Procedure brings controversy but could become more commonplace as MRSA spreads.
By Mary Ann Roser - AMERICAN-STATESMAN STAFF - Monday, July 30, 2007
Worried about the spread of a superbug that no longer responds to penicillin and some other common antibiotics, hospitals across the country — including some in Central Texas — are starting to test new patients for the bacteria and isolate those identified as carriers.
Some hospitals even isolate patients who are at risk of being carriers of MRSA, or methicillin-resistant Staphylococcus aureus, a bacterium that experts say has become drug-resistant largely because of overuse of antibiotics.
The Seton Family of Hospitals, the largest health system in Central Texas, says it isolates people at high risk of carrying MRSA but hasn't decided whether to do testing. St. David's HealthCare hospitals and Cornerstone Hospitals say they test high-risk patients and isolate those who test positive for the bacteria.
The bacterium, which in recent years has taken root in some football locker rooms and jails, causes infections that look like a pimple or spider bite. The wound usually clears up after treatment, often with vancomycin, one of the strongest antibiotics, or by draining the abscess.
But MRSA can invade the bones, joints, blood, heart valves and lungs, creating a potentially lethal infection for the elderly or people with weakened immune systems.
Hospitals, which are full of people who fit that description, have seen MRSA infections spiral. A broad survey of the nation's health care facilities found that 34 out of every 1,000 hospital patients had active MRSA infections, and an additional 12 were carriers, the Association for Professionals in Infection Control and Epidemiology reported last month.
The report's author, Dr. William Jarvis, and MRSA expert Dr. Lance Peterson, a physician and epidemiologist at Evanston Northwestern Healthcare in Evanston, Ill., said that although the report did not examine death rates from MRSA, a conservative estimate is that 10 percent of hospital patients with the infections die.
Jarvis is a consultant and former director of a program specializing in hospital infections at the U.S. Centers for Disease Control and Prevention.
Health care experts are divided over how far hospitals should go to detect and contain the bacteria. There are no national requirements, and the CDC offers basic guidelines but recommends that hospitals decide for themselves the best approach.
"Some places across the country screen everybody; some just look at their high-risk populations," said Joanne Dixon, director of infection control at Seton. "We need to make a sound decision here."
Evanston Northwestern's three hospitals, which admit 40,000 patients a year, became the first in North America to test all patients for MRSA two years ago, Peterson said.
At the end of the first year, in July 2006, it found 1,260 MRSA infections, 90 percent of which were picked up in the hospital, Peterson said. Once the hospital began testing all patients and isolating those who were infected or carrying MRSA, the number dropped to 80, Peterson said.
"You have to do a lot of surveillance," he said, adding that the testing program costs $600,000 a year.
The infection control association's report found that just 28 percent of the facilities it surveyed test patients for MRSA.
And Peterson said that up to 30 percent of people in some high-risk groups are MRSA carriers and may not know it. High-risk patients include anyone receiving invasive procedures — from dialysis to heart surgery — that could give the bacteria an opening and those transferred from places where MRSA can be easily spread, such as nursing homes, jails and other hospitals.
"If we had this level of avian influenza on Earth, we'd have everyone screaming," Jarvis said. "I'm hoping it is a wake-up call to . . . hospital administrators and CEOs of hospitals that it's a very significant problem that we now have evidence-based data on how we can reverse it."
The association has urged hospitals to be more aggressive about MRSA.
President Denise Murphy said facilities getting the best results in controlling the bacteria identify the hot spots in their facilities for spreading MRSA, test high-risk patients and take extra precautions with those who test positive, stress good handwashing procedures by staff members and disinfect patient rooms daily.
Seton, which operates seven acute-care hospitals in Central Texas, has been isolating patients at high risk for the bacteria since 1996, Dixon said. Seton said positive MRSA tests at its hospitals have increased 11 percent in the past three years.
St. David's HealthCare, which operates five acute-care hospitals in Central Texas, started testing patients at high risk for MRSA in May, following a policy its parent company, HCA, instituted nationwide.
The hospitals swab a patient's nose to test for the bacteria, said Karen Degtoff, infection control coordinator at St. David's.
If the test shows that the patient is an MRSA carrier, he or she is put in isolation, which means staff members take special precautions when treating the patient, such as wearing a gown and gloves. Visitors also are instructed to wear protective garb, Degtoff said.
The patients may be restricted to their rooms, depending on their condition and whether their recovery depends on walking. Those who leave their rooms are told to wear a gown and gloves, hospital officials said.
Dr. Steve Berkowitz, chief medical officer for St. David's HealthCare, said that since testing started, 11 percent of patients facing high-risk procedures, such as heart bypass or orthopedic surgery, have tested positive for MRSA.
But not all doctors agree with what local hospitals are doing, and some patients have been downright bewildered.
Norman Tolpo, 71, of Austin said he was put in isolation after testing positive as a carrier for MRSA while he was a patient at St. David's Medical Center in Austin in early June.
Tolpo said he found the restrictions baffling and inconsistent. He protested to the staff that he didn't have an active infection and asked why all incoming patients — and the staff — weren't tested.
Even without an active infection, a person who is a carrier can still spread MRSA, he was told.
"Let's say they get nasal secretions on their hands and they shook the hand of a nurse," Berkowitz said. "It could still be spread to another person."
Michael Killiam, Tolpo's family practice physician, said Tolpo has raised some valid points. "If you're going to be consistent, you've got to test everybody," Killiam said.
The CDC does not recommend testing hospital staff members, and hospital officials said they think proper handwashing and protective garb is enough.
And Murphy, the association president, doesn't endorse testing all patients.
"We believe you need to use finite resources wisely by doing a risk assessment," said Murphy, who said she lost her mother to a hospital infection. "If we had all the money in the world, it would be different."
Read more & listen to report
Tuesday, July 31, 2007
Saturday, July 28, 2007
Children's Health Care Bill Loaded with Extras
by Julie Rovner - NPR Morning Edition, July 27, 2007
On Capitol Hill, two House committees have begun work on their version of a bill to renew and expand the State Children's Health Insurance Program.
Last week, a Senate committee overwhelmingly approved a bipartisan bill to continue the popular SCHIP program. But in the House, the parties are far more polarized.
Republicans and Democrats on two panels — Energy and Commerce and Ways and Means — said they want to renew the SCHIP program, which otherwise is set to expire at the end of September. But that was about all they agreed on at simultaneous meetings that stretched late into the night on Thursday.
Republicans like former House Speaker Dennis Hastert of Illinois said the bill written by House Democrats expands the children's health program so much that it will substitute government for private coverage.
"Now we're sending messages to families across the country: Drop your private health insurance plans, the American taxpayer will foot the bill," Hastert said.
Democrats like Rep. Henry Waxman of California, however, said the Republican substitute proposal doesn't go nearly far enough.
"With the amount of money they're proposing, they won't even be able to keep pace with current enrollees," Waxman said. "They'd have to drop kids out of the program, let alone cover more of the children that need it."
But differences over how much to expand the children's insurance program are only the start of the dispute — although the expansion alone is enough to have drawn a veto threat from the Bush administration.
What angered Republicans even more is how the bill proposes to pay for the additional $50 billion that would go to the SCHIP program over the next five years. In particular, they object to cuts in spending for private HMOs and other health plans that serve Medicare patients.
Rep. John Shadegg, an Arizona Republican, said that makes no sense.
"So we're going to take money away from our seniors to give it to children in families where those families already earn $82,600 a year?" he asked.
That's not exactly how it would work. That $82,000 represents four times the poverty level for a family of four. Only a few families who earn that much could qualify.
And the money being taken from the private Medicare plans is what budget analysts agree are overpayments. The cuts would simply pay the plans what the average Medicare patient costs.
But the disputes underscore what has become an unfortunate fact that seems to hold true no matter which party controls Congress, says Patrick Morrissey, a health care lawyer and lobbyist and former congressional staffer.
"Unfortunately, nothing is simple in health care these days," he says.
Part of the difficulty is how the Democrats are trying to pay for their health care expansion — using not only the controversial Medicare changes, but an even more controversial 45-cents-per-pack increase in the cigarette tax.
Morrissey says that over the past several years, Congress has also created its own problem in health care, by making Medicare payment policies that last for just a few years at a time:
"So you have this amazing amount of pressure, funneling in to one or two health care bills a year, which means that any one bill, even if it should be noncontroversial, ends up becoming bigger and bigger and bigger," he says. "You literally have dozens and dozens or hundreds of groups lining up saying 'we would like more money, because our payment policy expires at the end of the year.'"
This year, the big money problem is a 10-percent cut in Medicare payments to doctors starting next January. The House bill cancels that cut.
But it comes at a cost — a big one. Eliminating the cut for just two years adds more than $100 billion to Medicare spending over the next decade.
That's considerably more than the entire expansion of the children's health insurance program. And lawmakers had to find the money by trimming payments for other health care providers, who aren't very happy about it.
Still, House Democratic leaders hope to have the bill on the floor next week, their last before the summer break. The Senate bill is expected to come up for a vote next week, as well.
Read more on NPR
On Capitol Hill, two House committees have begun work on their version of a bill to renew and expand the State Children's Health Insurance Program.
Last week, a Senate committee overwhelmingly approved a bipartisan bill to continue the popular SCHIP program. But in the House, the parties are far more polarized.
Republicans and Democrats on two panels — Energy and Commerce and Ways and Means — said they want to renew the SCHIP program, which otherwise is set to expire at the end of September. But that was about all they agreed on at simultaneous meetings that stretched late into the night on Thursday.
Republicans like former House Speaker Dennis Hastert of Illinois said the bill written by House Democrats expands the children's health program so much that it will substitute government for private coverage.
"Now we're sending messages to families across the country: Drop your private health insurance plans, the American taxpayer will foot the bill," Hastert said.
Democrats like Rep. Henry Waxman of California, however, said the Republican substitute proposal doesn't go nearly far enough.
"With the amount of money they're proposing, they won't even be able to keep pace with current enrollees," Waxman said. "They'd have to drop kids out of the program, let alone cover more of the children that need it."
But differences over how much to expand the children's insurance program are only the start of the dispute — although the expansion alone is enough to have drawn a veto threat from the Bush administration.
What angered Republicans even more is how the bill proposes to pay for the additional $50 billion that would go to the SCHIP program over the next five years. In particular, they object to cuts in spending for private HMOs and other health plans that serve Medicare patients.
Rep. John Shadegg, an Arizona Republican, said that makes no sense.
"So we're going to take money away from our seniors to give it to children in families where those families already earn $82,600 a year?" he asked.
That's not exactly how it would work. That $82,000 represents four times the poverty level for a family of four. Only a few families who earn that much could qualify.
And the money being taken from the private Medicare plans is what budget analysts agree are overpayments. The cuts would simply pay the plans what the average Medicare patient costs.
But the disputes underscore what has become an unfortunate fact that seems to hold true no matter which party controls Congress, says Patrick Morrissey, a health care lawyer and lobbyist and former congressional staffer.
"Unfortunately, nothing is simple in health care these days," he says.
Part of the difficulty is how the Democrats are trying to pay for their health care expansion — using not only the controversial Medicare changes, but an even more controversial 45-cents-per-pack increase in the cigarette tax.
Morrissey says that over the past several years, Congress has also created its own problem in health care, by making Medicare payment policies that last for just a few years at a time:
"So you have this amazing amount of pressure, funneling in to one or two health care bills a year, which means that any one bill, even if it should be noncontroversial, ends up becoming bigger and bigger and bigger," he says. "You literally have dozens and dozens or hundreds of groups lining up saying 'we would like more money, because our payment policy expires at the end of the year.'"
This year, the big money problem is a 10-percent cut in Medicare payments to doctors starting next January. The House bill cancels that cut.
But it comes at a cost — a big one. Eliminating the cut for just two years adds more than $100 billion to Medicare spending over the next decade.
That's considerably more than the entire expansion of the children's health insurance program. And lawmakers had to find the money by trimming payments for other health care providers, who aren't very happy about it.
Still, House Democratic leaders hope to have the bill on the floor next week, their last before the summer break. The Senate bill is expected to come up for a vote next week, as well.
