago, according to the Associated Press.
She expects the first shots to be distributed in early October, with most of the vaccine arriving starting on the 15th. Eventually there will be enough vaccine for all Americans who want it, according to Sebelius, but some people, including children and pregnant women, will be among those to be vaccinated first.
With Senator Tom Harkin replacing the late Senator Edward Kennedy as lead dog on the key health committee in the Senate, you might be more interested than before in what the Iowa Democrat has on his agenda. High on the list: radiation hazards from cellphones.
Harkin, long chairman of an appropriations subcommittee, kicked off a hearing Monday to lay out what's known about cellphone risks--and what we should know. His remarks, according to a written statement, were a little contradictory.
The senator said he'd use his cellphone right after the testimony but made an ominous comparison between the state of knowledge about cellphone safety today and the first alarms about tobacco hazards:
If more people had heeded those early warnings, or if we could have established the link between tobacco and cancer more quickly, many lives would have been saved.
A municipal public option takes hold in San Francisco. (Justin Sullivan/Getty Images)
Take a look at San Francisco for a clue. An experiment there in universal coverage is bearing fruit, KQED's Sarah Varney reports on Tuesday's Morning Edition.
Called Healthy San Francisco, the program for the uninsured isn't health insurance but instead offers care in clinics and covers admissions to hospitals located in the city.
After months of delays, the slowpokes on the Senate Finance Committee are finally set to release a draft overhaul bill, perhaps as soon as today.
Sen. Max Baucus says his committee's health bill is almost ready. (Evan Vucci/Associated Press)
Chairman Max Baucus (D-Mont.) said Monday that his committee had reached agreement on almost every aspect of a health revamp, but we'll believe it when we see it.
A few things seem clear, though. The chatter about illegal immigrants somehow having a loophole through which they could get subsidized health benefits would be closed with some specifics on verification of immigration status.
Some Colorado researchers report they've found high levels of pathogenic bacteria growing inside showerheads around the country. The particular group of microbes to pay attention to is the non-tuberculosis mycobacteria, cousins of the TB bug.
The chlorine in your water doesn't seem to faze these bad boys, which grew happily in mats called biofilms inside the showerheads tested. But are a lot of people getting sick from the stuff?
Doctors surveyed for their views on health care and how it might be overhauled are more receptive to change than you may have figured.
(iStockphoto.com)
When it comes to expanding coverage to the uninsured, guess what? A majority of doctors--62.9 percent--prefer a mix of private and public options, according to more than 2,100 responses from a national sample of nearly 5,200 docs.
What sort of public option do they like? Well, for the near-elderly--folks between 55 and 64 years old--some 58.3 of the respondents support an expansion of Medicare, an idea contemplated by the Senate Finance Committee.
In the race between vaccine and virus, the virus is still ahead. But the jockey on the vaccine horse -- Health and Human Services Secretary Kathleen Sebelius -- is using her whip.
Who benefits from limited early-October supply of H1N1 vaccine? (Tim Sloan/Getty Images)
After weeks of saying no swine flu vaccine would be ready until mid-October, Sebelius is now sounding confident that the first doses will be going into some Americans' arms in the first week of October.
But is that early enough to do much good?
Depends on when this second wave of swine flu crests. ( Or the H1N1 flu of 2009, as the government prefers to call it.)
It's hard to miss what Bloomberg has done to curb cigarette smoking in the Big Apple. Restaurants and bars there went smoke-free in 2003 despite complaints the move would ruin nightlife and discourage tourism. By this spring, most New Yorkers who've ever smoked have quit. All told, about 350,000 fewer adults in the city smoked in 2009 than in 2002, when Bloomberg took office.
Will it stay or will it go? The prospect of a government-run insurance alternative continues to dominate the debate over health overhaul, sharpening questions about whether President Obama's package for change can make it through Congress if the public option is included.
(iStockphoto.com)
On one hand, the administration says it will consider other methods to assure competition and choice in the insurance marketplace, yet it hasn't pulled the divisive proposal off the table. Obama "prefers the public option," but would contemplate alternatives, his press secretary, Robert Gibbs, said on CNN's State of the Union over the weekend.
The public option two-step isn't cutting it with some moderates, including Maine Republican Senator Olympia Snowe, who called the administration's continued jawboning in favor of a public option "unfortunate" on Face the Nation just a few minutes after Axelrod supported it.
