Category Archives: Medicine

Follow other states’ lead on Medicaid expansion

Doctor Speaking with PatientPennsylvania became the ninth state led by a Republican governor to expand Medicaid. Its expansion, which was approved last week, will be contracted through the state’s privatized Medicaid program, similar to KanCare, and will provide health coverage to nearly 500,000 low-income adults. Counting Pennsylania, 27 states and the District of Columbia have now expanded Medicaid, and several other states are pursuing it, including Indiana. But in Kansas, Gov. Sam Brownback and the Legislature refuse to act. As a result, about 75,000 Kansans are left without health insurance and Kansas hospitals are stuck with unpaid bills. It’s a lose/lose.

KanCare contractor may restore dental program

A valuable program that provided dental care to low-income children in 41 underserved rural Kansas counties was put on hold this year after the state privatized its Medicaid program. UnitedHealthcare, one of the state’s three KanCare contractors, chose not to authorize payments for teeth cleanings performed in Head Start classrooms, which effectively suspended the program, the Kansas Health Institute News Service reported. But after being contacted by KHI News Service, the president of United’s Kansas health plan said the company would review its payment policies to ensure it is covering the dental services. Kathy Hunt, the Head Start official who coordinated the program, is appreciative. “What we were offering was a way for kids who don’t have access to dental care to get it,” she said.

Funding cut, except for program KU didn’t want

The $66 million in state budget cuts to higher education over the next two fiscal years makes the Legislature’s approval of $2 million to help start the Midwest Stem Cell Therapy Center at the University of Kansas Medical Center in Kansas City seem even more ridiculous. KU never asked for the center. It was an idea dreamed up and pushed through by Kansas senators, including Senate President Susan Wagle, R-Wichita. Lawmakers even named the center. Kansas Board of Regents member Ed McKechnie wondered if the money for the center could be diverted to help cover the budget cuts, but other regents members didn’t think that wasn’t a good idea, the Lawrence Journal-World reported.

Hospital pricing part of what ails health care system

It’s hard to know what to make out of the wildly varying rates hospitals charge for the same procedures – other than that it shows how dysfunctional our health care system is. As the Eagle reported today, costs related to joint replacement ranged from $5,300 at a hospital in Ada, Okla., to $223,000 at a hospital in Monterey Park, Calif. Prices at Wichita hospitals and surgery centers also vary greatly, even between Via Christi Via Hospital on St. Teresa and Via Christi Hospital on St. Francis. Hospital officials warn that many factors are involved in pricing, including the health of the patient and whether the patient was admitted through the emergency room. Also, some hospitals charge higher because they have to cover the cost of training future doctors or providing charity care. They also note that few people pay the “list price” for procedures. Still, this complicated pricing system is part of the problem.

GOP’s turn to provide health care solutions

healthcarereformGOP lawmakers slammed President Obama’s blueprint for health care reform, so the burden will be on them to offer real solutions when they meet with Obama at a televised health care summit today. An earlier House GOP proposal had some good ideas for curbing costs but would not have significantly reduced the number of uninsured and would not have prohibited insurance companies from denying claims or coverage based on pre-existing conditions. Sky-high premium increases announced this month in California and other states — in some cases as high as 39 percent — show what can happen when people aren’t required to have insurance. The problem is that, because healthy individuals aren’t buying insurance, high percentages of people in the plans have major health problems, which cause the policies to become more and more costly.

Liability limits would help reduce costs

CB106307Medical liability reform is no cure-all for what ails our nation’s health care system. But imposing limits on malpractice lawsuits could save as much as $54 billion over the next decade, according to a new congressional budget analysis. The limits would lower malpractice insurance premiums and reduce defensive medicine, in which doctors order tests and procedures aimed primarily at defending against possible lawsuits.

Green light for ‘patient pot’?

marijuana1Will the regime change at the White House lead to more states approving the use of medicinal marijuana? Doing so seemed foolhardy as long as the Bush administration was raiding and prosecuting dispensaries in California and other states, which is why former Kansas Attorney General Robert Stephan’s advocacy of a medicinal marijuana law went nowhere in Topeka in 2007. But Attorney General Eric Holder has said the Justice Department plans to leave those operations alone as long as they comply with state laws. During his online town hall, President Obama drew the line at legalizing marijuana to fight the recession, though, saying he didn’t think that was good economic policy.

