Headlines: November 4, 2009
by Meg Larkin
Politics and Policy:
Senate Majority Leader Harry Reid has announced that health reform legislation may take longer than expected and fail to meet the year-end deadline Democrats had homed for. While Reid’s office maintains that it is still their goal to get legislation passed by Christmas, they have hinted that it might not happen. Republicans have released their own health care plan on the Internet today. It involves mainly a re-hashing of republican ideas from the years when they controlled Congress including caps on medical malpractice damages and Republicans claim it focuses more on cost containment than the democratic plan.
The health care debate is shifting its focus slightly this week in order to address the issue of coverage for legal immigrants. Some Republicans in congress want to exclude legal immigrants from coverage for five years in addition to excluding illegal immigrants permanently. In other health law news, a bill has been introduced by the chairman of the House Health Education Labor and Pensions Committee to mandate at least five paid sick days for workers sent home with contagious illnesses. This is in response to concerns over a lack of paid sick leave helping to spread swine flu because workers can’t afford to stay home. However, the bill would not allow paid sick leave for workers who simply assert they are sick and decide to stay home on their own.
Concerns over abortion funding are splitting democrats in the health reform debate. Many democrats want to ensure that public funds for increased insurance coverage will not be used to finance abortion, while others are concerned that this legislation may make abortions harder to obtain than they are now. In other spending news, a provision in the House health care bill would require evaluation of regional variation in the practice of medicine in a two year study by the independent Institute of Medicine. The study would focus on variations in Medicare spending and is designed to help congress slow spending and control costs. Hospitals from urban areas with traditionally higher fees were concerned by the legislation and have inserted language that would prevent the Institute’s recommendations from affecting payments for medical education, much of which occurs at urban teaching hospitals.
In regional news, Children’s Hospital Boston is limiting its fee increases in an effort to control costs. In an agreement with the three Massachusetts insurers and Medicaid, some of the insurers’ savings will be returned to the hospital so that they can find ways to control costs and improve quality of care.
Research and Science:
A new study by the National Center for Health Statistics has found that the high incidence of premature births in the United States is the main reason that America has higher infant mortality than other rich countries. While a premature baby born in the United States is more likely to survive than one born in another country, they are still more likely to die than full term babies. Asperger’s syndrome, a high functioning form of Autism, may be eliminated from psychiatry’s diagnostic manual in 2012 in favor of a broader diagnosis that encompasses the whole spectrum of autism. The change from the widely used Asperger’s diagnosis will likely be controversial, and some worry that it will discourage people who possibly have high functioning forms of autism from being assessed because of the stigma attached to the autism diagnosis.
A new study has come out in the Journal of the American Medical Association that questions the effectiveness of mammograms in preventing deaths from breast cancer. While the study shows the test is very good at finding slow growing forms of the cancer, it is less effective at locating more aggressive forms of cancer. Doctors are still recommending that women get mammograms as there is no sure way to distinguish between the more harmful and less harmful types of cancer they can uncover. In other cancer news, the New York Times featured an article on the researcher behind the revolutionary drug Gleevec for the treatment of Chronic Myeloid Leukemia. The article focuses on the path of his research and the development of the drug that has turned CML from a death sentence in to a manageable chronic condition.
The state of California has awarded $230 million in grants to research projects involving stem cells. While some of the projects use controversial embryonic stem cells, most of them involve less controversial types of stem cells. The projects range in scope and direction from targeting diabetes to Lou Gehrig’s Disease and cancer. In other drug and research news, a new Lupus drug is headed for FDA approval. The drug, by the company Human Genome, if approved will be the first new Lupus drug in 50 years. After 13 years in development a new drug for schizophrenia is scheduled to hit the market in 2010. The drug works to block a different set of neurotransmitters than an earlier generation of antipsychotic drugs.
An article in the latest issue of Health Affairs predicts that unless there is a radical change in approach, the AIDS crisis will still be out of control in 2031: 50 years from its inception. The study predicts increasing costs for prevention, and care for orphans and patients.
Meg Larkin is a second year law student at Boston University in the Health Law concentration. Any suggestions/comments/ questions are welcome via email.