Set aside the debate for just a moment over how big a factor medical malpractice really is in rising health-care spending.
(iStockphoto.com)
If not convinced it's a problem, President Obama at least entertained the notion of malpractice reform in his big health speech, saying "defensive medicine may be contributing to unnecessary costs." And, he said, Health and Human Services would move ahead quickly with some test projects contemplated by the Bush administration.
As the Wall Street Journal reports, those include early disclosure of errors and apologies for them, and screening of potential lawsuits by doctors to weed out frivolous claims.
We imagine there's quite a bit of that sort of chatter around San Diego right now, where authorities served 14 marijuana dispensaries with search warrants the other day, effectively shutting them down.
Marijuana for medical use is A-OK under California law, but the dispensaries that supply the stuff aren't allowed to make a profit.
That's the problem in these cases, according to the San Diego District Attorney Bonnie Dumanis, who alleges the 14 shops targeted in a four-month undercover investigation were "nothing more than for-profit storefront drug dealing operations run by drug dealers."
Say you're the editor of a medical journal and you've come to realize that lots of manuscripts coming your way have probably been shaped by the drug industry. You want to stop it, but how do you figure out which ones were the work of ghostwriters when those folks don't want you to know?
Well, you could start by taking a look at the data inside the electronic files submitted by authors. That's what Fred Curtiss, editor in chief of the Journal of Managed Care Pharmacy has done, and, as Reuters reports, he has found about one-third of manuscripts have been handled by people not listed as authors.
His method is to look at the metadata attached to Microsoft Word files, which often include identifying information about who has made changes to a document. (Microsoft explains how to find this stuff--and delete it--here.)
Health authorities say a mutated form of the H1N1 flu virus resistant to Tamiflu, a drug used to treat and sometimes to prevent its spread, may have passed between the cabin mates. It's also possible they caught it from a third person.
The first results from tests of swine flu vaccines in humans are in, and it looks like a single shot will be enough to protect people from the H1N1 virus.
A single shot should keep H1N1 at bay. (CDC)
Officials had worried two doses of vaccine might be required. But, as an editorial accompanying the online publication of two studies in the New England Journal of Medicine says, the data support beginning with a one-shot plan.
The results mean scarce supplies of vaccine can go farther and immunization can be done more quickly than if a two-shot regimen were required. For more, listen to this report from NPR's Joanne Silberner.
By now just about everyone knows the folks whose names appear at the top of articles in leading medical journals aren't always the ones who wrote them.
Ghosts pop up in some of the strangest places. ( piccadillywilson / Flickr)
A big concern is ghostwriting arranged and paid for by the drug industry? So how often are important authors left off the papers? Try, 10.9 percent of time in the New England Journal of Medicine, 7.9 percent in JAMA, and 4.9 percent in the Annals of Internal Medicine, according to a survey of authors whose papers appeared in six top journals last year. Overall, 8 percent of papers had ghost authors.
President Obama says no coverage of illegal immigrants in his plan. (Getty Images)
Republican Rep. Joe Wilson of South Carolina, generated a lot of heat for shouting, "You lie," after President Obama said that none of the proposals would apply to illegal immigrants Wednesday night.
But was Wilson right?
The charge that a health expansion would benefit people in this country illegally has become a rallying point for some opponents of an overhaul. What's the real deal?
We talked with some analysts at the Kaiser Family Foundation, a nonpartisan outfit that's been on top of the issue for a while, to sort through the fact and fiction. The bottom line, they told us, is the legislation proposed to date makes clear that undocumented residents of the US wouldn't be eligible for federally subsidized benefits under an overhaul.
What's not spelled out yet is how a person's immigration and citizenship status would be verified. The absence of an explicit enforcement mechanism is what appears to have opponents riled up.
The Census Bureau just released its annual numbers on the uninsured, and it has ammunition for those on both sides of the health overhaul debate.
Opponents of reform will be able to note that the overall number of uninsured was statistically unchanged from 2007 to 2008; rising incrementally from 45.7 to 46.3 million people. Put another way, 15.4 percent of the population is uninsured.
Check out our interactive map of state rates of the uninsured right here ( Alyson Hurt and Robert Benincasa/NPR )
But overhaul supporters will be able to note that the percentage of the non-Medicare population with private insurance continued to drop, by nearly a full percentage point, from 67.5 percent in 2007 to 66.7 percent last year.
Did Obama get the job done? His speech to rouse action on health legislation was more specific, yet easier to follow than past Obama talks.