Read more on NPR
GOP senators offer tax-based insurance plan
By BARBARA BARRETT - McClatchy Newspapers = Fri, Jul. 27, 2007
WASHINGTON -- A group of conservative Republican senators put forth a plan Thursday that seeks to ensure that every American has health insurance.
The bill encourages families to find their own health coverage and offers tax credits of up to $5,400 per family. Advocates for the uninsured say the proposal could jeopardize low-income families and chronically ill patients, as well as the employment-based healthcare system, which covers 65 percent of Americans.
"It's time for a major debate on health care insurance," Sen. Mel Martinez, R-Fla., said in a statement. "Not enough people have access to affordable health care, and the Congress has not done enough about this crisis." Martinez was joined in introducing the bill by fellow Republican Sens. Richard Burr of North Carolina, Tom Coburn of Oklahoma and Bob Corker of Tennessee.
The bill could bring health coverage to millions of Americans now without it. But Burr said in an interview that it also would begin taxing the value of healthcare plans that many employers now offer workers, a provision sure to face opposition. Such benefits are now tax-free for the employer and the worker.
"Our aim is to remove inequities in our tax laws and make tax relief for health insurance available to everyone," Martinez said.
The legislation would offer special tax credits to help cover the cost of health insurance and other health bills: $2,160 per person, up to a maximum of $5,400 per family.
The legislation, called the Every American Insured Health Act, comes amid debate this week in the House of Representatives and the Senate over the renewal of a joint federal-state children's health insurance program.
Republican leaders, including President Bush, want to keep the program roughly where it is. Democrats are trying to expand the program to cover more children.
The GOP legislation also comes as the idea of universal healthcare continues to consume political debate. Polls show healthcare as one of voters' top concerns. Democratic presidential candidates are being pushed to unveil their healthcare plans. And several states are considering legislation to cover uninsured residents.
But Kathleen Stoll, director of health policy for Families USA, an advocacy group in Washington, said the plan isn't terribly new. Republicans have long been working to dismantle the employment-based health system that most Americans use, she said.
"When we eliminate that tax break for [the system], we should do that with extreme caution," Stoll said.
Advocates for the uninsured fear that employers could simply drop health benefits altogether. And for many families,
Read more
WASHINGTON -- A group of conservative Republican senators put forth a plan Thursday that seeks to ensure that every American has health insurance.
The bill encourages families to find their own health coverage and offers tax credits of up to $5,400 per family. Advocates for the uninsured say the proposal could jeopardize low-income families and chronically ill patients, as well as the employment-based healthcare system, which covers 65 percent of Americans.
"It's time for a major debate on health care insurance," Sen. Mel Martinez, R-Fla., said in a statement. "Not enough people have access to affordable health care, and the Congress has not done enough about this crisis." Martinez was joined in introducing the bill by fellow Republican Sens. Richard Burr of North Carolina, Tom Coburn of Oklahoma and Bob Corker of Tennessee.
The bill could bring health coverage to millions of Americans now without it. But Burr said in an interview that it also would begin taxing the value of healthcare plans that many employers now offer workers, a provision sure to face opposition. Such benefits are now tax-free for the employer and the worker.
"Our aim is to remove inequities in our tax laws and make tax relief for health insurance available to everyone," Martinez said.
The legislation would offer special tax credits to help cover the cost of health insurance and other health bills: $2,160 per person, up to a maximum of $5,400 per family.
The legislation, called the Every American Insured Health Act, comes amid debate this week in the House of Representatives and the Senate over the renewal of a joint federal-state children's health insurance program.
Republican leaders, including President Bush, want to keep the program roughly where it is. Democrats are trying to expand the program to cover more children.
The GOP legislation also comes as the idea of universal healthcare continues to consume political debate. Polls show healthcare as one of voters' top concerns. Democratic presidential candidates are being pushed to unveil their healthcare plans. And several states are considering legislation to cover uninsured residents.
But Kathleen Stoll, director of health policy for Families USA, an advocacy group in Washington, said the plan isn't terribly new. Republicans have long been working to dismantle the employment-based health system that most Americans use, she said.
"When we eliminate that tax break for [the system], we should do that with extreme caution," Stoll said.
Advocates for the uninsured fear that employers could simply drop health benefits altogether. And for many families,
Read more
Friday, July 27, 2007
Health Care Policy Seminar Scheduled Aug. 7 in Arlington at UTA
By Lorraine Levine - Thu Jul 26, 2007
Please consider attending this forum and inviting your friends.
You are invited to an Education Forum “Solutions to the Texas Health Care Crisis”
Location: Rosebud Theater UTA, Student Center UTA Arlington ,
When: August 7, 2007, 7 PM to 8:30 PM.
Subjects addressed will be:
· Can all Texans have affordable health insurance?
· Can a system be improvised without raising taxes?
· How can the total cost of health care be reduced in Texas ?
· How can doctors take the delivery of health care away from insurance companies and pharmaceuticals companies?
· Can rising health care cost be stabilized?
· Can drug costs be reduced?
· Does the state and federal government need to get involved?
· Is there a cost analysis that would demonstrate the financial feasibility of
state wide coverage?
Invitees: All DFW Legislators, various physician groups, nursing organizations, hospital executives, county and municipal benefit executives, UTA students, church
organizations, League of Women Voters, local chapter of National Nursing Association and the general public
Co-sponsors: Health Care for all Texas (HCFAT), Arlington and Tarrant League of Women Voters, Local National Nursing Association and the organization “Free Thinkers” of UTA.
Directions: Go south of Cooper off I30 to Abrams, turn left or East to S West St, turn right, dead ends at 1st St. Rosebud Theater is on the East end of Center.
Map of University Student Center
Please make plans to attend this important event and bring some tough questions. Hoyt West, DFW Coordinator Health Care for all Texas
Please consider attending this forum and inviting your friends.
You are invited to an Education Forum “Solutions to the Texas Health Care Crisis”
Location: Rosebud Theater UTA, Student Center UTA Arlington ,
When: August 7, 2007, 7 PM to 8:30 PM.
Subjects addressed will be:
· Can all Texans have affordable health insurance?
· Can a system be improvised without raising taxes?
· How can the total cost of health care be reduced in Texas ?
· How can doctors take the delivery of health care away from insurance companies and pharmaceuticals companies?
· Can rising health care cost be stabilized?
· Can drug costs be reduced?
· Does the state and federal government need to get involved?
· Is there a cost analysis that would demonstrate the financial feasibility of
state wide coverage?
Invitees: All DFW Legislators, various physician groups, nursing organizations, hospital executives, county and municipal benefit executives, UTA students, church
organizations, League of Women Voters, local chapter of National Nursing Association and the general public
Co-sponsors: Health Care for all Texas (HCFAT), Arlington and Tarrant League of Women Voters, Local National Nursing Association and the organization “Free Thinkers” of UTA.
Directions: Go south of Cooper off I30 to Abrams, turn left or East to S West St, turn right, dead ends at 1st St. Rosebud Theater is on the East end of Center.
Map of University Student Center
Please make plans to attend this important event and bring some tough questions. Hoyt West, DFW Coordinator Health Care for all Texas
Thursday, July 26, 2007
Medicare Disadvantage- Privatized Health Care For Seniors Can Leave Them In The Dark As Insurance Companies Reap A Windfall
CBS/AP - WEST HAVEN, Conn., July 16, 2007
CBS) It was the summer of 1965 when Medicare was created to provide government-sponsored health care for seniors. Today some $381 billion tax dollars a year are spent on Americans 65 and older.
But in recent years, more and more Americans — 8.3 million and rising — are getting Medicare through private insurance companies. Tonight, CBS News chief investigative correspondent Armen Keteyian takes a closer look at the program critics charge has turned into a disadvantage for seniors, and a windfall for the insurance industry.
It was the winter of 2003 when Congress, in the dead of night, overhauled Medicare.
"This prescription drug benefit is a good deal for all seniors," said Rep. Dennis Hastert, R-Ill.
But buried inside the bill was another deal — one that CBS News investigation has discovered was not necessarily a benefit for seniors.
A large portion of one of the most successful public programs in history was quietly placed in the hands of private insurance companies. The goal of Medicare Advantage: to provide seniors with more benefits, like vision and dental care, and control rising costs. But today, for seniors like Aaron Cohen, it's become Medicare Dis-Advantage.
"I'd rather go back to the old-fashioned Medicare," Cohen told Keteyian.
Cohen, an 86-year-old who lives in Connecticut, says he switched to an advantage plan only after a salesman assured him he would be completely covered while staying in Florida.
But after breaking his leg in that state, Cohen began to believe he had been sold a bill of goods.
"There was something radically wrong," Cohen said. "They wouldn't give me any home therapy, claiming that it wasn't covered."
But that's only part of the problem. With traditional Medicare, there's one plan for everyone, everywhere. Private Medicare Advantage offers as many as 50 different plans, causing untold confusion over coverage, premiums, co-pays, provider networks.
"These insurance benefit packages are very complicated. Almost nobody without really technical sophistication can figure out exactly what they are buying," said Robert Hayes, who runs the Medicare Rights Center.
Hayes said every year his staff fields thousands of calls from seniors scared to death they've made the wrong choice.
Not only are private plans more confusing, they are more expensive to taxpayers.
In fact, three independent reports found private insurance companies are paid, on average, 12 percent more than what it cost the federal government to run Medicare — in some cases, 50 percent more.
FYI: Find out more about private medicare and how to find help navigating the system.
The head of Medicare insists private plans give you more for your money.
"I think there is a lot more that we could do in regular Medicare that we aren't doing currently, that some of the Medicare Advantage plans are able to do because of how the payment structure works," Leslie Norwalk told Keteyian.
But how much of that money is going back into the pockets of the insurance companies?
"Well, it's required by law: 25 percent goes back to the federal treasury, 75 percent goes back to the beneficiary," Norwalk said.
So the insurance companies are doing this, what, out of the kindness of their hearts, asked Keteyian?
"There, there would be, I'm sure, some small amount to administer the additional benefits," Norwalk said.
But CBS News has found that's not always the case. An independent report found when it comes to the fastest-growing plans, known as private fee-for-service, half of that extra money goes back to the insurance companies. All these private Medicare plans are expected to cost taxpayers an additional $54 billion over the next five years.
"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the structure of Medicare as a national treasure that we need to rely on moving forward, is being undermined."
So much so that key Congressional Democrats now want to cut payments to private plans. The insurance industry is fighting back with a direct mail campaign urging seniors to contact their representatives.
Ironically, Cohen got one of the letters. On the back, his very personal feelings about his Medicare Advantage plan.
"This plan is worthless," he wrote.
See broadcast and read more
© MMVII, CBS Interactive, Inc. All Rights Reserved.
CBS) It was the summer of 1965 when Medicare was created to provide government-sponsored health care for seniors. Today some $381 billion tax dollars a year are spent on Americans 65 and older.
But in recent years, more and more Americans — 8.3 million and rising — are getting Medicare through private insurance companies. Tonight, CBS News chief investigative correspondent Armen Keteyian takes a closer look at the program critics charge has turned into a disadvantage for seniors, and a windfall for the insurance industry.
Fast Fact
Three independent reports found private insurance companies are paid, on average, 12 percent more than what it would cost the federal government — in some cases, 50 percent more.
It was the winter of 2003 when Congress, in the dead of night, overhauled Medicare.
"This prescription drug benefit is a good deal for all seniors," said Rep. Dennis Hastert, R-Ill.
But buried inside the bill was another deal — one that CBS News investigation has discovered was not necessarily a benefit for seniors.
A large portion of one of the most successful public programs in history was quietly placed in the hands of private insurance companies. The goal of Medicare Advantage: to provide seniors with more benefits, like vision and dental care, and control rising costs. But today, for seniors like Aaron Cohen, it's become Medicare Dis-Advantage.
"I'd rather go back to the old-fashioned Medicare," Cohen told Keteyian.
Cohen, an 86-year-old who lives in Connecticut, says he switched to an advantage plan only after a salesman assured him he would be completely covered while staying in Florida.
But after breaking his leg in that state, Cohen began to believe he had been sold a bill of goods.
"There was something radically wrong," Cohen said. "They wouldn't give me any home therapy, claiming that it wasn't covered."