Pro-con: Has a link between autism and vaccines been disproved?

autismThe verdict is in. There is no connection between vaccines and autism. And it is time that all of us get our children vaccinated. In 2008, the United States had the highest measles rate in 10 years. An increasing number of parents have been refusing to vaccinate their children against measles because of this fear of a connection. It is not grounded in science. Major medical groups and government research are unanimous: The measles vaccine is safe, and you must get your children vaccinated, because if you don’t, you are endangering my children. You are endangering your neighbor’s children. You are endangering all of our children. This is serious stuff. Measles can be deadly. Parents, please don’t endanger all of our children based on a myth. Medical science has proved there is no link. — Campbell Brown, CNN

It would be a big mistake to take the recent U.S. Court of Claims opinion as the last word on whether vaccination can contribute to the development of regressive autism in some children. The U.S. Court of Claims special masters are hampered from considering evidence that has not yet been published in the medical literature regarding potential associations between vaccines and the development of regressive autism. There is inappropriate pharmaceutical industry influence on which vaccine studies do get published and widely cited in the medical literature. What is thought to be a scientific truth today can be proven false tomorrow. The answers will come when independent researchers, without ties to industry or government agencies concerned about protecting the status quo, can conduct appropriate scientific investigation into why many children who are healthy regress into autism after vaccination. — Barbara Loe Fisher, National Vaccine Information Center president

The cure worse than the disease?

drugsSome doctors are questioning the recent approval of Lyrica to treat fibromyalgia, a chronic pain condition that they say isn’t a real illness (other doctors disagree). Because Pfizer and other companies are poised to market the drug aggressively, millions of consumers might end up taking the drug who don’t need it, they fear.

Meanwhile, Congress is investigating the role of artificial heart pioneer Robert Jarvik in marketing Lipitor, the world’s best-selling drug. Jarvik, it turns out, may not be certified to practice medicine or qualified to offer medical advice.

And a recent study found that the pharmaceutical industry puts almost twice as much money into drug marketing and promotion as into research and development, contrary to the industry’s longtime claims that it is primarily research-driven.

Direct-to-consumer drug marketing deserves much more scrutiny.

Hey, doc, I am dying over here

Defibrillator Turns out those popular TV images of doctors and nurses racing into hospital rooms to administer electric shocks to patients gripped in cardiac arrest might be a bit, um, optimistic.

A study published in the most recent New England Journal of Medicine reports that one-third of patients didn’t get a jolt from a defibrillator in the recommended two minutes or less, instead waiting sometimes as long as six minutes for doctors to administer help. The delays cause thousands of deaths a year and greatly increase patients’ chances of getting brain damage or other complications, according to the study’s authors.

An editorial in the journal recommended more prevalent on-site defibrillators in hospitals and training for nurses to use them.

Meanwhile, if you’re going to have a heart attack, try to have it at a crowded mall, where someone will notice.

Ethics breakthrough on stem cells?

StemcellTwo different scientific teams have announced success in developing stem cells from skin tissue — without using human embryos. One doctor called it a “tremendous scientific milestone — the biological equivalent of the Wright Brothers’ first airplane.”
It’s still possible that embryonic cloning techniques might have some advantages over skin reprogramming, so research needs to continue on both. But if the findings hold up, this breakthrough could help defuse some of the ethical controversy surrounding stem cell research.
Posted by Randy Scholfield

No closer to getting cheap drug imports

The drug importation bill that passed the Senate Monday is too messed up to have any impact — kind of like Congress as a whole right now. The legislation requires the Bush administration to certify the safety and effectiveness of drugs before they can be imported, which the administration says it can’t do. Drug safety is crucial, of course, but as long as Congress refuses to do anything about skyrocketing drug prices in this country, it should allow U.S. consumers the opportunity to buy prescriptions affordably from reputable foreign sources.
Posted by Rhonda Holman

Brownback still looking out for embryos

Sen. Sam Brownback, R-Kan., had a commentary in Tuesday’s USA Today pleading the case against the latest Senate effort to further fund embryonic stem cell research. “For the sake of the patients, we should fund adult stem cell research to the exclusion of unethical embryonic stem cell research,” he wrote. Rooted in his opposition to destroying embryos and his contention that “embryonic stem cell research has not yielded any treatments or applications to date,” Brownback’s call is unlikely to receive majority support in the Senate. But President Bush sides with Brownback and likely will veto this stem cell bill, as he did the last.
Posted by Rhonda Holman

Amniotic stem cells hold great promise

Using amniotic fluid as a source of stem cells is an encouraging prospect that could sidestep the moral objections many people have with embryonic stem cells. Researchers at Wake Forest University and Harvard University report that the stem cells from amniotic fluid donated by pregnant women offer some of the same flexibility prized in embryonic stem cells. However, because the researchers don’t know how effective and adaptable amniotic stem cells will be, they think there is still a need for embryonic stem-cell research. The finding also is unlikely to change the Democratic Congress’ plan to pass a bill — similar to the one vetoed last year by President Bush — to allow federal research on stem cells from embryos discarded by fertility clinics.
Posted by Phillip Brownlee