Was President Obama's pitch on Capitol Hill enough? (Alex Wong/Getty Images)
He hammered away on the need for an overhaul now, citing unsustainably high costs, the ranks of the uninsured, the unique and embarrassing status of America among rich countries for not guaranteeing health coverage for it citizens and the fragility of coverage even for those who think they're in good shape.
He challenged critics, defused some myths and even threw a few bones to the Republicans, including jump-starting projects that could be a prelude to malpractice reform and embracing a John McCain proposal to offer low-cost insurance to people unable to get coverage because of preexisting conditions.
He even put a number--$900 billion over a decade--on what the White House thinks the health overhaul will cost as he outlined details, such as individual insurance mandate.
Just hours before President Obama is set to address Congress and the nation on his plans for a health overhaul, the New England Journal of Medicine pulls out the smelling salts.
(iStockphoto.com)
A pair of bracing commentaries published online says the time for change has come, so don't blow it, politicians.
In one of the pieces, two defenders of Britain's National Health Service concede its flaws, but say the jewel in its crown is "the strength of its primary care and its general practitioners," something the US would do well to emulate. Primary care doctors cost less and spend less than specialists, which the US has oodles of. So learn from the NHS, they say, and beef up primary care while pruning specialty care.
Since the 1970s, states have been closing down the large institutions that have historically housed people with mental illness. The "deinstitutionalization" movement came after those large state facilities were exposed as chaotic places where residents faced frequent abuse and poor care.
Large institutions like this one closed, but the alternatives are being questioned, too. (iStockphoto.com)
Now a judge in New York has ruled that what that state often offers instead--large group homes that sometimes house 120 to 200 people--also fails the people who live there. The decision applies specifically to adult homes in New York City, but it could influence courts in Illinois, Connecticut and other states that are facing similar cases.
Senators Dodd and Harkin talk health care in June.(Robert Giroux / Getty Images)
Before long we're expecting to find out officially that Connecticut Senator Christopher Dodd won't take the job as chair of the Senate health committee, succeeding his old friend Edward Kennedy.
There are quite a few reports out already saying Dodd has made up his mind to stick with his job running the Senate banking committee. If so, then next in line as chairman of the Health, Education, Labor and Pensions Committee would be Iowa Democrat Tom Harkin.
That's a big job--especially now, with health overhaul dominating Capitol Hill.
How could we not watch President Obama's health pitch to Congress tonight? We'll be parked in front of the flat screen in the family room, explaining the finer points of insurance rescission, the Gang of Six and health co-ops to a couple of toddlers.
(iStockphoto.com)
But what about you? If you're like most Americans, you'll probably tune in, too. Some 56 percent plan to watch Obama's speech tonight, according to polling data just out from the Pew Research Center for the People & the Press.
Democrats are making it must-see TV, with 72 percent expecting to watch, compared with 41 percent of Republicans and 52 percent of Independents.
What will President Obama say tonight in his speech before a joint session of Congress? And will it matter?
We're certain to be reminded of the necessity for changing the health system, as the president sees it, to cover more people and to restrain spending. That's the foundation for the admittedly complex and evolving plan he'd like to see implemented.
There are lots of reports Obama will stand behind a government-run, or public, insurance option as a competitive check on private insurance. The Washington Postreports House Speaker Nancy Pelosi expects Obama to affirm his support for a public option and challenge doubters who think they have a better idea to "put it on the table."
We doubt President Obama will be turning to Republican Newt Gingrich for political advice anytime soon.
Newt Gingrich argues for incremental health change. (Chip Somodevilla/Getty Images)
But if Obama listens in to NPR's Renee Montagne chat with the former House Speaker on Wednesday's Morning Edition, he'll get a prescription for legislative incrementalism when it comes to health care.
"I don't believe it's intellectually possible to take 18 percent of the economy of the largest economy in the world--life and death for every individual--and in one sweeping bill change all of it," Gingrich says.
People aren't smart enough to write a bill that does everything at once, he says, and a huge piece of legislation (1,300 pages or more) will be larded with "bizarre" goodies that may attract supporters now but cause problems down the road.
Discussions about cancer, vaccines, sexually-transmitted diseases, and the best interests of pre-adolescent girls are all hot topics. Put them together, and you've got a volatile mix.