But that's only part of the problem. With traditional Medicare, there's one plan for everyone, everywhere. Private Medicare Advantage offers as many as 50 different plans, causing untold confusion over coverage, premiums, co-pays, provider networks.
"These insurance benefit packages are very complicated. Almost nobody without really technical sophistication can figure out exactly what they are buying," said Robert Hayes, who runs the Medicare Rights Center.
Hayes said every year his staff fields thousands of calls from seniors scared to death they've made the wrong choice.
Not only are private plans more confusing, they are more expensive to taxpayers.
In fact, three independent reports found private insurance companies are paid, on average, 12 percent more than what it cost the federal government to run Medicare — in some cases, 50 percent more.
FYI: Find out more about private medicare and how to find help navigating the system.
The head of Medicare insists private plans give you more for your money.
"I think there is a lot more that we could do in regular Medicare that we aren't doing currently, that some of the Medicare Advantage plans are able to do because of how the payment structure works," Leslie Norwalk told Keteyian.
But how much of that money is going back into the pockets of the insurance companies?
"Well, it's required by law: 25 percent goes back to the federal treasury, 75 percent goes back to the beneficiary," Norwalk said.
So the insurance companies are doing this, what, out of the kindness of their hearts, asked Keteyian?
"There, there would be, I'm sure, some small amount to administer the additional benefits," Norwalk said.
But CBS News has found that's not always the case. An independent report found when it comes to the fastest-growing plans, known as private fee-for-service, half of that extra money goes back to the insurance companies. All these private Medicare plans are expected to cost taxpayers an additional $54 billion over the next five years.
"Taxpayers are losing; people in Medicare are losing," Hayes said. "And the structure of Medicare as a national treasure that we need to rely on moving forward, is being undermined."
So much so that key Congressional Democrats now want to cut payments to private plans. The insurance industry is fighting back with a direct mail campaign urging seniors to contact their representatives.
Ironically, Cohen got one of the letters. On the back, his very personal feelings about his Medicare Advantage plan.
"This plan is worthless," he wrote.
See broadcast and read more
© MMVII, CBS Interactive, Inc. All Rights Reserved.
Thursday, July 19, 2007
Report: Privatizing good for lobbyists, bad for taxpayers
Group calls outsourced social services a waste; official says that's wrong
By ROBERT T. GARRETT - The Dallas Morning News - Thursday, July 19, 2007
AUSTIN – Texas' efforts to hand off social services duties to private companies have enriched lobbyists while hurting poor people and wasting tax dollars, a watchdog group said Wednesday.
Over the past decade, 13 companies ultimately hired by the state after four big pushes toward privatization paid 102 lobbyists between $4.5 million and $11.3 million, according to a report by Texans for Public Justice.
The group, which tracks campaign money and lobby contracts in Texas, said the 13 companies hired well-placed lobbyists who nudged lawmakers to require outsourcing of work previously done by government health and human services agencies. The same companies then won bid competitions for $2.1 billion of contracts.
The report criticized the outsourcing efforts for failing to save as much money as was predicted – or, as with four privately run call centers for social program signups, not saving any money.
Health and Human Services Commissioner Albert Hawkins, who has run the privatization efforts during the past 4 ½ years, called the report "somewhat flawed."
Mr. Hawkins said $426 million spent since 2001 on a new Web-based computer system for processing applications for Medicaid, food stamps and cash assistance hasn't been wasted, as suggested by the report and even his own agency's inspector general.
"Funds expended for contract services, we've received services in exchange for those funds," Mr. Hawkins said. "That's not a boondoggle. That's not a waste. That's a point that I think is overlooked."
He also defended his actions to carry out a 2003 mandate from the Legislature to pursue replacing state eligibility workers with contract workers at private call centers. He said when problems arose, he ordered changes. And when those didn't work, he shut down the project and asked lawmakers for funds to fix it.
Mr. Hawkins said lobby expenditures didn't affect procurement decisions on the contracts mentioned in the report, some of which his predecessors awarded.
Contractors named in the report include HMOs, such as UnitedHealth and Amerigroup, which manage health care for elderly and disabled Medicaid recipients; and consulting giants Deloitte, which designed the eligibility computer software, and Accenture, which quit the call center project last spring.
Other firms in the report were Sagem Morpho, a French company that from 1996 until earlier this year analyzed food stamp applicants' fingerprints; and Convergys, which handles the health and human services agencies' payrolls, employee benefits and job applications.
Andrew Wheat, research director at Texans for Public Justice, responded, "He could say [lobbying] has no effect, but a shocking number of his agency's contractors clearly believe otherwise.
"Government contract lobbying is alive and well in the state of Texas. It's a massive, multimillion-dollar business."
Read more
By ROBERT T. GARRETT - The Dallas Morning News - Thursday, July 19, 2007
AUSTIN – Texas' efforts to hand off social services duties to private companies have enriched lobbyists while hurting poor people and wasting tax dollars, a watchdog group said Wednesday.
Over the past decade, 13 companies ultimately hired by the state after four big pushes toward privatization paid 102 lobbyists between $4.5 million and $11.3 million, according to a report by Texans for Public Justice.
The group, which tracks campaign money and lobby contracts in Texas, said the 13 companies hired well-placed lobbyists who nudged lawmakers to require outsourcing of work previously done by government health and human services agencies. The same companies then won bid competitions for $2.1 billion of contracts.
"Too often, architects of Texas' social services privatization schemes appear to have ensured that privatization would fill their own pockets and those of their past or future employers,"the report says.
The report criticized the outsourcing efforts for failing to save as much money as was predicted – or, as with four privately run call centers for social program signups, not saving any money.
Health and Human Services Commissioner Albert Hawkins, who has run the privatization efforts during the past 4 ½ years, called the report "somewhat flawed."
He said it suggests "that any money that you spend on a contract for service counts as wasted expenditures, and that's clearly wrong."
Mr. Hawkins said $426 million spent since 2001 on a new Web-based computer system for processing applications for Medicaid, food stamps and cash assistance hasn't been wasted, as suggested by the report and even his own agency's inspector general.
"Funds expended for contract services, we've received services in exchange for those funds," Mr. Hawkins said. "That's not a boondoggle. That's not a waste. That's a point that I think is overlooked."
He also defended his actions to carry out a 2003 mandate from the Legislature to pursue replacing state eligibility workers with contract workers at private call centers. He said when problems arose, he ordered changes. And when those didn't work, he shut down the project and asked lawmakers for funds to fix it.
Mr. Hawkins said lobby expenditures didn't affect procurement decisions on the contracts mentioned in the report, some of which his predecessors awarded.
Contractors named in the report include HMOs, such as UnitedHealth and Amerigroup, which manage health care for elderly and disabled Medicaid recipients; and consulting giants Deloitte, which designed the eligibility computer software, and Accenture, which quit the call center project last spring.
Other firms in the report were Sagem Morpho, a French company that from 1996 until earlier this year analyzed food stamp applicants' fingerprints; and Convergys, which handles the health and human services agencies' payrolls, employee benefits and job applications.
"Our process takes place in an objective structure," Mr. Hawkins said. "Lobbyists have no influence on that."
Andrew Wheat, research director at Texans for Public Justice, responded, "He could say [lobbying] has no effect, but a shocking number of his agency's contractors clearly believe otherwise.
"Government contract lobbying is alive and well in the state of Texas. It's a massive, multimillion-dollar business."
Read more
Tuesday, July 17, 2007
Farmers Insurance backs off rate hike plan
State was set to reject company's 6.6 percent hike for homeowners
By TERRENCE STUTZ - The Dallas Morning News- Tuesday, July 17, 2007
AUSTIN – Farmers Insurance withdrew a proposed 6.6 percent statewide increase in homeowners rates on Monday after the Texas Department of Insurance signaled that it would reject the proposal.
A spokesman for the insurance department said the agency was poised to oppose the rate plan when Farmers decided to pull it back, canceling a premium increase that was supposed to be effective on Monday.
Agency spokesman Ben Gonzales said state actuaries were concerned about the wide variation of rates in the plan – ranging from a 50 percent increase along the Texas coast to a 10 percent decrease for some customers in North Texas – as well as recent trends indicating the company's current rates are adequate.
"It was clear that we would disapprove the filing as it was written," said Mr. Gonzales, noting that it was "a lot simpler for them to withdraw the filing than to move forward" on a plan that was opposed by the state.
Under the current file-and-use law, Farmers is allowed to raise rates once it has notified the insurance department, but the company is subject to a rate rollback – and refunds – if the commissioner of insurance determines the increases are not warranted. An insurer also has to pay interest on any refunds.
Not giving up
Michelle Levy, a spokeswoman for Farmers, said that while the proposal was pulled back, the company still believes it needs to adjust its rates and is working on an alternate plan.
"They had questions about our filing, so we're working with them to answer their questions and we expect to refile a proposal within 30 to 60 days," she said.
Mr. Gonzales said state actuaries had reservations about charging homeowners in certain parts of the state so much more for their policies.
"The increases are heavily weighted toward the coast, which may be appropriate because of the risks. But we need to see more documentation," he said.
He also cited concerns about the company's loss ratios over the past year, which indicated healthy profits. Farmers' primary home insurance subsidiary in Texas had a loss ratio of 35.5 percent in 2006, close to the statewide average of 34 percent for all companies.
In other words, Farmers paid out 35.5 percent of premiums it collected to cover property losses – a relatively low percentage. A loss ratio of 58 percent is often cited by experts as a good benchmark for profitability.
The other two subsidiaries of Farmers – the third largest home insurer in Texas – had similar percentages.
An actuary with the insurance department also said some of the expenses cited by the company in its rate filing appeared excessive.
Allstate's proposal
Allstate Insurance, the second largest home insurer, also has filed a rate increase with the state that would raise the average cost of its policies by 6.9 percent. Unlike the Farmers proposal, Allstate wants to increase rates in all areas of the state.
Mr. Gonzales said the Allstate proposal – which is supposed to go into effect on July 26 – is still being reviewed by the insurance department actuaries.
"There is no indication yet of which way we will go," he said of the Allstate proposal.
Leading consumer groups have sharply criticized the actions of the two companies for raising their rates at a time when industry profits are soaring.
"If this [rate plan withdrawal] results in real reductions for homeowners, it is good news. If this is just more posturing on the part of the company and the insurance department, then it is par for the course," Alex Winslow of Texas Watch, a consumer group active in insurance issues.
"Homeowners are relying on the insurance department to do its job and make sure that premiums come down once and for all," he said.
Read more
By TERRENCE STUTZ - The Dallas Morning News- Tuesday, July 17, 2007
AUSTIN – Farmers Insurance withdrew a proposed 6.6 percent statewide increase in homeowners rates on Monday after the Texas Department of Insurance signaled that it would reject the proposal.
A spokesman for the insurance department said the agency was poised to oppose the rate plan when Farmers decided to pull it back, canceling a premium increase that was supposed to be effective on Monday.
Agency spokesman Ben Gonzales said state actuaries were concerned about the wide variation of rates in the plan – ranging from a 50 percent increase along the Texas coast to a 10 percent decrease for some customers in North Texas – as well as recent trends indicating the company's current rates are adequate.
"It was clear that we would disapprove the filing as it was written," said Mr. Gonzales, noting that it was "a lot simpler for them to withdraw the filing than to move forward" on a plan that was opposed by the state.
Under the current file-and-use law, Farmers is allowed to raise rates once it has notified the insurance department, but the company is subject to a rate rollback – and refunds – if the commissioner of insurance determines the increases are not warranted. An insurer also has to pay interest on any refunds.
Not giving up
Michelle Levy, a spokeswoman for Farmers, said that while the proposal was pulled back, the company still believes it needs to adjust its rates and is working on an alternate plan.
"They had questions about our filing, so we're working with them to answer their questions and we expect to refile a proposal within 30 to 60 days," she said.
Mr. Gonzales said state actuaries had reservations about charging homeowners in certain parts of the state so much more for their policies.
"The increases are heavily weighted toward the coast, which may be appropriate because of the risks. But we need to see more documentation," he said.