Spending more but not improving health care

“From 1996 to 2002, Medicare spending on treatments for heart attack victims increased about 14 percent, after inflation. But there was virtually no improvement in survival rates,” the New York Times reported. One reason is that there is a financial incentive in the health care system that encourages hospitals and clinics to provide more services, hire more specialists and install more high tech devices, the Times reported, rather than use effective and inexpensive measures such as prescribing beta blockers.
Posted by Phillip Brownlee

Get informed, be prepared for pandemic flu

A pandemic flu outbreak isn’t getting much media attention anymore, but it remains a serious threat that could quarantine thousands for weeks, if not months. It’s smart to be prepared, and Sedgwick County is trying to do its part. Its Web site has a “tool kit” for potential business disruption, updates from the Centers for Disease Control and Prevention and the World Health Organization, and information for consumers.
Posted by Angie Holladay

Visit India; get a new hip

Americans are not only seeing call centers and manufacturing outsourced, but increasingly are outsourcing their own health care as well — some 500,000 did so last year alone. They are turning to hospitals in less expensive countries for cosmetic surgery and other types of care. Hospitals in New Delhi, Bangkok and other places are creating a network for “medical tourists,” often offering high-quality care at a fraction of what U.S. hospitals and doctors charge.
The risks are obvious to those considering the venture: differences in culture and communication, lack of family support, travel issues and the possible surgical complications. Do the costs and availability of comparable care in the United States really make such risks acceptable?
Posted by Angie Holladay

China facing rapidly spreading AIDS epidemic

The worldwide spread of AIDS has not forgotten China. But the Chinese government needs to step up the efforts to provide education about prevention and the importance of adhering to drug therapy.
Reuters recently reported that AIDS was first introduced to the country mostly to poor farmers through botched blood-selling schemes in the 1980s and 1990s. This quickly spread to intravenous drug abusers and high-risk groups. According to a recent report, there are 190 new HIV cases every day, and 1 percent of all pregnant women in China are HIV positive.
Posted by Angie Holladay

Marijuana’s effects or Alzheimer’s symptoms?

The generation of peace, love and marijuana may have a strong new argument to keep its beloved weed. Marijuana has long been medically determined to relieve glaucoma and side effects of cancer treatment; it may also lead to preventing the progression of Alzheimer’s disease, according to the Scripps Research Institute in California.
Alzheimer’s disease is the No. 1 cause of dementia among the elderly, and is characterized by memory loss, impaired decision-making and diminished language movement skills. Ironically, the same symptoms of the disease appear to be the side effects of the treatment.
Meanwhile, a new goverment study released this week found that the prescription drugs most commonly used to soothe agitation and aggression in Alzheimer’s patients are no more effective than placebos and can have serious side effects, the New York Times reported.
Posted by Angie Holladay

Health insurance is the best employee benefit

The good news is that the 7.7 percent increase this year in health insurance premiums is the lowest increase since 2000. The bad news is that it is still twice the annual rate of inflation.
Currently, the average annual family premium is $11,480. This is too much for many employers to absorb. As a result, since 2000, the percentage of firms offering health benefits has fallen to 61 percent from 69 percent.
Some employers are trying to help themselves and their employees by offering plans with high deductibles and employee health savings plans to place more of the burden upon the employee. This may be an answer for some, but many can’t afford to get sick with a $2,000 annual deductible.
Posted by Angie Holladay
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Vaccine needed for Project BioShield

The Bush administration created Project BioShield to stockpile vaccines. But five years and $5.6 billion later, we are no closer to being able to combat a bioterrorist attack.

Squabbles among the major pharmaceutical companies, federal bureaucracy and liability risks have all but stopped research, and only two companies are left working on the project. The old anthrax vaccine, for example, needs to be reformulated to decrease side effects such as multiple sclerosis and allow for a longer shelf life. Rep. Christopher Shays, R-Conn., described the program as “a torturous labyrinth of federal fiefdoms into which billions disappear.”
Posted by Angie Holladay

Should insurance be based on lifestyle choices?

Medicare is attempting to save the financially troubled health care program by charging wealthier beneficiaries higher premiums — even though the wealthy use Medicare the least. But the real ethical dilemma facing Medicare and all health care insurers is whether premiums should be based more on health risks. If someone makes the lifestyle choice to smoke, he will use more health care dollars in treatment. Someone who has paid taxes, saved money and chosen to avoid fatty foods can reasonably argue he shouldn’t have to bear the brunt of those who chose to “supersize.”
Posted by Angie Holladay