Parents must weigh choices to vaccinate girls or not. (Tim Sloan/Getty Images)
NPR's Brenda Wilson reported Monday on Morning Edition that some doctors are raising concerns about certain shots the Centers for Disease Control and Prevention wants them to give to 11-year old girls to protect against cervical cancer.
A small but vocal group of doctors have doubts about the safety and effectiveness of a fairly new vaccine developed to guard against infection of some strains of the human papillomavirus (HPV), according to a recent study of Texas doctors in Cancer Epidemiology, Biomarkers & Prevention (free abstract here) and some nationwide data.
The genes may play "at least as big a role as four others discovered in the last 15 years," the Washington Postreports. That's the good and the bad news, it seems.
The science is fascinating, and every shred of insight about the still-mysterious cause of the dementia is a good thing. But for years now researchers have been finding genetic variants that appear more frequently in Alzheimer's patients--about 400 so far. Yet treatments haven't advanced beyond a few drugs that temporarily slow the march of the disease.
Back to school. Back to work on a health overhaul.
A man with a health-care plan seeks action. (Mark Lyons / Getty Images)
Lawmakers return to Washington today, and President Obama, after stumping for health overhaul on Labor Day, is prepping for a stem-winder before a joint session of Congress Wednesday night that could be his last best chance to gain support for his plans.
In case you were too busy grilling over the long weekend, the pick lines from Obama's speech before a union crowd in Cincinnati Monday went like this:
I've got a question for all these folks who say, you know, we're going to pull the plug on Grandma and this is all about illegal immigrants -- you've heard all the lies. I've got a question for all those folks: What are you going to do? What's your answer? What's your solution? And you know what? They don't have one. Their answer is to do nothing.
Will fiery rhetoric be enough to get Congress moving Obama's way? Not by itself, but The New Republic's Jonathan Cohn writes the situation isn't as bleak as it could be, considering the "train wreck of a month" the administration had in August.
Deep-fried butter. Just writing those words gives us a warm feeling in our stomach and more viscous blood in our arteries.
Deep-fried buttery deliciousness. (Sue Gooding/State Fair of Texas)
Crazy as it sounds, the stuff's for real. If you're brave enough, you can can sample some in a couple of weeks at the State Fair of Texas. The Dallas fair lays claim to being the birthplace of the corn dog and is also known as the "Fried Food Capital of Texas."
Those butter bombs, which we can't get out of mind, are finalists in a contest held over Labor Day weekend each year to pick foods that will be featured at the fair, starting Sept. 25.
Creator Abel Gonzales concedes the idea of deep-fried butter disgusts most people when they first hear about it. "But I'm not actually taking a hunk of butter and just putting in a fryer," he told NBC News. "That would be kind of gross."
For all the criticism lately that a health overhaul might go too far and cost too much, a close look at some of the legislation in the works shows it might not fulfill the promises of affordable coverage for plenty of Americans either.
Our pal Jordan Rau at Kaiser Health News takes a look at some families that are already having trouble paying for insurance out of their modest incomes and finds they could still be left behind.
"Under the House proposal, people receiving government subsidies could still end up spending 20 percent or more of their annual incomes on premiums, deductibles and co-insurance," Rau writes, citing estimates from the House Committee on Ways and Means obtained by Kaiser.
Day-care centers and nursery schools double as germ factories, so folks who work there and the kids they watch after need to get ready for the wave of swine flu that's probably on the way.
Elmo watches HHS Secretary Sebelius and a friend wash their hands. (Robert Giroux / Getty Images)
In a briefing on CDC advice for child-care facilities, Health and Human Services Secretary Kathleen Sebelius said the government leans toward keeping them open "knowing that they're safe and secure places for kids." An exception would be if there are too many caregivers out sick to adequately supervise the children, she said.
There are so many ways to make a living, but one of the most challenging may be working to reduce infant mortality in the inner city.
Take a look at a typical day for Lisa Uncles, a certified nurse-midwife who's the acting clinical director of the Family Health and Birth Center in Washington. She's one of three people profiled in an NPR multimedia feature called "The Way We Work" for Labor Day.
Unemployment just hit a 26-year high, but the health care and education sectors actually added about 52,000 jobs in August.
Federal funds are boosting research as far away as Guam. (Wikimedia Commons)
If you ever thought about working in a research lab, now might be the time to apply. The Boston Globereports money being pumped into biomedical research as part of the federal stimulus package is spurring hiring in Massachusetts, second only to California in the number of extra grants from the National Institutes of Health.