He also cited concerns about the company's loss ratios over the past year, which indicated healthy profits. Farmers' primary home insurance subsidiary in Texas had a loss ratio of 35.5 percent in 2006, close to the statewide average of 34 percent for all companies.
In other words, Farmers paid out 35.5 percent of premiums it collected to cover property losses – a relatively low percentage. A loss ratio of 58 percent is often cited by experts as a good benchmark for profitability.
The other two subsidiaries of Farmers – the third largest home insurer in Texas – had similar percentages.
An actuary with the insurance department also said some of the expenses cited by the company in its rate filing appeared excessive.
Allstate's proposal
Allstate Insurance, the second largest home insurer, also has filed a rate increase with the state that would raise the average cost of its policies by 6.9 percent. Unlike the Farmers proposal, Allstate wants to increase rates in all areas of the state.
Mr. Gonzales said the Allstate proposal – which is supposed to go into effect on July 26 – is still being reviewed by the insurance department actuaries.
"There is no indication yet of which way we will go," he said of the Allstate proposal.
Leading consumer groups have sharply criticized the actions of the two companies for raising their rates at a time when industry profits are soaring.
"If this [rate plan withdrawal] results in real reductions for homeowners, it is good news. If this is just more posturing on the part of the company and the insurance department, then it is par for the course," Alex Winslow of Texas Watch, a consumer group active in insurance issues.
"Homeowners are relying on the insurance department to do its job and make sure that premiums come down once and for all," he said.
Read more
Monday, July 16, 2007
Rick Perry's on Community Colleges and Health Insurance
In a sepcial statement to the Bryan College Station Eagle, published Saturday, July 14, 2007
Governor Perry said:
Governor Perry said:
Perry: Our colleges must follow the law
By GOV. RICK PERRY - Special to the Eagle
Community colleges are the backbone of our higher education system in Texas. They provide a community-based way for Texans to get a quality education close to home. To help them succeed in their vital role, I have supported increased funding for community colleges throughout my tenure as governor. In fact, state funding for instruction at these institutions has grown by $121.1 million, or 16.4 percent, in the past 6 years and I have proposed another $86.1 million in incentive performance funding above and beyond what the Legislature provided.
However, just as I have repeatedly supported increased state funds for community colleges, I have also consistently called for community colleges to follow state law by paying their appropriate share of health insurance for their employees. Unfortunately, they have been unwilling to do this.
Unlike larger universities with a statewide reach, community colleges serve the needs of a specific local area. As such, they are empowered to raise taxes from the population they serve, not unlike a local hospital, school or utility district.
These community colleges then pay their employees from either these local taxes (combined with tuition and fees) or state funds which are allocated by the Legislature and collected from all the taxpayers in Texas. State law clearly dictates that any community college employee paid with state funds can have their health insurance paid the same way. However, state law also says that if a community college employee is paid from locally-raised funds, their health insurance must also be paid from that same local source.
I fully support this sensible dividing line between funding sources. If the state pays an instructor's salary, then the state should also fund his or her health benefits. However, I don't support the notion that all Texas taxpayers should cover the health benefits of those local community college employees who are not paid by state funds. This would be akin to the state of Texas paying the health insurance of a local city councilman or a county commissioner.
Unfortunately, this is exactly what has been happening. And this is precisely the reason I vetoed a portion of community college health insurance funding for the 2008-2009 biennium
For years, community colleges have approached the Legislature and, on the advice of their association, insisted the state pay health insurance benefits for employees not paid by the state, but by local funds. Despite the clarity of the law on this matter, community colleges have continually pursued a distorted interpretation by arguing that any employee who is eligible in theory for a state-funded salary is entitled to state-funded health benefits even if they are not actually paid by the state. Their argument clearly runs counter to state law.
I addressed this issue in my 2003 State-of-the-State address, asking community colleges to begin paying their fair share. In 2005, the Texas Legislature, through the Legislative Budget Board, produced an eye-opening report showing that every community college was circumventing the law, shifting millions in local health insurance costs to the state. In their 2005 budget, the Texas Senate reacted to this report by phasing out improper community college health insurance funding and reallocating those funds to the colleges for instruction. I supported this change as a reasonable approach to address the problem. Unfortunately, the Texas House of Representatives did not.
Then, in 2006, the Legislative Budget Board and my office provided detailed, specific instructions to community colleges for requesting state health insurance funding for eligible employees. Unfortunately, the community colleges again refused to follow the Legislature's directives.
When my staff questioned community colleges about this issue at a public budget hearing on Oct. 2, 2006, a representative of the Texas Association of Community Colleges responded that their mission "supersedes" the law as it is written. I wholeheartedly disagree: no community college's mission supersedes state law. During the 2007 legislative session, my staff reminded the community colleges on the specifics of the law. In conversations with their association, my staff implored them to play by the rules set by the Legislature. The association refused.
As governor, I owe it to Texas taxpayers to ensure the law is followed and that taxpayer dollars are spent as the law intends. I will continue to call for increased formula funding for our community colleges because they deserve our support as they educate our future leaders. However, I will also hold them accountable to the spirit and letter of the law. Community colleges are an essential contributor to our state's future success and I remain committed to helping them maintain the highest standards in pursuit of their mission.
Lawsuit limits lure doctors to Texas, creating backlog
Associated Press - Tuesday, July 10, 2007
AUSTIN - An influx of doctors lured to Texas by new limits on malpractice lawsuits has overwhelmed the state board that screens candidates for medical licenses, creating a backlog that forces many applicants to wait months before they can start seeing patients.
Officials said many of the relocating physicians are filling shortages in areas such as Beaumont, where trauma patients previously had to be flown other cities because there weren't enough surgeons to treat them.
But Austin psychiatrist Dr. James Kreisle Jr. said he fears the Texas Medical Board's backlog could prompt some physicians to rethink their decision to move.
Kreisle and his colleagues have been waiting since the fall for two psychiatrists from South Carolina and Georgia to get licensed in Texas so they can join their practice. In the meantime, patients are being forced to wait three weeks for appointments.
The board received 4,000 applications for medical licenses in 2006, up from 2,992 the previous year. Spokeswoman Jill Wiggins said the board expects to approve 2,750 new licenses this year, 235 more than last year. There is a backlog of more than 2,398 applications.
Lawmakers approved $1.2 million to hire six more employees to process applications more quickly. The board has also hired temporary workers and is paying staffers overtime, but they still can't keep up, Wiggins said.
"The pipeline is just clogged," she said.
Approving an application for a medical license involves verifying the doctor's medical education, doing a criminal background check and other steps. In 2003, it took 45 days to approve the most complex applications and 20 days to approve the simplest.
Data provided by the board shows it is now taking the agency more than six months to process the most complicated applications, including those that come from out-of-state doctors or veteran doctors who have long histories to be checked. The simplest applications are taking about 41 days to approve.
Wiggins estimated it will take "a little over a year" before the agency's new staffers can bring the applications backlog under control.
"You're turning a battleship around," she said.
Several doctors who moved to Texas from other states said they were drawn by lower malpractice insurance rates.
read more
AUSTIN - An influx of doctors lured to Texas by new limits on malpractice lawsuits has overwhelmed the state board that screens candidates for medical licenses, creating a backlog that forces many applicants to wait months before they can start seeing patients.
Officials said many of the relocating physicians are filling shortages in areas such as Beaumont, where trauma patients previously had to be flown other cities because there weren't enough surgeons to treat them.
But Austin psychiatrist Dr. James Kreisle Jr. said he fears the Texas Medical Board's backlog could prompt some physicians to rethink their decision to move.
Kreisle and his colleagues have been waiting since the fall for two psychiatrists from South Carolina and Georgia to get licensed in Texas so they can join their practice. In the meantime, patients are being forced to wait three weeks for appointments.
The board received 4,000 applications for medical licenses in 2006, up from 2,992 the previous year. Spokeswoman Jill Wiggins said the board expects to approve 2,750 new licenses this year, 235 more than last year. There is a backlog of more than 2,398 applications.
Lawmakers approved $1.2 million to hire six more employees to process applications more quickly. The board has also hired temporary workers and is paying staffers overtime, but they still can't keep up, Wiggins said.
"The pipeline is just clogged," she said.
Approving an application for a medical license involves verifying the doctor's medical education, doing a criminal background check and other steps. In 2003, it took 45 days to approve the most complex applications and 20 days to approve the simplest.
Data provided by the board shows it is now taking the agency more than six months to process the most complicated applications, including those that come from out-of-state doctors or veteran doctors who have long histories to be checked. The simplest applications are taking about 41 days to approve.
Wiggins estimated it will take "a little over a year" before the agency's new staffers can bring the applications backlog under control.
"You're turning a battleship around," she said.
Several doctors who moved to Texas from other states said they were drawn by lower malpractice insurance rates.
read more
Sunday, July 15, 2007
About this site
People Power Profit - Healthcare & Insurance is a site of DFW-RCC (DFW Regional Concerned Citizens, am activist network/think tank of citizens in the 16 county North Central Texas Council of Government (DFW Region) focusing on govermental/policy issues. This particular site focuses on issues pertaining to insurance and healthcare.
Friday, July 13, 2007
Insurance Premius rely on credit reports for setting insurance premium rates
By Texas Watch - July 12, 2007
Check Your Credit Report Every Year
81% of Credit Reports Contain ErrorsInsurance companies rely heavily on credit scoring when they set their rates. At Texas Watch, we believe that insurance credit scoring is unfair and should be banned outright. Credit scores are often based on flawed and inaccurate data. As a result, consumers see their insurance premiums increase. We will continue to push for an end to the unfair use of insurance credit scoring, but in the meantime, one of the most important things you can do as an informed consumer is to check your credit report annually.
The Federal Trade Commission now offers you a free credit report every year from each of the three major credit bureaus-Equifax, Experian and TransUnion. We recommend checking all three of the bureaus each year to get the most in-depth report possible.
This free report offers a powerful tool to consumers so they can ensure they have the most accurate credit history possible. By checking your report every year, you can check for mistakes or even fraudulent claims. 81% of consumers have some kind of error on their credit report. Mistakes on your credit report can lead to higher insurance premiums and interest rates.
You can dispute the errors on your credit report by contacting the credit bureau that reported the error. Reviewing the reports gives you a chance to see what credit agencies see when they look at your history, and gives you the opportunity to make sure your report is as accurate as possible.
Be careful when using the internet to check your credit report. There are several credit reporting websites that will charge you for their service. You can access your free credit report at www.annualcreditreport.com, monitored by the Federal Trade Commission.
If you have seen your insurance premiums go up as a result of errors on your credit score, we want to hear about it. Please take a moment to share your story with us.
Check Your Credit Report Every Year
81% of Credit Reports Contain ErrorsInsurance companies rely heavily on credit scoring when they set their rates. At Texas Watch, we believe that insurance credit scoring is unfair and should be banned outright. Credit scores are often based on flawed and inaccurate data. As a result, consumers see their insurance premiums increase. We will continue to push for an end to the unfair use of insurance credit scoring, but in the meantime, one of the most important things you can do as an informed consumer is to check your credit report annually.
The Federal Trade Commission now offers you a free credit report every year from each of the three major credit bureaus-Equifax, Experian and TransUnion. We recommend checking all three of the bureaus each year to get the most in-depth report possible.
This free report offers a powerful tool to consumers so they can ensure they have the most accurate credit history possible. By checking your report every year, you can check for mistakes or even fraudulent claims. 81% of consumers have some kind of error on their credit report. Mistakes on your credit report can lead to higher insurance premiums and interest rates.
You can dispute the errors on your credit report by contacting the credit bureau that reported the error. Reviewing the reports gives you a chance to see what credit agencies see when they look at your history, and gives you the opportunity to make sure your report is as accurate as possible.
Be careful when using the internet to check your credit report. There are several credit reporting websites that will charge you for their service. You can access your free credit report at www.annualcreditreport.com, monitored by the Federal Trade Commission.
If you have seen your insurance premiums go up as a result of errors on your credit score, we want to hear about it. Please take a moment to share your story with us.
Friday, July 6, 2007
Healthcare Teleconference Monday July 8, 7 pm Central Time
Wondering what you can do about healthcare issues this summer after watching SICKO?
Democracy for America (DFA) has hired Illy Sheyman as their new Community Organizer. She will be holding a Texas (possibly nationwide) teleconference regarding Healthcare for America forums, legislative visits, and any questions we might have on Monday, July 8 at 7 pm Central time.
Please RSVP at : http//www.dfalink.com/event.php?=21412
Thanks,
lauri wiss
Democracy for America (DFA) has hired Illy Sheyman as their new Community Organizer. She will be holding a Texas (possibly nationwide) teleconference regarding Healthcare for America forums, legislative visits, and any questions we might have on Monday, July 8 at 7 pm Central time.
Please RSVP at : http//www.dfalink.com/event.php?=21412
Thanks,
lauri wiss
Wednesday, July 4, 2007
Surgeon's suit claims UT Southwestern patients mistreated
By BRETT SHIPP = WFAA-TV - Tuesday, July 3, 2007
The former chairman of Parkland Memorial Hospital's emergency room has made disturbing allegations about the care of patients.
In addition to claiming taxpayers are being cheated by his bosses who are breaking the law, he said patients are being mistreated. He also said the moment he voiced complaints to UT Southwestern officials, he was then demoted.
Dr. Larry Gentilello is recognized as one of the top trauma surgeons in the country.
However, he was demoted in March after he said he complained to his supervisor, Dr. Robert Rege, that UT Southwestern was cheating indigent patients and taxpayers by not properly staffing the emergency room with experienced surgeons as required.
Gentilello said he observed patients at Parkland's emergency room being treated by residents with no attending physicians. He also said he saw residents conduct surgeries without supervision.
In his lawsuit against UT Southwestern Health Systems, Gentilello claimed the situation at the hospital is not only "illegal," but has also resulted in "inadequate patient care," and at the very least, violates "proper operating room and patient treatment protocols."
UT Southwestern released a statement that said Gentilello's claims are "baseless" and that he was removed from his position for "legitimate reasons."
In fact, on the witness stand, Gentilello's supervisor said the ER director never talked with him about any problems.
But Gentilello said he did blow the whistle, not only because UT Southwestern has billed for services not rendered, but also because he said supervisory surgeons have been busy serving paying customers at Zale Lipshy Hospital next door.
Gentilello said he wants his old job back and wants UT Southwestern to treat patients and taxpayers fairly and honestly.
Watch report on WFAA
The former chairman of Parkland Memorial Hospital's emergency room has made disturbing allegations about the care of patients.
In addition to claiming taxpayers are being cheated by his bosses who are breaking the law, he said patients are being mistreated. He also said the moment he voiced complaints to UT Southwestern officials, he was then demoted.
Dr. Larry Gentilello is recognized as one of the top trauma surgeons in the country.
However, he was demoted in March after he said he complained to his supervisor, Dr. Robert Rege, that UT Southwestern was cheating indigent patients and taxpayers by not properly staffing the emergency room with experienced surgeons as required.
Gentilello said he observed patients at Parkland's emergency room being treated by residents with no attending physicians. He also said he saw residents conduct surgeries without supervision.
In his lawsuit against UT Southwestern Health Systems, Gentilello claimed the situation at the hospital is not only "illegal," but has also resulted in "inadequate patient care," and at the very least, violates "proper operating room and patient treatment protocols."
UT Southwestern released a statement that said Gentilello's claims are "baseless" and that he was removed from his position for "legitimate reasons."
In fact, on the witness stand, Gentilello's supervisor said the ER director never talked with him about any problems.
But Gentilello said he did blow the whistle, not only because UT Southwestern has billed for services not rendered, but also because he said supervisory surgeons have been busy serving paying customers at Zale Lipshy Hospital next door.
Gentilello said he wants his old job back and wants UT Southwestern to treat patients and taxpayers fairly and honestly.
Watch report on WFAA
Monday, June 25, 2007
Conflict-of-Interest Reporting Serves to Replace Fact With Fiction in Vaccine Injury Cases
PRNewswire-USNewswire - Monday, June 25, 2007
WASHINGTON -- With the Autism Omnibus Proceedings now in the second week of testimony in the US Court of Federal Claims, advocates for vaccine-injured children are calling the bulk of media accounts biased against families.
Often presented as ironclad in many media accounts, the misinformation parents and advocacy organizations note as appearing most frequently in mainstream news include:
-- the 2004 IOM report suggesting that research involving thimerosal be discontinued, even though the committee considering the research presented disregarded clinical investigation in favor of epidemiology conducted in Europe and funded primarily by drug companies and public health agencies
-- the assertion that the autism rate of one in 150 children is attributable to better diagnosing, while the symptoms associated with autism are profound, and according to parents and professionals alike "can't be missed"
-- the claim that the mercury-based preservative thimerosal has been removed from all vaccines, although most flu shots and several other vaccines still contain 25 micrograms mercury, an amount considered unsafe by government guidelines for anyone weighing under 550 lbs.
(See Vaccines Safety for a current list of vaccines and thimerosal content.)
-- that there is no science linking vaccines to autism, even though many peer-reviewed published studies confirm the link between mercury and neurological injuries with symptoms nearly identical to autism spectrum disorders (
View some of the relevant studies.
The use of spokespersons with ties to drug companies in news accounts has also been cited as form of bias. Dr. Paul Offit has been quoted frequently in defense of the practice of injecting mercury into pregnant women and young children. Dr. Offit's work has been funded for over 15 years by pharmaceutical giant Merck, with whom he is co-patent holder of the RotaTeq vaccine. The FDA announced last week that RotaTeq will now carry a label warning for pediatricians and parents about the vaccine's link to Kawasaki Disease, considered one of the leading causes of acquired heart disease among children in the US.
During the first week of the hearings, an NBC Today show segment featuring former Johnson & Johnson vice president Dr. Nancy Snyderman drew further criticism when Snyderman suggested that parents involved in the autism hearings were motivated by financial gain.
Johnson & Johnson subsidiary Ortho Clinical Diagnostics is involved in litigation for injuries, including autism, associated with its thimerosal- containing Rh immune globulin product, RhoGAM.
For more information, or contacts: Wendy Fournier (Portsmouth, RI) 401-632-7523 Rita Shreffler (Nixa, MO) 401-632-6452
National Autism Association or see National Autism Associates Website.
WASHINGTON -- With the Autism Omnibus Proceedings now in the second week of testimony in the US Court of Federal Claims, advocates for vaccine-injured children are calling the bulk of media accounts biased against families.
Often presented as ironclad in many media accounts, the misinformation parents and advocacy organizations note as appearing most frequently in mainstream news include:
-- the 2004 IOM report suggesting that research involving thimerosal be discontinued, even though the committee considering the research presented disregarded clinical investigation in favor of epidemiology conducted in Europe and funded primarily by drug companies and public health agencies
-- the assertion that the autism rate of one in 150 children is attributable to better diagnosing, while the symptoms associated with autism are profound, and according to parents and professionals alike "can't be missed"
-- the claim that the mercury-based preservative thimerosal has been removed from all vaccines, although most flu shots and several other vaccines still contain 25 micrograms mercury, an amount considered unsafe by government guidelines for anyone weighing under 550 lbs.
(See Vaccines Safety for a current list of vaccines and thimerosal content.)
-- that there is no science linking vaccines to autism, even though many peer-reviewed published studies confirm the link between mercury and neurological injuries with symptoms nearly identical to autism spectrum disorders (
View some of the relevant studies.
The use of spokespersons with ties to drug companies in news accounts has also been cited as form of bias. Dr. Paul Offit has been quoted frequently in defense of the practice of injecting mercury into pregnant women and young children. Dr. Offit's work has been funded for over 15 years by pharmaceutical giant Merck, with whom he is co-patent holder of the RotaTeq vaccine. The FDA announced last week that RotaTeq will now carry a label warning for pediatricians and parents about the vaccine's link to Kawasaki Disease, considered one of the leading causes of acquired heart disease among children in the US.
During the first week of the hearings, an NBC Today show segment featuring former Johnson & Johnson vice president Dr. Nancy Snyderman drew further criticism when Snyderman suggested that parents involved in the autism hearings were motivated by financial gain.
"Apparently, Dr. Snyderman is either completely ignorant of the emotional and financial devastation to families of children suffering from vaccine-related injuries or she's speaking on behalf of her former employer. Either way, it's unacceptable,"commented NAA president and parent Wendy Fournier. Dr. Snyderman's former employment with Johnson & Johnson was not disclosed to viewers.
Johnson & Johnson subsidiary Ortho Clinical Diagnostics is involved in litigation for injuries, including autism, associated with its thimerosal- containing Rh immune globulin product, RhoGAM.
For more information, or contacts: Wendy Fournier (Portsmouth, RI) 401-632-7523 Rita Shreffler (Nixa, MO) 401-632-6452
National Autism Association or see National Autism Associates Website.
Staph Superbug May Be Infecting Patients
By MIKE STOBBE – Associated Press - Monday, June 25, 2007
ATLANTA - A dangerous, drug-resistant staph germ may be infecting as many as 5 percent of hospital and nursing home patients, according to a comprehensive study.
At least 30,000 U.S. hospital patients may have the superbug at any given time, according to a survey released Monday by the Association for Professionals in Infection Control and Epidemiology.
The estimate is about 10 times the rate that some health officials had previously estimated.
Some federal health officials said they had not seen the study and could not comment on its methodology or its prevalence. But they welcomed added attention to the problem.
At issue is a superbug known as Methicillin-resistant Staphylococcus aureus, which cannot be tamed by certain common antibiotics. It is associated with sometimes-horrific skin infections, but it also causes blood infections, pneumonia and other illnesses.
The potentially fatal germ, which is spread by touch, typically thrives in health care settings where people have open wounds. But in recent years, "community-associated" outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels.
Past studies have looked at how common the superbug is in specific patient groups, such as emergency-room patients with skin infections in 11 U.S. cities, dialysis patients or those admitted to intensive care units in a sample of a few hundred teaching hospitals.
It's difficult to compare prevalence estimates from the different studies, experts said, but the new study suggests the superbug is eight to 11 times more common than some other studies have concluded. The new study was different in that it sampled a larger and more diverse set of health care facilities. It also was more recent than other studies, and it counted cases in which the bacterium was merely present in a patient and not necessarily causing disease.
The infection control professionals' association sent surveys to its more than 11,000 members and asked them to pick one day from Oct. 1 to Nov. 10, 2006, to count cases of the infection. They were to turn in the number of all the patients in their health care facilities who were identified through test results as infected or colonized with the superbug.
The final results represented 1,237 hospitals and nursing homes - or roughly 21 percent of U.S. inpatient health care facilities, association officials said.
The researchers concluded that at least 46 out of every 1,000 patients had the bug.
There was a breakdown: About 34 per 1,000 were infected with the superbug, meaning they had skin or blood infections or some other clinical symptom. And 12 per 1,000 were "colonized," meaning they had the bug but no illness. Most of the patients were identified within 48 hours of hospital admission, which means, the researchers believe, that they didn't have time to become infected to the degree that a test would show it. For that reason, the researchers concluded that about 75 percent of patients walked into the hospitals and nursing homes already carrying the bug. "They acquired it in a previous stay in health care facility, or out in the community," said Dr. William Jarvis, a consulting epidemiologist and former CDC officials who led the study.
The infection can be treated with other antibiotics. Health care workers can prevent spread of the bug through hand-washing and equipment decontamination, and by wearing gloves and gowns and by separating infected people from other patients.
The study is being presented this week at the association's annual meeting in San Jose, Calif., but has not been submitted for publication in a peer-reviewed medical journal.
See also:
Association for Professionals in Infection Control & Epidemiology
The CDC's Web page on MRSA
Source: Associated Press/AP Online
ATLANTA - A dangerous, drug-resistant staph germ may be infecting as many as 5 percent of hospital and nursing home patients, according to a comprehensive study.
At least 30,000 U.S. hospital patients may have the superbug at any given time, according to a survey released Monday by the Association for Professionals in Infection Control and Epidemiology.
The estimate is about 10 times the rate that some health officials had previously estimated.
Some federal health officials said they had not seen the study and could not comment on its methodology or its prevalence. But they welcomed added attention to the problem.