The Globe figures about $178 million in extra federal money has flowed into the state so far, a big change from essentially flat funding for most of the decade. Margaret Livingstone, a Harvard neurobiologist who studies the brain's processing of optical illusions, picked up $394,000 in a two-year grant made possible by the stimulus package. Now she's looking to hire two postdocs in a hurry.
Nobody in La Crosse, Wisconsin, ever thought the local hospital's initiative to help people prepare for the inevitable end of life would become a talking point in the national debate on health overhaul.
(iStockphoto.com)
But that's what happened to Gundersen Lutheran, the flagship hospital of a health system serving three Midwestern states, after a House health bill included a provision this spring to allow Medicare to pay for end-of-life counseling, the Washington Postreports. Gundersen Lutheran had pushed for Medicare to pay for the work.
It didn't take long for opponents of the administration's plans to remake health care to label these counseling sessions "death panels" and hold them up as Exhibit A for the government's intrusion into the most personal of health decisions. No matter that the characterization has been pretty much debunked. If there's one part of overhaul plans most likely to be dropped, it's government payment for end-of-life counseling, now a political "third rail."
In pursuing a case against Pfizer for fraudulently promoting drugs that eventually led to the largest health fraud settlement in U.S. history, the feds leaned heavily on evidence supplied by a half-dozen whistleblowers.
Justice Department explains its fraud settlement with Pfizer. (Chip Somodevilla / Getty Images)
Perhaps the most important was West Point grad John Kopchinski, hired by Pfizer as a sales rep when he left the Army in 1992. Kopchinski, 45, worked in South Florida until he was fired by the company in 2003. By then he was already talking with lawyers about evidence he had accumulated on the company's marketing of Bextra, a painkiller withdrawn from the market in 2005 amid safety concerns.
Under a law dating back to the Civil War, Kopchinski will get $51.5 million of the money recovered by the feds for his help. He'll also reap a share to be determined of money being returned to various states.
What led Kopchinski, now living in San Antonio, to blow the whistle? "You have to live with yourself when you look at yourself in the mirror," he told us in a telephone interview.
NPR's Ari Shapiro asksDr. Atul Gawande, a surgeon and writer for the New Yorker, to explain how decisions about care get made. Gawande says the simplest sort of rationing based on a "fixed allowance of care" may be scary but won't ever be reality in this country.
He argues in favor of rational care, basing decisions on the best evidence. If implemented systematically that approach would help eliminate plenty of ill-advised procedures.
If now isn't the last chapter in the administration's plan to overhaul health care, it's certainly the end of the beginning.
President Obama heads to Capitol Hill next week to sell health-care plan. (Alex Wong/Getty Images)
President Obama is heading to Capitol Hill next week to press Congress to buck up and pass something. He's also expected to be more direct about what he wants to see.
NPR's Mara Liasson reports the president aims to clear up confusion about how the health system he has in mind would work, particularly for Americans with health insurance. He's expected to offer some info on how the changes would cut costs.
Still, comments by David Axelrod, Obama's top political guru, leave us a wee bit more confused. "All the ideas are on the table now, we're well down the road, 90 yards down the field," Axelrod told Liasson. "And now we have to go the last 10 yards together and the best way to start that is for the president to address this issue with force and clarity and that's what he's going to do Wednesday night."
Americans put a lot of trust in their doctors and nurses and other health care providers, but sometimes they don't act in our best interest. Like when they steal drugs or abuse patients, a la Nurse Jackie.
NPR Health Correspondent Joseph Shapiro has a piece on Morning Edition tomorrow about a secret government database that has a lot of this kind of information in it. The problem? We can't get into it.
When doctors and nurses abuse these and us, shouldn't somebody know about it? (iStockphoto.com)
Shapiro looks at the story of the Healthcare Integrity and Protection Data Bank -- a wonky-sounding thing that contains 22 years of historic data on health professionals' wrongdoing.
Between lawsuits, congressional investigations and the occasional revelations of ex-drug company employees, you've probably started to get a hazy picture of how Big Pharma markets its wares.
Marketing side effects include government investigations. (Joe Raedle/Getty Images)
But the closest things we've ever seen to a team playbook came out today in a New York Timesreport on Forest Laboratories' marketing of the antidepressant Lexapro. The 88 pages, made public by the Senate Special Committee on Aging, are an excerpt from the full document, which may have run more than 270 pages, according to the Times.