"This is a welcome piece of information that emphasizes that this is a huge problem in health care facilities, and more needs to done to prevent it,"said Dr. John Jernigan, an epidemiologist with the U.S. Centers for Disease Control and Prevention.
At issue is a superbug known as Methicillin-resistant Staphylococcus aureus, which cannot be tamed by certain common antibiotics. It is associated with sometimes-horrific skin infections, but it also causes blood infections, pneumonia and other illnesses.
The potentially fatal germ, which is spread by touch, typically thrives in health care settings where people have open wounds. But in recent years, "community-associated" outbreaks have occurred among prisoners, children and athletes, with the germ spreading through skin contact or shared items such as towels.
Past studies have looked at how common the superbug is in specific patient groups, such as emergency-room patients with skin infections in 11 U.S. cities, dialysis patients or those admitted to intensive care units in a sample of a few hundred teaching hospitals.
It's difficult to compare prevalence estimates from the different studies, experts said, but the new study suggests the superbug is eight to 11 times more common than some other studies have concluded. The new study was different in that it sampled a larger and more diverse set of health care facilities. It also was more recent than other studies, and it counted cases in which the bacterium was merely present in a patient and not necessarily causing disease.
The infection control professionals' association sent surveys to its more than 11,000 members and asked them to pick one day from Oct. 1 to Nov. 10, 2006, to count cases of the infection. They were to turn in the number of all the patients in their health care facilities who were identified through test results as infected or colonized with the superbug.
The final results represented 1,237 hospitals and nursing homes - or roughly 21 percent of U.S. inpatient health care facilities, association officials said.
The researchers concluded that at least 46 out of every 1,000 patients had the bug.
There was a breakdown: About 34 per 1,000 were infected with the superbug, meaning they had skin or blood infections or some other clinical symptom. And 12 per 1,000 were "colonized," meaning they had the bug but no illness. Most of the patients were identified within 48 hours of hospital admission, which means, the researchers believe, that they didn't have time to become infected to the degree that a test would show it. For that reason, the researchers concluded that about 75 percent of patients walked into the hospitals and nursing homes already carrying the bug. "They acquired it in a previous stay in health care facility, or out in the community," said Dr. William Jarvis, a consulting epidemiologist and former CDC officials who led the study.
The infection can be treated with other antibiotics. Health care workers can prevent spread of the bug through hand-washing and equipment decontamination, and by wearing gloves and gowns and by separating infected people from other patients.
The study is being presented this week at the association's annual meeting in San Jose, Calif., but has not been submitted for publication in a peer-reviewed medical journal.
See also:
Association for Professionals in Infection Control & Epidemiology
The CDC's Web page on MRSA
Source: Associated Press/AP Online
New drug approved for Fibromyalgia patients
By MACIE JEPSON - WFAA-TV - Friday, June 22, 2007
As many as 13 percent of women in America have a neurological condition called Fibromyalgia and for the first time, the FDA has approved a drug that can help. It's called Lyrica.
Pamela Kennedy struggles everyday to take care of her toddler son.
"With Fibromyalgia, I've had pain for 15 years in all my joints," she said.
For many of those years, she's gotten relief from mind-altering pain pills that ease the muscular discomfort that she wakes up and goes to bed with everyday.
"If they could think of something I could take and be lucid all day and be a mom, that would be good."
The drug company Pfizer thinks it has. In clinical trials Lyrica was found to reduce pain, without the dangers of pain medication.
Lyrica decreased the release of neurotransmitters in the brain linked to the pain, fatigue and cognitive problems associated with Fibromyalgia. The disorder typically causes muscle pain, insomnia and stiffness.
Dr. John Harney already sees improvement in his patients.
Lyrica was already approved for treatment of tremors, migraines, muscular sclerosis and other neurological disorders.
Lyrica website
As many as 13 percent of women in America have a neurological condition called Fibromyalgia and for the first time, the FDA has approved a drug that can help. It's called Lyrica.
Pamela Kennedy struggles everyday to take care of her toddler son.
"With Fibromyalgia, I've had pain for 15 years in all my joints," she said.
For many of those years, she's gotten relief from mind-altering pain pills that ease the muscular discomfort that she wakes up and goes to bed with everyday.
"If they could think of something I could take and be lucid all day and be a mom, that would be good."
The drug company Pfizer thinks it has. In clinical trials Lyrica was found to reduce pain, without the dangers of pain medication.
Lyrica decreased the release of neurotransmitters in the brain linked to the pain, fatigue and cognitive problems associated with Fibromyalgia. The disorder typically causes muscle pain, insomnia and stiffness.
Dr. John Harney already sees improvement in his patients.
he said.
"In about 200 of my patients over the last year and a half, I've found they have more energy, get into their exercise program more and pain drops about 50 percent. It's great news,"
Lyrica was already approved for treatment of tremors, migraines, muscular sclerosis and other neurological disorders.
Lyrica website
Saturday, June 23, 2007
Two FW hospitals among nation's deadliest for heart patients
Baylor All Saints, Huguley say they respect U.S. study, but numbers may mislead
By JASON ROBERSON - The Dallas Morning News -Friday, June 22, 2007
Fort Worth is home to two of the nation's deadliest hospitals for patients being treated for heart failure: Baylor's All Saints Medical Center and Huguley Health System, according to a report from the U.S. Department of Health and Human Services.
After reviewing data on 4,500 hospitals across the country the department's Centers for Medicare & Medicaid Services division released a list of hospitals it said are performing either better or worse than the nation's average mortality rate for patients treated for heart attacks or for heart failure. The report did not list the national averages, nor did it reveal how far off a hospital was from those averages.
All Texas hospitals performed at the national average for heart attacks while five Texas hospitals made the Health and Human Services list for heart failure.
Hendrick Medical Center in Abilene and Christus St. Michael Health System in Texarkana also performed worse than average.
Meanwhile, Houston's Memorial Hermann Healthcare System was the only Texas hospital to do better – with a lower mortality rate than the national average.
The mortality numbers were based on a year's worth of hospital admissions, from July 1, 2005, to June 30, 2006.
The Centers for Medicaid & Medicare Services says it will use the report to help motivate hospitals to improve their quality.
In fiscal year 2008, ending September 2008, poor performing hospitals must show improvement in order to receive full Medicare and Medicaid reimbursements. Health and Human Services will tighten the "pay for performance" incentive measures it has used since 2003.
Executives and spokespeople at Texas' losing hospitals spoke of their hopes to do better. No one disputed the findings.
"What's weird is that we just received an award from the Texas Medical Foundation two weeks ago for clinical excellence," Mr. Adamie said. He added that Huguley, by just two deaths, missed the bell curve separating average performing hospitals from those performing worse than the national average.
The largest Texas hospital with a higher mortality rate than average is Baylor All Saints.
"Patients should be reassured that there is oversight; people are concerned and we're working to make the necessary improvements," said Dr. Clyde Yancy, medical director of Baylor's Heart and Vascular Institute. "I respect the overall study. Obviously we have to take a look internally."
In a letter obtained by The Dallas Morning News, the Centers for Medicare & Medicaid Services gave hospitals the following disclaimer to its report:
In an interview, Dr. Yancy said that adjusting for patient risk factors (such as the number with complicated cases) might have altered the findings.
Still, the report helped identify which areas of heart care need improvement at All Saints, he said.
Since the Fort Worth hospital was on par with the nation for heart attack treatment, Dr. Yancy said he targeted heart failure care with comprehensive educational programs for nurses in February.
Heart failure is the result of any number of diseases that prevent the heart from pumping blood normally. A heart attack is a type of heart failure where too little blood reaches the heart, resulting in damage to the heart's muscle.
Baylor's All Saints Medical Center has scored high in some state quality rankings. According to recent data from the Texas Department of State Health Services, Baylor All Saints' overall in-hospital mortality rate is the fourth lowest among more than 60 Dallas and Fort Worth area hospitals.
At the Hendrick Medical Center in Abilene, which also performed below average, marketing director Karen Brittain said patients should look at a variety of quality indicators. She added that her hospital was recognized as a Blue Distinction Center of Cardiac Care by Blue Cross/Blue Shield of Texas.
"But we certainly welcome any data sources that help us get better," Ms. Brittain said.
Houston's Memorial Hermann Healthcare System, which the Department of Health and Human Services ranks as one of the nation's best, was the only Texas hospital to have a lower than average mortality rate for heart failure patients.
Dr. Shabot said officials at the hospital were not surprised by their high ranking, having come to expect accolades. "In some ways we're competing with ourselves," he said.
Dr. Shabot did not take issue with the report's assessments.
Read more
By JASON ROBERSON - The Dallas Morning News -Friday, June 22, 2007
Fort Worth is home to two of the nation's deadliest hospitals for patients being treated for heart failure: Baylor's All Saints Medical Center and Huguley Health System, according to a report from the U.S. Department of Health and Human Services.
After reviewing data on 4,500 hospitals across the country the department's Centers for Medicare & Medicaid Services division released a list of hospitals it said are performing either better or worse than the nation's average mortality rate for patients treated for heart attacks or for heart failure. The report did not list the national averages, nor did it reveal how far off a hospital was from those averages.
All Texas hospitals performed at the national average for heart attacks while five Texas hospitals made the Health and Human Services list for heart failure.
Hendrick Medical Center in Abilene and Christus St. Michael Health System in Texarkana also performed worse than average.
Meanwhile, Houston's Memorial Hermann Healthcare System was the only Texas hospital to do better – with a lower mortality rate than the national average.
The mortality numbers were based on a year's worth of hospital admissions, from July 1, 2005, to June 30, 2006.
The Centers for Medicaid & Medicare Services says it will use the report to help motivate hospitals to improve their quality.
In fiscal year 2008, ending September 2008, poor performing hospitals must show improvement in order to receive full Medicare and Medicaid reimbursements. Health and Human Services will tighten the "pay for performance" incentive measures it has used since 2003.
Executives and spokespeople at Texas' losing hospitals spoke of their hopes to do better. No one disputed the findings.
But a Huguley Health System spokesman said the numbers are somewhat misleading. After receiving news of their mortality ranking on June 11, Huguley hospital administrators pulled the files of deceased patients submitted for the study.
Of the 29 deaths occurring during the study, 10 people were already in hospice care before their heart failure, suggesting they were expected to die, while one was 100 years old and another 98 years old, said Huguley spokesman Kurt Adamie.
"What's weird is that we just received an award from the Texas Medical Foundation two weeks ago for clinical excellence," Mr. Adamie said. He added that Huguley, by just two deaths, missed the bell curve separating average performing hospitals from those performing worse than the national average.
The largest Texas hospital with a higher mortality rate than average is Baylor All Saints.
"Patients should be reassured that there is oversight; people are concerned and we're working to make the necessary improvements," said Dr. Clyde Yancy, medical director of Baylor's Heart and Vascular Institute. "I respect the overall study. Obviously we have to take a look internally."
In a letter obtained by The Dallas Morning News, the Centers for Medicare & Medicaid Services gave hospitals the following disclaimer to its report:
"It is important to note that while your hospital, your state and the national crude mortality rates are all reported here for your reference, they are not directly comparable as they have not been risk-adjusted to account for patient differences, nor have any hospital adjustments been made to account for differences in sample sizes."
In an interview, Dr. Yancy said that adjusting for patient risk factors (such as the number with complicated cases) might have altered the findings.
Still, the report helped identify which areas of heart care need improvement at All Saints, he said.
Since the Fort Worth hospital was on par with the nation for heart attack treatment, Dr. Yancy said he targeted heart failure care with comprehensive educational programs for nurses in February.
Heart failure is the result of any number of diseases that prevent the heart from pumping blood normally. A heart attack is a type of heart failure where too little blood reaches the heart, resulting in damage to the heart's muscle.
Baylor's All Saints Medical Center has scored high in some state quality rankings. According to recent data from the Texas Department of State Health Services, Baylor All Saints' overall in-hospital mortality rate is the fourth lowest among more than 60 Dallas and Fort Worth area hospitals.
At the Hendrick Medical Center in Abilene, which also performed below average, marketing director Karen Brittain said patients should look at a variety of quality indicators. She added that her hospital was recognized as a Blue Distinction Center of Cardiac Care by Blue Cross/Blue Shield of Texas.
"But we certainly welcome any data sources that help us get better," Ms. Brittain said.
Houston's Memorial Hermann Healthcare System, which the Department of Health and Human Services ranks as one of the nation's best, was the only Texas hospital to have a lower than average mortality rate for heart failure patients.
"We as a hospital system are so focused on clinical quality for our patients that we take every guideline endorsed by cardiology societies to heart and work on those every day, so that every patient with a heart attack, every patient with heart failure, gets every known beneficial therapy,"said Dr. Michael Shabot, chief quality officer.
Dr. Shabot said officials at the hospital were not surprised by their high ranking, having come to expect accolades. "In some ways we're competing with ourselves," he said.
Dr. Shabot did not take issue with the report's assessments.
Read more
Friday, June 22, 2007
STC board passes state resolution opposing health insurance cuts
By Daniel Perry - The Monitor - June 21, 2007
McALLEN — South Texas College leaders want to send a message to Gov. Rick Perry that his decision to cut off $154 million in health insurance funding for the state’scommunity colleges is a bad idea.
College trustees approved Thursday night a resolution sponsored by the Texas Association of Community Colleges objecting to Perry’s line item veto in the two-year state budget going into effect in September.
Trustees also decided to write their own resolution against the cuts and ask area cities, economic development corporations and chambers of commerce to lend their support.
“We should not be bashful to tell the governor that what he did was wrong,” board member Mike Allen said.
College President Shirley Reed said she wanted the college to work with Perry and area legislators rather than burn bridges with them regarding the issue. The state requires community colleges to pay all medical insurance premiums, but in the past this has traditionally been handled with Legislature-approved funding.
In the present biennium the college received more than $7.7 million from the state for health coverage. The college is estimated to get $3.9 million for the 2007-08 and 2008-09 academic years, but must find a way to fund the remaining $4 million the state is taking away.
Reed said the money was in the governor’s proposed budget when the legislative session began in January. And the funding stayed in the Senate and House versions throughout the session.
“Now what happened between January and June, I don’t know,” Reed said. “I believe there is a difference in philosophy (between the governor and the community colleges). And with community colleges, we are not addressed in state statutes very well. Sometimes the law applies to us and universities, sometimes to school districts and us, or specifically us.”
Randy Jarvis, a sociology instructor, said he felt “blindsided” when he heard earlier this week about Perry’s funding rejection. Jarvis said the funding cut would be easier to accept if the state were in a dire financial crunch.
“It’s obvious it will fall on the backs of our students,” he said.
Jarvis said the Faculty Senate would take the issue up when it reconvenes in August after its summer break.
College leaders have some tough decisions to make in the near future if Perry’s decision stands.
Reed said tuition could be increased for the 2008-09 academic year, but this could hurt student enrollment and mean less money comes from the state through funding formulas. There is also a chance some services and programs could be cut to save money.
She said the college could ask voters in Hidalgo and Starr counties to approve increasing the current tax rate of 0.11 cents per $100 of assessed property value. “I do not see that happening,” Reed said.
Read More
McALLEN — South Texas College leaders want to send a message to Gov. Rick Perry that his decision to cut off $154 million in health insurance funding for the state’scommunity colleges is a bad idea.
College trustees approved Thursday night a resolution sponsored by the Texas Association of Community Colleges objecting to Perry’s line item veto in the two-year state budget going into effect in September.
Trustees also decided to write their own resolution against the cuts and ask area cities, economic development corporations and chambers of commerce to lend their support.
“We should not be bashful to tell the governor that what he did was wrong,” board member Mike Allen said.
College President Shirley Reed said she wanted the college to work with Perry and area legislators rather than burn bridges with them regarding the issue. The state requires community colleges to pay all medical insurance premiums, but in the past this has traditionally been handled with Legislature-approved funding.
In the present biennium the college received more than $7.7 million from the state for health coverage. The college is estimated to get $3.9 million for the 2007-08 and 2008-09 academic years, but must find a way to fund the remaining $4 million the state is taking away.
Reed said the money was in the governor’s proposed budget when the legislative session began in January. And the funding stayed in the Senate and House versions throughout the session.
“Now what happened between January and June, I don’t know,” Reed said. “I believe there is a difference in philosophy (between the governor and the community colleges). And with community colleges, we are not addressed in state statutes very well. Sometimes the law applies to us and universities, sometimes to school districts and us, or specifically us.”
Randy Jarvis, a sociology instructor, said he felt “blindsided” when he heard earlier this week about Perry’s funding rejection. Jarvis said the funding cut would be easier to accept if the state were in a dire financial crunch.
“It’s obvious it will fall on the backs of our students,” he said.
Jarvis said the Faculty Senate would take the issue up when it reconvenes in August after its summer break.
College leaders have some tough decisions to make in the near future if Perry’s decision stands.
Reed said tuition could be increased for the 2008-09 academic year, but this could hurt student enrollment and mean less money comes from the state through funding formulas. There is also a chance some services and programs could be cut to save money.
She said the college could ask voters in Hidalgo and Starr counties to approve increasing the current tax rate of 0.11 cents per $100 of assessed property value. “I do not see that happening,” Reed said.
Read More
Texas House honored registered sex offender as Doctor of the Day
By Associated Press - Houston Chronicle - June 22, 2007
DALLAS — A Fort Worth-area physician twice recognized by the Texas House of Representatives as its "Doctor of the Day" is a registered sex offender, according to a broadcast report.
"I don't like the idea that I introduced a sex offender," Rep. Leo Berman, R-Tyler, told Dallas-Fort Worth television station KTVT. Berman introduced Dr. Nilon Tallant to the House on Jan. 12.
"He should have told whoever selected him to be the doctor of the day that he is a registered sex offender and not try to appear before the Texas House of Representatives and make himself look legitimate before the entire state," Berman said.
Tallant was one of 90 doctors who volunteered for the Physician of the Day program run by the Texas Academy of Family Physicians in the last session.
Physicians who participate in the program treat patients at the Capitol for the day, including visitors, legislators, their families and staff members.
Republican Rep. Phil King of Weatherford was to have introduced Tallant, as he had in 2006. But he was away from the floor and Berman happened to be standing near the podium when House Speaker Tom Craddick called for the introduction, the station reported.
Tallant was indicted on 19 counts of sexual performance by a child in 1996, the television station reported, citing Hays County court records. The victim was a 17-year-old female patient of the doctor, who was then 64 and practiced in San Marcos. Tallant pleaded guilty to a second-degree felony and was given 10 years' probation. He also lost his medical license for four years, the station reported.Republican Rep. Jerry Madden of Plano told KTVT that he received a complaint about Tallant's criminal record from the Council on Sex Offender Treatment shortly after the 2006 Doctor of the Day appearance. Madden said he told House officials, but the Texas Academy of Family Physicians says it was not told of Tallant's sex offender record. It said he would not have been invited to participate in 2007 if the academy had known about the record.
"It's horrendous and I want to make sure that this never happens again," Berman said. "I'm sure now we will have a close check on not only who comes in as the doctor of day but also as our chaplain of the day."
A telephone call placed by The Associated Press to a number listed for Tallant went unanswered late Thursday.
Tom Banning, with the physicians academy, said doctors for the program are screened on the Texas Medical Board's Web site.
KTVT reported that Tallant's online physician profile didn't reflect a criminal history and that Tallant did not disclose his criminal record to the board for the past three years, according to records it obtained under the Texas Public Information Act.
Banning said the Academy regretted that Tallant served as Physician of the Day and blamed the Legislature for holes in information because it has "historically starved down the Medical Board by diverting physician licensure fees to state general revenue. The TAFP supports using physician licensure for the purpose for which they are collected, to fully fund the Texas Medical Board so that it can carry out its mandate to protect the public safety."
DALLAS — A Fort Worth-area physician twice recognized by the Texas House of Representatives as its "Doctor of the Day" is a registered sex offender, according to a broadcast report.
"I don't like the idea that I introduced a sex offender," Rep. Leo Berman, R-Tyler, told Dallas-Fort Worth television station KTVT. Berman introduced Dr. Nilon Tallant to the House on Jan. 12.
"He should have told whoever selected him to be the doctor of the day that he is a registered sex offender and not try to appear before the Texas House of Representatives and make himself look legitimate before the entire state," Berman said.
Tallant was one of 90 doctors who volunteered for the Physician of the Day program run by the Texas Academy of Family Physicians in the last session.
Physicians who participate in the program treat patients at the Capitol for the day, including visitors, legislators, their families and staff members.
Republican Rep. Phil King of Weatherford was to have introduced Tallant, as he had in 2006. But he was away from the floor and Berman happened to be standing near the podium when House Speaker Tom Craddick called for the introduction, the station reported.
Tallant was indicted on 19 counts of sexual performance by a child in 1996, the television station reported, citing Hays County court records. The victim was a 17-year-old female patient of the doctor, who was then 64 and practiced in San Marcos. Tallant pleaded guilty to a second-degree felony and was given 10 years' probation. He also lost his medical license for four years, the station reported.Republican Rep. Jerry Madden of Plano told KTVT that he received a complaint about Tallant's criminal record from the Council on Sex Offender Treatment shortly after the 2006 Doctor of the Day appearance. Madden said he told House officials, but the Texas Academy of Family Physicians says it was not told of Tallant's sex offender record. It said he would not have been invited to participate in 2007 if the academy had known about the record.
"It's horrendous and I want to make sure that this never happens again," Berman said. "I'm sure now we will have a close check on not only who comes in as the doctor of day but also as our chaplain of the day."
A telephone call placed by The Associated Press to a number listed for Tallant went unanswered late Thursday.
Tom Banning, with the physicians academy, said doctors for the program are screened on the Texas Medical Board's Web site.
KTVT reported that Tallant's online physician profile didn't reflect a criminal history and that Tallant did not disclose his criminal record to the board for the past three years, according to records it obtained under the Texas Public Information Act.
Banning said the Academy regretted that Tallant served as Physician of the Day and blamed the Legislature for holes in information because it has "historically starved down the Medical Board by diverting physician licensure fees to state general revenue. The TAFP supports using physician licensure for the purpose for which they are collected, to fully fund the Texas Medical Board so that it can carry out its mandate to protect the public safety."
Thursday, June 21, 2007
Surgeon sues UT Southwestern under whistle-blower act
He says medical school demoted him after he aired Parkland concerns
By KIM BREEN / The Dallas Morning News - Tuesday, June 19, 2007
WFAA NEWS
By KIM BREEN / The Dallas Morning News - Tuesday, June 19, 2007
Trauma residents at Parkland Memorial Hospital have performed surgical procedures without proper supervision, a surgeon and former division chair at UT Southwestern Medical Center alleges in a lawsuit filed last week.
Dr. Larry Gentilello, former chair of the Division of Burn, Trauma and Critical Care, is suing UT Southwestern under Texas' whistle-blower act. He alleges he was demoted and stripped of an endowed position after raising concerns about patients receiving improper care at the county hospital.
"Because this is pending litigation, we cannot discuss these allegations at this time," said John Walls, assistant vice president for public affairs at UT Southwestern.
Parkland is the primary training site of residents affiliated with the UT Southwestern Medical School. Parkland officials declined to comment on the pending lawsuit.
Visiting Judge Richard Davis issued a temporary restraining order prohibiting UT Southwestern from filling Dr. Gentilello's former positions. The order expires June 29. A temporary injunction hearing has been scheduled for June 28.
According to the lawsuit, Dr. Gentilello, a tenured professor of surgery, became aware of problems with patient care, resident supervision and operating room and patient treatment protocols that violated Medicare and Medicaid requirements and procedures.
"Plaintiff observed that the patients at Parkland were being treated by residents with no attending physicians present and were undergoing surgical procedures with no attending physicians in the operating room during critical phases of surgery," the lawsuit states.
Parkland patients are typically indigent and primarily minority, it continues.
At UT Southwestern University Hospital's Zale Lipshy building, where patients are not indigent, the lawsuit states, attending physicians are present during treatment and procedures.
The lawsuit alleges Dr. Gentilello was stripped of his positions in March after notifying a superior about the alleged problems.