Well, it looks like today is the day Pfizer, the world's largest drugmaker, will pony up around $2.3 billion to settle federal charges related to alleged marketing excesses.
(Tim Boyle/Getty Images)
The Justice Department will announce terms later today, the Associated Press reports.
The news isn't exactly a surprise because Pfizer said it was putting aside the money in January, mostly to cover allegations the company went way too far in selling Bextra, a painkiller taken off the market in 2005.
No conversation about overhauling health care can get very far before a doctor, just about any doctor, says lawyers and malpractice suits are big reasons health costs are so high. Republicans, even the ones who aren't doctors, generally agree.
Malpractice caps fire up doctors and the GOP. (iStockphoto.com)
On NPR's Morning Edition, Scott Horsley reports on "that old Republican chestnut: cutting down on frivolous lawsuits." Would caps on malpractice make a big difference in costs? Or, perhaps more significantly at the moment, would Democrats attract Republican support for health legislation by adding provisions to limit the liability of doctors?
Bill Bradley, the silky basketball shooter and deal-making New Jersey senator back in the day, suggested a political play to fellow Democrats in a New York Timesopinion piece over the weekend: "Combine universal coverage with malpractice tort reform in health care."
What exactly is so wrong with the American system of health care? It just costs too much.
Shifting health costs is a Band-Aid. (iStockphoto.com)
Aside from issues of quality and coverage, the price paid per capita for U.S. health care is more than $8,000 compared with about $5,500 in the next most expensive country (probably Switzerland) and the $4,500 paid in other developed countries, writes Stanford health economist Victor Fuchs in the current issue of JAMA.
So no wonder that every plan to overhaul health care aims to reduce costs. But Fuchs warns that some of the proposals might just shift the pain, not cure it.
Nearly one in six kids in this country is obese, and it's high time for local governments to take action about the country's childhood weight problem, says a report just out from the Institute of Medicine.
Healthy choices can be hard. (iStockphoto.com)
Parents, it seems, can only do so much to promote their children's health. So community measures are needed, a panel of experts says. The list of options from the IOM includes some that nobody could question, such as making sure water fountains are available in public places and that parks are safe and attractive.
Others are a little more provocative, such as taxing junk food, including sugary soda, and banning advertising for those products in areas where kids hang out.
Elmo is on the swine flu case and soon you won't be able to escape him.
The Sesame Street Muppet and his human pal Gordon, played by Roscoe Orman, star in some public service announcements to help kids and adults alike deal with the flu.
Elmo is always lots of fun. And Gordon, as his show bio says, "gives good advice." So what do they have to say about stopping the flu bug? Cough into the bend of your arm and be diligent about washing your hands.
You'll probably see these ads a gazillion times in the next few months. But if you can't wait, check out one of them below.
Now more than ever people are arguing about the cost and payback on investments for prevention.
Is an apple a day cost-effective? (iStockphoto.com)
As the green-eye-shade-wearing Douglas Elmendorf, director of the Congressional Budget Office wrote last month:
Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall.
So the idea that lots of prevention is somehow going to save, rather than cost money, under a health overhaul looks all wet.
Well, a paper just published online by the wonky journal Health Affairs suggests that looking at the costs and benefits of prevention over a really long time, say 25 years, might give a fuller picture than the 10-year period that's traditionally used in calculations for government budgeting.
Here come a bunch of tobacco companies to the federal court house in Bowling Green, Ky., to snuff out a new law they claim would put the kibosh on their ability to market cigarettes in this country.
Get ready for more fine print. (Spencer Platt/Getty Images)
The legal fight is likely to be waged all the way to the Supreme Court, as the companies seek to overturn a federal law banning the use of "color lettering, trademarks, logos, or any other imagery in most advertisements" among other things. The restrictions would also apply to displays in stores, direct-mail ads, and even hats and t-shirts.
Most galling to companies, as their complaint tells it, would be a government takeover of the top half of cigarette packs for anti-tobacco images and messages, leaving only the bottom for the companies "to communicate with adult consumers." Even that message would likely be obscured in stores, the companies say.
It's all a plot to do in the cigarette makers, the complaint charges. "The obvious purpose of this is to force Plaintiffs to stigmatize their own products through their own packaging," they say. Taken together, the restrictions would leave them unable to tell their story to adult consumers, the companies assert. That, they say, violates their rights to free speech, something they want an injunction to stop.