Dr. Gentilello did not return a call for comment. His attorney, Charla Aldous, said in a prepared statement that Dr. Gentilello has dedicated his professional life to caring for trauma victims, and that his distinguished career is what led UT Southwestern to recruit him."But when he tried to correct the gaps in emergency surgical services by ensuring that residents were being appropriately supervised by faculty, certain powers at UTSW stopped him and demoted him in retaliation."
She added:"We want to make it clear that this suit does not allege any wrongdoing on the part of Parkland but rather seeks to ensure that Parkland patients are receiving the medical services they deserve."
The whistle-blower act prohibits government entities from retaliating against public employees who report a violation of law.
Dr. Gentilello is seeking reinstatement to his positions, attorney fees and damages.
WFAA NEWS
Thursday, June 14, 2007
Studies say Texas lags in health care access
With high number of uninsured, state ranks 49th in one study
By JASON ROBERSON and ANGELA SHAH - The Dallas Morning News - Thursday, June 14, 2007
A study by Families USA, a Washington-based nonprofit group that advocates for universal health care, found
The problem of the uninsured is again getting attention from politicians. Presidential candidates are floating proposals to increase the ranks of insured Americans and even to provide universal health coverage.
Massachusetts is rolling out a plan that will cover nearly all of its residents. Politicians in California, New York and Pennsylvania are talking about doing the same.
In Texas, solutions have come in a more piecemeal fashion.
In the recent legislative session, lawmakers restored many of the funding cuts made in 2003 to the Children's Health Insurance Program. CHIP is designed for children of families who earn too much for Medicaid but not enough to buy private health insurance.
Lawmakers also agreed to settle a Medicaid-related lawsuit by spending $707 million to increase dentists' payments by 50 percent and physicians' 25 percent, and to dispatch up to 40 mobile labs into inner-city neighborhoods and impoverished colonias.
Mr. Homer, the former TMA president, said
Read more
By JASON ROBERSON and ANGELA SHAH - The Dallas Morning News - Thursday, June 14, 2007
To many people, Texas has a strong reputation for quality health care.Ms. Williams said.
Retirees who move to the state cite good hospitals as a key attraction. Dallas' Baylor University Medical Center and UT Southwestern Medical Center are renowned for churning out top-notch doctors. The University of Texas M.D. Anderson Cancer Center in Houston attracts patients from around the world.But among the 50 states, Texas' health care system ranges from average to poor,according to two reports released this week.
Industry experts saythe low rankings are explained largely by the widening gap between Texans who have health insurance and those who don't.
The large immigrant population and a high number of small businesses that don't offer health benefits to employees make Texas highest in the nation in the percentage of uninsured residents.
That helped rank Texas 49th out of 50 states and the District of Columbia for the overall performance of its health care system, in a study by the Commonwealth Fund, a nonprofit health care advocacy group. The study measured access to health care, quality of health care, avoidable hospital costs and deaths per 100,000 residents.
"We have too much pride in this state, and too much good economy, for us to sit back and tolerate this kind of rating," said Ladon W. Homer, immediate past president of the Texas Medical Association.
If Texas improved to the level of Hawaii, the best-performing state in the Commonwealth study, 2.7 million adults and 900,000 children would be insured, and the state would save $250.3 million a year, the study's researchers concluded.
A study released Monday by the U.S. Department of Health and Human Services pegged the state as average for health care quality, based on 129 indicators.The department began publishing the annual study in 2005 as a way to help state health leaders better recognize their strengths and weaknesses in providing quality care.
"Texas on overall quality is about average," said Ed Kelley, supervisor of the department's study."There are some things Texas is doing well and challenges that can be improved."
For example, the study found that Texas scored strongly for early colorectal cancer diagnoses and having a low percentage of nursing home residents who are depressed or anxious but poorly in areas such as full vaccination of children and avoidable hospitalizations for diabetes.
In both studies, Midwestern and Northeastern states such as Wisconsin, Minnesota, New Hampshire, Vermont and Maine performed the best. Those states have higher percentages of residents with health insurance and don't have the same impact from immigration as Texas does.
Many uninsuredIn a state with 23.5 million people, more than 5.5 million – including 1.4 million children – lack health insurance,according to the Texas Medical Association. Texas'uninsured rates are about 1.5 times the national average.Texas stands out for the ethnic makeup of its uninsured,said Anil Kumar, an economist with the Federal Reserve Bank of Dallas.Hispanics make up a third of the state's population – much larger than the 13 percent for the U.S. as a whole. More than half of the uninsured in Texas are Hispanic, compared with 25 percent for the nation.
Many Hispanics, particularly laborers, work at small businesses, said Roger C. Rocha Jr., state director of the League of United Latin American Citizens."Low-income people who cannot afford health insurance are in jobs that don't offer health insurance,"he said."And then with CHIP programs being cut or not being funded adequately, there is a big segment out there not covered."
Only 55 percent of Texans have access to employer-sponsored insurance, below the national average of 63 percent, according to the Texas Medical Association. For small businesses – which provide about half the state's nonfarm, private-sector jobs – coverage drops to 37 percent.
...
Strain on hospitals
The strain of supporting uninsured Texans pressures hospitals financially and in the quality of care, experts say.Total uncompensated care – including bad debt from people who can't pay their bills and charity care that hospitals agree to provide – increased 78 percent, from $5.6 billion in 2001 to $10.1 billion in 2005,according to the Texas Hospital Association.
Uninsured patients are more likely than their insured counterparts to forgo or delay treatment for acute illnesses or injuries, to go without needed treatment for chronic conditions or illnesses and to die prematurely.Besides the dangers to those who go without insurance, the situation also creates a drag on the state's economy,said Nancy Williams, president of the Health Industry Council of the Dallas-Fort Worth Region.Uninsured patients create higher health care costs for everyone as a result of the inherent cost shifting.
"The uninsured is an issue because the insured can't handle it,"
A study by Families USA, a Washington-based nonprofit group that advocates for universal health care, found
in 2005 that employer-sponsored family coverage in Texas costs $1,551 more per year as a result of the uninsured.
The problem of the uninsured is again getting attention from politicians. Presidential candidates are floating proposals to increase the ranks of insured Americans and even to provide universal health coverage.
Massachusetts is rolling out a plan that will cover nearly all of its residents. Politicians in California, New York and Pennsylvania are talking about doing the same.
In Texas, solutions have come in a more piecemeal fashion.
In the recent legislative session, lawmakers restored many of the funding cuts made in 2003 to the Children's Health Insurance Program. CHIP is designed for children of families who earn too much for Medicaid but not enough to buy private health insurance.
Since the cuts, CHIP enrollment had dropped from a high of 529,000 in May of 2002 to 300,800 this month,according to the Texas Health and Human Services Commission.
Lawmakers also agreed to settle a Medicaid-related lawsuit by spending $707 million to increase dentists' payments by 50 percent and physicians' 25 percent, and to dispatch up to 40 mobile labs into inner-city neighborhoods and impoverished colonias.
Mr. Homer, the former TMA president, said
the state was funding two-thirds of the actual cost of Medicaid – "which means many physicians opt out of this program, which means more people don't have access to health care."
Read more
Saturday, June 9, 2007
Three Heroes in Mesquite
By Steve Blair - Grassroots News U Can Use - June 5, 2007
Monday, June 4, 2007, three Registered Nurses’ employment by Health Management Associates at Dallas Regional Medical Center in Mesquite was terminated. Why?
They complained that their nurse to patient ratio was being raised critically high, so as to possibly endanger patients.
Normally, the nurse to patient ration in an Intensive Care Unit (ICU) would be 1:2. They were being ordered to increase that ratio to 1:5. Patients in ICU are in critical peril, and increasing the ratio only means that each critical patient will get less necessary attention.
Michael B. Rothburg, M.D., MPH, assistant professor of medicine at Tufts University and a physician at Baystate Medical Center, Springfield, Massachusetts, conducted a cost effectiveness study that seems to apply to the Mesquite case.
Dr. Rothburg found that the standard of an average ratio of 1:4 patients throughout the whole of the facility was maximum effective. Such a ratio could save 72,000 lives annually, and could result in fewer patient complications that increase patient stays by three to four days, “at a cost of $4,000 and $5,000 per day.” [“Study Finds Nurse-to-Patient Ratios Cost-Effective” by Christina Orlovsky, NurseZone, Wednesday, June 6, 2007]
Considering the health of the patients and even the cost efficiency, the three Registered Nurses took the correct position to complain to their Supervisor. However, they were terminated.
All Nurses take an Oath --The Florence Nightingale PledgeI solemnly pledge myself before God and in the presence of this assembly, to pass my life in purity and to practice my profession faithfully. I will abstain from whatever is deleterious and mischievous, and will not take or knowingly administer any harmful drug. I will do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping and all family affairs coming to my knowledge in the practice of my calling. With loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care.
Obviously, the choice of these Nurses was a morally difficult one if they knew their employment might be jeopardized. They decided to uphold their own Oath, and now they will pay the price to Administrators who fail to understand that both patient care and bottom line economics share one decision. The three Nurses were right.
People who stand by their morals, even when risk is real, are Heroes.
AARP Texas Vote News Alert; Hutchison, Cornyn Vote to Block Senate Decision
Giving Medicare Power to Negotiate Lower Drug Prices
AARP Texas - Wed, 18 Apr 2007
AARP Texas - Wed, 18 Apr 2007
AUSTIN, Texas, April 18 /PRNewswire/ -- Despite the support of a majority of the U.S. Senate and nearly 90 percent of surveyed Texans, Senators Kay Bailey Hutchison and John Cornyn voted to block consideration of legislation that would give Medicare the power to bargain for lower prescription drug prices -- S.3, The Medicare Fair Prescription Drug Price Act of 2007.
Similar legislation, H.R. 4, passed the U.S. House of Representatives earlier this year.
TEXAS VOTED TO BLOCK S.3 GIVING MEDICARE THE POWER TO BARGAIN FOR LOWER PRESCRIPTION DRUG PRICES John Cornyn X Kay Bailey Hutchison X
"Working Texans were poorly represented today in the U.S. Senate on this all
important issue," said AARP-Texas State Director Bob Jackson. "Score one for the pharmaceutical industry and the power of their lobby."
Jackson said the bill would have put downward pressure on Medicare drug prices. Given the overwhelming support in both Texas and the U.S. for giving Medicare the power to negotiate, he said AARP will continue working so that the will of the people will eventually be heard.
"We are particularly disappointed with Sen. Hutchison's vote as this is a reversal from her previous vote in support of negotiating drug prices. Nearly 11,000 Texans called her offices and another 1,400 sent e-mails or faxes urging her to support the bargaining for lower prescription drug prices," said Jackson.
David Sloane, AARP Director of Government Relations, added: "Pharmaceutical manufacturers have given more than $20 million in campaign contributions for the last two cycles alone. They followed that up over the last few months with misleading polling and disinformation aimed at scaring older Americans into preserving the exorbitant profits that pharmaceutical companies make on brand name drugs. Senators should know this issue is not going away. No amount of campaign money can trump the will of 90 percent of Americans."
AARP notified the 110th Congress that it was tracking roll call votes on key legislation important to its 38 million members, and reporting the outcomes of these votes back to its members. "We believe people make the right choices when they understand the issues and position taken by their elected officials. AARP intends to ensure that its members get that information," Jackson concluded.
BACKGROUND INFORMATION: Despite the outcome in the Senate today, prescription drug affordability remains a high priority for AARP and its members. Because an overwhelming majority of Americans support S.3, AARP is confident this issue will be back. The association will continue to fight to make prescription drugs more affordable for all Americans. While millions of older Americans and persons with disabilities have been helped by Medicare Part D drug plans, more should be done to put downward pressure on drug costs. AARP will continue to support legislation that would allow Americans to safely and legally import lower-priced prescription drugs from abroad, and legislation to help bring generic drugs to market sooner, including generic versions of biologic therapies. AARP is also working to pass legislation that would reduce the asset test that prevents low-income people from qualifying for extra help under the Medicare drug program.
AARP is a nonprofit, nonpartisan membership organization that helps people 50+ have independence, choice and control in ways that are beneficial and affordable to them and society as a whole.
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